Having A Mental Health Problem Doesn’t Make You A Bad Person

I often feel quite ashamed of my mental illness. It’s like by being so unwell for so many years I am less of a person than my peers who have degrees, careers, children, marriages and so on. I always feel embarrassed because I feel my life shouldn’t be like this, I shouldn’t be like this.

My mental illness has put me in situations that have made me feel shame, that have made me feel like a bad person. Claiming benefits made me feel awful, selfish, worthless. I felt like the scum of the earth but I was too poorly to work and needed money to survive. I never ever wanted to be in a position where I had to claim benefits. The night I spent in a police cell made me feel like a bad person. As nice as the police were to me, I was treated like a criminal. I had my belongings and shoes taken off of me, I was strip searched and then put in a cell for many hours. I felt like a criminal. I felt like the whole of society was looking down on me.

I feel extremely guilty for the pain I have put other people through. I have dragged family and friends through this nightmare with me. My dad hasn’t slept properly in 18 months, my mum has cried at her severely anorexic daughter. It’s not nice for me but it’s not nice for those around me who have to witness all this too.

I do feel like a bad person. I do hate myself. But I shouldn’t, having a mental illness does not make me a bad person or any less of a person. It just makes me ill. This is something I never chose to happen to me. My asthma doesn’t make me a bad person, yes it can inconvenience people when I’m having an attack but nobody thinks I’m an awful person because of it. I know there is a difference between physical illnesses and mental illnesses because mental illnesses can impact and influence someone’s behaviour. I feel like a terrible person for some of the text messages I have sent when I’ve been unwell, or for getting angry at my parents for what seems like no apparent reason. I feel like a terrible person when someone makes the effort to spend time with me and I can’t stay awake or I can barely utter a word. I hate myself when I can’t follow your conversation but what I need to learn is that it isn’t my fault.

Having a mental health problem doesn’t make you a bad personal, neither does it make you any less of a person. You are unwell and you had no choice over that. Don’t feel like you are a bad person over an illness that happened to you.

“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.

BBC Breakfast Interview

This morning I spoke on BBC Breakfast with Matthew Ellis, Staffordshire’s police and crime commissioner to talk about the use of cells as a place of safety for people suffering from mental illness.

A home affairs committee report has called for a change in the law so that cells are no longer deemed a ‘place of safety’ under the Mental Health Act. I spoke out about my experience of the night I spent in a cell due to a mental health crisis. I was not violent, I had not done anything wrong, I was unwell. You would not leave a physically ill person in a cell and in the care of police officers so why would you leave someone with a mental health problem in this situation? Mental illnesses are health problems requiring health care.

I hope by continually speaking out and raising awareness then change will happen. If we are to end the use of cells then we need to improve care. More beds are needed, there’s a lack of funding, a lack of staffing. We need changes not only in crisis care but in the little bit before crisis care when people are saying “Look I’m really not okay, I need some help” and are often brushed off or sent home and told to have a cup of tea. If we are to succeed in ending the use of cells, we need major improvements in our failing health care system.

bbc

Norman Lamb: “Don’t stick mentally ill in cells”

You may have heard me talking on BBC Radio 5 live this morning after Norman Lamb, the care minister pledged to end locking up mentally ill people in cells in England.

I was 19 when I ended up in a police cell after depression and an eating disorder led me to a mental health crisis. It was college policy to phone the police and so the police were called. I had tried to get help, I had been to my GP and to my mental health team, it had reached a point where the police were the only option and that in itself is unacceptable.

The police arrived and tried to find a place of safety but all the S136 suites were full, there were no hospital beds to go to and with no other choice the police took me to a cell. I was strip searched, given ‘safety’ clothing and sat in a cell on a Friday night. I was terrified, ashamed, the memories of that night will never leave me. I mean, getting help should not be the traumatic part!

9-10 hours later I saw a doctor, the first health care professional I had seen, it was a medical/health emergency and I was given care by police for 10 hours, that is unacceptable. The doctor then organised for me to be transferred to an acute psychiatric ward.

I welcome Norman Lamb’s pledge, I will die a happy woman if I know that vulnerable and unwell people will no longer have to go through the trauma of being placed in a cell. I hope it is something that future generations will never have to go through. A mental health crisis is just that, a health problem which requires health care in a health care setting. The help that people receive should not be traumatic or damaging and people should be looked after by trained professionals who are able to care for the person as well as administer medication in an appropriate setting.

