“You’re all incredibly thoughtful souls who keep my head attached to my body”
Some time ago, I connected with the Director of Quality, Patient Safety, Innovation and Improvement for the North East Ambulance Service (NEAS) – Sarah Rushbrooke, and we got talking about a collaboration. She put me in touch with NEAS’s lovely Mental Health Lead and their inspirational Communications Manager and we had a few productive and exciting meetings, which have led to this piece…
CHALLENGE ONE: RECOGNISING THAT YOU NEED HELP
The first part for you interacting with NEAS and their Ambulance crew is calling for one or finding yourself in a situation where someone calls one for you. Either way, the call tends to happen because you’ve recognised that you need help.
Initially, this was going to be ‘admitting that you need help’ but the word ‘admitting’ sounds like you are saying that you need help is some sort of weakness or an act that came out of being defeated. When I believe the exact opposite – recognising you need help and asking for it, are a sign of strength, resilience, and bravery. And I think this is particularly true for mental health related calls because in a world where self-harm and suicide are deemed to be ‘attention seeking,’ it takes a lot of nerve and courage to tell someone that you’ve done one of those things.
When I made my first suicide attempt way back in 2009(!), I just wasn’t ready to accept the help and support that ended up being forced upon me… I remember passing out at school and, in an almost absent-minded way, telling them what I’d done, and they called an Ambulance. The crew told me that I needed help, but I think that I was just so lost in the hallucinations that I’d been experiencing for the past ten days that I just didn’t recognise I needed support. I mean, the voices would almost constantly tell me that I deserved to die and that I should make it happen; so how could I possibly hear or listen to all the Ambulance crew – and then the Nurses and Doctors – telling me I needed help and that I wasn’t as worthless as the voices had managed to convince me I was?
It took about four years of me self-harming and making another suicide attempt before I finally recognised, I needed help. In 2012, I had made a suicide attempt that left me on life support in Intensive Care and when I woke up, I was taken to a specialist psychiatric hospital. After one year in that hospital, I managed to run away, but because I was detained under the 1983 Mental Health Act, the hospital called the Police. When they found me hours later, I had made another attempt and after refusing treatment, I was put in a coma and on life support.
When I woke up, the staff from the psychiatric hospital took me back, but instead of going back on the ward I’d been on, I was moved to the Psychiatric Intensive Care Unit (PICU). I remember being sick all the time from the anaesthetic and medications that had saved my life and being terrified of being on the Unit I’d only ever heard screaming from. After being eyesight observations for a few days, I came to realise that I really didn’t want that to be my life. I didn’t want to spend years in a hospital, running away, hurting myself, feeling poorly… It was like a kick up the bum! A wake-up call. So that when I was finally moved back to the ward I’d been on, I began cooperating with the staff, taking my medication, engaging in therapy, and confiding in my Key Nurse and the loveliest Psychiatrist. And lo and behold, I was discharged a while later and whilst I’ve had ‘relapses’ in my recovery, I’ve never felt as terrible as I did back then.
Another difficulty in recognising you need help is when you’re making comparisons about your health and the health of others. It’s incredibly ‘easy’ to look at someone and think that they’re ‘worse off’ than you. To think that actually, you shouldn’t be complaining or crying or even struggling because that other person is in a much more difficult situation. As though you should be grateful and appreciative that life isn’t as ‘hard’ for you! It’s a very straight road from that to being dismissive and disregarding your own health problems, which can be so dangerous and unsafe.
There are also so many people who worry that calling an Ambulance will take it away from someone who needs it ‘more.’ Well, rest assured, the Call Handlers and Triage staff have an effective process to prioritise calls, and life-threatening emergencies will always be attended to first.
These videos by NEAS will tell you everything you need to know about calling an Ambulance:
CHALLENGE TWO: MANAGING ANXIETY & FEAR
Whilst the first biggest battle is recognising you need help, I believe that the second is coping with any anxiety and fears that come up during the time of ringing 999 and waiting for the Ambulance. I mean, just because you’ve made a decision, it doesn’t mean carrying it out is in any way ‘easy’ or ‘simple.’
The first time I actually called an Ambulance was when I was younger, and a friend’s Dad was having a diabetic crisis. I remember being terrified purely with the thought that I didn’t know what to expect from calling 999. And I think having no expectations or previous experience of something, is a hugely contributing factor to anxiety and nervousness.
I’ve honestly never really thought of myself as an anxious person, but only because whilst I was in the psychiatric hospital, I witnessed so many of the other inpatients have panic attacks and feel so anxious that they needed sedatives. So, I compared my own thoughts and feelings with theirs and came to the conclusion that my anxiety just didn’t measure up. That it was in no way more powerful or detrimental than that the other girls experienced.
Over time though, I’ve learnt that making comparisons and using them to dismiss or disregard your own experiences, isn’t healthy. It isn’t good, and it isn’t fair. I think this because everyone is different and what might be a really challenging day for you, could be someone else’s definition of a ‘good day.’ So, the only time that I believe comparison can be safe and helpful is where you use it solely to gain perspective, gratitude, and appreciation.
