THE TRUTH & ADVICE ON RESTRICTIVE PRACTICES | IN COLLABORATION WITH CUMBRIA, NORTHUMBERLAND, TYNE & WEAR NHS FOUNDATION TRUST

A little while ago an opportunity came up with Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW) for someone to speak at a Positive and Safe Conference about their experiences of restrictive practices… 

Now, considering I’ve been a mental health Blogger for almost nine years, I think it’s totally reasonable to assume that I’ve talked about my entire mental health journey by now. In all fairness, I think even I thought that was true; until this opportunity came up… So when I was chosen to give the speech and first met with the lovely Lauren (who you’ll be hearing from later in the post) from the Trust’s Positive and Safe Team, I almost immediately realised two things:

1.     I have a lot of experience and a lot to say about the topic

2.     I actually haven’t talked a whole lot about it all before

In acknowledging these two points, I had a decision to make: did I want to change that? Did I want to change the fact that I didn’t talk about these things?

PRE-EVENT PROMO DAY ONE - Enhancing Mental Health Multi-agency Partnerships | Ad

For some time now, I've been working alongside Inspector Steve Baker, the Mental Health Lead for Northumbria Police, and Claire Andre, Police Liason Lead for Northumberland Tyne & Wear (NTW) NHS, on many different projects. And this event, is the next to become public! 
On Thursday 15th September, the Enhancing Mental Health Multi-agency Partnerships event will be held (details in above photo) and I've been asked to deliver a presentation on my experiences (good and bad) with the Police in regards to mental health. So on every day for the next three days, there will be a post about the event.
To keep up with the excitement, plans, thoughts, questions and general goings-on, use the hashtag #multiagencyNE on Twitter.

When I began I'm NOT Disordered, I decided that rather than write one long rambling post about the previous years of my life/mental health 'journey' at the beginning; I would, instead, tell you all as it came up. And so, many of you might not know the ins and outs of the three poorly years that led up to the long-term admission where this little gem began... I was on first-name basis with the Police. Basically.
The first time that I had contact with a Police Officer, was June 2009. I'd taken my first overdose in School (Sixth Form), passed out, was taken to A&E and then the voice that no one knew I could hear, got angry. So I left. I had never been to the town which the A&E was in and I can remember finally coming across some shops and the first thing I saw was a parked Police car. I can remember almost smiling with relief and thinking 'I'm safe now. I can go to them for help.' The Officers detained me under section 136 of the Mental Health Act 1983, and so it began...

Naturally, over the next three years, I had both positive and negative experiences with the Police...
Example of a negative experience: I was sat in a little room in A&E with two Police Officers who'd detained me under a section 136, when two female Officers came in to 'relieve' (Police speak basically for swapping places) the others. From the outset they were repeatedly telling me that if I'd allow my partner to come to the Hospital then they could leave. Firstly, I knew this wasn't true; the previous Officers used a 136 so they couldn't leave until I was assessed under the Mental Health Act - by this point I was so experienced with the whole 136 situation that I knew the ins and outs of it. And secondly, I felt too embarrassed with the whole mess to see my partner. Needless to say the Officers stood outside the door (but directly in front of it) and the next time it opened it was one of the Police letting my partner in. I told them that they had no right and was met with "you don't have the capacity to decide that." I countered with "if I don't have capacity and I'm under 136 then why would having by boyfriend here mean that you could leave?" At which point both Officers rushed at me, pinned me down on the hospital bed/trolley, one shouted in my face that I was a 'spoilt cow' before whipping out the handcuffs; whilst the other, who was restraining my legs, added "you're one of those people that should be locked away in those hospitals forever; so that everyone's lives get easier!"
Example of a positive experience: I was sat in a room in A&E with an Officer who'd just detained me under 136 (yes, three years of my life pretty much became this pattern) and he was finishing his shift so a female Officer came to 'relieve' him, as he left he called out to me: "good luck! You'll be fine!" During my time with the female Officer, there became a point where I was hallucinating rabbits under a chair in the room. I remember staring at their muddy fur and drifting off to a stereotypical scary wood; like the one from Beauty and the Beast, and then someone was calling my name and asking what I could see. The last thing I expected was for the Police Officer to pick up the little wooden chair and stamp her massive, black, shiny, boot all over the scary, dirty, evil, rabbits. But for her, there was nothing there. For her, she was stamping on thin air. But she believed me.

It's strange to think that both the negative and the positive experiences could motivate me in working with Northumbria Police - but for completely different reasons. The negative experiences have made me want to do all that I can to ensure no one else experiences these or similar. I want to tell Officers how these experiences made me feel and why I felt that way; in the hope that with this insight their understanding will improve, and with it, many skills that would be beneficial in such situations e.g. compassion, validation, kindness, respect, humility, and patience.
And the positive experiences, make me want to do all that I can to show my gratitude for the organization who, on many occasions, saved my life.Because in those times when my life was saved; I wasn't grateful. I didn't thank them. I did the opposite, really. I was rude and obnoxious. They were stopping me from doing what I wanted to do; the thing that I believed would make me truly happy; suicide. Death. But in doing this, they gave me the opportunity to access the help that I needed to go into recovery. They believed that I was worth saving. That I had a chance at recovering. And I'm 100% certain that they can do this for so many other people. And they are now! And it's such a great honour to be able to witness this happening.