I am happy to hear that we are moving forward, that changes are being made. It is such an important issue. Although, I know that from personal experience there is still a lot wrong with crisis care. Crisis care is lacking in mental health services, they are under-funded and under-staffed and there is still an issue with beds. This needs to change urgently in order to avoid the use of cells and to provide good care for people who are desperately unwell.

The night I spent in a cell: a post for Mind

I have written a post for the Mind blog about my experience of spending a night in a police cell due to a mental health crisis. I feel this is very important right now as today is the crisis care concordat summit.

People suffering from a mental health crisis need care and compassion and to be treated with dignity and respect. It is so important to speak out and raise awareness so that hopefully one day people will be treated in an appropriate way during a mental health crisis. No one should ever spend a night in a cell for being unwell.

This really needs to change.

http://www.mind.org.uk/information-support/your-stories/the-night-i-spent-in-a-cell/#.VHcoM71FBAj

The Mind Media Awards 2014

Wow! What an inspirational night!

I have shared my experiences of mental ill health in the media, particularly focusing on my experiences of spending a night in a cell after being detained under Section 136 of The Mental Health Act. As a media volunteer for mind I was invited to the Mind Media Awards in London last night.

It was such an amazing, inspiring night and I am still buzzing, I truly believe that it is possible to make changes in attitudes towards mental health as well as treatment of mental illness. A highlight was seeing Michael Buchanan and Andy McNicoll win their much deserved award, particularly as I worked with Michael Buchanan on the S136 piece which, again, highlighted the bed crisis.

Last night showed how as a society we have come on leaps and bounds. It was the norm to be silent about these illnesses not so long ago but as more people are speaking out we are stamping out the stigma that exists. Imagine a world where no one has to be ashamed or hide away whilst their illness destroys them. Imagine a world where we treat each other with compassion instead of judgement. It’s possible.

TV programmes such as ‘My Mad Fat Diary’ and ‘The Dumping Ground’ are highlighting mental health problems in a more truthful light than ever before. The character suffering from a mental illness is not put into the script for comedy purposes. More importantly, programmes such as ‘Rugby League: State of Mind’ which target an audience that is often hard to reach and starts life saving conversations.

There were so many inspirational individuals and stories last night, 15 year old Ellen won an award for her amazing OCD blog and Deana Collins, Karen Bonsall, Mary Brailsford and Richard Ward won the Speaking Out award for their brave, persistent and life changing work.

Last night made me even more determined to continue speaking out and reaching out because change is possible. You might think that one voice won’t make a difference but it really, really can. I will not be silenced by my illness.

S136: The night I spent in a police cell despite never committing or being accused of committing a crime

It was a Friday night in January and I was sat in a police cell with a blanket wrapped around my shoulders, my shoes sitting outside the door and my belongings locked away. Was I caught stealing? No. Drunk and disorderly? No. I was in a mental health crisis and a risk to myself and only myself. There was no reason for me to be sat in a cold, dingy cell other than lack of hospital beds and ‘places of safety’.

At the time I was living on the border of Oxfordshire, if relocating to Wales taught me anything, it taught me that there really is a postcode lottery when it comes to mental health care. I feel the care and treatment I received in Oxfordshire was appalling. I had been frequently contacting my CMHT in crisis for months prior to this night. I had spent some time in hospital from the August-September after I had taken an overdose and I was discharged from hospital with no support and the reason for my discharge was not an improvement in my presentation but that they did not feel an admission was appropriate. I was studying for A levels at the time and I battled my way through the Autumn term. I was addicted to laxatives, very low in mood, restricting my intake, full of self hatred. I was in such a dark, lonely place. There would be times that I would miss my entire lesson sat in the bathroom in agonising pain from taking an enormous amount of laxatives. There were college days missed because I couldn’t get dressed due to horrendous body image. I would self harm several times a day just to ‘get through’. I began overdosing on an over the counter medication because it had a herbal base, it would leave me in a dreamy state where I would feel as if I were floating and the walls would move. I couldn’t tell the difference between what was a dream and what was reality. Sometimes the tablets would put me in a deep sleep for 1-2 days. I used it to escape because my mental illness was consuming me and my CMHT were letting me down hugely. On one occasion I phoned crisis team and was told that my psychiatrist had said that crisis team should not engage with me, imagine being told that when you are in crisis! In comparison to my team in Wales, the care I received back in Oxfordshire was shocking.