So, for me, anxiety usually takes the form of my hands shaking and finding that I’m totally catastrophising things by imagining and panicking about the worst – but also least(!) – possible outcome/situation happening. And I think the times that this way of thinking is at its most dramatic, is when it’s anything to do with my pets! I mean, I’m usually quite good at having instincts with them in that when my first rabbit (Pixie) became poorly in April 2021, I said from the beginning that I had a bad feeling about it. That I had the feeling that this wasn’t going to end well. And she was put to sleep April 22nd 2021.
Being in tune with the pet’s health, is something I do actually also experience with my own, it’s just that I’d say that for my pets, I’m probably more emotional! For me, I really struggle with having to go to hospital or go in an Ambulance when it’s concerning something that I’ve never experienced before. When I used to self-harm, I used the exact same method every time because I would know what to expect from it. I mean, I’d know the side effects, how long you had to wait before they could do blood tests, how long the antidote treatment would take, the side effects to that treatment, what happens when it’s done… And knowing those things, at a time when I felt as though I was in constant mental/emotional/physical pain, was actually somewhat comforting!
Experiencing that notion of reassurance being when I’m totally aware of what would happen if I were to self-harm in a particular way, has meant that I’ve realised that one of the most helpful tools when you’re feeling anxious and scared, is being able to recognise and accept what it is that’s led you to feel that way. I think that this is the case because in doing that, you’re in a much better position to get help. If you can tell someone why you feel the way that you do, they can be more effective in offering you and providing you with help and support for you to safely cope with those feelings.
Knowing the cause for your anxiety, can be really helpful in being able to tell all of those you might interact with in calling 999 so that even if you don’t know how to change those thoughts and feelings, they have the opportunity to at least try to think up a way to help.
The NHS have some really useful information and tips on coping with panic attacks:
These videos by NEAS will tell you everything you need to know about what happens when Paramedics come, and what the inside of an Ambulance looks like:
CHALLENGE THREE: FEELING ALONE IN IT
With the theme of this year’s Mental Health Awareness Week being ‘loneliness,’ it was bound to come up in this blog post!
I think that the first instance where loneliness really comes into things in the context of this post (anything to do with an ambulance!), is purely just in being poorly – whether that’s with your mental or physical health. It could literally be a broken leg or suicidal thoughts or a heart attack or hallucinations; and no matter which, it’d be equally common to feel as though no one else could possibly understand how you’re feeling, what you’re thinking, and what you’re experiencing.
The fact that everyone is different – our level of pain tolerance is varied, our coping methods can differ, our ability to effectively verbalise what we’re experiencing can change – is really illustrated when there might even be someone right there who has broken their leg in the exact same way before, but you still feel like they just don’t ‘get it!’ This is one reason why, if you’re asked to rate your pain on a scale of one to ten, it’s actually helpful because it can be a much more efficient method of enabling the person asking you, to really appreciate how you’re feeling.
There’s no real frequently used and understood ‘scale’ for mental health though… So, you can say you’re suicidal without the ability to really be clear about just how intense and unsafe that feels. But people tend to have more words in mental health that’s definition is socially accepted. So, suicidal; people label that as ‘someone wants to die.’ But if you’ve actually felt suicidal, you’ll know there is so much more to it than that fundamentally stereotypical assumption.
Feeling alone in your ailment – whatever it is – can be affected (positively or negatively) by the response of the call handler when you’ve dialled 999. I mean, if they’re validating, approachable, friendly, and kind; you’re less likely to think of yourself as totally alone in the situation. And the absence of that loneliness can really help your mental health. I mean, if you’re struggling with your safety or have just self-harmed or attempted suicide, and are feeling like you have no one who can possibly even come close to understanding or empathising with you, how likely are you to actually reach out for help? And if you do get help, and that person leaves you feeling more and more alone, what are the chances that you’ll continue to engage and communicate with them, or that you’ll ever reach out again?
I think that the next instance of feeling alone in this scenario is that because of the coronavirus pandemic and subsequent lockdowns, a lot of hospitals have regulations in place that mean you’re unable to have a loved one with you. This is probably particularly difficult for a young person (children can be accompanied) or when it’s the first time you’ve attended the hospital. But in all honesty, I’ve found it difficult(!) despite being in my 30’s and having been to hospital numerous times! It’s hard when the Ambulance crew, Doctor, Nurse or whoever is talking to you and telling you a diagnosis or more test results and you realise that you need to remember all that information because no one else is there to hear the bits that you might miss or forget about. There’s also the fact that without another person being there, you might not consider questions that someone from the outside looking in would have thought of. There have been so many times that I’ve called my Mum to tell her the results of blood tests or a scan and she’ll ask me something and I’ll be like “oh! I didn’t ask them that!”
So, I think that the best things to do when you are feeling alone is to talk to whoever actually is there – even if it’s a professional you’ve never met. They’re there to take care of you and it’s important that you feel you have understood everything that’s been said or done, so don’t be afraid to ask lots of questions and to say that you need them to repeat something.
Watch this video to find out how NEAS can help and support a worried or upset patient:
I really hope that this post has helped you in some way, and if you have experiences (good or bad) of the North East Ambulance Service, then please know that they’d love to hear your feedback so that they can learn – whether that’s something they can discover that they’re doing right, or something that they need to improve on. Just visit this link to leave your comments:
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