Archive | March, 2014

Forced medication: resistance is futile

19 Mar
Pacific Northwest Ballet principal dancer Carrie Imler, with corps de ballet dancers William Lin-Yee and Andrew Bartee in Jiri Kylian’s Sechs Tänze (Six Dances). Photo © Angela Sterling.

Pacific Northwest Ballet principal dancer Carrie Imler, with corps de ballet dancers William Lin-Yee and Andrew Bartee in Jiri Kylian’s Sechs Tänze (Six Dances). Photo © Angela Sterling.

Someone found my blog today by searching “how to get out of the restraint that psychiatric wards use”. That lead to these tweets on my experience of forced medication on a psychiatric ward (set out below, slightly edited).

I discovered that nothing I did or said made any difference to the use of restraint on me: they were going to carry on and do it, no matter what. It made no difference to them what I said or did. All I could do was try to make a difference to me.

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Someone found my blog today by searching “how to get out of the restraint that psychiatric wards use”. Yeah, no chance there: it’s six to one. I discovered that nothing I did or said made any difference to the use of restraint on me: they were going to carry on and do it, no matter what.

In my experience of restraint, once there’s a tick on the chart saying “forced medication”, it’s going to be done to you, no matter what. Once there’s a tick in the box saying “forced medication”, it doesn’t matter where you are or what you’re doing, you’re getting it.

It made no difference that I’d never been asked whether I’d like pills or an injection. The forced med squad just turned up and did it to me. It made no difference that I’d never been asked which drug I’d prefer to take. They just climbed on top, pinned me down and stuck it in me. It made no difference that I’d never had a discussion about symptoms or potential diagnoses or treatments. They just carried out orders.

It made no difference that I was sitting on my bed, reading quietly, minding my own business. They’d turn up mob-handed & do their business. It made no difference that I’d stepped out of a meeting with the IMHA to get a letter from my bedroom she’d asked to see. They came in as I sat on the floor, document wallet in hand, surrounded by papers. They did it to me there, then walked off chatting, leaving me to wander back to the IMHA, disheveled and dazed.

It made no difference when I pleaded with them to explain what they were doing, what was in the syringe (or syringes – it varied), what effect it would have on me. None. It made no difference when I talked calmly to them, speaking to each by name, asking them to explain why they were injecting me. None. It made no difference when I repeatedly called out a friend’s name, calling to mind someone who cared for me, who heard my words. None.

It made no difference whether it was night or day. They could turn up any time, stick it in me, roll off, leave me lying in dirty sheets. It made no difference when (realising nurses wouldn’t speak to me) I wrote notes and handed them to the nurses. The notes asked the nurses to explain what drugs they were injecting, what the effects were, what they were for and what the plan was going forwards. No response. They just handed each note back to me later, unopened.

It even made no difference when I was first in the drugs queue so I could take the pills instead: they still came for me again. I had a double dose that day.

The staff weren’t monsters. Far from it. They’d chat away to each other, coordinating between themselves who was going to take which limb; who was doing what when; and then when to let go as one.

They’d chat away to each other as if the person beneath them was not a person who spoke their language but a wild and senseless beast. They’d leave behind a bed pushed out from the wall, sheets trampled under their boots, empty swab wrappers on the floor, lumps and bruises on my arms and legs. They’d leave behind a person who didn’t know what had just been done to them, or why, or when it would happen again, or how to make it stop.

I learned that, when they come for you, there is no escape. You are locked in and cornered. It is going to happen. It makes no difference what you say or do.

I learned that, when they come for you, there is no escape. You are locked in and cornered. It is going to happen. It makes no difference what you say or do. You can’t reason with people who won’t listen to you. You can’t persuade people who don’t hear you. You can’t resist them when it’s six to one, even if (unlike me) you knew how. You can’t reason with people who are just carrying out orders. You can’t persuade people who don’t think you’re worth asking.