Crying over the person I was

                                

Those of you who have read the blog for some time, will know who Chelsea is. For those who don't, I met Chelsea in the hospital I was in when I began this blog. We quickly became best friends and because of our previous experiences, the friendship seemed incredibly important and special. 
When Chelsea was discharged from the hospital first, she had a book made up, that told the story of our friendship; from the very beginning when I was first admitted and Chelsea was allocated my 'buddy.' This meant she showed me around the ward and introduced me to the rest of the girls, as well as sticking by my side through OT groups and activities. Chelsea had used her diary, my blog, and her own memories to write the short book about our time together; including the times we'd have fun and giggles, the times that I'd be hugging and supporting her, and the times when she'd be checking my room for my hallucinated rabbits. She included photos of us, and pictures from Pinterest with lovely quotes.
Now, for some reason, one night, I decided to clean the shelf beneath the table that my bedroom TV was on and when I spotted the book, I decided to read it. I hadn't looked at it in probably almost a year. I started crying when I read some of the things I'd done etc that had given Chelsea reason to support, protect and look after me. Things like me hallucinating and being so convinced that there was evil rabbits running around my bedroom that I refused to go in until Chelsea had checked the entire room and all of the possible hiding places. There was also details of the first overdose I took whilst in that hospital and the affect it had on Chelsea. There was a lot more too, and it all made me think about the person I once was.
I was remembering being restrained in the middle of Asda, and not caring or feeling any embarrassment because I was so lost in what the voices in my head were saying. I remembered lying on the hospital bathroom floor and crying because I had nothing sharp enough to slit my throat with. I remembered all the times that I'd be in a cubicle of a public toilet, feeling so incredibly lonely and I'd swallow all these paracetamol tablets. I remembered standing on bridges and the only thing stopping me was the worry that I'd end up paralysed and not dead. I remember all those moments when I'd feel so hopeless and accepting that my life would continue in this way until I eventually killed myself.
I'm very aware that stating that I cried over me being that way, sounds very self-pitying and pathetic. But I think that in a way, it's also understandable. I am in such a good, positive, safe, and happy place (mentally and physically), that it's making me reflect a lot on those hard days. I guess I just wish that the me that I am now, could go back and reassure the old me that things would get this good. But at the same time, so many people told me, during that time, that my future was bright and I didn't believe them. I think it makes me feel lucky that I was saved so many times so that I was given the opportunity to live the way I am now, to do all of the things I'm doing, and to feel so happy, positive and safe.

10 Things I Won't Do Again

Number One

Attack a member of staff.

Number Two

Get an overdraft.

Number Three

Take so long to report what was happening to me.

Number Four

Doubt the potential of my blog. And myself.

Number Five

Stop taking my medication without permission.

Number Six

Go horse-riding.

Number Seven

Get arrested

Number Eight

Let my past experience of education affect my future.

Number Nine

Take Haloperidol!

Number Ten

Let distance affect a good friendship.

Note: To see what I've been up to recently, go see my vlogs on my YouTube channel: https://www.youtube.com/channel/UCxkWBmMgubKY3zfqH_VkZJg

'Mistakes' I'm Happy I Made

Deciding to go to the High School that I did
I'm glad I didn't appeal against the decision to not be allowed into the High School with the best reputation, even though it means my trauma may not have occurred. Though, it could've happened in a different way and had a different result. And ultimately, my trauma made me stronger and had some good effects... Eventually.

Quitting my job
I wasn't happy working there any more and the voices just happened to give me the courage to leave. And I'm glad they spoke when they did or I might never have spoke up at how over-worked I was. Just me doing a three person job?! Enough to stress anyone out!

Not bothering with my A Levels
I wasn't supposed to go down the academic route. I enjoyed learning but it was the way I was taught for your future; GCSEs, A Levels, Uni, job. And I don't mean by family but by school. That's the path we were taught and so, when I struggled in my A Level exams (and by 'struggle, I mean that I was hearing voices and in the middle of an overdose) I thought it was the end of the world. I remember crying and thinking I no longer had a future, I'd never get a job, never get into Uni, never make my family proud. So, to discover there was other methods of education; distance learning, classes where you go in one day a week... I was glad I'd failed my A Levels; or I might've ended up in an intense Uni degree getting the job I thought everyone expected me to get but which I didn't enjoy.

My first Overdose
My first overdose had no real meaning to it; I didn't think it through. I just kept swallowing these tablets which I'd already discovered numbed your feelings. I didn't think that I wanted to die until I was being offered an anti-dote treatment to save my liver and I refused it. My first overdose was what made everyone sit up and think 'shit! Something's happened to this girl!', 'something is wrong!' For almost three years I'd been trying to make people realise I was being hurt. I acted up, was cheeky, rude and got into trouble at school, and still no one put two and two together. An attempt on my life did it; professionals were begging for me to tell them what had happened to me, promising they could help. And I did. I told them (eventually). And they helped (eventually).

Absolutely anything and everything I did between 2009 and 2012
 Overdosing, self-harming, attempting suicide, refusing life-saving treatment, being put in seclusion, being restrained, being carried from my Mum's home, being sedated, having to ask for permission to go outside, being put on life-support, prescribed anti-psychotic medication and spending vast amounts of money on travel to miles away from home in the hope that my memories wouldn't follow me and the subsequent admissions to strange hospitals... All of this, allowed professionals to gage some sort of understanding about how bad my pain was; how much I was hurt inside, and how much hard work it was going to take to make me better again.

