To make a complaint about my treatment on a psychiatric ward?

[dontrunwithscissors]

I was recently admitted to my local psychiatric hospital for a psychotic depressive episode. (I have bipolar). Overall, I got excellent care. With the exception of the occasion I'm about to describe, the nurses were wonderful. I apologise for the length of this post, but want to include all details.

When I was first admitted, I was put on constant observations due to the level of suicide risk. I was getting 'messages' instructing me to strangle myself (bag straps, clothing). By day 3, my psychotic symptoms had improved, but not resolved completely and I was still deeply sucidal and getting incredibly powerful urges. They took me off constant observations that morning after asking me 'if I can keep myself safe'. I said yes (genuinely thought I could). On reflection, I was still a risk to myself. They had still left me with some items of clothing that could be used as a ligature. I was put on the normal hourly checks.

That evening, I attempted to strangle myself. A nurse walked in on me, but didn't realise what was happening as I was on the floor, on the opposite side of the bed. A few hours later, I went to one of the nurses (night shift) and told her I felt unable to stop myself following the messages, I was very distressed, and said I needed help. She told me to go sit in the TV room. I didn't want to sit there sobbing so I went back to my room.

Ten minutes later, I returned to the nurse and said I needed help. She asked me why I had said I could keep myself safe that morning, but was now telling her something different. I said I didn't know, but I was really struggling now. (Night times are always my worst.) She walked off from me. I returned to my room. By this point, I figured they were not going to help me and seemed to be suggesting I was lying. I returned to her shortly after and said I needed help and asked to see the duty doctor. She threatened me that if I insisted on seeing the doctor 'they will section me'. (I was an informal/voluntary patient. I was asking for help not to leave at all.). She again walked off from me.

I again returned to my room and again started to strangle myself. I was very, very distressed by now. I approached the other nurse (male) who was on duty and again asked for help and to see the duty doc. He said 'you've already been told you can't do that.'

I was desperate by now. I rang my husband, sobbed, explained what had happened. He rang the ward and spoke to the male nurse. This nurse came to my room, asked me why was i behaving that way, and told me to go to bed. I told him I felt unable to keep myself safe. He left me with clothing. I ended up speaking to DH on the phone until I fell asleep (with him still on the phone.)

The next afternoon, I knew those two nurses would be on duty that evening and I again felt that I would deteriorate that night so I spoke to a 'nice' nurse and she immediately came to my room and took everything away that I could use. She highlighted the need to increase obs.

I've been out of hospital 1.5 weeks and thinking about how I was treated that evening. I was clearly distressed and communicating that I needed help, but they did nothing to intervene and ensure my safety. The threat that they would get me detained if I insisted on asking for a doctor seems particularly cruel (or maybe illegal?)

So, WIBU to issue a complaint about the treatment? Should these nurses have behaved differently? I'm caught between feeling this should be highlighted, but I also know that at some point I will be admitted again, and I will have to 'deal' with these nurses again. FWIW, the hospital has been in the news recently for allowing a sucidal man to leave and he subsequently killed himself--the ruling was they should have detained him, but he was assessed by a trainee pdoc who failed to recognise the dangers.

I'm sorry for your experience, captain cupcake. I'm still very traumatised by the behaviour of a HCP from 10 years ago, so I know where you're coming from.

But OP doesn't know whether her complaint will have an effect until she makes it. It might help her or to improve practice on the ward, fingers crossed.

i,m not condoning the behaviour of the staff in anyway i have seen mental health staff behave appalingly towards patients even years ago when we had loads of staff and loads of beds but in recent years staff have been cut to the bare minimum and they have shut down so many bed in my old trust its ridiculous complain because the more people that complain the more that will get done.

captain that's my fear. I know at some point, I will be back on the add and (quite selfishly) I'm worried about any kind of reaction from them if I complain.

x2 I'd had the two PRN medications a good few hours before and I think the effect was wearing off, but it was going to be hours before I could get anything else. Thinking about it, I think that was partly why I was asking to see the duty docto ask if I could be given something elseI was desparately scared of myself by that point.

On the whole, my trust has very good psych facilities. I'm in Scotland and things are generally better up here. By the time I left, it had 10/24 beds empty.

oh i agree frikadela some areas of the trust use fifeen mins some dont but like you said 15 mins is more than enough some people if determined enough will try something in front of staff.

yes that is good op in my old trust they are sleeping out patients all over the place but still insist on closing even more wards down.

OP, I too went in as a voluntary patient (but for Schizophrenia).

2 nurses sat and ate their takeaways when we were eating bland curry, whilst announcing "this is what you lot could be eating if you were better".

