Article regarding Bradgate Unit featuring J and myself Leicester Mercury 27/09/14

Article in Leicester Mercury on Saturday regarding the Bradgate Mental Health Unit and our experiences as carer and patient. 27th September 2014. (Yet to appear on the website, so please forgive the photos - click for larger views).
Incidentally to left is a photograph of me looking sad with the caption “ ‘It’s not making her better’ William Meddis, 42, who is concerned about the treatment his girlfriend is receiving at the Bradgate Unit.”
The More supplement in the Leicester Mercury is centred on “human interest” stories. J is very slightly fictionalized here, some generalizations have been rewritten as specific situations and so forth, but it communicates that sense of frustration we’ve had with the Leicestershire Partnership NHS Trust who run the Bradgate Unit. There’s some stats about deaths in there as well. I’m not sure I remember an agency nurse telling Jo to “pull herself together”, but it’s definitely the sort of thing I’d say about the attitude of some professionals we’ve met. It feels good that issues like incorrect medication upon admission were cited, because the head of the Trust has had to respond specifically to that, and she mentions the new pharmacy facility as an improvement (see earlier post where I had to go into the new pharmacy because of their failure to deliver to the ward and then getting stuck there whilst they corrected the prescription, incorrectly). 
Interestingly, the Head of the Trust also says that they would be happy to meet with me. This is funny because letters sent to specific staff seemed to be responded to by Customer Service so far. Also, when someone says that they want to meet you in person it suggests that you went to the papers first, which is not the case.

You can read in this blog the two detailed letters of complaint I’d already sent to the Trust.
My complaint resolution deadline has been extended by Customer Services until mid October. So much for, “we will respond within 25 days”. Hopefully this is a good thing or maybe it just means that some staff are on holiday. ;)

Edit: just reading the article again ... I have to say that when J is in crisis that I am a fan of "containment" or even sectioning because it can be the only way legally that she can stopped from destroying herself, but the Bradgate Unit in many situations even fails to do that. 

Pharmacy at BMHU. J returns home.

Just when we thought we were ready to bring J home from hospital the pharmacy forgot to deliver the discharge prescription to the ward (they have /one/ job), ;) so I walked over to what must be one of the most temporary and ugliest new buildings in the world. In reception it has a shiny plaque like in all hospital buildings, as if very proud of itself. It almost goes without saying that even when I picked up the prescription that there were three missing items. Some phone calls later, I left with only a partial solution. We’re so tired of having to get a doctor to reconfirm something because a pharmacist’s computer is saying “no” or a junior doctor has filled in a form wrongly. At least we ordered our own taxi, relying on hospital transport is yet another exercise in randomness (even been in the local news because of this, love this county). J is now reinstalled back at home, back in the charge of the local community mental health team, who we may be attending a meeting with this week. Mustn’t grumble, we’re lucky to have access to these people, but quite frankly I’m beginning to believe that these organizations are /not/ better than nothing, because at least with nothing you’re not tortured by the hope of useful support, or just something being straightforward. Another in/outpatient on J’s ward was also having trouble getting meds from the pharmacy today, and when one problem was solved the nurse seemed to think that this would completely absolve the hospital of the 5 hour wait this patient had (in comparison to this I think we were lucky). Then their transport was cancelled. Triggers. Anyhow, J and Lucy cat are very happy to be reunited with each other in the comfort of J’s house and her many books. :)
One day at a time.
(Thanks for reading)

Announcement that J is coming home

From own Instagram http://instagram.com/p/tRPXjqM6zF/ (text edited) pertaining to a couple of days ago.

Top right: yesterday sitting in reception at the MH unit waiting for patients’ mealtime to end, with gadgets and a bag of clothes. News: J comes home tomorrow(!). She’s sounding really positive and is desperately missing her home and Lucy-cat. I just wish they had planned for more support for her, but it doesn’t look like it. She’s less frantic, but to be honest I think this ward stay was a missed opportunity. (Still pretty angry about lots of things like this and realize that I have to eventually move on and move forward) We might be in the newspaper sometime soon, talking about difficulties in accessing care when in crisis - It didn’t appear in last week’s newspaper, hopefully it’ll be in on Saturday. Anyhow, madly rushing around, tidying up, washing, hoovering, converting J’s place back into her “home” and not to temporary man-cave-pit I create when she’s away. ;) She calls me the “Filth Wizard” which is fair enough (her OCD aside, I do tend create nests and piles of possessions, and leave washing-up until the last possible minute etc.) ;) Anyhow, busy but positive. Eating a lot of bananas. #penpal #mentalhealth #dungeonsanddragons #cat

Dr Arun Singhal suspended for telling patient to kill herself -BBC News Liverpool

BBC News Liverpool 18 Sept 2014

Dr Arun Singhal suspended for telling patient to kill herself

A doctor who told a patient who was threatening to kill herself to "go and jolly well do it now" has been suspended for three months.

http://m.bbc.co.uk/news/uk-england-merseyside-29254609

Seclusion Rooms, Blankets and Gowns at the Bradgate Mental Health Unit

From Tumblr blog 18th September 2014

Anonymous query:

do patients at bmhu have to wear gowns or are you allowed own clothes? do you have any pics from inside????