Overdosing bad enough to go onto life support
My overdose in the Hospital in Yorkshire, surprised me. It was a surprise I needed. Before then, I'd taken up to 80 paracetamol and on that occasion I took around 32 and my bloods weren't good; so the staff went to any lengths to make me have the anti-dote medication and I went to any lengths to avoid it. I remember when they put the drip in through a needle in a vein on my foot and I used my toes from the other foot to pull it out. It was as though I were so determined to die that I had all this strength against the people trying to restrain me and against all of the medication they were injecting into me to calm me down and then I just felt this great feeling of serenity. Like 'this is it.' And when it wasn't 'it'; when the professionals won and saved my life... That was the end. I'd gone as far as I could and it hadn't work. So I stopped. And I went the other way; towards recovery.

Closing down the blog
There are certain things in life where I think that it's ok to say 'no, it won that one.' But bullies, are not one of them. It's hard - they make it hard. But how would you feel if you stopped everything you enjoyed, everything you were proud of and good at, so that they won? It still wouldn't be enough. There'd still be some tiny area that people would pick up on; a fault, a flaw, a weakness... And then not only would you be the girl people didn't like; you'd be the one that was unhappy because she'd given up. Me and my blog; right there.

 

World Suicide Prevention Day

I've always tried to ensure that my blog is different to any others but with national days like this, that's a little harder... So, in keeping with the theme, I've decided to tell you all three very personal stories; my three suicide attempts.

I think a lot of people might think that each of my paracetamol overdoses would qualify as an attempt on my life; but they weren't; they were coping mechanisms. Although, at the time I couldn't understand why I would do something if it wasn't to kill myself and I often got into battles with professionals over this. 

Number One

The first time I attempted suicide was in 2009. I felt so hopeless that I assumed a college interview wouldn't go very well and begun swallowing paracetamol before I was even en route to it! I had gained some mis-placed confidence in the mental health system and thought myself untouchable so I willingly (and rather arrogantly) admitted to the overdose and allowed various professionals to be called in to my home. I was so completely submerged in the thought of ending my life that I was oblivious to the fact the relevant professionals required to section somebody under the Mental Health Act, were gathered in our living room. And after refusing to let paramedics escort me from my home, I was restrained by 6 police, handcuffed, put in leg restraints and literally carried to a van. At the medical hospital where I was admitted for an anti-dote, I had psychiatric staff with me 24/7 and at every opportunity I tried to escape. I was continuously restrained and sedated so that every time it wore off, I was trying to run again. In the end I was sedated for 24hrs in order to complete the life-saving treatment.  

Number Two 

My second suicide attempt was in July 2012 and it led me to this hospital. My hallucinations were at an all-time peak and I was so terrified of the thought that they were getting worse, that I overdosed. I used my previous experience to bluff my way through the various attempts at forcing me to have the anti-dote. That included a police search, a section 136 threat, a psychiatric interview with the liaison team, a mental health act assessment and a mental capacity assessment. I fell at the final hurdle and was taken to resuscitation to be put on life support. 

Number Three

The last time I tried to commit suicide was in October 2013 and for those who missed my blog posts at the time, I stored paracetamol and took them all. As in the first time, persistence and determination played a massive part. I was in restraint for about five hours and given far too much Lorazepam and ketamine to sedate me. Nothing worked. I was completely focused on avoiding the anti-dote at all costs that it was as though I were immune to all sedatives. Towards the end, I became so tired and the restraints were extremely strong so I used one foot to get hold of the drip between my toes and pull it out of the vein on the other foot. That was when they gave up and I was put on life support.

So, what was the point in telling you these?
I guess I'm hoping that you'll read this and see how badly I felt at these times, how convinced I was that I had to die. That it was my only option. That it was for the best.
But it wasn't. I'm still alive. And it isn't so bad.

Review of the Mental Health Act 1983 Code of Practice, Consultation Event



[note: please don't assume that this post will be too complicated as it sounds a bit more technical than usual, I have tried my best to make it easier to read and understand]

 

I was approached by the Regional Youth Engagement worker for Young Minds to see if I'd like to attend a consultation event for the changes being proposed for the Code of Practice of the Mental Health Act 1983 and I thought it'd be an amazing opportunity for me, and something interesting to blog about!

 

Bit of background for you guys; the Code of Practice was last published in 2008 but since recent cases have shown care isn't good or safe enough, the government responded by committing to review and consult on a revised Code of Practice before the end of 2014. So, the Department of Health have worked with health care professionals, service users and their carers to ask what changes should be made to the Code. The aim with these changes, is to support professionals in improving the care they provide,  making improvements to care, treatment and outcomes, improving the way multi-agencies work together, raising expectations of support and care, treating service users and family with dignity and respect, being clear about a patients rights and providing them with the knowledge of what to do should they not receive the best care.

