AIBU to draw attention to how mental health patients are being treated/things having to deal with through lockdown.

[UndertheCedartree]

It's not something that I've really seen spoken about but psychiatric wards are obviously in a difficult position right now but it seems they are more interested in covering themselves than thinking of the patients rights/needs.

One unit I know are not allowing any leave whatsoever. Not even for informal patients...not even just outside the front for a smoke. There is no outside space on the wards so literally no fresh air for any of them and as most MH use smoking as a coping strategy that important strategy has been removed. And surely it must be illegal to keep informal patients detained?

I am usualy on a mental health unit for EUPD during the week and home at weekends. Just before all leave was cancelled I got scared and went home. About 3/4. ward had Covid but many without symptoms. I presuably caught it from someone and have been ill for a couple of weeks. I think my DS may now have it. Obviously I couldn't go back to the ward after catching it. But it has been so difficut. I'm stuck at home with my anxiety through the roof, obsessing about my DCs education and feeling very down that I'm not coping well. I've been at home nearly 4 weeks now and I feel so anxious about going back and leaving my children - I don't know when I'll get leave again. The difficult thing is usualy on leave I have support from a volunteer, a charity helping sort my money and my DC SW plus meetings at school. Obviously not happening now. I also have support from my BF and the DC's dad. Don't get me wrong they've been great - the DC dad has been bringing food round and phones me everyday to see how I am. I've isolated upstairs and my BF has been in a couple of times to disinfect the downstairs, feed the kids and get things from the corner shop for us. Even my brother sent us a fruit and veg box which was lovely.

Sorry this is just a ramble/vent - this is so hard and I feel stuck in a world of anxiety, depression, paranoia, obsession and....far too many cigarettes 😷😞

@Terralee You need to let your GP know that too because if you end up in intensive care (which I hope you don't obviously) they will immediately request your records are faxed through or access or shared care records.

@Dipi79 - this isn't just about me it is about psych patients as a whole. The restrictions on them are far greater than that of the general population. I didn't see my DC for many weeks before I came home. I am only still here as I'm sick with Covid symptoms. I'm not able to see any family/friends as per lockdown. I'm struggling to take care of my DC as I can barely get out of bed. It's hardly fun and games here...my DC are being neglected. I'm not getting any support for my MH. And as soon as I'm well I'll be back in hospital and god knows when I'll see them again. And I have never said the world owes me a living - what a ridiculous comment! I just care about how psych patients are being treated.

@outtedagain - patients can still speak to family and friends on the phone, you know? Or would you rather all mentally unwell people just shut up about their experiences? Their increased anxiety from these conditions doesn't matter atall! Safe and treated? Hmmm....have you rtft - very little treatment is happening and incidences are through the roof! There is not always outside space within the ward.

@Complexico - the reduction in staff is a good point. I can see what you are saying on a large ward with many 1:1s but this has always been an issue to some extent. The extra freedom given to informal patients, though is often seen as a 'reward' for the hard work they have put in to get to that point. Formal patients understand there are more restrictions on their leave. The increase in incidents due to informal patients not being allowed outside for not just smoking but for fresh air and exercise and therefore harm to patients and staff makes a blanket ban make less sense - least restrictive practice is considered gold standard for a reason.

Banning people addicted to nicotine is not quote the same as 'encouraging' them to look after their lungs. An encouragement might be providing one use vapes. As for a patient legging it of course that must come under an individual risk assessment - that is not the same as a blanket ban. X y and z might run so noone is allowed out - mental health wards are not allowed to run like that.

Yes, my COVID was confirmed and no I've not been smoking. Are you still recovering at 6 weeks? How bad did you have it?

I'm not counted in the staff numbers, funnily enough as I'm a patient - did you even read my OP?

All patients were tested on the ward. It is a private hospital if that makes a difference?

