What could be different in mental health care, what helps, and what have you found to be useful reading?

[OwFriggingOw]

First off - this is a thread inspired by another thread - not about another thread.

I am a lecturer who teaches mainly MH nursing students, but also Adult, Child and Learning Disability field nurses about MH, and also occasionally medical students. I have no agenda for this thread bar a genuine desire to listen, share ideas, and have an open discussion about what is helpful / less so. I worked in NHS MH for 13 odd years.

In case anyone links the other threads that inspired this thread - I have been comissioned to edit a book about people's experiences (service users and carers / family / friends) within MH services and with MH issues. NONE OF THE POSTS HERE WILL BE USED IN ANY WAY, SHAPE OR FORM FOR THIS BOOK. You have my ABSOLUTE word on that. Similarly, NONE of the posts here will be used in any of my teaching.

My aim in starting this stems from several PM's and several on-thread comments about how this would be useful/ I hope it can be a helpful, supportive and productive meeting place for thoughts and ideas about what people have found helpful with regards MH care / services / support (statutory and non statutory) and what has been less helpful. Most importantly with regards the less helpful - what can be done differently?

And - beacuse I like books - maybe we can share reading ideas :)

Would it be helpful if I shared parts of my long thread from earlier regarding what I see as needed, without any other details from the thread?

Afternoon. We have no problem with this thread - it is an interesting discussion.

We're aware that it might be triggering/upsetting for some but we don't tend to delete for those reasons only (that would get us in a right mess!). Instead, we'd urge anyone who'd rather not see this thread to hide it.

As we hope most folks already know, we do, however, have a problem with posts that refer to/dissect another poster's situation or posting history. And we are likely to delete any posts of this sort when they come to our attention.

We also think that a general discussion about mental-health care is not the best place for one poster to seek or be given support. We think a separate thread is much the better option here - and we'd hope everyone on this thread would suggest that to anyone seeking individual support.

And, while we here, we also need to remind folks that personal attacks are against our Talk Guidelines.

I'm not going to read the whole thread, but I found CBT for Dummies helpful.

cheers helen. this thread is just that- a generalised discussion and attempts to derail are depressing.

a basic such as a knock on the door is the least anybody deserves :(

I found the crisis team to be pretty poor tbh.
The idea behind it is excellent but actually the execution is deeply flawed.

I saw some fairly bluntly tooled psychiatric nurses twice a day. One arrived with photocopies of a cbt handout which he had apparently never read
After stumbling through the first page, he left it for me to read later "when I felt like it". (as I was seriously unwell and unable to read more than a line this was very distressing)
Two were unable to withdraw blood (after 7 attempts) but treated it all as though it was hilarious. Snr said "oh this always happens, not to worry x is on this afternoon and she always ends up getting it for us" this was said in front of my mother who was(!) Then a "well that has kept us late, any dark thoughts? Someone will see you later"
They came for a few weeks, nothing changed except that I grew weary of explaining the entire situation to every new team member, eventually they stopped
Their basic remit seemed to be, ask if I was feeling suicidal and try their hand at remembering some CBT
I have no idea why they ever started or stopped

There should be an end to the fantasy that there is no stigma around mental illness, and this is related to the problem of constant patronisation. It is a nice idea but it is not true. And not helpful.

Nurses should not consistently ask patients leading questions such as whether they feel that the radio is talking to them. This is clearly looking to trick zombies into unwittingly ticking the box named schizophrenia. I put some thought into the word zombies. Patients who were all drugged up to the nines would wander up and down the ward in a sort of shuffle, like someone using a zimmer frame with some difficulty, but with no zimmer frame. They didn't hold out their hands straight out in front of them like zombies in films, but (I am trying to picture this for you) with their hands sort of held out as if on a non-existent type-writer.

suffling gait (as well as tics/ involuntary movements etc ) is often a long term result of antipsychotics.

tardive dyskinesia: www.mind.org.uk/help/diagnoses_and_conditions/tardive_dyskinesia

shuffling*

daisee
That wasn't my experience of hospitalisation at all.
Some people were having their meds adjusted to find an appropriate level but I never experienced people behaving in the manner you have described.

There is an older peoples CMHT in my area, there is just no crisis team, so even an urgent referral can take 2 or 3 weeks. They also won't take a referral until all physical causes have been ruled out, which can mean 6 or 8 weeks from symptom onset before they are seen by a mental health professional. There also.seems to be an issu with the cross over - someone at 64 with mental health problems doesn't magically get better on their 65th birthday, but the services available to them dimish.

