Continuity of mental health care

This is likely to be my last blog of the year, not the catchiest title in the world is it? Thoughts of last Christmas have been running through my mind quite a bit this week. At the moment my mental health is feeling reasonably stable, I am seeing friends and family, I’m not injuring myself, the suicidal ideation which has been pursuing me doggedly all year has finally abated. I am as prepared as I can be for the Christmas period. It feels quite unsettling to feel this stable after a year filled with such poor mental health and I wonder why things feel this way. I think I might actually be feeling content.

Lets look back to last year, I’d become unwell and had sought help from my GP, I could no longer manage my symptoms without support. I was very paranoid, which had culminated in me shouting at colleagues at work, accusing them of things which weren’t true. I was low in mood, very anxious and had started to control my eating. I was referred for counselling and waited months to be seen. When I was finally seen it was with a student training in CBT. I didn’t find it helpful and became more unwell. After another gap it was agreed I could see someone else and they taught me various techniques, were kind and validated my emotions and best of all it felt like they understood me. Unfortunately during that therapy I suffered a bereavement, a change in job (after doing my last one for 12 years) We spent a lot of time dealing with those immediate emotions rather than working on skills which could help me in the future. Our sessions were limited in number and came to an end before I was ready, I begged for the support to continue and was told it couldn’t as it was not how the service worked. I was told I may have Aspergers and a referral to the assessment service would be sent, but this would take months to be actioned.

The sudden cessation  of contact with someone who understood me and was helping me was really hard. I was very distressed, self harmed and my control over eating and exercise increased. I ended up being assessed by the crisis team who agreed I would be placed under the Community Mental Health Team and would have telephone support over the Christmas period. I was so distressed over Christmas I stayed at home alone, the first year I was unable to be there for my daughter. Through tears I did manage to wrap all the Christmas presents. When I spoke to the Community Mental Health team they advised that a referral would be sent for further therapy with their team – they dangled a metaphorical carrot at me. Sadly this wasn’t true and when I did see a care coordinator I was told I would need to get to know them first before a referral would be sent, I was so upset that a promise had been broken. I spent weeks seeing them, talking things over with someone not qualified to provide me with the therapeutic guidance that I so desperately needed.  My control over eating developed into a full blown eating disorder and I was very depressed. During this time I did receive a diagnosis of Aspergers syndrome, but without anyone to talk it through with it felt overwhelming and upsetting. I eventually ended up being sectioned twice. During my second admission I was a low weight and losing weight fast. I was placed on an eating disorder unit, I found it really overwhelming and stopped eating/drinking and was too frightened to leave my room. Due to physical health symptoms I was moved to the general hospital, where with support I was able to eat and drink, consuming more than I had done in months. After 3 days I was sent home. I was seen once at home, then not seen for 10 days. There was no clear plan in terms of the treatment of my eating disorder, I was given no written information and struggled.

Somewhere in amongst all that I had gone through an assessment for therapy, but was told my weight was too low to have the therapy. My eating disorder deteriorated further without clear support and I ended up in a psychiatric hospital as a voluntary patient as my weight was dangerously low, I was exercising alone in remote places to the point of collapse and felt suicidal.  I am not sure what would have happened to me if my family hadn’t doggedly pursued an admission. The care I received and seeing the hospital psychologist turned things around, I was able to make tentative steps towards recovery and gained nearly 3/4 of a stone in weight. When I came home I was eating well, thinking straighter and was ready to recover. I begged for the therapy to commence, but was told I’d have to wait. I had a care plan which set out the best way of communicating with me. The care plan wasn’t followed (in my view) by the nurse I was seeing in the eating disorder service. I relapsed. After around 4 weeks of emails/phone calls/reviews a plan was put in place to support me and I’ve now been having weekly support which meets my needs, with the plan to start therapy mid January if I continue to maintain/gain weight. I’ve still not managed to recover from the relapse I experienced when I left hospital, my eating disorder is still controlling me and making me unhappy. I am doing everything I can to fight it, but there’s still a long way to go.

I look back to last year and wonder if services were empowered to make decisions about continuity of care it would enable them to ensure the people they are supporting can recover faster or maintain stability at least. In the long run it could also cost less money. Whilst in hospital I witnessed a number of patients being discharged without clear plans in place, it was so sad to see and when news filtered back of people not coping in the community I felt angry for them. Simple things could be done in hospital to support someone’s transition home, rather than leaving this to start in the community a month after someone is discharged when they may have relapsed by then.

I’d like to wish everyone who has supported me online a safe and a ‘as stable as it can be’ Christmas. This year I’ve had to reach out to people online and in person and have been staggered by the kindness that I have been shown. My ears are always open to others and I would encourage anyone reading this to reach out when things are feeling difficult whether that’s to someone you know or local/national support services.

  • Samaritans (116 123) operates a 24-hour service available every day of the year. If you prefer to write down how you’re feeling, or if you’re worried about being overheard on the phone, you can email Samaritans at jo@samaritans.org.

 

** NB I am hoping I have captured the order of things correctly, but the periods of time when I was most unwell are very blurred in my mind. I also do appreciate that Care Coordinators are highly trained and at times can provide helpful therapeutic support, in the situation I was in the support just didn’t meet my needs and the level of support can be dependent on the background of the worker eg social worker/CPN/OT etc.

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One thought on “Continuity of mental health care

  1. I’m very pleased that you’re ending the year on a more relaxed note. You’ve had to cope with a huge amount – mental health problems, your autism diagnosis, and an eating disorder. One of these by itself would be enough for most people, but you’ve had to manage all three. You can take great pride in the way you’ve coped. I really hope next year is calmer, with plenty of snow for you to walk through and birds to spot 🙂

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