Back to January. I turned up to see my care coordinator from the CMHT, I was in a bad state, shaking and crying. I felt so done with fighting my battle and I actually got the guts to speak up and tell my care coordinator how bad things were. Her response? She mimicked my voice, repeated what I said back to me and then laughed. I was shocked, distraught and so I walked out. There was no point in me sitting there when she clearly was not going to help me.

The next day I went into college and told the college nurse how I was feeling, it was my last chance to get help, if she had not taken me seriously I do not know whether I would be sat here writing this now. The nurse followed the college policy and phoned the police, they detained me under Section 136 of the Mental Health Act. This Section gives the police the power to take you to a ‘place of safety’ where you can be held for up to 72 hours. Often ‘a place of safety’ is a room in a psychiatric hospital, it will usually have a bed, a chair and a bathroom to the side of the room, a mental health nurse will usually sit with you until a Mental Health Act assessment can take place. On this occasion I was taken to a place of safety and agreed to a voluntary admission on an acute psychiatric ward.

Two weeks later, I was worried that I was getting fat because I could no longer spend hours a day on a cross trainer and I had no access to laxatives. My eating disorder was screaming at me and so I asked to leave the hospital and the staff said yes. I was not at all well, I came home and doubled my ‘usual’ dose of laxatives which resulted in nights spent vomiting and passing out from pain on top of the obvious side effect of overdosing on laxatives.

It was only days later when I was sat in the nurse’s room waiting for the police to arrive again. I realised my mistake in leaving the hospital and I was willing to go back. When I told the police this, they decided not to detain me under Section 136 of the Mental Health Act but instead they would contact the ward and my mental health team and try to arrange another voluntary admission. They were told that they could not do this which left them with no option but to detain me under Section 136 of the Mental Health Act. They then proceeded to contact various hospitals with ‘places of safety’ but were unsuccessful in finding an available place. I remember when they broke the news to me that there was no option but to take me back to the police station. I remember grabbing the back of my head with my hands, curling up into a ball and sobbing partly with fear and partly with shame. I was an A grade student being marched through college with policemen to head off to a police cell, I felt so ashamed that I tried to hide my face with my hair and hands in an attempt not to be recognised by other students.

We arrived at the police station, and I was taken through to be checked in by the custody sergeant. I will never forget the fear and anxiety that I felt at that moment. Seeing the thick blue line and the signs telling me not to step beyond them, I was so afraid of being told off that I carefully put my feet up to the line. The sergeant asked me lots of questions but being quietly spoken he could not always hear my answer, he shouted at me to step forwards, which meant crossing the line. I was so frightened that I was doing things wrong.

I was shown to my cell and told to leave my shoes outside. Then I was strip searched. I cried the whole way through it, the officers were lovely and understanding but there is nothing that can make that experience okay. Admittedly I did have razor blades and laxatives hidden in my socks. After the strip search, the officers got me blankets, a hot drink and a book and an officer sat with me all night. I can not fault the police, it was not their fault that I ended up in a police cell and they were not happy with the hospital that this situation had happened. The police made sure I was safe and comfortable and really looked after me. However, this did not make the experience okay. It was a Friday night, if you have ever spent a Friday night in A&E then you have experienced an ounce of what I experienced that night. In my mental state I needed to be somewhere calm and relaxed but instead all I could hear were drunk criminals kicking off and shouting whilst being restrained. It was a night that I will never, ever forget. In the early hours of the morning I was assessed and then admitted to the acute psychiatric ward. If they would have admitted me when the police first phoned them then it would have saved a lot of painful, scary memories and I would not have had to experience something that no innocent, law abiding individual should experience.

I think that it is not acceptable for someone in a mental health crisis to be taken to a police cell, I was a risk to only myself. There would never be an occasion where someone who is physically unwell would be taken to a police cell due to lack of beds, so why is this allowed to happen with mental health?

I think it is important to also look at this from another angle. This was a Friday night, a busy night for the police and I was taking up a cell and an officer. It is the police’s responsibility to deal with criminals, they probably needed that cell and they definitely needed that officer and it is the mental health teams responsibility to provide care for their patients.