Tackling The Mental Health Minefield Part 11 - Being Admitted The Second Time Around

As regular readers will know I have recently spent a week in hospital again. I thought that I would write a post in the Tackling the Mental Health Minefield series detailing how this second admission went and how I found things on the Admissions Ward four months after my first admission.

I had found things becoming too much for me and thoughts of suicide had started to crowd in again. Having got to this terrible place, I knew that the only thing to do as it was Sunday morning was to make my way to A&E. I'd previously been told if I found myself in this position that I should phone for an ambulance but I felt that this was inappropriate as I could probably get to the hospital as quickly by bus, so that is what I did.

Once I arrived at A&E I booked in at the reception desk, telling them that I wanted to see the duty psychiatric team. I waited on the terribly uncomfortable seats for about 20 minutes and was then called in to see the nurse who was doing assessments. She asked what the problem was, so I told her that I wanted to see someone from the duty psychiatric team. That didn't stop her from taking my blood pressure (which was sky high), pulse (again very high) and temperature (which was normal). then it was back to the waiting area until someone came for me.

It was a long wait. Even the CPN from the duty psychiatric team commented on the length of time I had to wait. It seems that that A&E weren't in any hurry to call her, because she had responded to the call immediately. It seems that mental patients come way down on the list when it is necessary to call someone in. I find this rather strange because you would expect that they would want to get a mental patient out of the way as quickly as possible.

The CPN took me to the room set aside for them, and learning that I was known to the mental health services she proceeded to call up my records. I should perhaps explain here that this is a separate computer system to the hospital's because the mental health services are provided by a completely separate trust. After talking me through what had been going in on my life and had led me to coming to A&E she decided that I ought to be admitted.

There now comes one of those incredible little ironies that can only happen in the NHS. It seems that as a member of the psychiatric liaison team she was allowed to discharge patients but not to admit them to hospital; that needed to be done by a doctor. So she went to the desk in A&E and removed me from their computer then bleeped the duty psychiatric SHO. As with my previous admission, I struck lucky with the doctor who took care of me at this stage of the proceedings.

We had a long talk about how I was feeling, about the lack of sleep (even though the dose of antidepressants that I take at night ought to knock me out pretty quickly), about not wanting to eat, and when I did eat it wasn't the right things, about the nightmares, about the noises that I hear and the visions that I see. It didn't take him very long to decide that admission to the psychiatric hospital was necessary.

After a couple of quick phone calls, we left the hospital and walked to the psychiatric hospital. Then it was into the lift and entry into the Admissions Ward. This time admission onto the ward wasn't the frightening experience that it had been the first time. There were two members of staff waiting for me when we arrived at the airlock, a nurse and a care support worker, both knew me so everything went very smoothly.

Once the formalities had been done, it was through the airlock and onto the ward proper. There was no need to explain to me where everything was and what the procedures were as I had been through it all before, so it was straight to my room, which incredibly was the same one that I had occupied when I was on the ward before, to drop off the belongings that I had been allowed to keep, then into the treatment room for the usual blood pressure, pulse, temperature and blood sugar tests. In the intervening period my blood pressure and pulse had dropped from their excessively high levels although they were still much higher than normal.

With this taken care of, the next priority for the staff was to find me something to eat as I had not had anything since Saturday lunch time. A salad was presented which I half-heartedly ate but the cup of tea that was also provided went down a treat. Then it was back to my room, where I was joined by the duty SHO who took down details of my medication, doses, and when they were taken. He was about to carry out a physical examination when he was called away to an emergency on another of the wards.

So, I was on the ward again. What differences did I see? Most of the staff were the same as when I was on the ward before so little had changed there. Unfortunately, they still seemed to spend the majority of their time in the office and rarely ventured out to interact with the patients. I was berated a couple of times for self-harming and told that I should have asked to speak to one of the nurses, but in my defence I have to say that the reason that I resorted to the self-harm was frustration at never being able to get to talk to a nurse when I needed to. there was also significant evidence of excessive use of force being used on patients, so significant that one of the patients was badly bruised and unnecessarily drugged when her only sin was to not be in her bed at midnight. She made a formal complaint to the consultant psychiatrist when she saw him the following day at ward round, and was discharged a few hours later because it was recognized that excessive force had been used and that it would be better if she were not on the ward when the night staff came on duty that night.

The other change that I saw on the ward was something that surprised me and made me wonder whether there were staff in the hospital, particularly on the Admissions Ward who had been reading my Tackling The Mental Health Minefield posts. And if they had, were they aware that I was Madsadgirl? At my first ward round I asked the consultant if I would be granted leave. He said yes, as I was an informal patient, without any hesitation, but did ask if I would do anything silly if I went out for an hour or two. I said that I wouldn't, but that getting out for a while was the only way that I could get the exercise that I needed (walking does help free up my hip when it is really bad) and that I wanted to be able to go to the shops to get myself a few bits and pieces that I hadn't brought with me. After I had been into ward round, the nurse who was doing that day's ward round went to the office to report that I had been given leave and could have it whenever I wanted it. When I went to inquire about when the next cigarette break would be I was handed a lighter and allowed to go out into the garden by myself. When I had asked for this when I was in hospital the first time, although the consultant had said yes, the nurses had said that it was not possible. Can my posts have been responsible for the change? It's possible, and if they were then I have at least managed to make one change to the way that patients are treated on this ward, for it was not long before another of the patients was able to also partake of this little luxury.

Tackling The Mental Health Minefield Part 2 - The Admission Process

(This post continues the story from "Tackling The Mental Health Minefield Part 1 - The A&E Fiasco)

The ward that I was being admitted on to was situated on the first floor of the hospital. The nice man from the ambulance rang the buzzer at the entrance to the ward and because I was expected it took only a moment for a nurse to come and open the door. I said goodbye to the man from the ambulance, the door click closed and I found myself in a short corridor between two electronically-controlled doors being shown into a room on the left.

