I find it very interesting looking back at my admissions and realising the differences between when I was treated as an inpatient voluntary and when I was treated as an inpatient under section.
The most obvious difference to me is that when I was a voluntary patient I felt as though the ward were trying to discharge me in the quickest way possible, there was not particularly any care or treatment other than maybe a change in medication and every ward round pushed for discharge. However as a formal patient I met so many specialists and care plans were drawn up immediately, my family were involved and the focus wasn’t on discharge but instead on getting well and being in a place where I wouldn’t need re-admission in the immediate future, I was even told that it was better to spend an extra week there than to go home and need to be readmitted. The care should not be different for patients who are sectioned and for those who are not, it should be almost the same apart from the formalities of the detention that must be followed, for example forced medication.
As a voluntary patient I had been transferred from one ward to another and had only spent a couple of nights on the ward I was transferred to when I was asked to leave. I hadn’t eaten in days, my blood sugar was 1.3 and only a week or so earlier I had taken the most serious attempt on my life to date. A nurse walked in and told me that they needed my bed so I would have to go home and I got in a taxi and left. I cried so loudly that night that I kept my whole family awake. I had not even seen the psychiatrist, it was appalling care and it would not had been allowed to happen if I was a formal patient.
I think it comes down to beds, if there wasn’t such a bed crisis and more funding was put into mental health then I would hope that the care would improve for both formal and informal patients but for now it is apparent that the focus of care is on two very different things depending on whether you agree to go in or not, which is shocking really because had I not agreed to go in I may well have been a formal patient. Just because someone is sectioned it does not make them more unwell. In my opinion patients who are detained tend to have care and treatment that focuses on recovery and maintaining that in the community whereas patients who are voluntary tend to have very short admissions as the aim is to get the home in the quickest time possible.
In terms of aftercare I feel there is also a massive difference. In my informal admissions I was lucky to get any aftercare and often it was very poor. I was once given a care coordinator who went on sick leave for two months and by the time I saw anyone for ‘follow up’ I had been home from hospital over 10 weeks. When I was sectioned I left hospital with group therapy, a psychologist, a dietitian and a psychiatrist and I see all on a fairly regular basis.
By rights, there should not be a difference in the care received regardless of your legal status in the hospital and yet as someone who has experienced both types of admissions I can say that the difference was very obvious and clear. This needs to change.