 

The main changes to the Code of Practice consist of making it easier to read, a focus on the police powers under the act (including sections 135 and 136), guidelines on the least restrictive interventions, information on making complaints and that the code is now based on five principles:

1. Empowerment and participation

2. Least restrictive option and maximising independence

3. Respect and dignity

4. Purpose and effectiveness

5. Efficiency and equality

 

At the consultation event today, we all broke off into groups and had some discussions. The first was about guiding principles for the Code, enabling people to have their say in their care, ensuring privacy, dignity and respect and improving advocacy services. One of the main things to come up in the discussions was about the transition period and how support during adolescence is more low-key yet if they are to progress to adult services they will require a diagnosis and quickly find themselves on medication. We discussed what would help young people in this very vulnerable stage and touched upon a lack of education on mental health with young people rarely understanding any of the jargon and having very little idea on how to get help for their mental health. This, led us on to GPs and how they have very little experience in mental health though they might often be the first person approached. I raised how GPs are often seen because of a dip in mood, suicidal thoughts and depression but the first symptom I exhibited was auditory hallucinations. We talked about the stigma of mental health and how it can prevent people from asking for help. This also led on to normalising life for a young person with a mental health disorder as young people feel a lot of pressure to 'fit in' and be like their friends so being diagnosed at that time will be difficult and if there are any ways to normalize their situation... We began discussing social media. The Youth Engagement Officer pointed out that if there's an issue with staff's privacy on Facebook then it is their responsibility to change their privacy settings accordingly. I spoke up about how a lot of press focus on the negatives of social media e.g. bullying, but they ignore all the positives that are achieved through it. Another group, raised the 'right to know your rights.'

In our last discussion, the group I was in was made up solely of service users (there were a lot of professionals at the event) and we discussed care, support and treatment in hospital and in the community. This was very interesting because we each had different experiences of the aspects discussed. The first issue to be raised was in regards to a loss of services in the community as one service user told of how his local Mind had been closed and he worried where the people who got support through it, had gone. Also, there are massive differences in community services available Monday to Friday, 9-5 with resources being very limited as it gets to the evenings and weekends. Next, we spoke about support for carers, or rather, the lack of it. I had a bit of a revelation too that people mostly talk about supporting carers as they may be the service users biggest support... But, what about those carers who are the voice of the service user? The ones who have to advocate for their relative's? With regards to restraint and seclusion; we talked about using de-escalation techniques instead and that staff should work on building trust and improving communication in order for this to be effective. I then touched on physical care and the GP system at the Hospital I'm in and the facilitator realised there wasn't much in the Code review on this area. Finally, we all stressed that 'prevention' should be the main focus as avoiding a person being detained under the Mental Health Act is always favourable.

 

I really enjoyed this event today; it was so interesting and inspiring; talking about improvements to services and it's downfalls and failures makes me even more determined to help change and better things.

 

For more information click here: https://www.gov.uk/government/consultations/changes-to-mental-health-act-1983-code-of-practice

 

 

 



 

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

Crisis Care Concordat Part Two - urgent and emergency access to crisis care

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 second area of expectations is around accessing the urgent or emergency treatment. The first part to strike a chord with me was that a mental health crisis should be treated with as much urgency and respect that a physical health emergency would be met by. It was respect that got me; if you go into a medical hospital for self-harm then no matter how dangerous it might be you're treat differently merely because you did it to yourself.
There was also a statement regarding restraint and that it should be safely, supportively and lawfully. It must be so hard for professionals to restrain, because the majority of the time it's a sudden knee-jerk reaction and can often be in self-defence so I'd imagine that it's very difficult to remember all of the restraint techniques they've been taught. Right there and then they just want to stop someone hurting themselves or others. To be fair, I've never personally experienced a bad restraint; the worst I've come off with has been swollen wrists (from the handcuffs being too tight) and finger-mark bruises. And I think the most un-safe was when I was handcuffed and had Velcro leg restraints on and then was put in a cage in a Police van and I fell all over the place because I couldn't keep my balance. I have, however, heard of instances when service users have resisted restraints or attacked staff quite severely whilst I've also heard of  service users being injured through badly managed restraints.
Further into the Concordat it details that the NHS Mandate for 2014-15 is derived from this Concordat and will mean that no one in a crisis is ever turned away. It also details that they should get support no matter how they first present and who they first go to for help. E.g. if I was to overdose and tell a policeman I should receive the same quality of care as I would had I called a specialist mental health team with the plans of overdosing. I think this is a very important point because in my hometown we'd have these 3 different A&Es that I could travel to and each one had a different attitude and reaction towards me.
The most suitable crisis care is defined as being as mostly community-based as possible, closes to home as possible, least restrictive and the most appropriate to the service users needs.
There is some consideration given to black and minority ethnic communities as well as children and young people.
There was a large chunk around training and the belief that those professionals who may come into contact with mental health, should have the appropriate training so that they can deal with the situation. Also, the need for more training between services was identified as some do not know what the roles of others are. It went on to detail how places of safety that police have the power to take you to should not include a police cell. This makes it essential that NHS places of safety are well equipped and meet the demands of the local area. I've been in a few places of safety and they've all been different. They were all a part of a large psychiatric Hospital but one was literally just a room to sit in with the police and then be assessed in under the Mental Health Act and another was set-up like an actual ward but purely for those brought in by police under their section 136 of the Mental Health Act. There is also another recommendation to aid the Police and that is that when they the first to respond to a mental health crisis there are agreed timescale responses from the health and care sector so that the individual receives care at the earliest opportunity.  I experienced this in a London Hospital once where I was found after overdosing, sectioned under the Police 136, taken to A&E and I had my Mental Health Act assessment before seeing a medical Doctor so that the police were relieved almost immediately.  In the worst cases I've had two officers with me for over 48 hours waiting for medical treatment to finish so that I could have a proper Mental Health Act assessment and I was discharged from it and fined for 'wasting Police time.'
There is also extra training recommended within the police force to aid officers in making their decision as to whether someone really does need to be detained by the Mental Health Act.
This part of the Concordat also contained advice for those in a mental health crisis who present at A&E which I found interesting as that was usually the first place I went to for help. The Concordat stimulates that those circumstances should be treat in par with physical illness admissions.
In part B12, the Concordat covers a situation where a service users needs to be transported between facilities and specifies that this isn't done via a police vehicle and especially not within a caged one. This is such a good instance to include as it's very upsetting and scary to be handcuffed and put into a cage in the back of a massive riot van while you're hallucinating.