It’s like being in a science fiction novel. Resistance is futile. Your life as it has been is over. Comply, cooperate and engage. Resistance just prolongs the process. The quickest way to get out is to comply, cooperate & engage.

I found that there was nothing I could say or do to stop them using restraint on me. But things I said and did helped me cling on to me. Little things I did and said as they did their business on me helped me to cling to my sense of being a person, a human being not an animal.

It made no difference to them what I said or did. All I could do was try to make a difference to me.

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Hospital inspections and dashed hopes

13 Mar

Green tick list

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My weekly updates on waiting to hear from the hospital inspectors in response to my report. Months later, I’ve still heard nothing apart from automated email responses.

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I’ve spoken before about my experiences in hospital: I was brutalised at my most vulnerable to the extent I came out with post-traumatic stress disorder (PTSD). I recently found out that the hospitals inspector had given the place where that was done to me full marks. And not for the first time.

It seems as if the inspection system is a rubber stamp, reassuring people outside that everything is just fine. We can all relax and look away.

I hadn’t been able to contact the inspectors before: I’m still traumatised by the hospital experience (and I’m still waiting for PTSD treatment). But, when I learned that the inspectors were going in again, I made myself make contact with them.

It was hard, but I did it. I’d known for a while that it was possible to report concerns (anonymously, if you wish) via the hospital inspector’s website. That seemed a good way to give the inspectors a heads up on some things to look out for: little signs and subtle clues that things might be amiss (if they still were). To encourage them to join the dots, to look and see where the hints might lead – rather than dismissing them as individual, isolated issues of little importance. To follow the trail to find out whether, to use their phraseology, the hospital might not be meeting all of its essential standards.

I tried several times to make that report, before eventually succeeding. First, there was the challenge of steeling myself to do it: to bring to mind the poor care I’d received (without setting off too many flashbacks) and think about how to phrase it in a way the inspectors might find constructive. Any number of times that barrier was too much for me. Then there was the difficulty in navigating the website. Often I would go there, try my hardest to get to the right spot, fail and leave. It took a lot of effort – emotional and practical – but, finally, I was able to make contact.

However, other than automated responses, I have received no reply from the hospital inspectors. No response to say that my query was awaiting attention, and perhaps a timescale within which I might hear back. To this day, I’ve had no reply.

And now, the opportunity to make a difference has passed. The inspection has taken place. The inspectors have published their report. They gave the hospital full marks, as if to say, “Relax everyone, it’s safe to look away again.”

But it is? Reading the report, I can see little clues – remarks at the end, comments by patients, concerns mentioned briefly – that have seemingly been brushed aside. It’s as if they’re saying, “Move along now. Nothing to see here.” Despite these niggles, the hospital was still given full marks. An unbroken list of green ticks. All essential standards were met, apparently. So the message seems to be: this is the standard of care we expect the hospital to give. This – what was done to you and what may still be being done to others now – is good enough. This hospital need not change. This hospital is good enough. All is well.Hospital inspection standards

It’s hard to know what to think about that or how to process it.

In a way, it’s a vindication of not having raised any issues before (which would have come at some personal cost to me): because, clearly, they would not have been a cause for concern. I knew I wasn’t strong enough to stand up to the hospital and raise concerns direct: as my dad said to me, “You can’t break concrete with a feather.” I assumed that I’d be strong enough eventually, after treatment (other than drugs) – but I’m still waiting for that. I felt it was my duty to do what I could to try to make a difference.

Now, though, it seems it didn’t matter after all. Because, according to the inspectors, the hospital is doing fine. Or, perhaps, no on really wants to know what’s going on.

“The hospital is doing just fine, thanks for asking. And we’ll be back in another 3 years, to give it full marks again. Have a nice day now!”

When I searched under “hospital inspections” for an image to head this piece, up came a picture of one of the Winterbourne View residents being dragged by the arm. It seemed apt. If hospital inspections were effective, it wouldn’t need undercover reporters filming secretly (as they did at Winterbourne View) to expose abuses. That’s if we want to find them.