J answers (correcting my own response)

Hi, I’m J. Just read this. The seclusion room is very much like a police cell, nothing in it at all except a plastic wipe-clean mattress, no window apart from the tiny one in the door the staff stare at you through, and a seclusion blanket. This is a navy blue, very tough and hardwearing and sort of quilt-stitched with orange thread blanket. It is very stiff and not very warm. When you get put in seclusion, you are forced into the room by a team of maybe up to 6 nurses who control and restrain you until you are in the room and you can’t escape - there is a seclusion room on each ward. The seclusion gown is made up of the exact same material as the blanket. It is tough, stiff and hardwearing, certainly not comfortable in any way. It is floor-length, and sleeveless. It is fastened by Velcro, down the front. You are not allowed to wear anything else - not even underwear, they strip you totally naked before they force you to put the gown on. Then, when in the gown, they give you a cardboard egg-cupped-like box/tray to use as a toilet, and a couple of pieces of paper towel to ‘wipe’ with. Then the heavy door is locked, and the staff look through a tiny high-up window at you every five minutes. You can be kept in there for as long as they decide you need to be - anything from an hour to a day, is possible.

You must talk to us. Yes, we have no pills.

Visited partner at the mental health unit today. Mood low, but she was less frantic than on other days, just exhausted, a little scared and depressed.
She is often told by nurses to talk about her feelings and to ask for help.
Just been on the phone to her tonight (after 10pm). Earlier she had been crying. She goes with a nurse to her room to talk “one to one”. She says she wants to kill herself, so the nurse decides immediately to start taking things from her for her safety and suggests that she should be put on a seclusion gown. J then had to say that she wasn’t suicidal and that she was busy and asked the nurse to leave her room. The nurse respects her wishes and leaves. The sad thing about all this is that J is now having to pretend that she is okay because she’s frightened of an overreaction based on risk. I’ve just rung the nurses office and the nurse is denying mentioning the gown, but she did acknowledge wanting to tackle risk before talking further to J. I can, in part, understand how this has occurred (sometimes when in crisis J only hears the extreme statements), but at the same time you wonder how a dialogue is possible once a patient is frightened of losing possessions and dignity. I hoping that she gets to talk with her “named nurse” (the nurse who’s name is on the patient notes) because we trust him.
This has literally just happened. I’m hoping it doesn’t escalate into anything.
Damn. Silly place. Poorly J.

Edit: Not much came of waiting to talk to the right nurse, who was dispensing meds and certainly not willingly take sides in any patient testimonies about colleagues, and so actually talking about how she felt was pretty much a no-go with the reliable-but-busy-male-nurse.
Other fails today: They ran out of antibiotic pills for J’s festering legs, another pill was missing from her medication, and the pharmacy in this hospital have cut off her Zopiclone because that’s what happens after two weeks, regardless of what doctors write, this has all happened before. All hail the computerized dispensing system. Also, a special cream which was recommended by a tissue viability nurse a week ago has yet to appear, despite reminders. Notes were not made, emails haven’t been checked. Some of these things can be temporarily fixed by a junior doctor the following day, maybe if J’s lucky there will be a ward round soon, where they actually let her sit in. Day to day care can be very hit and miss on these particular wards. J is also not really at liberty to leave the ward and go looking for the absent staff with real authority. The powerlessness and hopelessness is tangible.
These things individually would be enough to wind up a well person. I think she is being remarkably restrained, all things considered. 

Return To Sender

I received a letter today from J's CPN (Community Psychiatric Nurse). He was returning the copy of the complaints letter about the Liaison & Diversion Team which was for his information and to be added to J's file. It's seems that the confidential process regarding complaints against colleagues (? not even in the same building) means he is unable to handle the letter in any way. I might post the actual exchange between us here at a later date but it's a bit long winded. However, I described his attitude as absurd and told him to black out the names or hand it to a colleague if that was the problem, as we want other professionals who read her file to see experiences from her perspective and this may help in safeguarding her in future. I sent the letters back again asking him to add them to her file and that since he was our only consistent contact in the CMHT (Community Mental Health Team) that all future correspondence will be going to him. She has yet to see her new consultant for her community care, Dr K. Inherited notes and nonsense prevail. 