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

The Admission For The OD

[note: this post contains discussion of suicidal ideation]

At 5:20am on Monday morning, Annie woke me up telling me 'today is the day' and so I began taking the tablets I'd saved. I was so happy going around the ward and going to groups with no one having the foggiest idea what I was doing in my bathroom. Then, I'm not sure what happened... I went and told my Key Nurse though. I don't know why. She read through the writings I kept during the time I'd been storing the tablets (last post) and said they were helpful in making her understand how I felt. Next thing I knew, I was being told to pack a bag and went with two staff to A&E. I remember telling the triage nurse and she got me rushed straight through to a cubicle. And I remember them getting blood and saying I needed the treatment (but I assumed it was because the overdose had been staggered) and then they had a job getting a cannula in for the treatment and then they started the treatment and I kept telling the nurse the needle wasn't in properly but she didn't believe me until my arm was all swollen where the treatment had gone into the tissue rather than the blood. I can't remember them getting another needle in but they must've because then I remember being moved to the Medical Admissions Unit and having two lovely staff with me through the night. I managed to get a bit of sleep and then got another two nice staff in the morning. As I was watching the Doctors doing their ward round ,I noticed the rabbits. And there was too many. I went to the toilet and took the sharp I had hidden and cut my arms. Then as I came out of the bathroom the staff tried to hold onto me and some nurses came and got my arms bandaged up before taking me back to my bed. I don't even know how it managed to spiral so far so I can only tell you what I remember.
I remember them deciding to restrain me the entire time it took them to put another cannula in (I must've pulled the second one out) and I had security, our staff and nurses and doctors holding me down but every time I realised where they were trying to put the cannula in, I fidgeted and eventually, they let go. I can remember having this sort of certainty that I was going to die. And it made me feel really peaceful.
And then they called the anaesthetists in, and it turned out I'd met one of them already so he knew how bad my veins were. He had me restrained to give me an injection of ketamine and it was horrible because unlike the last time they did that, I didn't hallucinate, I knew what was happening but I just couldn't be bothered to move or fight. In a way, it felt worse than the hallucinations. Anyway, they got a cannula in my shin and one in my arm and connected the treatment to my leg. I could hear them all talking by my bed about putting a cast over my leg so I couldn't get the drip and I just thought "you sarcastic arse holes" and it didn't help that one of the anaesthetists gave me the "children-could-be-dying-because-I'm-with-you" lecture. So I went for the leg cannula and they all pounced on me, but I managed to wrap the treatment lead around my other foot and pull it out and then they attached it to my arm and gave me some Lorazepam but I still kept trying  to get the cannula out and I remember this female Doctor  saying "shall I just give her all the Lorazepam? It's only 4mg?!" and then the drip stopped working.
I was told that since I was on a section three (which enables treatment to be forced) I could be made to have the anti-dote but I continued to refuse so I was taken down to the anaesthetic room (with the two hospital staff and two security) and they put a mask over my face and told me to take deep breaths.
I woke up Wednesday evening in ICU with tubes everywhere and holding the hands of the DBT Facilitator and one of the Charge Nurses. Apparently I said a few worrying things to them and then they left. The ventilator was removed, the NG tube too (apparently they used it to give me my meds) and the catheter. And then I had two cannulas in my groin. We eventually got back to our Hospital and I was told I was going to the PICU (Psychiatric Intensive Care Unit).
It was so scary, at first I was on 1:1 obs so I had to shower with my door open and then the nurse came and put me on 5minutes and finally a nurse from my ward came Thursday evening and said I could go back down. It was so overwhelming walking into Reflection! I cried my eyes out when I hugged my best-friend and didn't leave go of her hand the whole half an hour! My three closest friends bought me some lovely PJs too and even though I was put in a 'stripped' room (empty but for a few of your own things) I was so grateful to be back on the ward.
Since getting out of ICU I've done nothing but sleep until this evening when I started to pick up and got my appetite back as the vomiting subsided. I feel like I'd been to hell and back. I'm so exhausted from all of the fighting (physical and mental) that I just need a good long rest and a lot of self-soothing.

