Having A Difficult Time

Things are far from easy right now. I have a tribunal this week to see if my section can be lifted which is stressing me out and the date to go to cygnet is getting closer and I’m generally just not very well.

Last night I planned to take my life, I concealed the object I was going to use in my slippers but got caught out…cue medication and restraints and a lot of tears and trying to run away. I eventually managed to get some sleep but even in my dreams anorexia was present. I don’t seem to get a break these days.

Today hasn’t been any easier. I ligatured and tried to abscond this morning ending up in two floor restraints and then more tears, medication and restraining this afternoon. I am exhausted.

I have to be honest here, I hope they lift my section on Wednesday because I can’t carry on living like this. If I were an animal suffering so much they would put me down. Why shouldn’t I have the right to die?

What’s It Like To Be Restrained?

Being distressed is horrible, those feelings of utter desperation, sadness, anger, fear, guilt…the list goes on. All those emotions and thoughts that form a ball of intolerable distress. So you can imagine how horrible a distressed person is feeling but imagine on top of that being restrained so that they can’t move their limbs or go to a different room. They are stuck. From personal experience I can tell you that it’s truly horrible.

I understand why restraint is necessary. Restraining is used to prevent harm either to the individual or to other people. I have always been restrained to stop me from hurting myself or absconding.

Frustration comes to mind when I think about restraint. Frustration mixed with terror, anger and shame. I’ll share with you a recent experience of being restrained. I had attempted to pull my NG tube out and it was half out by the time the staff noticed. They both grabbed me, one on each wrist and with a tight grip. I couldn’t move my arms. At that point I didn’t particularly care as the NG was already too far out to put back in but it still wasn’t nice to be held down. They held my arms for what seemed like ages and I needed to use the bathroom. I was escorted one on each arm to the toilets. After I had used the toilet I wanted to look in the mirror to body check and I admit this often takes me some time. The staff I was with thought I had spent long enough in front of the mirror so went to hold me and escort me out and back to my room. I hadn’t finished and it the distressed state I was in, I felt I needed to finish. So to stop them from walking me out and away from the mirror, I put myself down to the floor and sat cross legged with a person still on each arm. I was so frustrated that I couldn’t do what I wanted to do. I hated that people were holding me and touching me. I was angry at them because they were stopping me from doing what I felt needed to be done. I was also deeply ashamed, there is little more shameful than being restrained. Having the control over your body completely taken away. Being held down so that you cannot move. Being injected with a medication you don’t want and surrounded by staff. Being watched whilst in such a vulnerable position is horrible. I understand that it’s necessary…in fact it’s probably saved my life a good few times in the past but that doesn’t take away how traumatic and horrible it is to be restrained.

IM: Is it Always Appropriate?

IMs, intramuscular injections, a topic I never wanted to have personal experience of, I never wanted to have my own personal opinion on, but unfortunately I do. I think that IM medication is something that needs to be approached in a very sensitive way when professionals are considering using it. It should not be used as a threat to the patient, whether that be just mentioning it or actually carrying out the injection but it is also important that the professional involved thinks about the possibility that it could traumatise the patient involved and any patients witnessing the IM. If IM is the best course of action and is appropriate then it must be done in the least traumatising way for everyone involved.

I want to make it clear that there have been times when IM medication was helpful to me and was used in an appropriate way. I do, however, feel it is important to share a negative experience of ‘being IM’d’ because the way in which it was used was unfair and somewhat traumatising:

The 31st December 2014, I was detained under Section 2 of the Mental Health Act and out of fear, shame and hopelessness I ran out of the assessment and found myself wandering the streets in the dark on my own. My thoughts were racing, I was lost and grasping hold of the occasional rational thought that fleeted through my mind was nearly impossible but I ended up phoning the police as I knew they were looking for me and telling them where I was. I was taken back to the ward and it’s a bit of a blur but I engaged in self harming behaviour. I was marched up to the clinic room with an elbow digging into my spine, I was telling them they were hurting me but it didn’t stop them. They put a pot of tablets in front of me. I struggle to take tablets at the best of times and there were so many, these were not my regular medication and so I asked what the tablets were. The nurse responded by saying that she was not ‘playing games’. I took a few of the tablets and then said that I couldn’t swallow anymore before asking again what the tablets were to which the nurse responded, “I will IM you!” I was upset enough without being threatened, I’d never been IM’d before, I wasn’t even sure of what it meant. I ran out of the clinic room and went and laid in bed.

I was in a dormitory and there was another young woman in the room when the nurse came in accompanied by two or three people. I think I put up a verbal fight, but I can’t really remember. They all held me down whilst the nurse injected me. I then slept until the 2nd January 2015. Over 30 hours of medication induced unconsciousness. An entire New Year’s missed-although that was the least of my worries but it still matters to me.

In this particular situation I feel things could’ve been handled differently. Firstly, where was the protection for the other patient? I would be distressed if I had to witness someone being injected against their will, I imagine that it has affected the other patient. Also, what about my privacy and dignity? Now I am feeling more stable I’m not very happy that another person witnessed that happening, I would much prefer that it was only the staff and myself that knew about it. How could that have all been prevented? They could’ve asked the patient to leave the room for five minutes. That’s all it would’ve taken to protect her and to respect my privacy and dignity.

Should medication ever be used as a threat or in a threatening way? No. That is the simple answer, just no. There are many other ways that the nurse could’ve worded it, perhaps in a caring and compassionate way. I also wonder if the nurse would’ve told me what the medication was and would’ve listened to me saying that I struggle to swallow tablets, would the situation have been very different? I do feel that listening to why the patient isn’t taking their medication is of key importance in these situations. I’ve had other nurses say similar when medication has been refused, “I’ll give you an injection, is that what you want?!” No, what I want is for you to listen to my concerns and worries about the medication you are forcing upon me.

Yes I was distressed, yes I needed some help but was it appropriate to restrain me and inject me with something so strong I slept for two days? Was it appropriate to use IM as a threat? Or to do it in front of another vulnerable patient? I’m not so sure it was.

Mental health care services should not be causing trauma to their patients. It can be very isolating to have traumatic experiences like this. Personally I find it difficult to talk to my mental health team about the trauma they have occasionally caused me.