24 Hours in Hell: Update

Two Years Later…

It’s almost two years to the day since I suffered this terrible and traumatising experience at the hands of Camden and Islington NHS trust (CANDI), and I thought it was time to provide an update on what’s happened since then.

It took me quite some time to get over my unlawful detention, in fact I still haven’t recovered. I no longer trust authorities, and I certainly don’t trust the medical staff at CANDI, which is a shame as they’re the only ones who are available to treat me. Instead, I pay to see a private counsellor. The cost of one fifty-minute weekly appointment is more than one week’s Employment and Support Allowance, but I have to do what I can to stay alive.

After the unlawful detention, I requested my medical notes. They took over six months to arrive, by which time I was starting to feel better mentally, and just wanted to put the awful trauma behind me. Then I got ill again. Eventually, after a whole host of other terrible treatment by CANDI, I decided I’d had enough and complained about being locked up against my will as well as a number of other issues.

My complaint was upheld. They didn’t have much choice, really, since their own Mental Health Law officers had told them that they were acting unlawfully. I didn’t receive an apology, unless you count a generic one-liner that tags off the end of all their complaint responses. No indication that they understood the severity of what they’d done, or the impact such an experience might have on someone who is already suicidal and vulnerable.

I submitted a complaint to the GMC about the doctor who’d unlawfully detained me, Sophie Gascoigne-Cohen. They didn’t pursue the complaint as they didn’t deem her to be a risk to patients (mental scars being conveniently less visible than physical ones) although they did say that the matter would be reported to her supervisor. The matter of her refusing to give me information to allow me to give my informed consent to stay on the ward, and refusing to record that I was staying under duress, they classed as ‘administrative issues’ – a cynical misunderstanding of facts if ever there was one.

Did I feel a twinge of guilt, reporting a young psychiatrist and potentially damaging her career? No. I felt an overwhelming sense of responsibility to protect other vulnerable patients from a doctor who sat there and refused to let me assert my legal right to leave the ward, despite me asking. And asking. And asking. Who wilfully role roughshod over mental health law and the safeguards put in place to prevent unlawful deprivation of liberty. I felt worried that a young woman, not long out of medical school, could feel the need to assert her authority to the extent that she cynically deprived me of my human rights. If she showed no compunction in doing this to me when I was quite calm and coherent then lord knows what she might be capable of doing to someone who lacked capacity. There are many, many ways mental patients can be abused by authoritarian doctors, and although pursuing this complaint has been stressful and upsetting, the treatment I’ve received at the hands of Camden and Islington shows that we need to continue holding NHS staff to account to prevent the abuse of vulnerable people.

Finally, I spoke to a solicitor. What happened to me was undoubtedly a legal breach, but sadly there’s little or no money in such a claim, and so they weren’t willing to represent me unless I paid for myself. Since the amount of any compensation would be small, I would be putting myself through terrible stress and expense to pursue this any further.

The only thing I have left, really, is to record my account here in the hope that others who have suffered in a similar way might not feel so alone.

Stay strong and keep fighting.

 

 

 

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Goodbye Facebook, It was fun while it lasted

 

A month or so now, I finally cracked something I’d tried and failed many times before – I quit Facebook.

True, it took a traumatic breakup of a friendship to make this happen. But every cloud and all that.

This morning, it being my birthday, I cynically sneaked a peep to see if I got one of those digital balloony greetings things (I didn’t; I forgot that I don’t have my birthday on my profile anymore to avoid the data harvesting that I used to think was me being paranoid…ha ha, thanks Cambridge Analytica).

The thing is, I realised, that for me Facebook has turned from that friend who loved me and made me feel good about yourself, to one who is constantly sniping at me and who you leaves me with that sinking anxiety feeling every time we have coffee. And yet, it’s also that one friend who holds the key to so many others. Breaking off this relationship would be social suicide. Or would it?

Here’s a few things I miss, and those I don’t, about the most enduring of the social networks.

I miss my comedy group. I set this up a year or so ago, and have made some lovely real-life friends through it.

I miss an occasional funny status update from an acquaintance.

I miss being part of the zeitgeist, seeing news and reaction as it happens (OK, perhaps not as instantaneously as on twitter, but Facebook still reacts within minutes or hours). But conversely, I find that without social media, I don’t feel the same pressure to be the first to be aware of every reaction and counter-argument. In fact, I feel slightly more rested, now that I get my news from a couple of trusted sources and can arrive at my own opinion, without considering a host of variables. Old-fashioned perhaps, but I’m 43 today, so maybe it’s time to hang up my placard and start narrowing my mind…

I don’t miss the constant negativity spewed from certain domains within my digital world. I’d not even really noticed this until this morning’s brief scroll. Like, I know (many) straight white men are trash display problematic behaviour but it’s actually a bit demoralising seeing evidence of this dripped before my eyes 1,000 times a day. I have no problem with anyone posting this sort of thing, by the way – I think it’s an important tool in letting off steam and building solidarity. I just hadn’t noticed until now how draining it is when you’re subjected to it constantly.

I don’t miss the endless and meaningless merry-go-round of “you like my post so I’ll like yours”.

I don’t miss being exposed to other people’s shallow and banal shite (in fairness, I don’t have many people like this on my FB, but the algorithm always lets a couple through).

I don’t miss the constant stream of adverts for things that I just looked at a couple of minutes before.

I miss keeping in touch with people, but without Facebook, I’ve realised I’ve more time to focus on the relationships that are important to me, and where the other person also has the same investment to send a text instead.

On balance, I’ve come to realise that what I loved about Facebook (the sense of community and friendship, the personal element, the increased chances to organise politically) have largely gone now, to be replaced by an endless feed of tuppenny “shock” opinion pieces, sniping, vitriolic comment threads and endless commercialism.

All friendships run their course, and I think this is the end for me. I’ll still keep my hand in – Facebook is too intrinsic to my life to duck out completely, and no one would read this bloody blog if I didn’t post it on there. But I will be keeping you at arms length from now on, old friend.

Thanks for the algorithm-fed memories.

 

 

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Balancing Act

I’ve lost two and a half stone, and I don’t know how to feel. A blog about body positivity and recovery.

 

Content note: this post is about body image, dysmorphia and weight loss.

The current resurgence of the fat- or body- positive movement, or perhaps my raised awareness of what was always there, has left me feeling conflicted.

How do I talk about Body Dysmorphia – when a large part of my hatred towards my body is rooted in my weight – without it sounding negative towards “fat”? It’s not right to keep on about hating my size and shape while other people are working to make being larger just as desirable as the model in the notoriously shitty “beach body” ad.

