The Secret Life of Pets and Mental Illness

Living with a mental illness is horrible, it comes with really tough times, a lot of emotions and nasty side effects from both medication and talking therapies. By this I mean the pain of opening up your whole life to a therapist or the nausea and sedation from your new pills. Throughout my battle with mental illness my dog, Candy, has eased my distress no end.

When I was well enough to live at home being greeted by Candy’s wagging tail means the world. I am someone and I am wanted. When she cuddles into me whilst I cry it makes me feel less alone. Those difficult, dark hours through the night were made better by the dog I had sleeping beside me on my bed. I have stroked her under the chin and told her that I’m sorry when I’ve attempted to take my life and seeing her with her tail tucked in tells me she understands. Pets get it, perhaps more than humans do.

I have really missed being around animals since coming into hospital in 2015. It’s a real shame that animals aren’t allowed on the ward and therapy dogs don’t visit. I think it’d really help anyone in hospital regardless of whether they are there for a physical or mental health condition.

The other night my mental health team allowed me to do something special. I was allowed down to the entrance in a wheelchair to meet my parents and Candy. She was so excited to see me and she cuddled into me in my wheelchair and I instantly felt relaxed. My stresses and worries from the day disappeared slightly. I became mindful. All I was thinking about was the beautiful animal on my lap. I was 100% focused on stroking her coarse fur and running my fingers over her smooth ears. For me animals are magic. Pets bring humour, happiness, unconditional love and companionship and I dread to think of my life without Candy in it.

Making a Complaint

The complaint process is something I am currently going through and it has not been an easy ride. I was unsure of whether to complain at all because I didn’t want the hassle on top of everything else and neither did I want to make it awkward between me and the staff member I was making the complaint about. Then I realised that actually I matter and this matters. It’s important that the issue is raised and the staff member is educated otherwise her comments could haunt me for years to come. You are entitled to, and have a right to complain about the care you are given. If you would like to make a complaint about the care you have received then contact the service and ask for their complaints procedure.

Time To Talk Day

Today is Time To Talk day 2017 so take 5 minutes to talk about mental health. It is so important that we get these conversations going because they can save lives as well as working to stamp out stigma.

This Time To Talk day, I’m going to tell you a little bit about how I’m spending it. I’m currently in a general hospital being tube fed for my anorexia, I’m on 2:1 observations meaning I have two members of staff with me at all times and I’m on a level 4 which means I must be within arms length of the staff members, this includes when using the toilet. So there the facts about my situation but now it’s time to talk about how I feel.

I’m confused, recovery and weight restoration is being forced on me and I’m not sure that I want it. I’m scared about the future, my team are looking for a unit to send me to and so far none have accepted me. I don’t know what the near future holds for me. I’m homesick, I haven’t been home in 18 months and I would give anything to sit on the sofa with my family and dog and watch some rubbish telly. I feel alone and lost, I haven’t seen many people in the last 18 months and my grandmother has passed away during that time, I never got to say goodbye, I wasn’t well enough to go to her funeral and that breaks my heart everyday. I’m annoyed and angry at myself for losing out on so much. My goddaughter will be 3 in March and I’ve missed so much of her growing up, my dog is 14 and I’m scared she will die before I get home.

I have conversations about mental health every single day because I am unwell, but you don’t have to be ill to talk about mental health. We all have mental health, so please this Time To Talk Day 2017, take 5 minutes to ask someone how they are, send a text, natter over a cuppa, get the conversation going about mental health.

Happy Time To Talk Day everyone!

Section 3

I’m sitting on the end of my bed in hospital. Numb but in pain. I don’t understand anymore. Utter confusion. Dreaming of a future like a child, imagining I’ll be a vet or a teacher but seeing reality like an adult…I am just a psychiatric ward patient….I probably don’t even deserve the word ‘just’ in front of that. I’m a nothing, a no one. Three months locked away has completely detached me from the world around me. I belong nowhere and with no one. The world outside the window doesn’t feel like mine. It’s like I don’t remember what the rolling hills look like, nor the supermarket aisles or petrol stations. My ballet shoes disintegrated when my life turned into compost. Maybe new flowers will grow out of the soil but I doubt it. It feels like I’ll never feel the sun on my skin again and that my heart will never vibrate with the bass of loud music. Will I always be gone? Will I ever find me again?