I'm sorry for those you have lost. I have lost a friend too 😞

In these times sometimes the smallest things can mean so much. When a psych patient has had most of their freedom taken away, they miss their DC desperately and have no idea when they will see them again, they are struggling with very little treatment and are having to deal with family and friends dying. Would you really begrudge them a smoke?

And if you do and their mood further tanks and ends up with an incidence requiring many staff to deal with it and harm to staff and patients. The patient has to be taken to hospital, a member of staff to escort, another staff member has to go home and the whole ward is unsettled. Or you could have just let them go out for a smoke?

@UndertheCedartree Apologies for misreading your OP - I was reading it as you were working on an EUPD ward during the week; it makes more sense now and I will try and be a little more empathetic with any future responses.

@Complexico - thank you. I hope your recovery continues. I've had a really bad day today and started smoking again! I had stopped for the first 2 weeks but my anxiety is so bad at the moment. Probably why smoking was on my mind so much!!

It’s a big waste of resources so as nurse in charge it would all be a big no from me. Short staffed most likely and basically a member of staff a shift doing smoking duty =no way. Plus what about the staff members rights? Passive smoking is a problem and yeah staff do have rights.

I work for a trust where escorting a patient to smoke would lead to a disciplinary. So yeah it’s probably for the best you aren’t in hospitals l have worked at and lm glad l don’t work at the hospitals you have been in. Smoke free actually means smoke free. It’s not just lip service

It’s not a lack of compassion. It’s allocating minimal resources. For me doing meals, 1;1’s, dispensing meds, ordering meds etc are way more important. Maybe some people want to drink alcohol or take drugs, l don’t condone of facilitate them either

@EL8888 - well we'll have to agree to disagree. Unescorted patients would not need a member of staff with them so not sure how your argument stands up there. But of course as I have reiterated before my personal experience is not letting patients smoke - leads to higher incidents and more staff needed and more danger to staff and patients. So less staff for all the other jobs and staff in harms way. My ward is able to allow patients to smoke and do all those things. And yes, removing someone's one coping mechanism is cruel and shows lack of compassion. 'smoke free' hospitals are lip service in my experience. Certain people will insist noone smokes there...it's not usually the truth!

@EL8888 - and clearly you are talking about something very different to me. You never let your patients smoke - I'm talking about wards that do - suddenly removing it during a high anxiety time. My ward and others manage it through good organisation. It doesn't obviously impact meals - as they are restricted times, 1:1s are obviously planned in the numbers and meds are done by the nurses.

I think it’s very interesting that you made the choice to leave the provision. So many people at the moment are unable to access any treatment for anything, and know their cancers are growing unchecked.
You put your addiction before your mental health. (It very normal to do so - my good friend who uses alcohol to self medicate and always hospitalizes herself when she feels she cannot keep herself safe always goes to the store to buy booze when she discharges herself. She’s done it for years. Checks in suicidal, dries out and gets some support, leaves weeks later and goes via the offie.
In fact, thinking about it, I actually have two friends that have done that.
The health service isn’t there to facilitate lung disease. Ever. And Particularly not right now. Not when cancers aren’t being treated, no patients at all on any ward are allowed visitors, and no patients will be allowed to pop off the ward unchecked to spread Covid.
But it would obviously be better if you could utilize the support you do have (you do have someone checking in). In the interim when you are feeling calmer are you able to contact the service and ask for a zoom call instead? DD’s clinic are offering either phone or zoom at the client’s request. Dd prefers zoom as she can see who she is talking to. It also gives visual cues to the caller.
Being a patient of any sort is very hard right now. In or out. We all have to take responsibility for ourselves as far as possible and not put further pressure on the system. That means making hard choices for ourselves about whether we need in patient care or not. We do get to select on a menu what choice of care would be ideal. There is no ideal. There is keeping you safe if you are unable to do it yourself. That’s it.