Beach body

I love the fat-posi movement. They’ve made me realise and confront deeply held prejudices that I never knew were there. This podcast, where comedian Sofie Hagen talks to artist and activist Scottee, made me feel like old issues to do with size, sexuality and identity were finally being dealt with in a new way. I wish they’d been around when I was growing up.

Sofie Hagen and scottee
They look fun to hang out with.

But all that falls to pieces when I try to apply these ideas to myself. Like (I’m guessing) all Western women and some men, my conception of my size, and my feelings towards food, eating and fatness are deeply rooted in feeling and emotion. They’re not something I can rationalise away, no matter how much I cognitively want to.

My problem was that I had got fat, and it made me desperately unhappy, triggering feelings of dysmorphia that had been latent since my teens. I couldn’t look in the mirror, I couldn’t leave the house. Back in July I blogged about how I’d stopped seeing friends due to my appearance, and looking back this period of self-imposed exile lasted months.

From being a pretty stable size UK 10-12 all my life, I began to gain weight uncontrollably. I had no idea why, or what was happening and neither did the doctors (not much change there). However, its no coincidence to me that my sudden and rapid weight gain coincided with the worst ever mixed bipolar episode I’d experienced, and nor is it much surprise that as my symptoms started to recede, my weight dropped.

In the July post, I wrote about my body and my concerns about how I was feeling. I was desperate for someone to talk to about it, but it was strangely hard to get support. Eating disorder services wouldn’t deal with me, because I hadn’t got an eating disorder. Everywhere else I tried referred me back to ED services. I was torn between wondering if what I was feeling was actually just “normal” and how all women felt, or that there was something deeply wrong with me. In the end I got no help regarding how I felt about my changed body, but I did get help on how to stabilise my mood, and consequently my appetite plummeted like a stone. I’m now one of those annoying arseholes who can use the phrase “the weight just dropped off”.

I’m sure in a large part this is down to quitting alcohol, as I was probably getting through my daily calorie allowance in booze alone, and that’s without the crisps that inevitably accompanied it. Mmmmmm, memories of lovely crisps and booze…

Homer drooling

Something else that helped ease the symptoms of my BDD was accidental. Due to a change in domestic set up, I moved to a bedroom without a fixed full-length mirror. Only having to see my entire body when I chose to (which wasn’t often) helped a lot in terms of processing my feelings towards my body. Ultimately, though, my BDD eased as I returned towards my old weight. It’s not gone altogether, as I now direct my hatred to my ageing saggy face.

Up to now I’ve lost fifteen kilos, which Google tells me is two stone five pounds, and I hope to lose more (but then I don’t think there has ever been a moment of my life, at any weight, when I haven’t wanted to be thinner). To return to my opening comments about feeling conflicted, basically by listening to fat-posi people I’ve realised that it’s not really OK to go round shouting “hey look I’ve lost all this weight aren’t I great”, but now I’m not really sure how to talk about it. I know it’s perfectly OK for me to have a personal goal and to reach that, but I don’t know how to talk about this without fetishising thinness, and feeding into the insidious social pressure about our bodies that causes me and millions of other so much pain.

So it doesn’t feel like reaching a goal, or happiness, or victory. Psychologists would no doubt say that I fudged confronting my feelings about my fatter body by losing the weight rather than learning to accept it and be happy. Nasty little right wing neo-liberal shitbaskets might say I got off my fat arse and did something about it. In reality, I can’t claim that I’ve had the mental strength required to follow a diet or eating plan – my appetite has just reduced, and weight loss has been an unsurprising side effect.  In the end, thinner doesn’t feel better, just different.

Which is probably how it should be.

 

 

 

 

 

 

A Chink of Light

Andy and Rita

My dear old mum (RIP) used to have a rule: if I phoned her in a crisis, I had to also remember to let her know once the crisis had passed. It’s a good rule and I’ve tried to bear it in mind ever since.

After a good few months of the worst mental and physical health I’ve ever experienced, I’m feeling a little better. This week I’ve managed to leave the house twice, admittedly once was for medical appointments, but today I actually managed to go out for a purely fun and social event! Stone the crows! I was whacked and in a lot of pain by the time I got home, but it was wonderful to be outside, to see the trees in their end-of-autumn colours, and just to breathe some lovely London pollution. Just to feel normal for a while.

I know there’s no one-size fits all with mental illness, but a few things have really helped me and I may as well share them with you.

Firstly, being able to afford the input of a private psychiatrist really helped me. Although I can’t afford to be treated by him in the long term, just a few sessions really helped me (the beneficial effect no doubt being increased by the frighteningly large sums of money dispensed) because he gave credence to my experience in a way that my NHS practitioner seem to have given up on. He confirmed I was experiencing a bipolar mixed episode and said that I must be facing unimaginable torment. Although his words didn’t take any of it away, it was such a relief to put a name to the beast and feel validated.

The downside was that the only medications available to me were antipsychotics, which have a pretty horrendous side effect profile, or repetitive Transcranial Magnetic Stimulation (rTMS) which costs £12,000 and is unlikely to be effective in the long term. But before we came to medication, the doctor thoroughly audited my life, and recommended this book which is one of the few I’ve come across to deal directly with mixed episodes.

Although the advice the doctor gave me was fairly basic stuff, especially to anyone who’s had years of therapy, it served to motivate me to kick my arse back into gear. Here’s the bottom line of the doc’s advice.

  • Stop drinking. I’ll admit this came as a body blow to someone who is a self-confessed seasoned drinker. I knew that I used alcohol problematically to deal with the crazy way I was feeling, and I was prepared to wave goodbye to that, but I also knew that there were times that I loved drinking and would really miss it. Some people can manage moderate drinking, but being a very all-or-nothing person, I know the best thing for me is to be completely abstinent. I stopped that day and haven’t drunk since, although I will never rule it out. I am resigned to the fact that alcohol will probably be a permanent struggle for me.
  • Give up caffeine. Whaaaaaaaat? Dear sweet lord, is nothing sacred? Apparently not. I quit coffee and my beloved Coke Zero and I can safely say it’s harder to give up than alcohol. Pass the decaf chai latte.
  • Practice sleep hygiene. I’m normally pretty good with this, but in my manic state was waking through the night or very early in the morning. At first I was so overstimulated I had to step away from tech from around 7pm.

With the help of the above – plus a two-week script for Xanax – I managed to bring down my mania within a couple of weeks. However, I was still left with the sticky anxiety and depression that dogs my footsteps.