Nurses who claim that there is no stigma in mental health should not be overheard by compulsive eavesdroppers called Daisee as 'fruitloops'

I eavedropped constantly (but remember I was in that hellhole for 4 months). According to the 'Ward Manual' there was meant to be a public phone box which inmates could use in private. In fact, on many occasions I worked out that there were two places where two members of staff could stand out of sight in a concerted plan to listen. Towards the end the staff used to say 'What are you doing, Daisee?' and I would cheerfully reply that I was eavesdropping for my notes.

There was a lot of stealing on the ward. I am not sure how this could be dealt with. It was a hassle to find a member of staff who clearly resented being dragged away from her Daily Express to let one into one's room. On the other hand, constant room searches would have been an unwelcome intrusion, although they were never bright enough to find the little Marks and Spencer bottles of red wine that Tracey and I used to wash down our 10mg of valium. We would keep the other 20mg for emergencies, such as dealing with Dr Clot.

was there any facility for a locked cupboard or locker in your room daisee?

Daisee and Perry - both really interesting points, thank you for sharing. I agree that unhelpful intervention - whether it be percived as patronising, or intrusive, or just downright rude as in turning up with worksheets not read before, or not knocking before entering a private space for a patient - is really unhelpful towards people's overall experiences of MH services.

It doesn't seem like there's any minimum, basic standards if that makes sense - maybe there's too many guidelines (NICE etc) and policy frameworks, but not one basic charter? Just the sheer diversity of people's experience of inpatient and community MH makes me wonder why there's so much disparity, as even taking into account people's differing experiences because we're all human and connect to some people better than others, things like knocking before entering a bedroom, or not getting a decent amount of talking, one-to-one support, should be universal?

Not sure if that makes much sense!

I think it might help if there was consistency between wards. For example, one ward of a hospital i know of doesn't allow mobile phones. Another ward does, which can be upsetting for patients, particularly of that phone is used for therapeutic ends, ie listening to music on headphones.

I'm so sorry to see you go Maryz :( And really sorry that parts of this thread have been derailed.

Thank you Helen for the clarification - that's really useful. And I agree - this thread is best kept as open and general as possible, as per it's aims?

There have been some great suggestions, links, insights and thoughts from a range of different posters (staff, people with experience of services, carers, and people who cross into more than one box like most of us do) which has been great to see, and I really hope useful to many.

There's been some mutual empathy and support too, but I'm glad the general tone of the thread has stayed precisely that - general - rather than being a specific support thread if that makes sense?

Anyway, back to linking - This campaign is one I've used a lot in various forms with students to help them understand stigma:

Time To Change - fantastic resource I found - wonder if others feel the same or if others have encountered it?

Yy upward
We weren't allowed mobiles or Internet access at all.
The reasoning was that we were there to focus on wellness and to an extent to remove outside influences as not all might be seen to be positive.
I now know that other hospitals allow access
A blanket policy and reasoning would make sense

I think my local hospital was making noises about clinical decision making about whether an individual should have their phone, so moving away from a blanket yes or no. Sorry you've had similar experiences.

Perry, read about 'tardive dyskinesia at 13:31. I didn't know that it had a specific name but I observed it constantly. I called it the x-ward shuffle. It was also accompanied by an open mouth and blank eyes. Thanks for that link.

Aesop, there was a safe in each cell and a great deal of fuss was made of this privilege, but the staff had a skeleton key so it was not a private space in any real sense.

Food. There was always access to toast and jam and marmalade and many inmates spent their days confort eating. Almost all of them, and especially the staff, were clinically obese. The only fruit that I ever saw was tinned mandarins, which I really liked, but their was no attempt to produce a balanced diet.

I helped one of the most seriously ill (learning difficulties) patients to make and decorate a suggestions box. I also carried out several surveys of which how the diet could be improved. None of this was carried through and the suggestion box quietly disappeared.

It makes perfect sense Ow. You're saying that thee doesn't seem to be a consistent baseline of patient respect/consideration that is observed by all providers, yes?

My experience was good, bar some insults to individuality (toilet watching & being told I couldn't give an interview) and some unprofessional / illegal behaviour by a few members of staff. But, as discussed on the other thread, the chasm between my private treatment and that received by people I've known, who were in NHS hospitals, is too great to be explained by budget alone.

After-care and pre-care are obviously dismal to the point of being fatal. Surely better 'community' services would reduce the pressure on the hospitals?