I have mentioned the rights of staff to avoid exposure to smoke a few times but you have ignored that each time. It depends on if patients have unescorted leave they can smoke but not patients with escorted leave. Smoking causes way too much trouble, removing it was a good move and to be honest l look back and shake my head about how it was. The day revolved around it way too much and too much time was spent on it. Definitely something my future self will look back and cringe on when l reflect on the early parts of my career. No one smokes at the last 2 places l have worked unless unescorted

If they are facilitating smoking leave it is a matter of time until they are forced to stop anyway to come in line with the rest of tge country. While I defend the idea of allowing patients to smoke generally, no one has a right to smoke, especially if this puts lives at risk. @UndertheCedartree you are extremely dismissive of this risk, MH staff have died (I mentioned I know someone personally), and MH patients are at huge risk. As a RMN I'd much rather respond to incidents of violence than see someone critically ill or dying.

I do feel really sorry for the patients not being able to get fresh air. But I feel sorry for people without gardens in cities, residents of care homes, and for prisioners locked up for 23hrs. Covid is shit all round, and everyone needs to make sacrifices to contain it.

Please let's stop talking about smoking! The effect on staff of smoking is not good but not the subject of this thread. It was not the point and the thread is being derailed by those going on about it. Some places apparently don't allow patients to smoke but that has nothing to do with Covid it was already the case. Every hospital I have been in patients can smoke. However I was talking about changes made due to Covid. So a patient is not allowed for fresh air, to go to the shop or go for a walk like everyone else can. The treatment is not being able to be provided, people in the community have no support.

@enragedpenfold - it was nothing to do with smoking that I left. I said I was 'scared' - I was scared of not seeing my children especially as their birthdays were coming up. And I didn't discharge myself I just went on leave. I am only still here as I have Covid. My psychiatrist said it was a good thing I came home - better to be ill here than there - although obviously it hasn't been nice for my DC. Zoom is a good idea, thank you. Our hospital is much more than just keeping us safe. I'm not necessarily saying all the rules are wrong but they sre hard - not being able to go for a run etc. Once we've all either had it or isolated shouldn't we be allowed out like other people? I also think not allowing any fresh air atall is pushing it too far.

@CoffeeIsMyOnlyJoy - I didn't start this thread to talk about smoking practice in normal time. It may be that sometimes escorted patients can't smoke but everyone else can. I'm talking about not being allowed out for fresh air atall - ok not having a garden is hard but at least you can go for a walk. In Psych hospitals you can't go for a walk or even get a breath of fresh air. You could be cooped up all day - no activities, no groups, no therapy. It is hard. But I just can't see the justification to not allow patients some fresh air.

There are people on this thread who have a very poor understanding of how severe mental ill health works and no idea at all what parts of being an in patient are so distressing, including someone who apparently runs a ward.

I'm going to hide this thread now as it's sending me into a bad spiral and if I keep reading it I don't think I'll be able to maintain contact with my CMHT, because I'm already feeling sick at the thought that they might want to lock me up with people like EL8888 in charge of me, or CoffeeIsMyOnlyJoy who seems to think it's reasonable that patients be treated like prisoners in a max security.

No one should have to feel grateful for being warehoused inside, with no access to outdoor space or any kind of autonomy and the only human contact being a nurse shoving a tray of pills at you and then ignoring you until next dose. Oh, and there are a load of other people there who are also really unwell, which isn't always great and doesn't feel safe at times either. Last time I was on the ward, another patient decided to follow me around for a day, threatening to stab me because she thought I was spying on her. It's a shit situation and smug people who have never had to deal with it shouldn't pontificate about how those of us who had 'need to take responsibility for our own care'. You have NO idea how hard it is to manage a shitty condition like the one I have, and I do that every single fucking day of my life. I am in a constant fucking battle with this shitty stupid condition that stops me telling when something is real and when something is not. Right now I have days when all I can hear are voices whispering that this whole pandemic is all my fault and I need to hurt myself to make it stop. I'm not sure whether I should believe them or not, but I am trying to ignore them. I can't sleep without meds, and then when I take the meds, I spend the whole next day with a foul taste in my mouth, feeling sluggish. I have moments, regularly, when my arms and legs stop working and I can't move because I'm so overwhelmed by everything around me. I make lists every day - remember to shower, remember to eat - because otherwise I won't.