In desperation, I tried CBD oil. A couple of people had recommended it to me, but I had dismissed it because I was already on so much medication I didn’t want to add anything else into the mix. However, my Xanax was running out and I wanted to come off benzodiazepines, so I got hold of a bottle from Holland and Barrett.  I am a super sceptical person, especially when it comes to unevidenced alternative remedies, but I can only describe the effect as incredible. After about three days, I started to feel far less anxious and actually something resembling ‘normal’. I was able to stop Xanax with no problems. I’d say the CBD oil helped bring my anxiety down from a seven or eight to a two or three. I’ve taken it every day since.

The other thing that has helped me no end is the selfless support and care of my best mate, who moved in a couple of months ago. He’s unfailingly caring and generous with his time and willingness to listen to my daily trials, to take me to my many medical appointments and to motivate me to go out. Not only that, he literally provides me with something to lean on. My back has been particularly bad lately and I’ve had to invest in some crutches, but thankfully I’ve not had to use them yet as I’ve had my friend’s arm to grasp. Having battled with this alone for years, his support means the world to me.

With the help of my excellent MP, I’ve managed to finally get referred away from the personality disorder service to the mood disorders team. My diagnosis remains contested, with yet another psychiatrist disputing the BPD diagnosis last week.

I also managed to get referred to a psychiatrist endocrinologist, who has recommended a trial of hormone therapy. Every doctor I’ve spoken to recently (and there have been MANY) have spoken about how the role of hormones in affective disorders is massively under-researched, and when you consider the role of hormones in PMS it makes sense that an imbalance would cause mood disruption. I strongly suspect this won’t be cracked in my lifetime, but I’m pleased to be giving it a go.

On the physical side, I’ve involved my long suffering and hardworking MP here too. He’s intervened to challenge my neurologist who refused to give me pain-relieving injections in my spine because I’d self-harmed. Still waiting for an update on this (hey, they’ve only had my complaint since June, why rush); it seems likely I’ll get some help eventually, be it the injections or an operation. I suspect it may be some months though. In the meantime, I’m limping around and relying on my wonderful housemate to dress me.

So that’s about it as far as current health developments go…I’m by no means out of the woods yet, but things are a hell of a lot better than they were.

Did I do OK mum?

 

 

My Pregabalin Hell

It was recently ruled that the drug Pregabalin, used for anxiety and pain relief, is to be reclassified a Class C controlled substance. Here is my account of nine years addicted to the prescription drug.

 

This week the Guardian reported that the anxiety drug pregabalin is to be reclassified as a Class C drug. This means it will be considered a controlled substance and no longer available on repeat prescription.

This comes as no surprise to a state-sponsored pregabalin addict like myself.

I have been prescribed pregabalin continuously for over nine years, since the drug was relatively new, and I know the damage it can cause. 

I was originally prescribed the drug for anxiety and found it to be as effective as Valium, but my tolerance to the drug increased and after a slipped disc left me with nerve pain I was placed on the maximum daily dose. After that I found it impossible to quit.

It took me some time to realise that, rather than helping, pregabalin was becoming part of the problem. I realised how heavily addicted I was to the drug when I realised that my anxiety symptoms were not anxiety at all, but in fact withdrawals because I was due my next dose. On the rare occasions I found myself without the drug I experienced withdrawal symptoms many times more horrific than withdrawal from benzodiazapines and opiates – I can only describe the level of terror like being buried alive. I have broken down in my pharmacy screaming because the GP had made an error and left me without the drug. The humiliation of clinging to the pharmacy counter in tears, explaining that you can’t ‘call back later in the day after work’ because you can’t go to work, because you cannot function without the drug. 

pregabalin lyrica withdrawal

I have spoken to my psychiatrists many times to request help with withdrawing from pregabalin but in the early years they were unwilling to accept that it was as addictive as I told them. I found myself researching ‘pregabalin addiction’ and finding little in the way of research papers, but reams of anecdotal evidence. Yet again, it seems, a licence was granted for a drug without studies as to the long-term effects.

My struggle continued, and the NHS started to doubt me less when I explained my addiction. Recently, a nurse who works in substance misuse told me pregabalin addiction is now recognised as a problem, not just as a prescribed substance but recreationally. Pregabalin has become a currency in prisons and was last year linked to 111 deaths.

I needed it, yet hated the hold it had over me. When I spoke to my doctors about reduction there was the ever-present argument not to change my drugs and risk upsetting my mental state. Furthermore, the NICE guidelines for quitting the drug suggested it should be tapered over a week, when I knew such a rapid reduction would be impossible unless they locked me up as an inpatient – which I even put forward as an option. 

I eventually managed, with the help of a supportive psychiatric team, to reduce my dose over the course of six months, but even by doing this in small increments I suffered suicidal impulses – and actually tried to commit suicide one one occasion. In the end my psychiatric nurse told me to stop trying it as it was causing too much risk. 

I’ve also taken massive overdoses of pregabalin mixed with my many other medications to attempt suicide. On being admitted to hospital, the psychiatrist asked how I was feeling. I replied “I feel fine – I’ve just taken a fuckton of drugs”. Sitting in a windowless room in A&E having tried to end my life I literally felt like I was floating on a lovely cloud. I can understand why pregabalin is used recreationally. 

Although I know this new classification will make my life hell obtaining my regular prescriptions, having seen the damage it can do I’m in favour of greater regulation. The question I would really like answered, is how the hell do drugs like this get licensed in the first place without long term trials.

Effectively, I have been an unpaid guinea pig for the manufacturer Pfizer so they can line their pockets. The drugs industry has profited from my pain – and it’s about time they were made accountable. 

A list of shits no longer given

If you read this blog, or even worse, have had the misfortune to meet me in the last few weeks, you’ll know that I am not in the best mood.

I have a washing machine of vitriol churning in my head and a blaze of anger what I formerly assumed was a cold, dead heart.

So I have made some resolutions. Here are some things that I have resolved to no longer do/ignore/allocate any of my precious thought time to.

  • Tits and nipples. We (very nearly) all have them. If you can see mine, and choose to sexualise them, that’s your sweet issue. I realised at the grand old age of 40 that I don’t, and have never needed a bra. The reason I wear a bra (I suspect like a lot of women) is to a) make my breasts a more desirable shape as deemed by decades of media imagery or b) to COVER MY NIPPLES. Why, I find myself wondering? Which imaginary deity deemed that visible nipples were somehow an invitation for unwanted sexual contact or the sign of the sexually promiscuous? If I can see a man’s nipples/moobs through his t-shirt my last thoughts are of sex, believe me. So rule one: fuck your views on my perfectly natural human body.