It was at this point that I entered virgin territory. I've been in A&E departments before, I've ridden in an ambulance before, and I've been admitted to hospital before. In fact, I actually managed all three one day in 2005 when I collapsed at work, an ambulance was called to transport me to hospital, I spent several hours in A&E writhing in agony while they managed to find painkilling medication strong enough to deal with the pain I was in, and then I was admitted for emergency surgery. However, even though I had been in several different hospitals, I had never been admitted to a mental hospital before.

I am an short (5 feet 3 inches on a good day), middle-aged (well 55 is middle-aged if you intend to live to be 110) lady, who is a bit overweight (it's the tablets that have done it, honestly), who doesn't speak any foreign languages (although I can understand what is written or said in quite a number of them), is white, London born and bred, who has travelled the world extensively but has lived her entire life in this country (always south of the Wash), and who was severely depressed, hadn't had anything to eat or drink for hours, who was emotionally drained and really just wanted to curl up in the corner and die. The nurse who was carrying out the initial admission procedure was male, more than 6 feet tall, built like a brick sh*thouse, black, from Africa and with an accent so strong that it was almost impossible for me to understand what he was saying to me.

I was submitted to an interrogation, the technique of which the KGB would have admired. I should remind you that I was being admitted voluntarily, there was never any suggestion that I needed to be 'sectioned' but you would have thought that I had stolen the Crown Jewels and then run amok slaying the Royal Family to judge by the manner of the nurse admitting me.

All the relevant personal information had been faxed through to the ward so there was no need for me to go through all that again (they also had faxed copies of all the stuff that my GP had given me when he referred me to the first hospital). So the admission process started by me being told to empty the contents of all my pockets onto the table in front of me. This didn't amount to much; just a few screwed up tissues and a safety pin (no, I don't know why I had a safety pin in my pocket either). I was then told that I could put the tissues back into my pocket, but the safety pin was confiscated. Then I had to empty out the contents of my handbag and the other bag that I had with me. I started with the other bag (it's a cloth bag that I bought in the Natural History Museum and which I invariably carry with me all the time) which contained a waterproof jacket (it had looked like rain when I had left home that morning) and a book. these were deemed to be 'safe' objects so I was allowed to put them back into the bag and keep them.

I'm afraid that I am a typical woman and my handbag contained lots of stuff. I should explain that I am a firm fan of Kipling bags, I love the fact that they are so hard wearing and that they have lots of compartments in them so that you don't end up having to rake around in the bottom of your bag looking for whatever it is that you want. I am quite methodical about where I put everything in this bag so I can always find what I want in a matter of seconds, but I was required to take everything out of every compartment and place it all on the table. Then I had to hand over the bag so that it could be inspected to make sure that I wasn't trying to hide anything. This was when I completely lost my sense of humour, which wasn't particularly good anyway. Each item was lifted from the table in turn and I had to explain what it was and why I had it in my handbag. The purse and the credit card wallet were fairly easy to explain, but I was only allowed to retain the purse (with the money that was in it). My tiny filofax with its attached pen was considered safe, so that also went back into my handbag. There followed my two Oyster cards (safe), my house keys (safe), my cigarettes (safe), my lighter (confiscated), a USB stick (safe), my digital camera which I always have in my handbag because you never know when a photo opportunity might arise (confiscated), my mobile phone which like most mobile phones also functions as a camera (safe), some of my daily medication (confiscated), two biros (safe), a lip salve (considered safe after some hesitation), my library card (safe), the tear off parts of two prescriptions which show what repeat medication that I am on (safe), a Waterstone's gift card (a birthday present from Mr Smiley) (safe), The remains of the tickets for Les Miserables and Phantom of the Opera (safe), a mini A-Z atlas of London (safe), my driving licence (confiscated), my building society account book (confiscated), and a GTN spray which I have been told that I must always have about my person (confiscated). For those not in the know, the GTN spray is for use when someone has an angina attack and as I have an unusual form of unstable angina that can occur at anytime (even when I am lying down or asleep) it is quite important that the spray is readily to hand. This completed the examination of the contents of my handbag; the safe items I was allowed to put back into the bag, the confiscated items were listed on a form which I then had to sign.

Then next form to be filled in was one listing the clothes that I had with me. Bearing in mind that all I had was what I was actually wearing, this was a little academic. But the form was duly filled in and again I had to sign it. This finished the preliminaries, so picking up my handbag and my other bag containing my jacket and a book, I accompanied the nurse from the room and went out into the short corridor and was then taken through the second electronically controlled door and into the ward proper.

At this point the nurse actually introduced himself (I have to be honest and say that I have no recollection of his name and I can't even read it on the discharge papers that I have which give details of my progress through the hospital. Then he pointed out the TV Room and the dining area before taking me to a room labelled 'clinic'. this turned out to be a room with medicine cabinets along one wall and a variety of medical equipment dotted around. My height was measured, my weight recorded, my blood pressure taken, a test for blood sugar done, and then I was handed one of those grey pressed cardboard receptacles that you get given in hospital and asked to provide a sample. As I hadn't had anything to drink for about nine hours this proved to be a bit of a problem, but with use of a running tap I eventually managed it and somewhat belligerently handed it over.

I was then taken down the corridor and shown to a room that was to be my home for the next eight days.

The whole experience was disturbing and somewhat frightening considering the fragile state that I was in. At no point was anything done to put me at my ease, or to explain what was happening. I don't think I could have been treated more unsympathetically if I had stolen the Crown Jewels and murdered the Royal Family and was going through the detention procedure at a police station with a crusty old custody sergeant.

To be continued.