Shameful

A mentally ill, suicidal teenager was ferried around for hours by an ambulance crew because no NHS unit would accept her, the BBC has learnt .

The girl eventually had to be taken to a police cell, documents revealed under the Freedom of Information Act show.

This is just shameful.

Sadly I have often said that of all the psychiatric referrals I have made over the years first as an A&E nurse, and then for the ambulance service – only a handful have gone without incident.

I've had units refuse patients that they should be taking, and one unit had a mental health nurse accuse me, and the police, of lying in order to get them to see a patient. This goes without mentioning the sometimes awful 'care' that they get for existing medical problems. Or the inability of trained staff to do CPR should one have a cardiac arrest.

Sadly it seems that mental health is still the unwanted child of the NHS.

Today I attended a man with obvious (though undiagnosed) mental health issues. He'd had a fall and had been unable to get up for two days. When we arrived he was laying in his own urine in an unlit bedroom.

The flat in which he lived had no electricity and no heating. It was freezing. There was no food in the fridge.

Needless to say we have referred him to our 'vulnerable adult' team and with luck and a fair wind he'll get a proper psychiatric assessment and then social care input.

For those ambulance people who want to learn a new tool – thank the EMS Garage in an upcoming podcast for highlighting the PEAT scale. (I would have scored this patient as a 21 – referral for assistance).

3 thoughts on “Shameful”

  1. 'The default place of safety is a police cell' the article says. But how would a vulnerable child feel being locked up in a strange place with no human interaction or supervision. She could easily have committed a great deal of self harm purely through fear due to being in a place she did not recognise. People with mental health issues need a place where they can feel safe and a cell is the most unsafe place imaginable.'The default place of safety was probably dreamt up by a civil servant who believes he knows everything about mental health because he read it on Wikipedia.

  2. Several years ago, my nephew was diagnosed with a bipolar disorder. Currently I am reading a book by Berk et al titled 'Living With Bipolar.'It is a very unpleasent read, as there is a certain defiance within the psychiatric community to 'label' a patient with a mental illness. However, I do recognise belated efforts to care for him. Especially by the LAS crew, who were detailed for the section, leaving two police officers standing outside very relieved.

    He is within the 'system' but he is tagged as a treatment resistent patient, hence the agony of the family will continue. Currently he is detained under Sn3 of MHA, and in for up to 6 Months.

    It looks like another mess. However on this occasion I, and the patients family can empathise with the comments and views expresed above.

  3. Hi, I've been reading your blog for a while and I thoroughly enjoy it. Never commented before because I had nothing to say basically.But, in this case I can relate;

    Some time ago I was a mentally ill, suicidal teenager in a comparable position.

    My childhood was the kind of experience some people have written books about, but personally I feel very uncomfortable talking about these experiences even today. Needless to say; I saw many things a child should not see, did many things a child should not do and for over decade a day didn't go by where I didn't gain a new scar or as I grew older, left someone else with one, I discovered drug dealing at age 12, starting as just a runner. It proved to be a profession that suited my own personal brand of 'messed up' quite well. I was well accustomed to violence, lying, manipulation and dealing with the police, my childhood til this point had been filled with master classes on all areas, thanks to my step-father

    Until I was 16, none of it bothered me at all. I never felt regret, remorse for my actions nor self pity or depression over what had been done to me. I didn't have to sleep on a wooden floor any more, I feared no-one and I could afford any computer game I wanted. In my twisted view of the world, life was good.

    Then the faces of those I had hurt and who had hurt me would wake me up in cold sweats, screaming. My mental health went rapidly downhill from there and I was nowhere near the top to start with.

    Now as you might imagine this is the point in the tale where the NHS comes in.

    At first I was referred to the local CAMHS, while logical as I was a disturbed 16yr old. Unfortunately by now I was also 6ft2, 250lb, violent, intelligent former drug dealer. Sent to a psychiatrist who was used to dealing with hyperactive 6yr olds. After hearing my sordid tale in great detail and moving to a seat closer to the door. He admitted he had no idea how to help me and referred me to the local adult service(forgotten their acronym, but they keep changing it round here anyway).

