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Saturday, 8 October 2016
Saturday, 28 May 2016
Children "denied mental health support" (BBC News Health 28.5.16)
http://www.bbc.co.uk/news/education-36398247
Edit: Link to Children's Commissioner report:
http://www.childrenscommissioner.gov.uk/sites/default/files/publications/Children%27s%20Commissioner%27s%20Mental%20Health%20Lightning%20Review.pdf
Article text 11am 28th May 2016 -- BBC Health ---
Children 'denied mental health support'Thinkstock
A total of 28% of children referred for mental health support in England in 2015 were sent away without help, some after a suicide attempt, a report says.
The Children's Commissioner's review of mental health services also found that 13% with life-threatening conditions were not allowed specialist support.
This group included children who had attempted serious self-harm and those with psychosis and anorexia nervosa.
A government spokesman said no-one should be sent away in need.
The commissioner obtained data from 48 of England's 60 child and adolescent mental health service trusts.
One trust in north-west England said it focused resources on the most severe cases.
'Russian roulette'
There have been concerns in recent years about the patchy nature of services offered by child and adolescent mental health trusts (CAMHs), with many seemingly unable to cope with local demand.
And school teachers and heads in some areas have highlighted the growing mental health need amongst pupils which are having to be met within schools.
'Frightened the living daylights out of me'
Ellie Fogden, now 19, sought help when she was 16:
I did not become ill immediately at 16. For a number of years, I felt quite down, so to speak.
It was constant worrying, pressure from school, and my own body image.
I got to a point where I had had enough. I am waking up every day and I am not wanting to be here.
I self-referred to a local counselling service and I was on a waiting list for about three months and then started sessions. The counsellor was very worried and she referred me to CAMHs.
I had to go to the doctor to get a referral and it took about three to four weeks to get a session. I was in there for about three hours and I was just bombarded with so many questions. Some of them I didn't have the answer for because I didn't understand what was going on in my head.
I wasn't taken seriously enough. Some of the questions were dismissed as - it is not that bad, people have it worse. For me, it felt awful. There was no compassion which made it so much worse.
I didn't go back for another CAMHs appointment. It frightened the living daylights out of me. I finished counselling at this independent service. I wasn't great but wasn't as bad.
As I have grown older, it has just gone into a downward spiral where I am currently worse than I was when I was 16, with depression.
The review, by commissioner Anne Longfield, aimed to cast light on local weaknesses so provision can be improved, and more young people's needs be met.
She told BBC Radio 4's Today programme that over the past year, she had heard from a "constant stream of children, parents and professionals" about their inability to get help when they really need it.
They go to their GP who refers them to specialists, but the specialists then say their conditions are not serious enough, she said.
"There is a gap emerging between the help and support that GPs can offer and the specialist services," Ms Longfield added.
"I don't yet know quite why they are being turned away but certainly being turned away or put on a waiting list for up to six months is clearly playing Russian roulette with their health."
Missed appointments
The average waiting time for those accepted for support ranged from 14 days in a trust in north-west England to 200 days at one in the West Midlands.
More than a third of trusts, around 35%, said they would restrict access to services for children who missed appointments.
However, the report notes that children and young people are known to have difficulty in attending appointments for many reasons.
Ms Longfield said trusts have told her there was "too much demand" for their services.
"There is more awareness, more people coming forward for help," she said.
"But actually this is about recognising the terrible conditions children are in and looking at how their local systems can respond. Clearly in some parts of the country, they are doing the job much better than others".
Natasha Devon, formerly the government's mental health champion, said in order to identify problems in the early stages, it was necessary to look at the root causes.
"Anxiety, for example, is the fastest growing illness in under-21s, and we need to look at what's happening to young people - the culture and the society they live in, the pressures that are on them.
"Rather than medicalising what is actually just a response to what is happening to them, we need to look at the environment they are in."
'More compassionate'
James Morris, the Conservative MP who is chair of the all-party group on mental health, acknowledged that problems had been building up in the system over many years and a "fundamental transformation" was required.