A Letter To Those Who Deal With Mental Health Crises

Dear Police/Crisis teams/Nurses/Doctors/Healthcare workers,

I understand that many of you see mental health crises on a daily basis and I can understand that you probably become quite numb to the situation. I can imagine that seeing your first patient who is seriously contemplating suicide was probably very emotional and difficult for you but after seeing hundreds of patients who want to take their life you become so used to it that it becomes the same as walking to the shop and buying some milk

I understand that for some of you it is simply just your job and just your way of making ends meet but I also know that many of you are incredibly passionate and caring human beings and you want to help those people in need.

Whilst I know that you may become quite numb to your work, please try to put yourself in the patient’s shoes. In every patient’s shoes. They may just be another patient to you but it is this person’s entire life and if that person was found very distressed or mid-way through attempting to take their life then that is heartbreaking. Whilst you cannot get emotionally attached to each case that you come across, please think carefully about how you treat them.

When I am in a mental health crisis small talk becomes big talk. I’m often asked if I’m in education or have a job or if I aspire to. I can barely think, I can’t get my mind to form sentences and right at that moment my occupation is the least of my worries. If someone was in front of you having an asthma attack then you would ask about their breathing and so on, I doubt you’d start asking them if they have a job.

Be aware that the person in front of you probably doesn’t like themselves or their life very much and therefore may feel very sensitive or self-conscious. I tend to get comments on how I look very young or like a 12 year old and “I bet you don’t get served in a pub!” These comments are not helpful when I feel like I don’t want to be alive. I know that you are just trying to make conversation but sometimes when I’m poorly I don’t want these conversations.

Please try to look at each person in crisis as a ‘new person’ rather than ‘another person’. Try to imagine yourself in that person’s position. If you wanted to die would you want to discuss your employment? If you had anorexia would you want to be asked “Do you ever feel hungry?” and constantly offered a sandwich? If you were struggling with body dysmorphia would you want people to comment on your looks?

Finally, please realise that the care you provide to that person will be remembered. I have had triage nurses put me off going to A&E, I have the worry of ending up in a police cell again every time I reach crisis point and I’ve had very triggering and upsetting comments from mental health professionals that have left me feeling like it is easier to remain silent.

Please be the person that the patient remembers for outstanding care, please be the person that helps a poorly and vulnerable person and offers them an appropriate ear. Give hope and help at a time when that person really needs it because in that moment you are the one with the power to make a difference.

Many thanks in advance,

Claire Greaves

999 Mental Health Option

I’ve been thinking about this for years now, there should be a mental health option when phoning 999. There are many situations when a person who has mental illness needs urgent care, for example when someone is trying to take their life or when someone is very unwell with psychotic thoughts and an individual’s family don’t know what to do, but who do you phone? Is an ambulance the right service? Or the police? Do you want to phone the police on your daughter? All these thoughts that go through the minds of those who care for people who have a mental illness. In my opinion there isn’t a correct option for mental health when dialling 999, paramedics may be good at handling mental health problems but they are not trained specifically in mental health and again the police can often be caring and compassionate when helping someone with a mental illness but they are not trained. If a firefighter turned up to a cardiac arrest it wouldn’t be particularly helpful, they could probably help calm the situation but they probably couldn’t use a defibrillator.

There are crisis teams and home treatment teams dotted around in community mental health teams up and down the country but these are not the same as an emergency number. Often patients must be referred to these services and be on their books in order to use them which isn’t helpful. An initial crisis could occur as a result of having no mental health support, people have to already seek help for their crisis in order to be on the crisis team’s caseload so these services are not accessible to all. Another issue with these crisis teams are that they do not run 24/7. Some may run from 9am-9pm and others may only run 5pm-9pm. Not all crisis services run a 24 hour service and whilst you are often given an instant conversation, contact in person does not happen on an emergency basis. If you are in need of seeing someone urgently then crisis team will often turn to emergency services.

I think that when dialling 999 there should be a mental health option in which a mental health professional is urgently dispatched to the person in crisis. In a mental health crisis it is vital that the right support is received. The help should not be traumatic, we should not be handcuffing patients or putting them in cells but neither should we be leaving vulnerable people alone because we don’t know what to do or don’t have the resources to help. This is why it is vital that trained professionals are available in these urgent and often desperate moments. By having a mental health option when dialling 999 it will take the pressure and strain off of untrained professionals and other services and it will mean that those who are unwell get the correct treatment at the most vital time. It would save a lot of lives and a lot of trauma.

“Call The Police”

During times of crisis I have been told many times to call the police but I often wonder the appropriateness of this. I have phoned my crisis team during a crisis and been told that I should call the police and this completely and utterly baffles me. In a mental health crisis whilst on the phone to the mental health crisis team why is it appropriate to call the police who have very little training in mental health?