I am taking responsibility for my own health but it is HARD and one of the FEW tiny things that makes me feel better is being able to go outside and get some fresh air and see some flowers. And you are telling me that people like me should be grateful for losing the few tiny bright spots they have, because they have become sick, and 'take responsibility'. There's some real bullshit on this thread.

My experience is different if I’m honest, I have bipolar. I was due to have a review this week at my local mental health unit, it was obviously cancelled. I instead had a phone review. My psychiatrist was late calling due to the fact he had been so busy on the unit (telling sign).

We had a chat, discussed my mental, I suggested re-introducing a med which he agreed with. I was told if I had any worries etc to call the unit. My prescription was sent to my GP and I picked it up the same day.

I think it’s had to draw the line between mental health patients coping during lockdown and those who aren’t coping.

I find the lock down fine, no problems at all. But I also find it difficult when people lump as all together. I’ve had messages of friends and family, concerned for me because of statements like this. I then have to convince them that I am totally fine. Just because I am bipolar, doesn’t mean I’m struggling. I’m compliant, I take my meds, I have routine and I know if I don’t follow that I’m screwed.

Nhs worker here, no sympathy sorry. My mum works in a mental health unit. Why on earth would people coming and going and smoking be a priority in a pandemic? Yeah nevermind the staff and all the other patients.... The priority here is to stop the spread of the virus.
At my mum's unit people were given the choice, stay in the unit with no visitors and no leaving the unit, or leave. I guess if they prioritise smoking over their mental health then that's that. And if lack of smoking correlates directly with their mental health, still better that than a unit and staff full of covid.

@batvixen123 you are so entitled it's unbelievable. You either comply with lockdown or leave and lose support. There are people who are immuncompromised who will die if you get your freedom.

thank you for your input OP

some of the frothers here might like to know that smokers are at less risk of Covid and some countries are doing experiments with nicotine patches.

I'm asthmatic but couldn't help laughing at the irony.

are prisoners allowed to smoke?

Is it worth someone contacting Birdmans LLP, I know they fought for amendments to exercise for autistic children and wonder if they could help with those in mental health facilities.

@batvixen123 my role isn’t to be “nice” or be someone’s “friend”. It’s to get people better and keep everyone safe. There is a duty of care to staff as well as patients. It’s not “fuck the staff, do what the patients want at all costs”. Confused as to why you and the OP think lm so dreadful, lm hardly recommending beat the patients and they have no rights etc. I prefer to spend resources on things that are evidence based and help people e.g. internet access to contact friends / family, 1 to 1’s, medication, food / drink etc.

Swathes of mental health trusts also see it my why and that’s why smoking is banned in hospitals. Plus why patients can’t smoke in front of staff, l doubt non-smoking patients would want staff smoking in front of them

@Ghostoast yep there is a lot of entitlement flying around

@batvixen123 - I'm sorry this has triggered you. I'm so glad not to have to be around some of the apparent professionals on here. The 6cs seem to have been forgotten by them and it is all about the easier way for them while virtue signalling at the sime time. I hop you are ok.

@EL8888 Please don't lump all patients in the same category though too. I have never smoked on our Trusts ground - even though you can, and I have only smoked once in front of a member of staff (during a break from a court hearing where I was the victim).

I have now given up due to COVID as well. I smelt it the other day (neighbours) and threw up so I don't think I will be going back.

@Reallymissthegym - great to hear you are coping so well. I need routine too - the hospital routine really helps me and I'm trying to get a routine going at the weekend. Obviously this is completely different again and think the lack of routine is hard.