Something stinks. 

For the moment I'm trying incorporate the CPN into part of the solution, not the problem. If he doesn't want to cooperate with J or myself then he should find us a new CPN. (If you sack a CPN, they just shrug and you go without a CPN for months, if you get a new one at all) We could decide that some mistakes have been made because of what he writes and says to other professionals about J. Although I haven't actually complained about him yet, he has let her walk out of his office after she has explained that she needed to kill herself. It's only by chance that I met her at the door to building, if I hadn't she'd happily be on a bus to the motorway. In fact, on that day, I had the pleasure of overhearing a policeman tell him off over the phone (whilst J was struggling in the back of a police car) something along the lines of "I know it's in our ... [domain?], we're dealing with it now" and basically stuff about how "yet again" the CMHT had let someone go and now the police had to "clear up the mess". Along those lines. It was nice to have a bit of validation for a change, and see someone else being indignant.

I know there's all sorts of issues here, but why is safeguarding such a problem for these guys? Why is listening to our views in anything other than a 15 minute minute such a problem?

I'm starting to sympathize with anarchists. My passive aggressive fair-but-firm letter writing will only get me so far. Do we need to move counties? We've definitely had it better than this. 

Visiting Hours Random Thoughts

Got a bit frustrated today at always being ushered into this well kept but pokey dining area, after being made to wait at every intercommed door. The room is too warm. There’s window but it’s jammed in one position - there’s no draft. The coffee machine, just off the ward, was bust, but we didn’t have change. Patient’s kitchen is off limits and the toilets are four corridors and three locked doors away. I get a taxi to the unit (mainly paid from J’s savings) because I’ve given up on the ridiculous routes taken by public transport to get to this stupendously badly located hospital. Heat makes me sleepy and grouchy, not the best company for J. Staff are treating her like badly behaved child, she is going along with it. Her legs still look pretty bad, but apparently they are healing (swelling plus eczema plus impetigo). This is one of the better wards. I’m not convinced that staff even talk to her enough. Mental Health care, my arse. She seemed in slightly better spirits today. Almost looking forward to next Saturday when there’s a chance that we’ll be in the local newspaper, mainly about poor access to decent services (I think). It’ll be yet another article to add to a damning pile. Eventually that pile has to get high enough for real and positive change.

Patient being a risk to the mental health professional?

J showed me a letter today from her CPN (Community Psychiatric Nurse - you’re lucky if you can get one these days). I think after the previous admission to hospital, advice was given to the Community Care Team that J would benefit from the occasional visit at home, due to the anxiety she experiences when trying to walk cross town. In fact her referral to an Occupational Therapist (who has since cancelled the assessment appointment) was partly based upon her agoraphobic-like symptoms. She gets so stressed that her legs and back give way and she falls to the floor. To avoid this she has to sit down every 20 metres or so. Naturally this effects her quality of life in a very big way.

In the letter the CPN states that he will not be visiting her at home. The reason given is simply “risk” after “recent incidents”. No further explanation given. Risk to whom? The recent incidents might be her overdoses.

As far as I am concerned, this is a man who has allowed J to leave appointments at her most distressed whilst being a danger to herself (after we had hung on until the next meeting with the CPN, hoping that there would be a message of support, a coping strategy or the offer of extra help). As well as being a means of support for mental illness meetings with professionals can be emotionally triggering for outpatients. His own ability to safeguard and assess risk is in question.

The language used by professionals in the presence of J is utterly soul destroying. Her self esteem is rock bottom at the best of times, and she is talked at as though she is an irresponsible liability. Every time she comes into contact with a consultant or MH professional, she is accused (inferred, implied) of “dependency upon services”. All previous contact with services, therapy and ward stays are cited as though she has somehow manipulated the system. In my eyes she is blamed for not becoming well. Her illness, her OCD, her depression, her self harm and suicidal thoughts become packaged up as a personality disorder. The doors start to shut. Her anxieties about treatment, or lack of, are interpreted as her being disruptive and uncooperative. It’s like a prejudice. Even if she had the worst, most ugliest, hard to work with, aggressive, personality disorder it still wouldn’t warrant the way she is treated. I’m tempted to start citing the Disability Discrimination Act 1995/2005 for what good it would do. I might as well, since patient rights to quality of care mean fuck all in this country.

