DISCHARGE AFTER 35 DAYS ON THE CRISIS TEAM’S CASELOAD

“The power we discover inside ourselves as we survive a life-threatening experience can be utilised equally well outside of crisis too. I am, in every moment, capable of mustering the strength to survive again – or of tapping that strength in other good, productive, healthy ways.”

Michele Mosenthal

Having had a horrific psychiatric hospital admission in February this year (which resulted in filing a complaint to CQC and discovering the ward I was on ended up on the news because they had actually been put under ‘Special Measures’ in their most recent inspection) I found myself briefly under the care of the Crisis Team before being transferred to the Step-Up Team. However, I quickly established the realisation that they were actually making things worse – I felt that I was almost feeling pressured to be poorly so as to not waste their time and to feel deserving of their efforts! Apparently upon discharging me, the Step Up Team told my Mum that I self-refer back to them so when – a few months later – I found myself struggling again, I gave them a call, and on August 23^rd I had an assessment with someone from the Community Mental Health Team (CMHT). She validated that my current symptoms and the reasons for my lack of safety are completely different to those when I struggled with Borderline Personality Disorder (BPD) and said she would be recommending I go under the care of the Crisis Team. Two days later – August 25^th – I was put on their caseload…

THE MOST IMPORTANT MENTAL HEALTH MOMENTS FROM ONE YEAR OF BEING DISCHARGED FROM SERVICES

Maybe we always look back and think it was better than it was
Maybe these are the moments
Maybe I've been missing what it's about
Been scared of the future, thinking about the past
While missing out on now
We've come so far, I guess I'm proud
And I ain't worried about the wrinkles around my smile
I've got some scars, I've been around
I've felt some pain, I've seen some things, but I'm here now

Macklemore ft. Ke$ha

 

One year ago, I was finally discharged from my local Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW) Community Mental Health Team (CMHT) after over twelve years in and out of their care. The plan was for me to have six months of stability outside their care before beginning trauma therapy but so much has happened in the past year that this plan hasn’t really been followed through. However, I’m so happy with the place I’m in now and everything/everyone I have in my life; so, I decided to go through the past year of blog posts and talk about the most important moments for my mental health since my discharge from services…

 

The Pharmacy’s Mistake

http://www.imnotdisordered.co.uk/2020/07/you-shouldnt-become-complacent-with.html

Unfortunately, not long after being discharged from CMHT, I was faced with a situation that really made me wish I still had their support and guidance…

I had begun to worry that maybe I needed to request my antipsychotic medication (Aripiprazole) be increased when the hallucinations seems to be coming back, but it wasn’t until I was showing physical symptoms that I called the non-emergency NHS 111. When they asked what medication, I took and I went to check my dosette box to list them all, I realised that the Aripiprazole was missing and the Doctor on the phone assured me that all my symptoms collated to those you might experience in withdrawal from that medication.

I’VE BEEN DISCHARGED!!! | EVERYTHING YOU NEED TO KNOW ABOUT MENTAL HEALTH SERVICES

June 12^th 2020, I was discharged from my Community Mental Health Team (CMHT) after being under their care (on and off) for eleven years! Now, I’m very aware that with my audience being so big there are readers who don’t have a lot of insight into mental health services and therefore may not appreciate just how big an achievement discharge is. And that is the aim of this blog post – to provide insight and to educate readers about mental health services…

You can be referred to Services in various ways…

I was eighteen when I was first allocated a Community Psychiatric Nurse (CPN); I was sort of lucky in the way I first came into contact with Services because I didn’t have to be referred and sit on a waiting list for months on end. However, I was definitely unlucky too, in that I was only put under the care of the CMHT because I had attempted suicide and been sectioned under the 1983 Mental Health Act, and apparently the automatic aftermath of being sectioned is that you’re allocated a CPN upon discharge.

I recognize my luck in the situation because I know of the many instances where people have been referred to their CMHT through their GP and have then had to sit on a lengthy waiting list. The saddest thing about the waiting lists is the fact that all too often, the person’s mental health deteriorates to the point where they attempt or succeed at committing suicide. This happens for a number of reasons, but the main one is that there’s often the development of feelings of hopelessness and a conviction that Services don’t care enough about the person to rush through their referral through.

BUT AM I READY TO BE DISCHARGED? | DISCHARGE FROM MENTAL HEALTH SERVICES | IN COLLABORATION WITH CUMBRIA, NORTHUMBERLAND, TYNE & WEAR NHS FOUNDATION TRUST | AD

This post may come as a shock to some people but it’s actually something that’s been talked about behind-the-scenes for about two months now and I just hadn’t told anyone it was a topic of discussion amongst me, my Community Psychiatric Nurse (CPN), and the rest of the Community Mental Health Team (CMHT).  As part of these discussions, my CPN suggested I write a blog post about discharge from mental health services; the technicalities behind it, the thoughts and feelings around it, the importance of it, and advice I’d give to others going through the process.


WHY I STILL NEED THERAPY

So, the talk about discharge actually came up when I got a new CPN; she was asking me what I thought I needed to do and what she could do for me to help me be ready to be discharged from services, and I told her that there’s still a lot to talk about around the abuse. You’d think that somewhere among all of these blog posts would have been the point where I’d worn out talking about the abuse but actually, I’m very short of that mark. And I think that’s because the most detail I’ve ever gone into it about it was to the Police; and for all their amazing work, they aren’t the best people to support someone with that. For them, it’s all about the technicalities in using the proper words – who cares about the words that make you uncomfortable or that you find triggering, you better be prepared to talk like you’re in a Biology class(!) – and naming absolutely everywhere and everyone that was even remotely involved. Now that that interview is over, all I can do publicly is say at one point in my life it happened… I can’t tell you his profession or the location of it because people will easily guess – my point with this though, is that, if you can guess from just those details then maybe that says more about him than it does about me oversharing! And there have been so many times when those details have been relevant to blog posts and I’ve just had to bite my tongue! So, having the ability to tell one person absolutely everything would be so refreshing and comforting that I feel it’s the one necessity missing for my mental health recovery. I have the support system, I have a positive attitude, I have safe coping mechanisms… all of that isn’t the answer if you haven’t worked on the root cause though.

MY THOUGHTS ON DISCUSSING DISCHARGE IN MENTAL HEALTH

“Are we talking about discharge right now?!”

“Well it has to happen eventually!”

After my recent mental health crisis, Northumberland, Tyne and Wear NHS Foundation Trust’s Crisis Resolution Home Treatment Team carried out an assessment at my home and I was admitted to their caseload. From the offset, the plan was that I’d be with them until Tuesday (today!) when my Community Psychiatric Nurse (CPN) returned to work and they would have a discussion to review whether I still needed to be on caseload and it’s made me think about the subject of discharge in mental health…



CLARITY

I’ll be honest, that first year of me being poorly is a bit of a blur; but I do remember that my first admission to a psychiatric hospital was the epitome of confusing and scary. I hadn’t long turned 18 so I was admitted straight into an adult ward and having had no contact with the Child and Adolescent Mental Health Service (CAMHS), I had no understanding of anything mental health - including the Act of law that I was being detained under (Section 2 of the Mental Health Act 1983)! To be fair, I think that everyone was so busy being worried about me that they didn’t have the time to explain anything and inevitably, after two weeks, no one explained the discharge process either. I didn’t know that after being sectioned you have to be allocated a CPN in a Community Mental Health Team (CMHT) and I didn’t know what that even meant - what it would entail.