Wednesday, 26 February 2014

Crisis Care Concordat Part Three - quality of care and treatment when in a crisis

The Concordat is broken up into four main areas (and so are these posts); the ability to access support before crisis point, access to urgent and emergency treatment when in a crisis, receiving the right quality of care during the crisis and recovery; staying well and working to prevent future crisis.
Mind (
https://www.mind.org.uk/) worked with service users and carers to form statements  expressing the expectations around crisis situations.
The third area of expectations is with regards to the care and treatment you receive and that it should include people with the right skills for your recovery and in the right setting for you. For me, this means that once I was diagnosed with Borderline Personality Disorder and it became clear local community and inpatient services couldn't help me, I should have been admitted to a service where staff have the right skills; where they were properly trained in dealing with those with my diagnosis. It shouldn't have managed to go as far as it did (me winding up in ICU) to enable me to get the right help.
'The dignity of any person in mental health crisis should be respected and taken into account."
There are countless incidents that I've had happen or have seen or heard of them occurring to others in times of crisis that have meant their dignity has gone out of the window. The argument within this, lies though, as to what may be considered reasonable reactions to the risk posed by the person in the crisis. For example, I was once put into a police station cell to wait for a Mental Health Act assessment and because of that, I had to remove all of my clothes in exchange for a safety suit. Those who aren't familiar with this; a safety suit normally means a top and pair of shorts that have a slightly padded quality to them. When I had to wear them I was slightly underweight and so even the smallest size was massive and the shorts kept falling down which wouldn't have been so bad except I'd had to take my knickers off. Most recently, one of the girls on the ward had tried to ligature with a pair of pants and they were removed. Not just to end the attempt at her life but actually taken away so that the girl was walking around the ward with a jumper wrapped around her waist. There were male staff on the ward and we had a new admission being shown around. It was completely inappropriate and while I can understand staff were trying to minimize the risk there's a fine line between keeping someone safe and denying them their dignity.
Restraint is once again mentioned with the highlighted area of the person's physical and psychological wellbeing to be constantly monitored whilst in restraint.

To read the concordat yourself and make your own opinions, you'll find it here: https://www.gov.uk/.../36353_Mental_Health_Crisis_accessible.pdf