"It is unacceptable that somebody who's suffering from a serious mental health problem should find themselves in a situation where they can't get access to care," he told the Today programme.
"We do need to move towards a more compassionate system for children and young people but the transformation is going to take time. It's going to require additional investment; it's going to require better commissioning on the ground."
An NHS England spokesman said: "While the data in this report does not substantiate the conclusions drawn, it is clearly the case that CAMHs services need to expand and the additional £1.4bn pledged will help us to do that."
A Department for Health spokesman said: "This investment is just beginning and is creating new joined up plans to improve care in the community and schools to make sure young people get support before they reach a crisis point."
Friday, 27 May 2016
Local bed made available :)
Yesterday afternoon we got a call and by evening J was admitted to one of the local wards. Despite my reservations about this particular unit, after the possibility of being sent too far from home, it feels like she’s landed on her feet. Some of the local wards have really old dorms and shared facilities, but in this ward she gets her own room with ensuite shower/loo, which helps her OCD and anxiety in general. I was pretty surprised when she arrived, they were already talking about care plans (and even wanted my input!). Naturally there’s the odd hiccup when it comes to acquiring the right medications, but hopefully this stay will have a less bumpy start than others have.
Phew.
Thursday, 26 May 2016
No beds in whole of country (J's care update)
Several days in and we're still waiting for an acute care bed in hospital for J (mental health related) ... there are apparently "no beds" in the whole of the country, and a queue of outpatients in front of her. 7+ hours wait in Urgent Care (A&E, EDU at LRI) on Friday night just to see the right professional (Crisis Team) after the CPN couldn't get through on the phone to make a referral in the day. This is when you are already "in the system".
(Leics. UK)
(I'm behind on synching this blog with Tumblr - please check my Tumblr and Twitter accounts for recent updates, MH news and links etc.)
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Saturday, 26 March 2016
Updates on Tumblr and Twitter
This is just a quick reminder to anyone glancing over this blog that sometimes I post a little faster to Tumblr and then mirror the better posts on here (Blogger) when I get to a PC. This is partly because the apps I use for Blogger on the iPad are just atrocious when in comes to editing or pasting content. I have less problems with Tumblr (which in turn can be convolted in a PC web browser).
http://failingmentalhealthservices.tumblr.com
Sometimes I growl on Twitter as well.
https://twitter.com/FailingMHblog
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Thanks for reading.
http://failingmentalhealthservices.tumblr.com
Sometimes I growl on Twitter as well.
https://twitter.com/FailingMHblog
( @FailingMHblog )
Thanks for reading.
Sunday, 6 March 2016
Teen who thinks he is in prison can leave psych unit (BBC 6.3.16)
Teen who thinks he is in prison can leave psych unit
BBC Health 6.3.16
http://www.bbc.co.uk/news/uk-england-london-35739304
-----Text follows in case BBC re-edits story ----
Matthew Garnett: Teen who thinks he's in prison can leave psych unit
PAA 15-year-old with autism who believes he is being held in prison after being sectioned is to be moved to a treatment unit, following a campaign.
Matthew Garnett was removed from his home in south London in September after attacking his father.
He was placed in a unit normally used for short-term emergency admissions, resulting in his family campaigning for him to be moved.
NHS England said he would be moved within weeks.
'Six-month jail sentence'
It said Matthew would be transferred from the psychiatric ward in Woking, Surrey, to St Andrew's Healthcare in Northampton, which specialises in treating patients with autism.
Writing on petition website Change.org, his mother Isabelle Garnett said: "For the last six months he has been denied this, trapped, alone, in a place unequipped to look after him."
"What I was promised would be a six-week pit stop has become a six-month jail sentence," she continued.
PAHis move has been held up by other patients awaiting transfers out of the facility, although to date more than 150,000 people have signed the family's petition calling for Matthew to be taken off the psychiatric ward.
His father Robin Garnett said he now wanted to see words become actions.