IMG_6281

  • Smiling at strangers on trains. I am a sociable bean, and also from Yorkshire, so my automatic response upon meeting someone’s eye is to smile at them. This is nice and I don’t want to stop doing it. But I was one the tube yesterday and looked up to catch a man letching at my aforementioned rack. I was literally halfway through my automatic smile when rational thought intervened and I realised that I was smiling at this man because I somehow felt like I owed his unwanted sexual attention a friendly response. So rule number two: from now on, stinkeye for letches. Speaking of letches…

 

  • …those guys who slide into your DMs at quarter to twelve on a Friday night. The kids are in bed, the wife has followed and they are sitting alone, deep into their collection of craft ale. The messages begin innocuously enough, perhaps with a tenuous link to a mutual friend or a shared interest. I used to wonder ‘why are you messaging me? I don’t know you’. But being a nice person, or at least a shadow of one, I would reply. I would engage, because that’s what I was brought up to do; be friendly and polite. The only difference here is this is not a civil exchange such as one you might have with the elderly lady or gent at the bus stop. This is a highly gendered phenomenon, because it relies upon two of the great pillars of patriarchy: men’s entitlement to women’s attention, and women’s obligation to grant them this. It took me a good few months of messaging back and forth with randoms before I saw the pattern emerge: the lateness of night, the alcohol, the fact that it was never, ever women getting in touch at 1am ‘just for a chat’. The crunch came for me when one of these Facebook buddies decided in his drunken state to send me a meme that amounted to ‘show us your tits’. I realised then that these guys wanted neither friendship nor sex, what they wanted was a bit of a diversion, some idle flirtation to bolster their sagging self images. I also realised I was gaining nothing from these transactions, and they were taking up a whole load of emotional energy.  So from then on, rule three: I don’t accept ‘chatty’ DMs from men anymore, instead just telling the sender that I’m happy to be Facebook friends but I don’t chat with people who I haven’t met in real life.

manspreading tories

 

  • Taking up space. I refuse to apologise for occupying my 68kg 160cms volume of space. Take a look at the picture above. the four women in the front row clasp their legs together, cramped into a small amount of space, while the seven men have spread, relaxed legs, occupying as much of their own sweet space as they wish. OK, its a picture of a load of Tories who by their very nature are bound to be a bunch of cunts, but the pattern is repeated everywhere. Theatres, trains, airplane seats. Rule four: without needlessly encroaching upon other’s space, I will take up as much as I need. If that leads to a battle of wills with the fella sitting next to me, so be it. I am more than capable of giving passive aggressive kneeing when required.

 

  • Rule five: I will not apologise for myself. My education (hard fought for – I got a first class degree but it took eleven years of interrupted study including dropping out of Cambridge to get there), skills, vocabulary and what my mate calls ‘grit and determination’ can often be perceived as a threat by people in authority. I was brought up to have an enquiring mind, which goes down like a lead balloon when you’re sitting in a psychiatric ward at 2am asking for the NHS policy on voluntary admissions before you sign anything. Frequently this has brought me to blows with medics who view this as a personal attack and as a result, become upset and defensive. Whilst it is absolutely not my wish to hurt or disrespect another human being, I’m resolute in my belief that professionals need to be impartial and open to questioning and, at times, criticism. It’s really not personal.

 

  • Rule six: I’ll try my best to give love, appreciation, support and credit where it’s due. In a world filled increasingly with dangerous bell ends, I will hold close those dear to me, thank them for their care, seek to make connections with other good people and show empathy and support to those people going through their own hell. I’ll use what little I have in the tank (mainly lying like a lump on the sofa writing blogs or going on Facebook) to support new artists and creatives, to challenge cuntiness, and to bring good people together. I will try.

 

  • I will pace myself. So instead of lying on the sofa feeling overwhelmed by the chores, I will do one thing each time I get up. So I go for a wee, and put a wash on. I water the plants while I boil the kettle. I am aiming for three chores a day, anything else is a bonus. The prospect of unpacking my suitcase from the crisis house is a faraway fantasy. Leaving the house alone still a long way off. But rule seven seems do-able at the moment, which is the best I can hope for.

 

If you have any suggestions for rules for living in this difficult world, or thoughts on mine, I’d love to hear them. I moderate all comments and will happily post critical comments but only if they’re constructive and non-abusive.

Diagnose and Treat…or Discipline and Punish? 

After just a week I decided to leave the recovery house. I’m not better since my admission; I’m worse, but I fear that being in the house was one of the factors in my deterioration.

When I was studying towards my PhD I became acquainted with a chap called Foucault, who had a lot to say about power and its role in modern society. By ‘power’ I’m not referring to the copper-plated buffoons in Westminster, I’m talking about the subtle mechanisms of power that make you lower your voice while visiting a church, or refer to your GP as Dr Smith whilst she calls you by your first name. 

Mental health treatment is a seething morass of such displays of power. To me, each transaction seems to be test in which the person in authority seeks to assert their power. You will receive treatment, but only if you’re humble. 

In crisis and require some diazepam? Turn up to the surgery, head bowed, in jogging bottoms and makeupless (for god’s sake don’t wear lipstick as this is a clinical indicator YOU ARE FINE). Utter your request in hushed tones, explaining you are desperate and you don’t know what will really help. It’s touch and go, but the diazepam genie may just grant your wish. Don’t under any circumstances be articulate. Don’t make your request calmly and confidently. For pity’s sake don’t point out that your consultant psychiatrist (who outranks them in their tinpot kingdom) has left instructions on your notes for you to be given diazepam in such circumstances. Because this is an affront to the power of your GP, and as a result you will be punished by them failing to find the letter supposedly held electronically on your patient records, a claim that they will need to speak to your psychiatrist directly and other such complicating factors. You’ll get your 5mg diazepam, but only after much anguish and a possible invocation of the Human Rights Act.

Such assertions of power – in fact lets call them what they are, micro-aggressions – were no less in evidence when I checked into Drayton Park, the crisis house in my London borough. If you’re not aware – crisis (sometimes optimistically called ‘recovery’) houses are places for people who would otherwise be in psychiatric hospital. I have been in Drayton Park before, and although it was not without its frustrations I found it to be a broadly positive experience. Having said this, I was really, really reluctant to relinquish my liberty and go back there. By the time I referred myself, I was very ill indeed.

I asked my best friend to accompany me to the assessment, partly because my trust in mental health services to treat me fairly and with respect has been irreparably damaged after previous instances outlined elsewhere in this blog, and partly because I’m not good at showing my mental distress. Apart from a very tiny number of occasions when I’ve fully flipped, normally the anguish and turmoil is buried deep inside. I can explain it, by god I can intellectualise it, but I just can’t bloomin’ show it.