1 Year Ago

[note: this post contains discussion of suicidal ideation]

Today, is a year since I was brought here... I thought maybe I should tell you all how that came about. I was assessed to come here by two of the staff but I decided I didn't like the sound of  the place and refused to come when they offered me a place. On Tuesday 10th July 2012, I took an overdose of 80 Co-Codomol. Once the voices quietened down (after the last 16 pills) I went to a medical Hospital and the voices got louder so I had to leave A&E. The Police called my mobile and said they'd meet me at the bus station and take me home to make sure I was ok, within minutes though, my bus stopped and was surrounded by blue flashing lights, four Police came on the bus and took me back to the Hospital; explaining that they hadn't realised A&E wanted me back. From A&E I was put onto a ward then taken to theatre to be sedated for a central line. I managed to undergo some of the anti-dote for the paracetamol OD (21hour long drip called Parvolex) but the voices became strong and I refused the last 12 hours. I realised something; I realised I wanted to be dead. If I had to live with these voices then I didn't want to live at all. I'd rather have no life than a life shared with them. I was given a Mental Health Act assessment and they told Doctors to treat me under the Mental Capacity Act; I no longer had the capacity to decide what to do with my life. I was taken to recuss, restrained, sedated and put on a ventilator and took to ICU. This was Thursday morning. Thursday afternoon, I was woken up as my blood results normalized. My Mum was in ICU with my Aunt when I woke up; she told me that she'd told the Psych team if I wouldn't go to this Hospital then she wanted me brought here. I told her I would go so there was no need to worry; I think a part of me had been shocked into sorting myself out and the other part of me thought they wouldn't actually make me come. The next day, I went to see my Community Psychologist with my Mum and the Ward Manager from here called; she gave me my move-in date; Tuesday 17th July 2012.

A friend asked me last month if I thought this Hospital was benefitting me. I told her yes, I've made changes since I've been here that I couldn't have made if I'd been in the community and able to self-harm as often as I was. The point is though, I made the changes, the environment has meant I've been able to and the staff have had some impact but ultimately, it's been me who has changed me.
So, here are the changes:
1. I care more about others. The girl in here that I'm closest to (CS) has really helped me to make this change. I've never had a friend like her; she's so similar to me yet so different. On the surface, with music, fashion and things we have completely different taste (I recently got upset that she was dressing like a man!) but then we have things we'll do for the same reasons though those reasons aren't caused by the same thing... If that makes sense. She's also the first friend I've made in Hospital who's not been a bad influence (not that any others have intentionally been), if anything; we're both good influences on one another. In DBT you learn that you have reasonable mind (the part that follows the rules), emotional mind (the part that acts on your feelings) and wise mind (equal of both) and we both joke we're each other's wise mind. We don't listen take the advice we give. Anyway, the relationship I've noticed this change most in, is with my Mum. I care more about her feelings, thoughts and opinions. I take them into account when making decisions. I think the Hospital has helped me make this change because of having to live with all the girls; our behaviours affect each other; when one self-harms it upsets others and if you do something with a ward object then it's taken from the whole ward. Everyone gets punished because of you. It makes you stop and think because you then have to live with these girls and see them every day so the last thing you want to do is piss them off.
2. I think about the consequences. I consider the implications of my urges and I actually let them impact on whether I act or not. In the community, there wasn't exactly any punishments for my actions; there was obviously consequences like hospitalization and all the hoo-har that Parvolex (the anti-dote for Paracetamol overdoses) entails; vomiting, temperature, needles. . . But the thing was, none of it seemed good enough to stop me. None of it was enough to make me think before I self-harmed or overdosed, I didn't consider any of it. Now though, if I self-harm I could be put on 5minute obs, locked out my room for the daytime, cause a room search or lose my leave. Back home I used to buy cheap cups from Morrisons or Wilkinsons for 99p and smash them outside the house and then cut but here, if I smashed my cup then all the pot cups would be taken away and the girls would all be using plastic. It's quite impressive really that I've gone from having four cups and pieces hidden all over my bedroom at home, to not smashing a cup for a year!  
3. I know now that the urges will pass. In the community, before this Hospital, whenever I felt suicidal or wanted to self-harm or the voices were bad, I always thought 'this won't go unless I do something about it' and I did; I cut or I overdosed. And it worked. Now though, my coping strategies (because that's what they were) have been taken away from me and I've been forced to learn new ones, and before I have I've had to go without. And I've lived. I've always had it in my head (until now) that if I didn't do what the voices were commanding then I'd implode. Seriously. But now I know that's not possible. I can survive, I can get through it. I can fight without tablets and sharps. And it does pass, I stop feeling suicidal and the voices quieten (sometimes with meds) and I stop needing to self-harm.
4. I know that the voices can't hurt me. It's only me who hurts me. Like I said, I used to fear that if I didn't do as they commanded, I'd implode. Occasionally, I still sometimes believe this but only in the moment that they're loud. I also sometimes thought that someone I loved could get hurt by them if I didn't hurt myself. But now I know it's me that hurts others.  
5. I talk more. To my Mum, to staff... When I had an appointment at the opticians, a year ago I wouldn't have bothered telling the staff my concerns or how they could help me get through the appointment but now... I asked for one of the staff to link arms with me and told them to come into the room with me. I tell my Mum absolutely everything that goes on now too because I realised that's the only way she's going to understand and appreciate how hard things are. It was no use struggling alone, overdosing and having my Mum wondering why I'd acted the way I had. Now, if I'm telling her how bad things are she isn't so surprised when I self-harm and she can support me better with it because she knows what's going on in my head.