No admission date
Matthew "thinks he's in prison and is being punished for attacking us," he said.
His son has learning difficulties, attention deficit hyperactivity disorder (ADHD) and "like a toddler" is unable to control his emotions, Mr Garnett added.
A spokesman for NHS England said: "We have every sympathy for Matthew and his family and we understand that this has been a very difficult time.
"It has been confirmed that Matthew will be moved to St Andrew's, where he will be able to receive the specialist care that he needs. We anticipate this will happen in a matter of weeks but cannot confirm an admission date at this point."
Thursday, 11 February 2016
Mental health beds search 'a scandal' BBC
Mental health beds search 'a scandal' BBC
11.2.16
http://www.bbc.co.uk/news/health-35521180
We live in the East Midlands and J was offered a bed in Essex, and she was told that seven other outpatients were queued to be admitted to the Leics unit. After a days wait she gained access to the Leics unit.
11.2.16
http://www.bbc.co.uk/news/health-35521180
We live in the East Midlands and J was offered a bed in Essex, and she was told that seven other outpatients were queued to be admitted to the Leics unit. After a days wait she gained access to the Leics unit.
J’s care update - Leics County Crisis Team refusing to assist
I think it was on Tuesday, but I'm getting confused about the days. Today is Thursday. On Tuesday, J asked the ward consultant if she could discharge herself and come home (to be with her shelves of books and Lucy-cat). She was an voluntary-informal patient. The consultant agreed to her leaving on the grounds that she would accept support from the Crisis Team (Acute Care, Home Treatment, Recovery Team, or something which doesn't actually have the word "crisis" in it, but absolutely everyone, including themselves, still call them the “Crisis Team”). We wait most of the day on the ward for the Early Discharge / Crisis Team to arrive (after several phone calls from nursing staff, possibly to a building next door). As always, they did not have the best people skills, as always, only one talked. They certainly didn't like me in the room prompting J (I pushed back a bit this time). They weren't happy with the fact that J had recently ligatured and that her meds had been put up suddenly. J wanted to come home partly because day-to-day care needs were not being addressed (phobias, OCD, leg ulcers, diet, sleep). The Crisis Team told us that they wouldn't be providing support because J was too much of a risk. We were stoic and reflected upon accommodating for the randomness of the Crisis Team’s appointments and logistics in the past (i.e. they turn up when they want, they can’t find J’s address and on at least two occasions just give up). I don’t think they liked that either. I think that they may have been trying to force the hand of the ward. Whilst I sympathise with the Crisis Team’s position, and am pretty worried about her safety at home, this doesn't help J, who has had the blessings of the ward consultant to lead her own care and return home. I too would have preferred J to stay in longer so that they could monitor the meds change, but I also welcome being in the same town as her and not having to ferry supplies, fix mobile phones, cat-sit without an end-date. A nurse told us that the team had then told them that J had “declined” their help. Which was simply not the case at all. Apparently phone calls were being made and arguments had. The opinion here was that they couldn't be bothered with the paperwork and had already decided to reject J’s referral before talking to J in person. End result: we pick up meds and get a taxi home and J’s CPN is expected to fill in any gaps. What I like about this scenario is that the Crisis Team managed to irritate everyone and lie to other professionals in a way which surpassed expectation. Astonishing.
J is saying that the strength of the voice has lessened with the use of a new anti-psychotic. Already her PA has started working with her again, and we've seen her GP. Naturally there’s a few issues about who’s in charge of prescribing the new meds (deferred to local CMHT shrink, not GP), but J was so desperate to leave hospital that we’re seeing this as a minor complication. I'm pretty baffled about the whole situation. Whilst she was at the unit she never even saw a care plan.
Is she better than she was? Probably.
Is she safer at home than she was on the ward? No idea.
Friday, 5 February 2016
A return to hospital (J's care, update)
J's back in hospital.