The police cannot provide me with my PRN medication or administer it. Mental health problems are medical and most require medication. If they were to assess me at my psychiatric hospital then I would have access to a nurse who could administer medication should I need it. How are the police going to handle someone in need of medication in an appropriate and non-distressing way?

The police, whilst they have been kind and caring towards me, they simply do not having the training in mental health to help people who are desperately unwell. When my illness had beat me down to the ground, when I was exhausted from anorexia and crushed by depression I did not want to be explaining what anorexia is like or hearing, “So do you just not like food?” I needed someone trained in mental health to be caring for me and the option to have a conversation if I needed to talk.

Funding cuts aren’t just being made within the health care system, they are also being made within the police force. The police are needed to keep our streets safe, to fight crime and to arrest those individuals that aren’t complying with the laws of society. When I was unwell I had two officers with me for an entire Friday night…this was the Friday before Christmas. The police force needed those officers on the streets but because my mental health team didn’t step up and take responsibility, two police officers spent their entire shift sat with me in a hospital waiting room.

It’s absurd that people struggling with mental illness are told by mental health services to phone the police….it’s like calling for an ambulance because someone is having a heart attack and being told to phone the police instead.

These are peoples’ lives, a mental health crisis is often life threatening and getting the care wrong can have fatal consequences. The police’s resources are also limited, they need to be doing the job that they are trained to do. So why do mental health teams feel that it is appropriate to direct patients to call the police during times of crisis?

Pre-Crisis Care

I think that when we are talking about crisis care we need to recognise that a big part of problem is the care that people experience prior to their crisis because maybe then some crises can be prevented and people can go through less distress rather than ending up at the point where emergency services are required and hospital admissions are needed.

Firstly, I feel that GPs need more training in mental illness so that they can better understand patients who present with mental health concerns. Often people don’t want to go to their GP about their mental health difficulties when they first appear and so when they do make an appointment it is usually out of desperation. We all know how hard it can be to get a GP appointment these days, my surgery has a 6 week wait for an appointment at present. If someone walks into their GP surgery and says that they are struggling with mental health related symptoms then this must be taken seriously. I had been living in remission of my illnesses for almost a year when a huge relapse hit me and I had to go to a new GP surgery, I was drastically underweight and thinking of taking my life and my GP told me to book an appointment in a month and if I was still struggling he would make a referral then. I was in general hospital the next evening on drips and oxygen. Often it takes a lot of guts for a patient to turn up to an appointment and admit to a professional that they are unwell, GPs must realise that and act immediately on what the person is saying whether that be making a referral to a counsellor, the community mental health team or discussing medication. Help needs to be offered. Four weeks is a long time to be unwell and/or suicidal with no support.

The next problem with ‘pre-crisis care’ is the assessment process at community mental health teams. People may have waited weeks, or even months, for their assessment with the CMHT. I have known several people who have clung onto that assessment for dear life. It has been their glimmer of hope but at the assessment they have been told that they will be discharged back to the care of the GP and if things escalate then their GP should re-refer them. I think this is unacceptable and often leaves people feeling very hopeless and like there is no help for them. When I first moved to Wales I had an assessment with the mental health team before my notes had been sent over. I explained my history, my current struggles but was told that primary care (my GP) was appropriate for me and when I received the letter with a summary of the assessment it said that they felt the relocation to Wales was my primary difficulty. This was despite me explaining my history of anorexia nervosa, depression, avoidant personality disorder and previous inpatient admissions. I feel that they are under so much pressure practically and financially that they are using all the excuses they can to turn people away but this is life threatening. I fought hard and ended up with some support and then when I ended up detained under the Mental Health Act I finally got the help I needed. It’s just a shame that things were allowed to get to that point. Unwell, vulnerable patients should not have to fight for help when they are fighting for their lives. When depression is leaving you housebound and/or you are having psychotic episodes how are you meant to push your GP and mental health services to help you?

Next, I come to waiting lists. Where I live there is a two and a half year wait to see a psychiatrist if you are a non-urgent case…I imagine after two and a half years of an untreated mental illness the patient will be an urgent case! If the patient isn’t an urgent case then they are going to need more treatment to get well than they originally required, two and a half years of being ill is a long time! There is a 9 month wait to see a psychologist, the eating disorder specialist…people can die from their eating disorder in that time. I was in treatment for my eating disorder when the funding changed and as I lived on the county border it meant that my treatment had to go to the other county. I was discharged mid-treatment and put on the waiting list for the other county. I ended up waiting 18 months and spent that time in and out of inpatient care meaning that I lost my place at college. I was in recovery and doing well but being placed on that long waiting list made me unwell, cost me a lot in terms of life and by the time treatment came around I was so ingrained in anorexia that I couldn’t engage with the therapy.

