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 23rd 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 25th – I was put on their caseload…

1.    No matter how important they are, your memories can be fragmented

One of the most annoying things for me when my mental health is poorly is that I often struggle to remember things that have happened during that time unless I’ve written them down/blogged about them immediately or as they were occurring! I think that a huge reason for my head doing this is as a protective factor. Having gone through rape and abuse… Well, during that absolutely horrific time in my life; my head definitely chose the ‘flight’ option when confronted with the opportunity to ‘fight’ instead.

One of the most frustrating results of this was that the fact that my head disassociated throughout the majority of the acts of abuse, meant that I wasn’t able to give some specific details to the Police when I finally reported everything. Because when I would recall exact occasions/instances it was often from the perspective of floating on the ceiling and watching it all happen to some poor other girl that I couldn’t help.

Professionals later said that this almost instinctual response of mine was likely the largest reason why I began hallucinating and experiencing episodes of disassociation – because my head had seen distancing itself from reality as an effective coping mechanism and so I persisted to engage in that sort of behaviour and attitude whenever things got tough. It’s also meant, however, that I actually don’t 100% recall the early days of being on caseload and a part of me wishes that – for the sake of this blog post – I had maybe written something each time I’d seen them in the last 35 days so that I could give a bit of a better, more thorough and effective account of my experience under their care.

2.    Getting my medication (Aripiprazole) increase

In February, when I was sectioned, I requested that this antipsychotic medication (Aripiprazole) be increased because when it was in a previous relapse everything got better. However, the Psychiatrist I saw when I was discharged from the psychiatric hospital claimed to have reviewed my notes since 2009 and concluded that mostly, medication didn’t seem to change the amount of self-harm or how much I struggled didn’t decrease in any way. Even though I persisted to point out that my last increase had led to me being discharged from services completely – she stuck to her refusal to do it.

With that experience in mind, when I was put on caseload with the Crisis Team, they asked me what would be helpful I was hesitant to tell them that I felt an increase in this medication might help. But I told them anyway and initially, they said that they tend to only do short-term medication changes e.g., Diazepam (which they also put me on) or sleeping tablets etc. but, around a week after being on caseload, I was offered an appointment with a Psychiatrist and a member of the Crisis Team to review my medication. And oh, my goodness, was I impressed?! I felt as though I didn’t even have to ask for the increase; he just asked me about my ‘symptoms’ (the weird thoughts I had started experiencing and how they were impacting my safety) and then said that he wanted to – and thought that I would benefit from – an increase! And I could not have been more grateful and relieved nor felt so validated and reassured.

Fortunately, the increase has already (just over 2 weeks in) started working very efficiently in that the two largest, most unsafe beliefs have completely gone and a new one that’s come up just these past few days is losing traction too! Of course, this is brilliant news – like, I couldn’t be happier or more relieved! However, the way I see it, there’s also two – sort of – downsides – or maybe concerns is a better word to use – to it working so well:

Firstly, it means that the Psychiatrist I saw back at the beginning of the year who refused to do the increase very obviously made the wrong decision there. And this, almost instinctively makes me wonder, if she had done the increase there and then, maybe I wouldn’t have gone through all I have in the time between seeing her and getting the increase…?

Secondly, it cements the fact that this crisis or relapse has been due to psychosis and absolutely nothing to do with my other/much older diagnosis of Borderline Personality Disorder (BPD). And the reason this is a ‘concern’ is because I don’t know how I really feel about the psychosis side of things just yet. I mean, with BPD I was immediately like ‘yes, I have all those symptoms,’ but it still took a while to accept it and it took even longer to recognise that it wasn’t the definition of me – that it is – or was – just a part of my life and now who I actually am (hence the title of I’m NOT Disordered). So, whilst I recognise still that I’ve definitely experienced the symptoms or whatever you want to call them of psychosis, it’s still hard to come to terms with the fact I now have this diagnosis (albeit not officially yet though, that’s happening over the next few months of evaluation with a community psychiatrist).

3.    Feeling terrible when they aren’t helpful for others

I have a best-friend who also has mental health problems and is really struggling at the moment – to the point where the same Crisis Team have been involved in her care too. Except she says she’s had/having the complete opposite response from them. And whilst I totally recognise that I’m really only hearing her side of things, everything she’s said is exactly how they used to treat me a number of years ago and she’s my best-friend – why would I disbelieve her or question her? I wouldn’t like if she were to do that with me if the situation was reversed.

It's been tricky though… that she’s finding herself so frustrated and feeling alone and failed in every which way possible from the same Team who – I will 100% say – have a saved my life! A few nights ago, this actually came to a head, and I found myself ringing the Police and later, I was crying hysterically at the fact that because services aren’t helpful for absolutely everyone, I almost lost a best-friend. I felt quite furious to be honest, furious and frustrated because a part of me recognises that this is the reality of mental health services; they can’t – and don’t – save every life.

Whilst I wouldn’t want to take anything away from the family of those who they have lost in this way, you actually have no idea how hard it is to be the person finding these services helpful and benefiting from them too! It’s almost very obvious that it will leave you thinking ‘why am I deserving of their help and these others aren’t?’ and ‘how can I take and accept this help and support when I see others being so deprived of it?’

4.     Thank You Gifts (in collaboration with Amazon UK)

I had to see a GP recently and since I’m hardly ever there, I didn’t know the Doctor I was seeing, but she turned out to be amazing; so I took some flowers and a card in for her and since she wasn’t in that day I gave them to the Practice Manager. She told me almost immediately that they very often get complaints and abuse, but very rarely do they receive compliments or thank you’s. I told her the ethos I’ve had for a long time – if you’re readily willing to put in a complaint against a service or professional, why can’t you be equally willing to tell them when they’ve done a good job? And I get that the GP should be nice and helpful and should she be rewarded for acting the way she’s supposed to? The fact of the matter is, not every GP is like her, so yes; she deserved a thank you. And so do the Crisis Team…

Sentimental Keepsake: £7.99

Seed Bomb Card: £5.99

Ceramic Keepsake: £7.99

Motivational Cup: £9.95

String Bracelet: £3.50

Thank You Keyring: £6.99

40 Pack of Thank You Cards: £7.69

Costa Coffee Thank You Gift Card: price of your choosing

Thank You Plaque with Wooden Stand: £9.99

Thank You Candle: £16.99

Stemless Wine Glass: £11.99

Thank You Chocolate Hamper: £9.99

Motivational Thank You Pens: £12.59

Decorative Hanging Puzzle Piece: £5.99

Here’s two photos of the card I got and wrote out for the Crisis Team: 


 

5.     Thinking about the future & the new CPN

So, tomorrow (September 29th) I have my transfer of care meeting with a member of the Crisis Team and my new Community Psychiatric Nurse (CPN) who are going to come out and talk about everything that’s gone on. I was offered that this happen and that I be there for it and decided ‘yes’ because I recognise how important it is to ensure everyone is on the same page – especially in care around mental health. I realise that there’ll obviously be some discussion between themselves that I won’t be around for, but at least if I can hear the bulk of the handover and add in my two cents if I feel something is wrong, misunderstood, forgotten about, or unclear(!) then, that way, I can feel somewhat confident and reassured that the new CPN has a good understanding and appreciation of how hard things have been and all that I have gone through and experienced these past 35 days!

The Crisis Team have said that they believe the new CPN and I will get on really well and that she has a lot of experience in working with people who have psychosis so the notion that she knows what she’s doing, I think, will be really helpful as I try to navigate my way around it too.

So, thanks to the Crisis Team, here’s to the future!

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