Seemingly this makes me a less credible candidate for crisis care, because following my assessment when I was offered a place, I was told that their decision to admit me was borderline because I ‘clearly found it difficult to show my feelings’ as if this somehow makes me less ill than someone running round naked screaming. It’s as if the concept of being high-functioning mentally ill has yet to reach Islington.

I was assigned a wonderful and highly-skilled worker, who unlike me had actually managed to complete her PhD; in a similar field to my own. As well as discussing my health problems and possible solutions, she also sympathised with my feeling of being lost in the mental healthcare system. Despite having a dual diagnosis of Emotionally Unstable Personality Disorder and Bipolar Affective Disorder I’m not deemed ill enough for continuing support, but the drop-in type services which are being offered to me as an alternative are in no way suitable for my needs, because they focus on stuff I’ve covered comprehensively over the years: sleep hygiene, exercise, basic CBT and mindfulness.

Sadly my excellent worker was part time, so on her days off I was assigned an endless stream of other workers with whom I was obliged to have a one to one meeting with each shift. During the week I barely saw the same person twice. The team at Drayton are kind and committed but I found discussing how crap I was feeling depressing rather than helpful, and I dreaded the twice-daily meets. Often, because of my propensity to put on a brave face, I found myself smiling and making small talk in order to just tick the box of attending the session.

However, it was the regime of rules and surveillance that really made my stay untenable. I couldn’t bear the constant scrutiny and invasion of privacy. Strangers coming into your bedroom at midnight to (incorrectly) tell you you’d not taken your medication; being referred to as ‘non-compliant’ for choosing not to take a painkiller if I’m not in pain. 

I didn’t have the freedom to break in half a 5mg tablet of diazepam and take the other half if/when I needed it. It was take the whole pill and feel like a zombie or take nothing at all, and then risk having my script reduced because I wasn’t using it ‘as prescribed’. I’m used to managing my own medication to cope with both my moods and my chronic pain and having this taken away from me made both conditions worse since the rigid system allowed no room for me to alter my levels of meds to meet my needs (despite my psychiatrist being fully supportive of this approach). 

Because of the emphasis upon staff contact, I couldn’t relax, write or take a nap (which I sometimes need to do as my pain meds sedate me) because staff would come and knock on the door every couple of hours. I was constantly on a high state of alert knowing I could soon be interrupted.

One of my workers told me I shouldn’t sit alone in my bedroom, and when I said I didn’t feel well enough to be around other unwell people I was told to ‘sit in the crèche and watch TV’. I don’t watch much TV at home (OK, OK, apart from Ramsay’s Kitchen Nightmares), I’m certainly not going to sit in a playroom and begin now. If anything that’s more bonkers than the situation I’ve just gotten out of. 

Don’t get me wrong, I understand that every one of the rules I’ve complained about above is there for a reason, and the fact remains that Drayton Park remains a wonderful haven that provides help to a lot of people. But one of their core claims is to treat residents as individuals, and this just didn’t seem apparent in my case.

It also transpired that Drayton Park, despite its progressive ideology, is not immune to micro-agressions of power. I told my allocated worker I was leaving, explaining that it was nothing that the house itself had done but that I felt it wasn’t helping me. She was very regretful and kind, and said that a senior member of staff would want to come and discuss my decision with me; I assumed to get some feedback on my leaving and risk assess my departure.

However, in the twenty-five minutes I sat by reception waiting for my medication to be returned to me, no-one spoke to me. One of my key workers walked past me with no words, no eye contact, despite me sitting surrounded by my bags. By having the temerity to make my own decisions, it was clear they weren’t going to pay me the respect of wishing me well or even saying goodbye. Neither of the managers came out to see me, despite me being sat on the other side of their glass panelled office. I gained the strong impression that if I was going to make my own decisions, they weren’t going to bother with me. My kindly worker came to return my medication to me and I was outta there, in more of a mess than when I’d entered the week before.

Dry your eyes, mate

I’m ill, which means I need to access mental health services, which in turn makes me more ill. Oh the sweet irony of NHS mental health care.

I write this in my GP’s waiting room having just had an encounter that was almost as unpleasant for the doctor as it was for me.

As ever, whenever I deal with authorities I find myself trapped in some kind of hideous Catch 22 in which the people with the most power have the least intellect.

I turned up for a routine appointment to review my mental health. I explained that things had got worse and please could I have some more diazepam. After a lecture from my somewhat-new-and-inexperienced GP on how addictive it was, I explained that I understood that but my choice was currently to take medication to control how I was feeling, or chuck myself under a bus. I am dealing with the lesser of two evils here.

I also asked for one of my prescriptions to be changed from three times daily to ‘as required’, as I’ve been instructed by the crisis house to which I am hoping to be admitted this afternoon that they can’t administer more medication than prescribed.

There followed the most ludicrous and cyclical conversation, in which the doctor repeatedly told me that she couldn’t give me any more tablets. I explained I did not want any more tablets, I had plenty. I wanted her to change the     prescription from TDS (three times daily) to PRN (as required). She couldn’t give me any more tablets, she repeated. I DON’T NEED ANY MORE TABLETS I repeated.

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No word of a lie, this conversation went round in circles at least four times before she informed me that my psychiatrist would have to agree to this, but she was too busy to contact him today. The crisis house would have to phone the surgery, speak to the duty officer, ask them to phone my psychiatrist (who, as a consultant, is not easy to get hold of at the best of times).

I expressed the view that this was not good patient care, and would likely leave me in a situation of extreme distress with no access to medication for a period of days until contact could be made with the appropriate people.

She refused to budge from this point, so, knowing that I would have to explain this situation to the assessment team at the crisis house, I asked to record her reiterating her position, and turned on my phone.

At this point she left the surgery and did not return. Instead, her senior colleague returned and informed me that she was very upset.

He asked me to stop recording and said he would end the consultation unless I did so, so I agreed I would do so provided he would give me a written account of our consultation to take away with me. On this basis, I quit the record.

He then agreed to contact my psychiatrist today and to phone me and let me know the outcome.

I thanked him. I explained that I was sorry that his colleague was upset but pointed out that I thought it showed skewed priorities that he was asking me to empathise with her.

I was a patient who had presented in the midst of a mental health crisis and has asked for a course of help that would prevent causing me further distress. When that was denied to me I asked for evidence because I knew that I would have to progress this battle with other authorities in the health trust. At no point did I raise my voice or be impolite; what I did do was give a frank account of being unlawfully detained by the trust last year and explained why I felt the need to cover myself from all angles in interaction with mental health services. The other crime I seemingly committed was of having an understanding of my rights and of prescribing guidelines on controlled substances.