At some point around two weeks ago, she started begging to be kept safe. On the 28th January (also my birthday, she gave me presents at midnight the night before cos she's smart like that) she was finally admitted to my least favourite MH unit. In saying this, I don't have any to compare it with, and I hoped that when they said that there was a queue of seven other outpatients in the county needing a bed, that she would be sent somewhere else in the country. Looking on the bright side, at least she is only two bus rides away for me and perhaps three or four for her father.
Over the last year she has mentioned a disconnected whispering chorus of voices, but now she is talking of specific presence, a male, who shouts terrible things at her. Bizarrely, this took away some of the fears we had that if she was admitted again that she would be sent away for some sort of year long therapy for suicidal BPD-ers. It's a screwed up world when you think a psychotic episode might bypass institutional prejudice about personality disorders. The consultant on the ward still insists that she is BPD (despite J not corresponding to half the factors in a standard diagnose of BPD) and that this sort of thing is common. I think someone, the CPN perhaps, has also suggested that voice hearing can be borne out of dissociation.
J is currently a voluntary patient, not, as yet under section, which changes the control somewhat. The one thing NHS MH hospitals seem to be able to do is alter medication in a safe-ish/controlled environment (I always have to remind myself of this). Having seen, read and attended a few talks through work, regarding voice-hearing -none with much useful conclusion or explanation, mainly recommending empathy- it makes sense to me that the brain might close off one pathway in the mind when there is too much traffic of a single type, and yet the activity may still pass through another part of the brain, like the bit which interprets speech or perceives sound. A little knowledge might be a dangerous thing, but although the voices are from a named presence, I don't believe J thinks she's listening to metaphysical devils of angels. She seems to accept that it all comes from her, but scarily, she's starting to believe that the presence can affect/infect/permeate the rest of us (like the black poisonous miasma she normally imagines coming from inside of her). She wants the voice to stop. It shouts at her if she sleeps, so she's terrified of resting. If we talk about the voice it tells her off and becomes unbearable.
The doctors are tweaking her pills, throwing in a new anti-psychotic and so far there has only been a couple of minor screw-ups with the meds. Any of you who regularly read this blog will know that one of my pet grudges is the fact that when a person is admitted to a local ward there's a good chance they will go without the correct (or amended) medication for at least 24 hours (when the need it the most) and that junior doctors, available at night (and weekends) don't want to take any risks which will challenge a consultant in the morning. Randomly, an error this time was junior doctors taking it upon themselves to reduce J's PRN meds*, because she wasn't using them efficiently, or effectively or some sort of nonsense. This was put right immediately the following day by the consultant.
* ”PRN” (Latin medical gobbledegook “pro re nata”) These are the pills a patient can have throughout the day, "as and when" they need them; provided the appropriately qualified nurse can be found, with the right key for the clinic room and pills cupboard, and that they are able to log on to the dispensing computer, that the computer and network is working, that the pharmacy hasn't hopefully capped the meds on the dispensing list, and that they actually have those pills on that ward, and that the nurse in charge doesn't have some absurd reason to make the patient wait or try to talk them out of having medication (which was policy on one ward). They'll say all this crap about self-empowerment, but they might not let you have same diazepam which you are trusted to take at home when you likes. The responsibility here is on the patient to identify when they need top-up medication, and they should be championed and even rewarded for doing this, i.e. plucking up the courage, whilst in crisis, to ask a stranger for help, but no, like the twisted morality we apply to smokers, some nurses who have just met you feel that their platitudes will be more useful than sixty years of brain science. But I digress.
She has her own room (very rudimentary) on one of the older wards, where they still have dorms, a handful of toilets and a couple of shower rooms. Some of the staff seem to be okay, and yes there's a few turkeys in light blue I wouldn't trust with dog walking. Some of them remind of beleaguered school dinner staff told to watch the special needs kids whilst the teachers go off for a smoke. I'm winding myself up again.
I visited her today. She was spaced out, more from lack of sleep, than from the pills (the meds barely touch her). She was colouring-in mandalas in a book for distraction. Apparently, the voice was loud and present, but we couldn't discus it because we made him angry. It’s a “he” and he has a name.