When a doctor gave the all clear that I was okay to leave as of my will, I was told by the nurse "hope we don't see you again, try harder to get things together".

Obviously not quite as bad as your appalling experience but certainly not great. I was just 14 at the time.

I also quickly discovered voluntary wasn't actually voluntary, and I couldn't just walk out (not walk out but you get what I mean).

Please complain to Mind, and PALS (if they cover mental health sectors).

tudor, that is awful--TBH, sounds much worse than my one-off incident. I have been in the MH system for 6 years and this was the first time I've experienced anything negative. I realise that makes me very lucky indeed.

I'm under the crisis team at the moment and they're very good. I also have a fantastic CPN.

I've heard such terrible tales of care elsewhere. There have been a number of good job opportunities elsewhere in the country, but we have decided to stay here because I get such good care.

PS Loads of takeaways delivered to the hospital so lots of patients chose to order food in. The food was awful.

I have no experience here, but it seems strange to ask someone whether they're going to be okay ob this sort of situation. Surely if someone isn't then they can just say they're fine to deliberately left with stuff they can use.

Equally well, rather than going to them and saying cone and get anything, why couldn't you have said "this is mine, keep it away."

And I'd have thought that being worse at night was not unusual so surely they shouldn't take just one talk in the morning to count for 24 hours. I'd have thought it was the sort of thing that should be reviewed fairly frequently, a few times a day.

All things that I think they should be able to answer you. If they can't to your satisfaction then I would put in a complaint.

Sorry about spellings. Thick fingers, little phone.

OP my experience with mental health teams have never been positive, I just stick to my GP now

"OP doesn't know whether her complaint will have an effect until she makes it."

Exactly. I complained about some MH-related NHS treatment and got a very full and complete apology that helped me find some closure with what had happened.

I don't buy short staffing as an excuse for not speaking with basic respect and courtesy. It wasn't that they were doing their jobs well but had too much to do - they were not doing them well.

Do complain, and if you can get the help of PALS I absolutely recommend them. Sorry you were treated so badly

Sorry if I was being unhelpful I got the response in the post this morning and am feeling very low

If you are unhappy/concerned about your treatment, then you would be within your rights to complain.

The threat that they would get me detained if I insisted on asking for a doctor seems particularly cruel (or maybe illegal?)

I am fairly sure the mental welfare commission would have something to say about using threats of detention to induce patients to act in a certain way because the effect of this is that the patient is actually "de facto detained"- i.e. the patient feels obligated to do something against their will- but as it is not a formal detention the patient will have none of the legal protections (access to a solicitor, advocacy worker, etc) that detention under the Act provides. That goes against the spirit of the legislation and is definitely unethical. I don't think it is illegal, but could be wrong.

That said, it is appropriate to explain to the patient the consequences of persisting with a wish to discharge themselves/ not have treatment etc by explaining the range of options available: e.g. an assessment would need to be made as whether they were detainable under the Mental Health Act (for their own safety of that of others). This would allow the patient to
make a fully informed choice. It's in the way you say it- "if you don't do x, then we will have to detain you" is not ok. "If you are sure you do not want to do x, then the next step is to make a formal assessment with consideration for detention under the mental health act for x, y and x reason' is fine.

Sorry to hear that captain. Might be worth starting your own thread to ensure you get some hand holding

They do ask very directly about your risk to yourself and others when you are a MH patient. I admitted some stuff to my psychiatrist a few months ago that I have never told anyone before though a long standing user of these service.

Of course people tell fibs or are just economical with the truth, I have discussed this with other patients. I have even told MH staff about someone who I knew who had a plan and broke her confidence I felt bad but she got further assistance at home.

Just caught up with the last few posts:

captain--you weren't unhelpful at all, I was grateful for your response. Hope you feel better soon.

jacks, I've had the 'if you don't do X, we will detain you' once before. My current pdoc (I see the same one on the ward and at the CMHT) is very careful to follow the rules. I think he would have something to say about the the way I was threatened. He's previously commented upon how the threat of detention can be used as a way to force people to behave and that is unacceptable.

While people can debate the different perspectives (he said/she said) of what happened that evening, I can say with absolute certainty that the nurse threatened to get me detained in response to asking for the duty doc. She didn't ask why I wanted to see the doc, which I think would have been most nurses' response (& I didn't really want to see the doc, but I was desperate, exhausted all my PRN medication options, and felt like they just weren't listening to me.)

I think I'll start with requesting my notes; if nothing else, I'm curious to see what they wrote and how it corresponds to what DH told them.