 

I can forgive, but forgetting’s the bastard.

Like everyone, bad things have happened in my life. Some have been done to me, and some, I’m ashamed to say, I’ve done to others. Yes, at times in my life I have been a complete cunt.

Years of therapy (man) have helped me move on from childhood shit, from blaming parents for omissions, for the lovers who cheated. There’s a couple of things, however, that I just can’t move on from.

These two betrayals are insidious by the cloak of mystery that surrounds them, because although completely different in nature, these offences have in common that they were carried out by an anonymous aggressor. And no matter how much you try to move on, it still rankles in the wee small hours that someone hates you so very much that they would intentionally hurt you.

The most recent of these occurrences was the absolute charmer who took advantage of the Tories’ ‘shop a scrounger’ anonymous benefit fraud telephone line. Up to then, I had been fortunate to have avoided the perils of ATOS and their heartless and senseless assessments, and had been automatically awarded fairly decent levels of disability benefit. This award was no doubt largely down to a letter from my long-serving psychiatrist who explained that due to my complex, severe and enduring mental health problems I would not only be unable to hold down a job, but (and I have to admit this bit brings me to tears a little) I would ‘never be able to live a normal life’. So, lucky old me with my fucked up brain, at least I got the princely sum of ninety quid a week from the social with which to live like a Queen (in my abnormal life).

However, my nameless adversary knew better than any medical professional. Sitting on the phone, very possibly masturbating with joy, they gave the DWP a full rundown of my appearance, previous married names, height, weight and hair colour. The crux of their analysis, though, was that I am able to leave the house and ‘obviously lead a full life’.

How that phrase rankled my agoraphobic brain. My best mate is my carer and drags me our once every few days, without which I remain inside, often in my pyjamas, sometimes rarely able to shower. God forbid we should put a photo on Facebook of a rare moment of fun, because that obviously means THAT I AM FINE AND DESERVE NOTHING.

Well, dear reader, it’s 1-0 to my nameless Daily Mail reading wanker because my benefits were stopped and now, well I get by in the only way I can. And I can’t pretend that it’s good for my mental health.

My second beef that burns brightly dates way back to university. I studied at Cambridge as a mature student, after a less than illustrious schooling and adolescence. I was aged 29 and I remember the date because it was Burns night, 2005. I attended an all-female college and was invited to the neighbouring mixed-sex college for the Burns night dinner. The booze was flowing and I remember having a silly tiff with one of the male students, who was well known for fancying himself somewhat. Later that night he handed me a drink, and that’s the last thing I remember.

I came to about 14 hours later, having been attended to by paramedics; my friends had seen me become suddenly floppy and completely out of it, and had called an ambulance. The paramedics didn’t do anything except observe me, and lord knows why they didn’t test my blood, but I was subsequently ill for two whole weeks; I couldn’t look at light, I had a blinding headache and was constantly throwing up. I felt like I’d been physically assaulted.

Again, the sense of not knowing is what makes it hard to move on. I have no doubt that someone spiked my drink, but I have no way of knowing who it was, regardless of my suspicions. In the days that followed (because naturally the event had shocked the college; they immediately ran a campaign to raise awareness of drink spiking), several students came up to me independently with suggestions of who the perpetrator could be. For the record, their suspicions matched mine.

This would all be ancient history, an unpleasant anecdote but something that I’d write off as ‘one of those things’ were it not for an unpleasant twist in the tale. The person I suspect assaulted me in this cowardly and pathetic way is still part of my life, and keeps popping up due to mutual friends and interests. I’ve tried blocking on Facebook, and even unfriending people to avoid seeing his image, but he is physically present at places I go to.

There’s nothing I can do. I one thing I refuse to do, is absent myself. No matter how someone chooses to be a bully, their aim is to remove you from their domain. Sometimes just existing in a time and place is a radical act.

 

So these are my confessions. I’m not proud that I can’t forgive, forget and move on from these horrible events. I’d be a better woman if I could. I’d love to hear from anyone who has found that peace.

 

What’s the difference between Ant McPartlin and a civilian? Rehab is not an option for most of us

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I was sorry to read today that TV presenter Ant MacPartlin was “going into rehab” after admitting a struggle with depression, alcohol misuse and addiction to prescription drugs. 

Although McPartlin is in no way my cup of TV tea, I understand that it must have been incredibly hard to have stayed at the top of his game for so many years in a business that delights binning those who have outlived their light entertainment shelf life. I’ve known enough people in the entertainment industry to know how hard they have to work to keep their heads above water.

I understand that McPartlin’s problems have partly arisen as a result of being left in chronic pain following knee surgery, and as a fellow pain sufferer I can see only too easily how this came about.

Dan Baldwin: Fragile - Private View

I suffered a herniated disc back in 2012, as a result of going running to try and control my bipolar disorder. The running was incredibly effective, but my spine was not in agreement andI ended up having to have surgery for a slipped disc. During this time I was placed on high-strength opiate painkillers, on top of my ordinary psychiatric medication, with the advice to “take them, whether you feel the need to or not” (this advice is based upon the reasonable assumption that if you wait until you are in pain, the muscles around the area will be in spasm and the pain will be worse, whereas if you take the painkillers regularly you are less likely to restrict your movement and cause further problems).

Great, I thought. No problem, I thought. 60mg of codeine per dose was easily enough to convince me of the doctor’s wisdom. After the first dose, in fact, I believed I’d never have any problems again. It wasn’t enough to completely kill my agonising pain, but it was certainly enough to help me not care that I was now bedridden.

I had my op. Post-operatively I was prescribed Tramadol on top of the co-codamol and three other painkillers I was taking. I used one of those old lady pill organisers to ensure I was taking my medication correctly and found I couldn’t shut the lid, so great was the number of tablets inside. I didn’t care. I found I didn’t care about much, until I realised it was a year later, I was two stone heavier and I hadn’t left the house for eighteen months.

By this point, I was a long, long way away from being able to enjoy any of the therapeutic effects of exercise on my mental health. I was terribly depressed. The codeine no longer had the same joyous effect, and so I’d drink to try and replicate the blissful state of blotto. When that didn’t work, I’d take extra co-codamol. I remember phoning NHS Direct (now 111) because I couldn’t breathe, and them advising me to sleep propped up on pillows. They didn’t ask the right questions to discover what I know now, which is that my breathing was suppressed as a result of overdosing on co-codamol and alcohol.

This unhappy state of affairs culminated with me being awoken from a drugged sleep one night by the police banging down the door. I’d told my friend online that I’d taken (as had become my custom every evening) about 20 co-codamol, as well as alcohol. Oh and I’d sliced up my arms for good measure.