(And yes, I'm hoping the voice isn't based on me. I think that's a joke I'm making with myself. I think.)
Poor thing. The phone reception sometimes goes bad and drops. That doesn't help.
I'm cat sitting at her place, Lucy-cat is being adorable, as always.
Argh.
___
After I finished typing this she texted me to call her. She says she didn't plan it, or conceal the bag, but she managed to ligature herself around her neck using a plastic carrier bag and a door handle (plastic carrier bags have been banned from the ward). She was found by a nurse and they cut it from her. She says the voice wants to kill her, and she has to kill herself before he "breaks her down". This is new to me. Unfortunately, the MH unit is very poor at tackling anything resembling self-harm and suicidal behaviour, so I'm concerned where this may lead. But, she's alive. Honestly, I'm not making anything of this up, and I don't want to be sensational or to create a reaction, but things have to get better than this. I'm angry with myself for typing these things as though they were the most normal things in the world.
Get this. The carrier bag had contained dressings for her legs, given to her by a nurse on a trip to a leg clinic, whilst she was still in the care of the MH unit. She didn't think to declare the bag. A suspicious person might suggest she had concealed it specifically to ligature with. The idea only occurred tonight - cue BPD argument about “impulsive” behaviour. Her legs are another casualty of many years of medication related weight gain (severely aggravated several years ago on another ward in the same unit, when she sat up for 13 nights because she was too scared to sleep in a dormitory with other patients). The sores on the legs get worse if she doesn't elevate them, like in bed, when you sleep. And now she can’t sleep because the voice is telling her not to. I can draw cause and effect flow diagrams, but eventually they stop making sense because there’s too many lines!
She’s safer in hospital. Not safe, but safer. I keep being told this by friends and professionals.
(Apologies for mistakes or typos, too tired right now)
Thursday, 4 February 2016
Personal Complaint to BBC regarding suicide news article
Email sent my myself to Newswatch re. news item today 4/2/16 on the 6 O'clock News:
I take a keen interest in all mental health related news and welcome the mention of the shockingly high statistics of suicide being a major killer for men under 50, but an emphasis in the interview with a bereaved wife was on whether or not she thought the act of suicide was “selfish”. I’ve since watched a more balanced clip of the same interview on the BBC Health news feed and that question was not included.
This was all used as an introduction to a story about Mersyside Mental Health Services investing in an “app” which can predict suicidal behaviour. There was an opportunity here to ask if people who ask for help are getting adequate mental health support, medication or counselling. Risk assessments of suicidal patients on wards is a very different problem to suicide in the community. Fortunately, helplines were mentioned, but the whole article was painfully clumsy, alienating to mental health sufferers and seemed to ignore anti-stigma advice given by charities in recent years.
Regards
(Name, number etc)
Saturday, 23 January 2016
In-patient Suicide Under Observation Report (NCISH Manchester University 2015)
National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCISH)
In-patient Suicide Under Observation
NCISH / University of Manchester 2015
http://www.bbmh.manchester.ac.uk/cmhs/research/centreforsuicideprevention/nci/reports/ipobsreport.pdf
I'm still reading this report. There should be no suicides whilst under observation by mental health nurses. Statistically damning.
In-patient Suicide Under Observation
NCISH / University of Manchester 2015
http://www.bbmh.manchester.ac.uk/cmhs/research/centreforsuicideprevention/nci/reports/ipobsreport.pdf
I'm still reading this report. There should be no suicides whilst under observation by mental health nurses. Statistically damning.
Teenager failed by CAMHS (Mail Online 4.12.15)
Fostered teenager killed herself after 'being raped by an older man', breaking up with her boyfriend and being called the wrong name when she met her drunken birth father
Daily Mail Online,
“Her adoptive parents, Carol and Ann Holmes, now feel she was ‘let down’ by social services, after she killed herself in November 2013, just five days after being dismissed [by CAMHS] as not at 'immediate risk’.”
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