Woman evicted from NHS hospital ward after being stuck for 18 months

[SerendipityJane]

https://www.bbc.co.uk/news/articles/c897ew0ekp4o

the cases I know of from my own experience date from the Blair years

I fully accept what lots of people are saying about our duty of care when someone has severe mental illness that presents in this way. What I want to ask is, at what point do you draw a line when that person comes up against the duty of care we have for others? What about the rights of everyone else in that ward when she was disruptive? What about the staff she abused, don't they have a right to respect in the workplace? What about all the people who suffered because that bed wasn't free?

Assuming everyone has the same human rights, how should situations like this be managed. Should her rights negate those of others - because it seems to have happened. I'm not being disenguous, it is a genuine question to which I, not being a professional in the area, would like to hear views.

From the report: "When stressed, she self-harms and can threaten to harm others."

Self-harm is complex and isn't merely a manipulation technique. If it was, I wouldn't have self-harmed in secret and hidden the injuries from others.

But from the lady who had the misfortune to have to spend several weeks in her company, she sounds exactly like a manipulative piss taker who is using her mental health to get what she wants even if that means cutting herself.
I hope the hospital next time they have the misfortune to have her land on their doorstep stitch her up and send her straight out and not to a ward. A ward is for sick people not this malingering piss taker who makes everyone’s life hell.

That would be awful. In that case, her mother shouldn’t have been able to visit her though if so? Presumably, though the 24 hour carers in the flat that was offered, were not family?

So in that circumstance, she's more important than the other patients on the ward? As pp above, what point do you draw a line when that person comes up against the duty of care we have for others? What about the rights of everyone else in that ward when she was disruptive? What about the staff she abused, don't they have a right to respect in the workplace? What about all the people who suffered because that bed wasn't free?
Why is she and her wants/demands the only thing that's considered?

The more I think about this, of course, mental health care provision is woeful, but the NHS is a disaster.

People are dying due to lack of access to healthcare. There are so many homeless people.

While I feel desperately sorry for somebody like her, she has been given options. If they’re not perfect then that’s unfortunate, but honestly, so many people are without any options at all.

The amount of money and effort put into this, and I’m sure trauma on patients and staff, and maybe even the police, at some point, and it seems it was reached, it’s not just about the needs of one person.

If self-harm was a free choice for everyone who does it, no one would do it.

You used the phrase "pathologisation of selfishness". I assume, by that, that you refer to her EUPD diagnosis? EUPD is caused by prolonged severe childhood adverse events, such as abuse. It's extremely difficult to treat and the patient learns all manner of maladaptive responses when trying to navigate that abuse. Previous posters talked about compulsive lying as a coping strategy for gaslighting, for example. Self-harm is another coping strategy: it allows the patient to feel physical pain in lieu of the emotional pain that she has been taught to suppress. To minimise EUPD as "pathologisation of selfishness" is to deny its causes, minimise the effect it has on the patient, and deny both its existence and the existence of the trauma that caused it.

abusive, aggressive and derogatory to people

There's a difference between "acceptable" and "understandable", when describing someone's behaviour.

she sounds exactly like a manipulative piss taker who is using her mental health to get what she wants even if that means cutting herself.

That is basically what the clinical presentation of EUPD looks like.

stitch her up and send her straight out

The escalation will look like her suicide.

A ward is for sick people

She is sick. She shouldn't be in a hospital ward though.

You are looking through your own eyes of someone who is genuine.
This woman on the other hand is an utter piss taker.

Her needs and wants weren't the only thing considered, that's why 120 care providers were asked to take her and she was evicted!

It's possible to believe that:

• she shouldn't be in a hospital bed outwith a psych unit

AND:

• she is genuinely ill and needs a care place

at the same time.

But at what point does her victimhood give her the right to fuck everyone else and society? I’m sorry she’s had a hard life and has problems, but that doesn’t give her the right to behave as she has. We’ve heard from 2 people on this thread who were on ward with her and interacted with her and have been very clear she was playing the system, she might have a PD, but that doesn’t mean she should be able to whatever the hell she wants- where is the line?

What is the answer, though, when people don’t, or are unable to, accept the support they are offered? From the sounds of it, by doing what she did, she was offered vastly more than pretty much anybody else in her, or worse, situations are? It still wasn’t enough, so would anything be?