    After making me recount the entire tale again(something I really don't like doing as I said earlier) and getting one of their doctors, who didn't seem to understand that accusing the highly agitated mental patient of lying about the most secret and painful parts of his life might not be a great idea, punched in the throat. They decided the best thing to do was let me walk out and refer me back to CAMHS. At this point I should have been sedated and sectioned, even I see that. I wasn't in control of myself in the slightest. I was becoming very aggressive and had begun self harming quite badly; One of my arms already had 8 stitches in I arrived for this appointment. No psych eval in the A&E when they stitched it, as it was after 6 o'clock. I was sent on my way with the promise of a phone call the next day.

    Over the next 18months I got to see the best and worst of the mental health service. During which time my levels of violence and self harm climbed steadily. Not long later I tried to kill myself for the first time. I was passed around almost every adolescent and adult mental service in the Northwest. Each time forced to relive my past in great detail, for a different stranger, because apparently shrinks cant share notes. Each reliving pushing me further into my depression. Each time getting a new powerful concoction of drugs(normally ending in a stomach pump. Protip; don't give the kid who just told you he wants to die a big bottle of anything with a name that ends with -azapam) and a referral to someone else or back to where I came from.

    Nowhere would take me. Either citing age, health and safety or just plain fobbing me off. The few places that tried did ok while while I was lucid and calm, but were so woefully understaffed, under trained and underfunded that as soon as my state of mind took a turn for the worse they were overwhelmed. I was outright turned away by more than five, maybe even ten inpatient units.

    One 'secure' unit was so incompetent, that despite my now being sectioned(something that only happened once during this whole fiasco, by all accounts because they had trouble getting the two doctors needed, by the time they did I was either lucid again or simply long gone). I was able to walk up to the nurses station press the button to unlock the front door and take a set of car keys, unchallenged. All the staff were watching the Big Brother eviction in the TV room.

    They only realised I was gone 4 days later when my CAMHS shrink who by this time I quite liked and kept going back to after my escapades phoned them to tell them I was safe and their member of staff would find their car at their local train station where I left it.

    The only reason I am not dead, in jail for murder or my own sensational headline is my very dedicated mother and that single CAMHS shrink realising he couldn't really help me professionally, but doing his best to keep me safe and busting his balls for over a year trying to get me the help I needed. Eventually he managed to get his boss's, boss's, boss in a room with me and shortly after the NHS funded my treatment at a Priory Group hospital, which helped me greatly and despite not being able to work yet, I am able to live a relatively normal life that I don't wish to end. It took them 9months of inpatient treatment, half the time it took the NHS simply to decide what to do with me.

    Though by this time my liver was on the brink of complete failure thanks to the repeated overdoses, something the NHS missed for over a year but the priory caught by the end of the first day. I'd also lost some sensory and motor function in my left arm/hand due to extended self harm.

    Due to this shambles of a system I almost died. Innocent people just trying to do their job were hurt(to my eternal regret), sometimes badly, my family went through hell and rather than helping me, for over a year all it did was exacerbate my problem greatly. It's only saving grace were the few people that, like yourself, genuinely cared and did their absolute best to help me and every other patient they treated.

    Strange thing is my local NHS trust is very good in most areas. You are seen quickly in a modern and clean A&E. The wards are bright and clean. You honestly you only have a very small chance of catching something that will kill you from the hospital. Even fallen old ladies are attended to quickly by the local ambulance service.

    However my current psychiatrist(and the rest of his department) works out of a 1960's portacabin with no heating, in a car park.

    The fact is; I'm a 2nd class patient. If I had any other life threatening illness, like cancer or heart disease and yes mental illness can very easily be life threatening, I have watched good friends die from it and came close myself. Patients being treated in a portacabin would cause a national outrage. The tabloids would be apoplectic. There would be questions in parliament, heads would roll, but nope that portacabin's been there for decades and probably still be there for a couple more.

    Shameful is in indeed the word.

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