Email sent 8.9.15
Hi [local MP name]
We've corresponded before on local mental health matters and was wondering you are attending any local meetings where someone will perhaps listen. I need to share the dismay I have with Leics Partnership Trust for changing, yet again, the way in which they support outpatients during out of hours times. If I remember rightly, the Trust received criticism from the CQC for not providing 24 hour phone support (especially when other services are closed). Briefly, there was an improvement (maybe this was only a transitional period) whereby if a patient phoned the local community health team, during out of hours, they would be automatically transferred to a member of the crisis team, who was available to talk to for support and advice in an informed context. The advantage of talking to a CPN or a Crisis Team member (Acute Care Home Treatment Team?) is that they may have access to the outpatient's file, as held by the CMHT. Previously, as is the case now, the Crisis Team would not speak to anyone "not open" to them (regardless if you were an outpatient of a CMHT or not). We have now been told that when a problem occurs out of hours, to ring the Richmond Fellowship's phone line (a non-NHS vol. sector service provider for MH support in the region). The phone line closes at 1.30am. Also we were told that the Crisis Team were no longer taking calls from people who weren't already open to them. http://www.richmondfellowship.org.uk/leicestershire/leicestershire-crisis-services/
My partner J [-] (for whom I am an unofficial carer), who lives in [town name], has been out of hospital for 7 weeks, after a long six month stay at the Bradgate Mental Health Unit. We would both prefer that she remained out of hospital and in the community, if possible. This seems to be what everybody we talk to wants as well. The Crisis Team had signed her off after the first two weeks of her being back at home, despite her intermittent to constant suicidal thoughts. J was recently in crisis around 3am on a Saturday night and it was the Samaritans helpline which recommended that she dialled 999 for an ambulance for a welfare check (sometimes Samaritans will make the call themselves for reasons of safety/safeguarding). When the ambulance arrived, the paramedics wanted her to be taken to A&E at the Leicester Royal Infirmary where she can be seen by a mental health professional (Triage ?/ Crisis Team). My partner agreed to go with them. After being processed by A&E she then waited in EDU a further 3 hours for a MH professional to see her. This is not uncommon as I have sat there many times with her in the same situation (we have waited longer in the past). A&E is a very distressing place to be, and I have my doubts as to the safety of the LRI for a MH sufferer, as we have even walked out after many hours of not being seen. I don't understand that with so many mental health professionals in the county that no-one can talk to her on the phone, with her file, without an ambulance having to be redirected from other emergencies. I'm frustrated and sick of this situation. People in a mental health crisis should not be going to A&E in the middle of the night, and often in our case, left waiting well into the hours of the following morning before receiving a cursory chat and being sent home. Last Saturday this is what happened, and MH professional did not even offer phone support with the Crisis Team. Curiously, the MHP pointed out that if J lived in Leicester that she would be able to go to a drop-in that was open 24 hours day and speak to someone face-to-face for support, but since Jo lives in the county this services isn't available to her. Why are the types, or even, standards, of services different for county and city?
Her CPN is on leave this week, and at best she is lucky if she sees him twice a month. We are also waiting on Adult Social Care for a care assessment, a process which could have been started whilst she was still at the Bradgate Unit. Her discharge meeting didn't have anyone from the local mental health team present and yet again, J doesn't even know the name of her psychiatrist because it is a temporary doctor / locum. I think this situation with different psychiatrists has been going on for as long as I remember now (at least five years?) Why are the Trust unable to keep a doctor in that post?
The main point of my email was that a few months ago I was relieved that the LPT were finally providing 24hr phone support and that is no longer the case, so much so, that if my partner wants to see a professional who has access to her notes she is being advised to call ambulances and, or, police; and suffer long waits in an A&E with screaming drunks and critically injured people, 20 miles away from home, when she is feeling at her most vulnerable. She is trying to stay alive and "do the right thing", but I feel that the whole process is doubly alienating. Why would anyone who normally feels guilty for asking for help allow themselves to be put through this process? Is MH crisis support based on disincentives? Is even the long waiting in EDU a deliberate part of the process as well?
After a half a year of day-to-day care problems in wards at the Bradgate Unit (run by the LPT) I am at the end of my tether, and see little mileage in writing to any staff at the LPT, since I genuinely believe that they are not interested, or their complaints procedure cannot cope with anything that is not a "specific incident" involving named staff. If something is the norm, they don't see a problem at all.
If you can feed even the smallest part of this back into any local meetings or reviews in Parliament of services we would be grateful.
My main concern at the moment is that LPT are not providing a 24 hr support service, or even a 24 hr phone line (without the need for emergency services), and are unable to attend to a person in crisis in a timely manner which shows that they have no concern for the patient outside of an exercise in bed counting; My second worry, which may effect people nationally, is that A&E triage should not be a single point of access for MH problems, since the environment itself is not appropriate due to the emotional trauma it causes in itself and that it is not even secure for people who may or may not have control over their own actions or their own safety (regardless of it being defined as a "place of safety").
Thank you so much for your work on mental health, help for carers, so far, and for raising awareness of these issues in parliament.
Regards
[name]
[address, email etc.]
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