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?

Just seen I xposted with you, Maryz. Score one for family therapy, then! Hurrah!

I'm not eligible because I am seen by CMHT people instead. You can't use both services I don't think?

I'm not bloody surprised that stung almeda - what a hurtful thing to be told.

The ethics of forcible detention are so so hard to make sense of. It's a huge human rights issue but I can also see how it can be necessary sometimes. Very very hard. Being under a section must be immensely disempowering. Ditto forced medication. One I don't have any solution to at all - if anyone has any reading suggestions on this area I'd be grateful.

people should not have to reach crisis point before they receive help. early intervention that is easy to access and the person's choice of support would go a long way to ensuring that a lot of the damage done once within the system for many folk would be minimised. there needs to be much more invested in counselling and i believe that everybody would benefit from having counselling in their life at some point :) and then of course aftercare- that is very often totally insufficient too leading to relapses and suicides etc. i always mention MIND to people because they are often peer led and collectively run and offer so much to people in a ethos of equality. i may be rambling now, apologies lol

That sounds really interesting Garlicbutter - assertiveness for People in mental health services not something I've come across but can really see how some of the principles could be fantastically empowering?

Peer support is a growing area - Gail Hornstwin's book 'Agnes's Jacket really opened my eyes to this - amazing the number of support groups that MH services have no idea exist - which is both good (in that it may be this fact that enables them to function) and bad (in that we then can't alert people to them). Fascinating reAd.

Hornstein sorry :) Know I recommended before but wanted to add here too!

or is IAPT primary care and CMHT secondary/tertiary?

I hate the whole idea of sectioning and medicating people against their will but do accept that sometimes there is no alternative, obviously.

Heh, empowering is the exact word I was going to use but thought I'd better try something less 'department speak' Yes! And also uplifting! When you've been dysfunctional all your life, it's fantastic to discover there are effective ways to make yourself heard without conflict. And everybody always loves the "NO" class! Especially in a mental hospital

Thanks for the info about IAPT. I presume that's one of the waiting lists my GP put me on 18 months ago, then. I'll check. Sigh.

daisee's issue about wanting to ensure that the police were not violently dragging people off is a crucial one. the police need much better training. i am sure that there was a mind campaign and directive about this some years ago but cannot for the life of me remember enough about it.

yes my lingo is often Department :) IAPT do often have long waits - as any talking therapy. More funding for Samaritans maybe so they could offer face to face?

almeda I think so - but it varies area to area, and seems to change all the time!

Not sure how much training police do get? And their restraint techniques seem to differ from what I was taught. Not that all are bad - but we train MH nurses for 3 years - police training is what, 20 weeks, with a tiny amount of MH?

i don't know how long police train for in mh but i bet it is not much.

ow- samaritans in the area i worked did use to offer face to face, do they not now? maybe varies as to area?

I've not come across it - I know one lady who worked for them wanted to offer it to some regular callers but wasnt allowed tho that may have just been that one office, or temporary?

Right off to bed following a late night Solero ice cream (mmmmmmm).

Really hope this thread has started something positive and helpful in terms of information and sharing. Thank you for all the links

Hope everyone has a good night and catch you all tomorrow :)

Gosh maryz that must have been terrifying as a parent :(

also wanted to mention safe houses. the mind branch that i was involved with raised funds to buy a house and do it up- all building bits and decorating done equally. the mind centre was a collective amd "user led" ( i hate that term ). brilliant place. anyway, the house was turned into a crisis house that anybody could access and it was very successful. just a safe space to go and be overseen by a volunteer. it then became funded by ss if agreed. if not then we did not charge. as far as i know it is still going. i put up them there plaster boards! it took a whole summer and we had many volunteers. more places like that would reduce need for acute admissions imo and keep people's dignity.

And not ignorance at all - you sounds as if you've had plenty of experiences with a range of services - my 13 years and research etc doesn't make me more or less ignorant than anyone else, just different knowledge if that makes sense - both types really valid and valuable.

night ow and thank you for starting this thread which is informative and positive. and yes to maryz- terrifying :(

I can't see any reason at all why the police should not routinely use the same restraint techniques that you've learnt. Different if a patient is armed of course, but that would be a different callout anyway. It's perfectly possible to immobilise and direct a struggling adult using three people, without knocking the person to the ground or placing weight on them. I don't know how to do it, but have seen it loads of times. Police DO have de-escalation training, and plenty of it, but rarely seem to employ it when sectioning. If the person has been moved safely to the van or car, they can then be strapped in with a locking belt, can't they? Why the bloody cuffs?

WRT assertiveness (promise this is my last post on it), what's that therapy for talking to your 'voices'? Dialectical?? I've forgotten. Anyway, I talked to someone who specifically incorporates assertiveness into this. So, when your 'voice' is telling you to do negative crap, for example, you discuss and negotiate with it assertively. Reduces fear. I used this with my inner critic, which isn't a 'voice' exactly but responded well to respectful conversations :)

Thanks garlic - sounds really interesting - will definitely look into it in more depth!

aesop - i think there's the Arbours which certainly was running a large and very successful safe house, and another in London that was specifically for people feeling suicidal. Fantastic resources.

like this garlic?

beyondmeds.com/2009/04/03/talking-back-to-your-voices

are you talking about maytree OP?

And no idea re: why police training different - the techniques we were taught were certainly not pleasant (no restraint would be) but were not painful and didn't cause injury. They were very, very tight on who could and couldn't restrain, you had a 5 day intense course that covered verbal de-escalation and risk of restraint (ie vomiting, poetical asphyxiation) and had to pass the course. Rarely used and I as often took the 'head' - where you're the only person who talks, leads and directs others - I would always tell any gawpers to bugger off and make sure everyone else was ok, to be as dignified as possible. Luckily, being tiny (5 foot on tiptoes) I used to rely on my non-threatening size and verbal skills to try and avoid full restraint wherever possible - didn't always work but as someone female and small, and generally smiley and calm, it did sometimes help.