The One Where A Medical Admission Turned Into Restraint

Sorry for my silence these past few days; I've been in the medical hospital since Monday. I felt really poorly and was vomiting so I got permission to skip groups and I managed to nap a bit before the pain in my stomach woke me up and I went to get staff. They gave me painkillers but I was sick again and after half an hour I felt worse so the Doctor decided to ring the ward I'd been on with pancreatitis two weeks ago. I went to my bathroom to vom again and the next thing I knew the staff nurse appeared and said 'are you ready?' Apparently, the ward had advised they bring me straight down so I went there with the Nurse and we sat in the waiting room by the assessment part of the ward. We were waiting for a while before a Doctor called me into the assessment area. He decided they needed bloods and a chest x-ray so another Doc came to try and get the blood but failed, then another failed so I was given oral painkillers and anti-sickness before being moved to a proper bed on the ward with my new member of staff (an agency NA who I'd never met before). My cannula (the line in my vein) collapsed when the nurse was trying to put an anti-sickness into it and a drip of fluids to re-hydrate me. So, another anaesthetist put a bigger cannula in and then I started struggling... The voices got loud and there were five rabbits running about the bed so I asked the nurse for Lorazepam and before it got a chance to work I went to the toilet, locked myself in and slammed my head off the floor. The staff unlocked the door from the outside and they all restrained me (apart from the NA) and used a pillow to stop my head hitting the floor. They were trying to calm me down by asking about the rabbits and it was weird; it was like I had word vomit and just all this random shit was falling out of my mouth and even though it was true, it was a bit like nonsense. . . I talked about wanting to go to the beach to build a sandcastle and eat candy floss and how you couldn't name the rabbits. It was all very surreal. I was quite disassociated. They gave me an Olanzapine and put me in a different bed so I didn't disturb the ward then moved me back to my bed when I was sleepy. The next day (Tuesday) is quite strange because I remember nothing about that day! Either then, or yesterday I struggled again and this time I was given IV (in my vein) Diazepam (a sedative).
Today, I was finally allowed back to the Hospital and I was really looking forward to seeing all the girls and having a shower and a nap but a nurse took me into a room and told me I'm now on 5 minutes obs because of what went on at the medical hospital. So, my room is locked 9-5 during the week and 11-5 on the weekend. I cried a bit but then I just thought 'well, there's nothing I can do about it now' so I've accepted it. I'll be busy all day tomorrow anyway and at the weekend I'll sleep on the settee.
I'm still feeling quite low and things are very loud. I just want to cry in a dark corner and be by myself... Admittedly, with a box of pills. But hey-ho gota roll with the punches and all that

The AWOL Procedure

[note: this post contains discussion of suicidal ideation]