I don’t know what Ant’s rock bottom was, but I’d hit mine.

But if there are parallels between our stories up to now, this is where they diverge.

Because the thing is, there is no “rehab” for those of us reliant upon the NHS. I spent a few days on a general NHS ward whilst the drip treated my damaged liver. I went on to spend the next six months being buffeted between home (where I could not cope), psychiatric hospital, where they kept on trying to discharge me because, although i was actively suicidal, I wasn’t mentally ill enough, and various short stay ‘crisis’ houses, which had very strict time limits of a week or so. There was no rehabilitation facility for someone who had become addicted to prescription drugs because they were prescribed those drugs by their GP. It was a matter of going home and sitting it out; or more realistically, going home and taking regular overdoses and being buffeted in and out of crisis care, which amounts to one visit every couple of days to check that the knives are hidden. Not “rehab” by a long chalk.

The Telegraph reported McPartlin to have said about his difficulties:

“I’ve spoken out because I think it’s important that people ask for help if they’re going through a rough time and get the proper treatment to help their recovery.”

I’m really pleased McPartlin has spoken out, but let’s be realistic about what this “proper treatment” amounts to for those of us not wealthy enough to afford The Priory. The NHS does not have these mythical rehab facilities. If we feel sorry for McPartlin, we should extend this pity to the average service user who is struggling through these problems alone.

 

This is how it feels.

Are you one of those folk who ‘don’t really understand’ mental health problems? Pull up a chair, my friend.

IMG_5762I am terribly, terribly sad and nothing is making it go away. I know people say that they can’t really understand what mental health problems are like if they haven’t had them – well please allow me to illustrate my example.

A few years ago, I lost my mum to lung cancer. We were close and I very much looked up to her. I thought her death would be the very worst thing that could ever happen to me, and it was pretty horrific.

The way I feel now is worse. With no reason. No bereavement counselling, no reassurance that I will work through ‘stages’ to recovery, no concerned relatives and certainly no fucking flowers. Just a terrifying feeling of darkness, worthlessness of myself and everything around me.

My mental health nurse has moved on to another job and I won’t get another, because the NHS has no money and they have to focus on the people actively taking overdoses rather than the ones fighting the urge. My Personality Disorder psychiatrist  sees so many chaotically ill people – emaciated, angry, covered in scars and cigarette burns – that he understandably says I’m ‘doing well’. I get where he’s coming from, but it’s cold comfort.

I’m so grateful to my friends for sticking around the bundle of definite un-fun that I am. My best mate tells me this will pass, and I have to listen to him. It’s all I have to hold on to.

Hospital Fun

My experience of being in the Royal Free hospital following an overdose.

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Theres not much fun about being in hospital, the exception being that this morning I got the see the Bristol Stool Chart in action.

Otherwise, it’s been a series of SNAFUs, FUBARs and other WWII based acronyms.

From my arrival at 6:45am A&E yesterday morning, my care has been nothing short of Bristol Stool.

Someone turned up at 8am and tried to introduce himself but wouldn’t be specific about why he was there. He was wearing a lanyard from another hospital so I assumed he was on a placement of some sort. He proceeded to sit at the entrance to my bay with his back to me all day. At no point did he mention I was on one-to-one observations (I was only aware of these happening on psychiatric wards) and when I was finally transferred to another ward I shook his hand to say goodbye only for him to say he was coming with me. He pulled up a chair within 50cms of the end of my bed, which felt like an uncomfortable invasion of my space.  I explained I was extremely tired (after a night of overdosing, like durr) and wanted to go to sleep, so would be pulling the curtain round.

No, I was not allowed to do that, he replied. I had to be visible to him at all times.

No way, I said disbelievingly. There was no was I going to sleep with a complete stranger peering over me, especially one I’d only exchanged three words with all day. And where were these “vital” one-to-one observations when he’d dallied off for his lunchbreak earlier on? (there was no replacement).

We continued in much the same vein for a few minutes with me closing the curtain, him opening the curtain, like a really crap game of hide and seek. Eventually I asked to speak to the Duty Psychiatrist. They sent me a Psychiatric Nurse. I asked again, could I see the Duty Psychiatrist. Eventually I got to speak to the duty team and explained that I thought it was completely reasonable to want some privacy from the rest of the ward to go to sleep. Appaz not folks, hospital is the place where you arrive depressed, beaten and exhausted, only to lie in a brightly lit room with a complete stranger staring at you. I believe the NHS could probably have a sideline in teaching the Chinese more elaborate forms of torture.

The Duty Psychiatrist never turned up with what I’d asked for, which was written justification for my denial of right to privacy and a copy of the “hospital policy” where this information was iterated. Instead I found that my carer had changed shift and I got to close my curtain. Result! Victory had been brought about not by application of common sense or our of respect for me as a patient, but by complete inertia on the part of one bank nurse handing over to another and not bothering to let them know I was meant to be on permanent observations.

It would have been a victory, except new Registered Mental Health Nurse didn’t know how to work my drip machine, so I when unplugged it to go to the loo (as I’d been shown to do) and it kept bleeping , she told me it was my fault for a) not holding my arm straight; b) moving and c) not pressing the override button (I did say I’d been told – quite sensibly I thought – not to touch the buttons) but this was the sage advice of the trained professional.

The not-sage outcome was that actually the machine wasn’t drip feeding me, and I’d spent two hours without my medication. Way to go CANDI, you’re really maintaining that reputation for excellence and quality of care!

Things I learned today:

Don’t expect to be treated with respect as a mental health patient;

Don’t expect to be provided with written hospital policies informing you of your rights upon request;

Don’t expect your medication to be administered correctly.

Sadly, my experience went from bad to worse, but thats a tale for another day.

 

 

 

 

 

 

 

 

 

24 Hours in Hell

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I hardly even know where to start on what happened over the last 24 hours. After voluntarily admitting myself to a psychiatric ward at Highgate Hospital, I soon realised it was a frightening and unsafe place, with half-naked people screaming, spitting and shouting throughout the whole ward, and staff doing little too stop them. I’ve been on psychiatric wards before I moved to Camden – and yes, there are some extremely ill people in such places – but this was chaos.