This brings me on to therapy limits. When I began the therapy mentioned above my BMI was classed as ‘severe anorexia’ and the treatment team gave me 20 sessions. 20 weeks…that was it. I couldn’t even gain the weight I needed to reach a healthy BMI in that time and they wouldn’t start the therapy until my weight was healthy due to cognitive function. It was never going to work. How can you put a time limit on someone’s recovery? Everyone is different, someone might be back on track in 6 weeks, someone else might take 2 years. You cannot expect someone who has been unwell for 17 years to get better in 20 weeks.

I have reached crisis point several times, I have experienced personally how appalling pre-crisis care can be, or pre-hospital should I say. It shouldn’t take for a person to need a lengthy hospitalisation for them to receive the help they need. Some of my admissions could have been preventable, as could my detentions under the Mental Health Act. It’s quite scary to think that I have been admitted to hospital 7 times and only two of those times was I admitted without the police detaining me under S136 first. That’s 5 admissions where the NHS ignored my pleas for help, brushed me off and I ended up in a life threatening situation.

  1. I had spent weeks speaking to my GP and CMHT and was told to “go to the library and study.” I gave up speaking to them and tried to cope on my own but deteriorated and ended up being detained under a S136 after the police were called by concerned college staff. I was admitted for a very short admission but as soon as they could they discharged me.
  2. Following the above, I tried to pick myself up for two weeks. I wasn’t prescribed any medication or given any support. College called the police again after a friend had seen me in town in a bad state and persuaded me to go to the nurse. I was detained under S136 and spent the night in a cell due to no ‘places of safety’ being available before being transferred on to an acute psychiatric ward.
  3. I was not on any medication at the time and had recently gone through a trauma. I don’t remember the weeks leading up to this day but I had been to see my care coordinator that morning and I told her I wanted to die, she took the mick out of my voice and I left in tears. The police intervened and detained me under S136 before I was admitted to a ward.
  4. After my failed treatment with the eating disorder team after I was only offered 20 sessions after an 18 month waiting list I believed life was over for me. I thought I’d never get better. I tried to take my life and scarily nearly did. I was found barely conscious by police after being reported missing. After a stay in a general hospital, I was admitted to a psychiatric hospital and spent the admission being passed from ward to ward as no beds were available near my home.
  5. I had been speaking to my mental health team constantly, saying how strong the suicidal thoughts were getting, how I was struggling to take my medication due to the side effects. I was convinced someone was trying to kill me. I was terrified, hopeless, caught in depression and trying to cope with the weight I’d had to gain in hospital. I was given an urgent appointment at my CMHT and wasn’t taken seriously. I was crying and told to leave the room as someone else needed it so I went into the toilets to compose myself and was told to leave the building as they needed both cubicles. Later that day the police stopped me from taking my life.

‘Pre-crisis care’ requires a lot of change. Crisis care is important and life saving and we absolutely must get that correct but if we are to truly help people and help the strain on crisis services then we must get the care right in the first place before the patient experiences horrific and life threatening distress. I survived, but I often wonder how many people haven’t? How many people have died because they haven’t been able to get the care and treatment that they need? It’s a scandal and it needs to change.

Crisis Plans Should Be The Most Important Part

Following my recent detention under Section 2 of the Mental Health Act, I received my care plan in the post this week. I am receiving aftercare from my mental health team and I am in treatment and I am grateful for that because I know from past experience how fortunate I am to have help. However, I feel the purpose of a care plan on paper should be that people can refer to them. For example, if things were deteriorating or if I was in a crisis situation then my family or myself could look at the care plan and know exactly who to contact and exactly what the plan of action is. The thing is, the most important box on my care plan is blank:

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The crisis plan has no plan. There are no names, no contact numbers and it has never been discussed. If I were to be in a crisis tomorrow then I would have no idea who to call and it would end up going around in circles as always because in a crisis situation I always feel as though nobody is really sure whose responsibility it is to intervene. It usually ends up with the police involved.

I know the day to day bits that they have included on my care plan, I know who my psychiatrist is and who I see for appointments. I didn’t need that written down for me but the crisis plan. The life saving plan that everyone needs to be able to access isn’t included. I don’t even think it’s been thought about. Surely it is the most important part of the plan?! How useful would care plans be if everyone involved had a copy and in a crisis everyone knew exactly what to do from family to professionals? I feel like this is a box that isn’t optional to fill out, it should be a MUST and it should be thorough and up to date.

What is the point in a care plan that misses out the vital parts of care?