Sorry it's been so long since a blog but not a lot was happening and then all of a sudden a lot happened!
On Sunday 24th I went on my home leave and when I was packing a bag of more clothes to bring back, I picked up a pair of bed socks they felt heavier than usual and I felt something hard inside them. I found two big pieces of broken cup, still with blood on them, I knew that in the community I used to hide pieces in my bags so that if I went out it didn't matter which bag I took, if I needed to cut then I would have something. The fact I'd put stuff in my socks... It made me sad to think it must've been that bad. I must've been that desperate at one point. I gave the pieces to my Mum and she told the staff who said how good it was that I'd admitted to them and not tried to sneak them back to the ward. This, sparked up the voices; they shouted at me for handing them in, they said I gave in too easily and that I'd regret it when I got back to the ward and needed to cut and had nothing; they'd make sure of it. They got louder and louder as we drove back to hospital and we stopped at some services so I could get a drink then the staff gave me two sedative tablets and when I carried on crying they gave me an anti-psychotic which helped me calm down and get some sleep for the rest of the journey.
Back on the ward, I decided to run away on my unescorted leave and overdose. The voices were telling me to do it and they'd been so quiet for so long and things had been going so well that I was sure I was getting better and now I was back to the start... But it felt different this time.
I went out first on my escorted local leave where I went to Asda and withdrew some money to pay for my taxi away from the hospital then at about half two in the afternoon, the same day, I got signed out on my unescorted ground leave; I called a taxi company as soon as I'd walked past the staff office and then headed round the back of the building. I was almost at the low fence that I'd jumped over last time when I realised the PICU (Psychiatric Intensive Care Unit) were having their smoke break so I had to wait until I heard them go back in then I was literally inches from the fence when a member of staff started making her way to the staff smoke shelter and I stopped in my tracks but she didn't notice me so I jumped over the fence; scratched my knee in the brambles I landed in and grazed the top of my thigh on the fence but I ignored it and kept running across the path of the old people's home who's garden I'd jumped into, jumped over a fence into a person's garden and walked down their side path, through their gate and across the road to the newsagents. I bought tablets and got my taxi to a nearby city. I bought more pills there and carried on taking them throughout the afternoon, I took a bus to a town an hour and a half away, then went back to the city where I swallowed the final sixteen tablets in one go in the train station toilets. The voices went silent instantly and I felt myself again; for the entire overdose (six hours or so) I'd felt like a zombie, walking around in a trance, taking tablets without thinking. It felt like I was one of the voices; Annie - I didn't care about anyone, I didn't care about myself, I didn't want to be alive. Now I was Aimee again, I found a member of railway staff and asked if there was any police in the station, I explained I was a missing person and he took me to the British Transport Police station just next door. They asked where I'd runaway from and if I'd hurt myself then called an ambulance and asked more questions while we waited. They followed the ambulance to the nearest hospital and two NA's from our hospital came to swap with them. The Doctor took my blood and managed to put a cannula in a vein right on my knuckle which meant a nurse had to bandage two of my fingers together to keep it in place while I was connected to the anti-dote drip. They switched the first drip bag over from going through in fifteen minutes to taking two hours, then I had the second one over four hours and was moved up to a medical ward but there was no beds so I had to stay on the A&E trolley in a room. It was so uncomfortable and I hardly got any sleep but I got on well with the two NAs that were with me so we chatted quite a bit and played eye spy before they swapped with day staff. The voices started getting loud again just before I was moved into a proper bed and a nurse went to get me an anti-psychotic and a sedative but they got really bad, really quickly and I stopped the machine on my drip so the treatment couldn't go through and then when the nurse came with the tablets they all told me that I'd be restrained to have the treatment and that I wasn't allowed to discharge myself and the voices and I got angry so I tried to take the drip out and was squashed to the bed. Someone injected 2mg Lorazepam (a sedative) into my cannula and I felt sleepy but I must've still managed to get the cannula out in the end because while I was sleepy a Doctor put another cannula in my other hand. Within an hour it was bad again and I'd pulled the drip out of my vein so that all of the fluid collected in my hand (it's still being absorbed!) and they injected me with 4mg Lorazepam and an anti-psychotic. Security were called to swap with our staff and give them a break and they were a lot more careless about how they restrained me and how much pressure they used. A Doctor tried to get another cannula in my foot and at one point about six staff were holding me down while she tried to avoid me kicking out at her. She failed three attempts on both feet so they took a blood sample to see if my levels of paracetamol had gone to a safe level, it took about five hours before a Doctor came and said my clotting levels were abnormal so he took another blood sample from an artery in my arm. While we waited for the results (by this time I had the NAs who'd originally been with me back) the female NA came to the bathroom with me because the Doctor had got me a razor and the nurses got me wash things so I had a shower because I knew I wouldn't be able to have one when I got back to our hospital and I didn't want to go to bed feeling all scruffy. My results came back fine and at 3am we came back to hospital.
I had ward round today and at first, I was told me to try harder and to be more honest and I told them I'm honest all the time until I need to do something and then I have to lie through my teeth so I can do it. I'd wrote a letter and one of the staff asked me to read it but I refused because I said what was the point in pouring my heart out to someone who didn't have a clue. They offered to read it, and then the SHO offered and I was worried that if I read it and they still had no clue I'd feel even worse but I thought at least I would've tried to explain. So I read it out:
'I'm afraid this might not make much sense and it'll probably be difficult to understand but this is how my life's been for the past five days and I'm having so much difficulty understanding it myself that I'm struggling to explain it to anyone else.
Rather than just hearing Annie and Albert, I feel I become them now. Originally, it was a case of me having to balance keeping Annie and Albert happy enough so that they're not angry at me whilst staying safe and alive. And I can't always get the balance right and I don't always care or want to because it's so much less effort to give in.
I used to feel like even though I was doing what I was told by self-harming and overdosing I've always known I didn't properly want to kill myself, but not every inch of me wants to fight Annie and Albert and not every inch of me wants to lie still and accept help. And those parts, want what they want whole-heartedly. So not only have I had to fight against the voices, but I've also had to fight against a piece of me I hate to acknowledge exists, so forgive me if I occasionally slip and lose the battle but it's very tiring.
These past few days I've not felt like myself; the voices have felt powerful and unstoppable. On Tuesday, it felt like they were so strong that I actually became them - there was no longer the me who didn't want to kill herself. My head wasn't consumed by their voices, but by their thoughts... It was physically exhausting and I don't know what I've done wrong or what I did to deserve it. I'd thought I was getting better - I didn't lie; the voices were quieter and I did stop wanting to overdose. Up until Tuesday, I was honest but I had to stop so that I could do it. I felt terrible, I feel like I've let everyone down since they had only just begun to trust me again. I can't stand the person I become when I run and overdose so I wonder if the only way away from this is to die. I'm tired of living and these past few days things have gotten worse and been hard, it's been enough to take all of the hope I'd built up over the past few months.'
The room was silent, they all looked sad, and then my Doctor said it'd been really powerful and that they'd needed to hear that because it'd helped them understand and that he knew they'd never fully understand because they can't hear what I can but it's helped them appreciate how hard I try. I was so pleased and happy I'd ended up reading it out. They didn't give me the leave for mothers day that I wanted but I had a feeling they wouldn't because it's not long away and I'm on five minute obs now and you can't go on home leave until you're on at least half hourly so they gave me leave for the weekend after and my Mum is happy with that but I'm still disappointed in myself.

'I've been trying to do it right, I've been living a lonely life, I've been sleeping here instead, I've been sleeping in my bed, so show me family, all the blood that I can bleed, I don't know where I belong, I don't know where I went wrong' - The Lumineers - Ho Hey