I’d arrived at 6pm. I realise there are resourcing issues in the NHS and I realise this was the day of the junior doctors’ strike, but as it happens this ward did not appear understaffed – when I arrived on the ward it had a ratio of 1 staff to 2 patients. What was obvious was a culture of contempt within the staff team for the service and for the patients, with one staff member standing around bragging about how she “couldn’t wait to get out of here in six months” Only one member of staff introduced himself to me. No other staff member smiled at me or said hello. No one told me about meal times, medication rounds (in fact my medication was missed once – the staff seemingly forgot about me – and the other two occasions I had to chase nurses round the ward telling them I needed my meds – there seemed to be no system in place for dispensing meds at regular intervals), no one told me who staff were, I had my valuables removed with no receipt and was told I could not have them back, no one mentioned the role of care plans/keyworkers, who would be my assigned worker for the shift, where I could get a cup of tea, where the fire exits were…it was terrifyingly shambolic. I phoned my boyfriend in distress and he could hardly hear me over the cacophony of noise outside my bedroom.

I was especially afraid that I would not be able to sleep, as the ward had no sense of day or night. On previous wards I’d been on, evening staff had a routine to create a calming atmosphere by dimming the lights, speaking more quietly, and even offering patients a milky drink. On this ward the staff walked around the bedroom corridors shouting to each other with no regard for patients who might be sleeping. The lights were glaringly bright and even though you could switch off your bedroom light, every half hour staff would remotely switch on a light in your room to check on you through the observation window.

At 10pm, unable to deal with the noise and threatening atmosphere, and convinced that being here would not help me get better, I asked for my belongings and tried to leave. The person on the desk, who wore no ID – so I have no idea of their position, be it nurse or support worker – told me I couldn’t leave until I’d seen the doctor. I asked them if, (not having yet seen the doctor) I had been formally admitted to the ward. If I hadn’t, then I wished to leave.

I was not given a clear response. I was told “you need to be seen by the doctor” but when I asked again if I had been admitted (as since I’d been on the ward I’d had no medical, been given no information and in fact nothing except a thorough search of my belongings and the removal of my phone and laptop charger, medication and anything sharp); the official simply repeated, you have been admitted because you are here.

I stood and “queued” at the nurses station for two hours until the doctor finally appeared. During this time I experienced patients climbing on the nurses’ station, spitting in boxes behind the station, constant screaming and shouting and staff doing little to manage, calm or soothe distressed or angry patients.

At midnight I finally saw the doctor with another ward official, who I had asked to be present as a witness. I sat down and  again asked if I had been admitted as a patient to the ward. She replied “that’s what we’re doing now” so I said “well in that case, I don’t want to be admitted and would like to leave, please.” I explained that although I was very depressed and anxious the atmosphere on the ward was in no way therapeutic and was exacerbating my symptoms.

The doctor was adamant that I could not leave until she had spoken to me. I asked her several times for written information about my rights as a voluntary (“informal”) patient but she refused to give me them “until she’d finished admitting me”, despite me repeatedly saying that I wanted information on my rights before we continued with the process.

At 2.30 am, after the doctor had finished her paperwork she presented me with a factsheet on informal admissions. The first paragraph read “The patient must give informed consent to their admission. They must be informed of the restrictions that will be placed upon them BEFORE they are transported to the hospital ward”. This was my first sight of this information.

I told the doctor I hadn’t given informed consent and that I believed they were unlawfully detaining me. She responded by telling me that there was no way they would release me because it was the middle of the night (despite the fact I’d been trying to leave since 10pm, and my boyfriend, who I’d phoned in distress and asked to come and help me, was waiting outside in a cab). I had a “choice” of remaining as a voluntary patient or she would place me under a section of the mental health act compelling me to stay against my wishes. This section 5(2) of the Mental Health Act allows the hospital to detain you for up to 72 hours, and carries no right of appeal.

I realised I had no choice but to remain “voluntarily”  but asked for it to be noted that I’d made the decision to stay under duress and headed back to my room. There was a patient asleep on the floor in front of the fire exit, and outside my bedroom, two patients were having a party, playing music and singing at the tops of their voices. When I said to the ward nurse “it’s 2.45am, how am I supposed to sleep?” he responded that “he’d ask them to turn it down” but couldn’t do any more than that.

The whole place was threatening and frightening and it was unbelievable to me that they’d place someone whose main presentation is anxiety into such a place.

At 9am the next morning I phone the Borough’s Mental Health legal manager, who is responsible for the Deprivation of Liberty Safeguards which relates to the section of the Human Rights Act that says you have the right not to be unlawfully detained. He informed me that by being threatened with a Section I’d been coerced into staying and that in fact the nurses had no authority to prevent me leaving when I’d originally asked at 10pm.

He phoned and spoke to the consultant who, although she advised me to stay in hospital, judged that I was not “sectionable” and was therefore free to leave.

The whole experience was terrifying and traumatic, and should never have been allowed to happen. Everyone I dealt with that night had a shocking lack of knowledge of, or regard for, patient’s basic human rights.

 

 

 

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Lament of the lone (female) drinker

I’m sitting, for the millionth time in a thousand years, in the afternoon, in a pub, on my own.

I’m almost certain I’m the only woman who drinks on her own in pubs at any time of day, let alone before the sun’s over the yardarm, but my personal disregard for both male privilege and convention has meant that I’ve never really cared about breaching this particular social norm.

The thing that gets me is the looks. Not from other groups, because they’re there with their mates and aren’t really that arsed about what other people are up to. No, it’s the looks from the hardened bar-sitters that gets me. Their features thickened with drink, and their age, outfit and demeanour always entirely inappropriate to the pubs’ aspirational “edgy” hipster vibe. They come in because they’ve always come in, and no amount of scotched eggs and slate plates is going to dislodge them.

They sit at the bar so they can drink alone and keep up the pretence of sociability by chatting to the barmaid or (less enthusiastically) barman.

Me tipping up and opting to get pissed alone in the corner whilst catching up with Facebook, is undoubtedly daunting to this dying breed. Except I don’t think they’re a breed that will ever die. While ever alcohol exists, you’ll find the hardened drinkers, escaping from reality on a fluffy pillow of lager.

And maybe one of these days, one of the hardened bar-sitters will be me.

Mental Health Activist Angst

As a mental health service user I’m really passionate about having a say in how my services are run. This isn’t entirely altruistic; I’ve been on the receiving end of enough piss-poor services when I’ve been ill that I have a vested interest in improving them, not just in the hope that others won’t have to bear the burden of dreadful care provision, but in the hope that things will be better next time I embark on the inevitable descent down the rabbit hole of insanity.

I’ve been part of an amazing project that has really made a difference to how staff on psychiatric wards treat (and think about) patients. It was a shining star of good practice where senior medics, NHS execs and service users all worked together with a shared aim of changing a poor organisational culture.

Unfortunately that jewel shone bright in what has otherwise been something of a dunghill of well-meaning but inept professionals with a professed “clarity of vision” but little clue about how to put it into practice for Joe and Joanne Bloggs.

Read on for insights into this glorious world…