I hate them. I hate what they write about her, or what they glean from outdated notes. I hate what they think hey are trying to achieve whilst using “tough love” and guarded euphemisms. 

The sick thing is that she is literally one re-assessment or change of diagnosis away from being treated like a human being.

Report on Suicide in Primary Care in England 2001-2011 (March 2014)

I’m a day late for Suicide Prevention Awareness Day. I’m sure there’s a particularly dark joke in there somewhere. I’m always in two minds about awareness campaigns with mental health, since usually thats as far as most campaigns go. At least it seems that way. Perhaps real change only comes about through devastating scandals. I saw this link on Twitter I’ve only read the report in part so far.

Report on Suicide in Primary Care in England 2001-2011 (March 2014)

http://www.bbmh.manchester.ac.uk/cmhr/research/centreforsuicideprevention/nci/reports/SuicideinPrimaryCare2014.pdf

Glen Parva suicidal detainee 'not kept safe' (BBC Leic 11th Sep 2014)

BBC Local News: 

http://m.bbc.co.uk/news/uk-england-leicestershire-29148979
 http://m.bbc.co.uk/news/uk-england-leicestershire-29155788

"Steven Davison died in YOI Glen Parva, Leicestershire, where he was detained after threatening to stab himself. …" “Mr Davison had originally been arrested for possession of an offensive weapon after threatening to kill himself. His mother said: “When he was sentenced, he said in court he would kill himself. “The judge said he would have to go [to Glen Parva] because there were no mental health beds so he would have to go on suicide watch.”

—- “The suicide risk factors and potential triggers included: -His discharge from a psychiatric facility, prior to being imprisoned -Self-harming …” —

J, herself suicidal, at present a resident in a Leicestershire “psychiatric facility” brought these articles to my attention today.

This all sounds very tragic and preventable. Glen Parva YOI has a shocking record of at least 26 suicides that we know of since 1988. It doesn’t sound as if this man should have been there in the first place. One thing we may never hear about is the conditions of his discharge from a psychiatric facility (possibly in Leicestershire, possibly run by the Leics Partnership NHS Trust)

BBC News  9th September 2014

Chief medical officer: Make mental health bigger priority

http://m.bbc.co.uk/news/health-29116354

Visiting Hours Thoughts

billiambabble (via Tumblr):

Drawing desert tiles, whilst charging phone, in reception at the hospital before visiting J. An efficient use of spare time. ;)
An odd day. Felt like we were brokering a deal with the doctor in charge of her care. Pragmatism usually wins at the expense of optimism, and maybe at the expense of recovery. Hard to explain. Reluctant gaolers asking prisoner patients to be in control and choose to be free? Informal stays vs. MHA Section, are you safe from yourself? Take responsibility whilst we've taken everything away? If you don'™t get well then maybe you're not working at it hard enough? No therapy, just containment. Keep her safe. This isn't a paranoid rant about social control. This seems real. It feels like being at school in the headmaster'™s office. The questions all seem tortological. We've all been here before. It's like having to retake the worst classes with teachers you no longer have respect for (because they keep failing you). May have to write about it at a later date - with the actual details. Really trying to avoid making generalisations atm. Must keep mind open. People genuinely want what's best.
The worst hand at a game with the highest stakes.
No, it was a better day, some switches have been reset, things will move forward. Onwards and upwards! ;) Thanks for reading.
#visitinghours #Latergram #mentalhealthward #hospital #diagnosis #carer #patient

Family of hanged Nottingham pensioner say "system failed her" Nottingham Post 4 Sept 2014

Family of hanged Nottingham pensioner say "system failed her"

 Nottingham Post 4 Sept 2014

As I read this I became more and more angry at what the doctor says at the inquest. It certainly raises more questions regarding hospital accountability than it answers. Really shocking.

Visiting Hours

billiambabble:

From the other day. Although I approve of extra precautions, getting the visitors to wait in a small dining area, where they are then joined by the patient, it can at times, remind one of how prison visiting is portrayed on TV. Of course it’s nothing like that really. This modern MH ward is a big improvement on the others.

#visitinghours #mentalhealthward #nophotos

Got really pissed off with the stupid doors and intercom system today, misdirected frustration? J is pretty unwell, and there’s still the odd care issue, but like I said, this a much better ward than the others.