We know that lack of hospital beds results in deaths. There was one less bed available for 18 months in this case.

Absolutely this.

There's a difference between "acceptable" and "understandable", when describing someone's behaviour.
No there's not, if you're at the receiving end. This is the problem for staff... 'oh yeah, you've just been verbally and physically abused, but hey yeah 'reasons' alls good.'
Do you work with this client group and are assaulted verbally and physically and expected to suck it up?

Yes, and there are multiple victims in this case. Directly and indirectly.

That may all be true but I think there comes a point, rightly or wrongly, that the people and systems affected by this person's behaviour are exhausted by it, they have nothing left to give.
Let's say this person wanted to live in a house in Mayfair, waited on hand and foot by a team of servants. Her mental health problems might make it impossible for her to understand that this isn't an option, and so she kicks off daily to all around, who as far as she can see, are deliberately and maliciously not letting her have this. How can demands like this possibility be solved.

The fact there are people on here who think we
need a return of the old style mental health institutions makes my blood boil.

I work in a geographical area where there happened to be many hospitals which were closed down. The people who moved to small settings stayed in the local area. I cannot tell you how sad I feel when I people in their 50s upwards with mild learning disabilities without teeth. They automatically removed patients’ teeth to prevent biting even when there was zero history of biting. Of course some people do have complex needs and show behaviours that challenge staff. These people still require 24 hour care but now they lived in a 5 bedroom house in a residential street (for example) and go to the shops and local cafe. Living in a giant hospital in the arse end of nowhere is going backwards. Institutional abuse is still a problem.

Well she isn't. And in saying so I'm not blaming her for her condition. But the fact that she can't help being who she is, doesn't mean that others have to endure the effects of it alongside her.

She is clearly not safe to be around other vulnerable people in a care home. Other patients at the hospital who need a quiet and calm environment to recover from their own conditions, have had to endure her behaviour.

It's not ableist to say that other vulnerable or sick people should be protected from her. It's a fact. They can't help their vulnerabilities and illnesses either.

It was clearly a hugely difficult and complex situation.

But if you had the child they are your responsibility. Surely you don't accept the premise a parent should only be responsible for a child without any issues?

I don't think a sibling is your responsibility but I do think there is some responsibility, morally, for a parent , especially if they loved you and brought you up. I am not saying the state should never help, I am saying it should not be saddled with complete responsibility.

One lady who is very frail and has dementia on this elderly care ward my aunt is currently on has 3 adult children who live locally and have not visited her once in the month she has been there. She lies in shabby hospital gowns, no nightdresses or dressing gown, no slippers, has nothing with her, no toiletries, no face cloth, no hair brush (the hospital provide little tubes of toothpaste and a thin toothbrush in a plastic bag). I knew her 8 years ago, she lived in our old street- she has no idea who I am now. I spoke to her yesterday and she just looked vacant. The nurse said she doesn't really speak . I asked if she recognises her children still and was told 'She hasn't had any visitors or phone calls while she has been here so we don't know'. She lives in a carehome- no one from there has brought her any nightdresses or stuff. Her husband was such a nice man but he died just before we moved house about 8 years ago. I don't know why she is in hospital now. She can walk (unsteadily) with a walker and sits in the chair. Doesn't eat much, doesn't interact, can smile at the nurses.

And we absolutely should not be allowing people like the woman in the article, who is clearly very challenging, to dictate to the NHS where she will be placed. It is entirely wrong that she should dictate that she takes up an acute bed for years. The NHS should have the power to remove her to care it deems appropriate.

Agree

There isn't a national-scale answer at this time under this or any recent Govts. That's why we have so many clearly unwell rough sleepers.

The long-term answer, if I was PM, is that:

• we recognise social care as the public service that it is and nationalise it to stop the "that's too tricky for us, sorry" cop-outs.
• we set up dedicated provision centres for refractory cases of specific psychiatric disorders.

Yes even when someone is cutting themselves like this manipulative bitch is.Have you not read the comments by those that had the misfortune to encounter her.

There were approx 120 professional care providers who could not manage this woman’s complex presentation, I cannot imagine her family would be able to!

Before anyone says "she's bedbound/a wheelchair user" we know nothing about her actual level of physical ability/mobility and physical health issues.

@Uricon2 - she is massively, morbidly overweight. Assume that contributes to her mobility issues.