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Some weird conversations with the CQC’s Kay Sheldon

  • June 2014 – In which Kay Sheldon asks for my details TEN times in a row.
  • June 2014 – Some conversations arising.
  • November 2014 – Kay wades in again with victim-blaming.

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Hopefulness

11 Mar

Daffodils at the allotment

I’m a little bit in shock. I’m still not sure how to put it. It seems too good to be true. It’s taken nearly 3 years to be able to say this:

I’m being seen by a psychiatrist who seems to relate to me as a human being, wants to get to know me as a person and work with me in partnership.

What’s puzzled me so far is why all the psychiatrists I’ve seen haven’t been like this. I know they’re intelligent, caring professionals. So it’s been a genuine puzzle to me why the mental health care I’ve received so far has been so bad or inadequate, and in so many different ways. It’s one thing having one bad experience of care: it happens. But for it to happen repeatedly, with different professionals? It’s a puzzle.

I had no idea that, two years after joining twitter, I’d still be banging on about bad experiences of care. (It’s not because I like them!). I never thought I’d still be going on about what was done to me in hospital. (I’d much rather have had treatment for the resulting PTSD.) I never imagined I’d still be moaning about my bad experiences of community mental health care. (I thought I’d learn how to work the system to get what I needed.)

In fact, just so you know, I don’t do nearly as much moaning on about my supposed “care” as I could. (It would sound way too negative!) I’d summarise my experience of mental health care as having been brutalised, traumatised then parked on welfare benefits and sedating meds. Mental health nurses & doctors who’ve treated me so far have been akin to veterinary staff: they’ve observed, diagnosed and neutralised me.

Non-medically trained staff have related to me with humanity. But, ultimately, they’ve all had to defer to the doctors and nurses. It’s almost as if mental health training gets in the way, prevents staff from seeing the human being experiencing human distress right in front of them.

Does training prevent health care professionals from seeing that what’s in front of them isn’t a diagnosis but is a human being experiencing distressing symptoms? Is the human experience so broad and varied that mental health staff steel themselves to stick rigidly to assigned roles and designated boxes?

Let’s be clear. When I’m in mental distress, it’s not about mental health staff being “nice” to me. It’s not about them being my mate. I don’t need a new friend.

I need a competent professional who’ll work with me in partnership: I’m the expert in me; they’re the expert in mental health care.

No matter how unwell someone is, they’re still a person with thoughts, feelings, quirks, preferences, friends, family and a life to return to. They’re not a puzzle to be solved, a problem to be fixed. They’re a human being, not an animal.

I want to be able to write about good psychiatric care, I really do. I have a vested interest, after all! It’s just not been my experience. I’d much rather have been able to write about fantastic treatment by great nurses and doctors; and about how much better I was in myself. I’d even have settled for half decent care and a bit of respect, mediocre care with a modicum of interest. What I got instead was damaging.

I have seen excellent psychiatric care elsewhere: caring, effective, transforming treatment and support. (Though still with no talking therapy.) I’ve just not received it myself. The comparison is bitter sweet.

Is now my time? Am I on the threshold of receiving effective help? Can I get excited about it yet? Am I on my way to living a full life? I’m not silly. I’m not going to pin all my hopes on one busy professional “fixing” me. I know it doesn’t work that way. But … I feel a sense of anticipation.

I’m hopeful the new psychiatrist and I can come up with a plan that will achieve good results going forwards. I’m hopeful the plan we come up with will include meaningful support and help going forwards, so I’ll be able to get back on my feet. And, this time, it feels as if my hopefulness could be a realistic. I’ve been getting by on wishful thinking for too long.

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  • Collated tweets (Storify) – My tweets (and some initial responses from the lovely twitter people)
  • Twitter conversations – Responses and conversations with the lovely twitter people (these are really interesting – take a look!)

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