Sunday, 28 February 2010

Tackling The Mental Health Minefield Part 10 - Hot-bedding

(This post continues the story from Tackling The Mental Health Minefield Part 9 - The Nurses: Carers or Prison Warders)

Hot-bedding is a military term, particularly used by the Royal Navy but understood by the other Armed Forces equally, that indicates that there are insufficient beds for all on board and that as one seaman climbs out of his bed to get ready for his watch, so a seaman coming off watch climbs into it to get some sleep. It isn't actually that common these days, although I suspect that it may still be necessary on some submarines.

Beds are at a premium in all NHS hospitals. Many hospitals have more than 100% occupancy (I know that sounds impossible but it happens) and the fact that is that as soon as one patient is discharged, and sometimes even before that happens, another patient is admitted to take the bed. There have been huge cuts in the number of beds available in an effort to save money. If these cuts have been bad in main stream hospitals, in mental hospitals they have been catastrophic.

The problems that arise from this policy are something like this in the Mental Health Trust that looks after my area of London. The trust has seven hospitals which either take patients from a particular area or are specialist psychiatric facilities (eating disorders, young people, addiction). The hospital that you are put in is therefore dependent on which borough you live in, and then the ward that you are assigned to is decided by whereabouts in the borough you live. This is hardly ever deviated from so even though you may be in desperate need of a bed, if there is no-one who is well enough to be discharged then you are left on your own. There can be no doubt that having to operate in this way that there are more attempted suicides or successful suicides than there would be if there had been a bed available when the patient needed it. To show this happened in the hospital that I was in, it is only necessary for me to relate what happened to me.

I was moved from the admissions ward to my permanent ward at no notice because they needed my bed in the admissions ward. This was on a Thursday evening; the following Wednesday I went home for my ill-fated overnight leave. When I went back the next day, my room was already being occupied by somebody else, so it became necessary to discharge someone so that a bed could be made available for me. A couple of days later I was told that I had to vacate my room because it was needed for a male patient being admitted to the ward. I wasn't in any fit state to be discharged or sent home on leave, so I was told that I would be given a bed for the night on another ward. I was to spend the rest of the day on my ward, up to and including night-time medication, then I was to move to this other ward, where I didn't know any of the patients or the staff, for the night only to return to my proper ward for breakfast the next morning when it was hoped that a bed would be available for me. I'm afraid that I really lost it at that point.

My immediate question for the staff was why it was necessary for me to be moved in this way; wouldn't it make more sense for the male patient to be put on the other ward. There seemed to be no sensible answer to this; I was told that this was just the way it had to be. I decided to dig my heels in at this point and said that I would not be leaving the ward after medication and that it was up to the staff to find me a bed somewhere on the ward. And so it came about that I spent the night sleeping on one of the settees in the ladies' TV lounge. The following day, one of the patients was sent out on home leave and I moved into their room. A few day's later I was moved again. The room that I was occupying was in the main corridor and they wanted this room for someone else, so a bed was made available for me in the female corridor. I remained in that room until I went to the assisted-living accommodation about a week later.

In the period that I was in the hospital I was on two wards and slept in six different rooms, one of them not even a bedroom. One of the most important things that most mental patients require is a sense of stability something that was definitely lacking in my case and I am sure that it was this sense of not belonging that caused me to be in hospital as long as I was.

To be continued.


DeeDee Ramona said...

That sounds monumentally shit.

BTW a US friend I spoke to recently talked about the custom of "hot-racking" as they called it on submarines - they still do it, apparently.

Alison said...

There was a lot of room moving on my ward but for some reason in the three weeks I was there I had the same room all the time that I was thankful for, as having OCD, I honestly don't think I could have stood changing rooms all the time, it would have made me a whole lot worse...

intothesystem said...

An absolute nightmare.

I was on the ward for 5 weeks and had 5 rooms. I was pretty much only discharged because they needed the bed.

Our ward was reduced from 20+ beds to 15 a long while ago. Some of the old rooms were turned into offices and a couple into storerooms. At one point they had to open up an extra bed and I was moved into one of the storerooms. They couldn't find enough of the new mattresses, so I had to have an old saggy one that they hadn't yet thrown away.

A couple of other patients were moved onto different wards. One woman in her 50s had to go onto the dementia ward - in the same way as you - stay on the ward for the day and sleep downstairs.

One day they had a queue of 5 patients needing admission. They'd tried every hospital in the north west. So they went down the current patient list and tried to discharge as many as possible, citing avoiding institutionalisation as a reason to let out patients who had not improved.