Source: billiambabble

Rise in self-harm incidents in Leicestershire's mental health wards | Leicester Mercury 3 Sept 2014

Rise in self-harm incidents in Leicestershire's mental health wards
Leicester Mercury, 3 September 2014

http://www.leicestermercury.co.uk/Rise-self-harm-incidents-Leicestershire-s-mental/story-22870617-detail/story.html

This article is mainly focussed on the Leicestershire Partnership NHS Foundation Trust (which includes the Bradgate Mental Health Unit)

From what I've seen as a visitor and heard anecdotally (locally) the approaches and responses to patient self harm vary from nurse to nurse and ward to ward.  Also I believe that with statistics like these that there is a confusion over actual suicide attempts, sudden acts of frustration and ritualistic, negative coping repeated self harm of a specific type.  This may depend upon how it reflects upon the staff on duty and whether or not they have properly risk assessed the patient and taken sensible, yet sensitive, precautions.  Sometimes having a room stripped of possessions or being put in a seclusion room will happen after a traumatic self harm event or suicide attempt and the patient will feel as though they are being punished by staff.  I am unaware of any specialist therapy or advice provided by LPT in the cases of self harm, apart from "talk to staff".  It's one thing to have policies about patient risk, to have rules about "collapsible ligature points" and so forth, but it's another to actually train staff in understanding some of very common acts of mental health sufferers.  Perhaps they do they train their nurses, but maybe some days the staff all come from an agency where the nurses barely understand what a mental health ward actually is. (Just surmising here)

Regarding Self harm and injury two good UK resourses are
LifeSIGNs   http://www.lifesigns.org.uk/
and
NSHN  http://www.nshn.co.uk/

See also:
Mind Charity - Info on S/H 
http://www.mind.org.uk/information-support/types-of-mental-health-problems/self-harm/
Suicide help from The Samaritans
http://www.samaritans.org/

Query: What is the Bradgate Mental Health Unit like inside?

What is the Bradgate Mental Health unit like inside? Is it modern? It doesn't appear to be very 'homely'. Most units are less 'clinical looking' but I've heard that BMHU is lots of different 'wards'? and that it looks just like a hospital inside, unlike other units? Is this true? Like are the beds hospital beds? Are there any single rooms? and apart from the bedrooms, what other rooms are available to patients to utilise? Thank you

Anonymous, Sept  2nd,  2014 (on Tumblr)

Hi, Sorry for the delay. I’ll try to put together some pictures taken over the last few years. Basically there’s older wards which have a mixture of single rooms and dormitories and then there’s some very new wards where patients get their own rooms with en-suite loos and shower. The newer wards have more small lounges for special activities, whereas the older wards have one dining area and lounge which doubles as a TV room through which can be accessed a kitchen for making hot drinks. The older wards have toilets and showers which are shared. Every now and then they redecorate the wards, but the older wards seem very institutional. The dorms aren’t like the bays with beds in normal hospital, it’s quite literally just a room with four beds in (no nurses’ station).
I’ll ask J if we can use her couple of her photos of her room on the newer ward, and we can compare them with the rather stark and functional environs in the odd picture I’ve been able to take. The main experience of a ward can often be down the the personalities of staff and patients. I’ll try to post some pics and diagrams sometime.

Today at the Bradgate Mental Health Unit

There's nothing more reassuring to wake up and to find that the organization which is caring for my partner's welfare was in the newspapers yet again for professional misconduct. However, in the greater scheme of absconding patients and deaths at the Bradgate Unit, a nurse flirting by text with a patient is hard for me to gauge without more information. Nonetheless, there's vulnerability, safeguarding and possible grooming issues, and just straight forward unprofessionalism.

The current ward J is on is a world away from Bosworth and Ashby Ward. It's one of the more newly built wards, and although I have no access as a visitor to the main ward or rooms, J has shown me photos, and the accommodation is of a better quality. She has a room with an en-suite loo and shower. This is a far cry from her sleeping in chairs because she was petrified of her bed in a shared dormitory.

She's still pretty unwell, but at least the ward itself, the staff, and the other patients seem to be less triggering. I won't go into to details but she is still managing to do things which shouldn't happen in a safe and secure environment, and she even managed to escape off the ward and run down a couple of corridors. The new secure doors and intercoms were out of order (possibly due to recent rain damage). It's very easy to see how this place can go from being secure to open, due to one electrical fault and staff not closing doors properly.

Mental health nurse Leigh Jennison struck off for sex messaging (BBC News Leicestershire)

Mental health nurse Leigh Jennison struck off for sex messaging

http://m.bbc.co.uk/news/uk-england-leicestershire-29012119
BBC News Leics.

The nurse in question was working for the Leicestershire Partnership NHS Trust and at the Bradgate Mental Health Unit (based on on article at the time of posting)