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This post is in collaboration with the Newcastle Upon Tyne Hospitals NHS Foundation Trust (NUTH) who I’m helping and supporting in their creation of a Trust-wide Mental Health Strategy (which I’ve previously blogged about here, here, here, here, and here). Together, we’re marking Time To Talk Day 2024 which is a date where everyone is encouraged to talk more about mental health in the hope that it will tackle the discrimination and stigma held against the topic and that, in doing so, it will also improve the help and support that is offered or available for those who might be struggling with their mental health. We’ve decided to utilise the fact that whilst there is – rightly – so much content around encouraging conversations, there are too few pieces around the importance of recognising when a communication around mental health needs to be reconsidered whether by terminating it completely or changing the route it seems to be taking – something which is as equally important as starting a chat. Thankfully and admirably, it’s also something NUTH recognises to be an essential component to their upcoming Mental Health Strategy…
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If you’ve read, I’m NOT Disordered for a while now, you may know
that there was a point in my mental health journey where I was labelled an
attention-seeker and actually even had professionals (mostly the Police and
Crisis Team staff) regularly say it to my face! I remember this one time in
particular when I had walked down the middle of a motorway and the Police had
put me in their car and then called the Crisis Team in front of me and said
“oh, this is just what she does for attention?”
This name-calling came not too long after I noticed ‘possible Personality
Disorder’ on a discharge summary and sadly, I genuinely don’t think that was a
coincidence. For some people who are more recently diagnosed with such a Disorder,
might find it difficult to believe that in around 2009/2010 (when I was
diagnosed with Borderline Personality Disorder) there was so little awareness,
understanding, or compassion around it. I mean, I do see social media content
regularly detailing a stigmatised experience of someone with a Personality
Disorder (PD), but I think that – whilst it still isn’t good enough – the
mental health sector or industry has massively improved from how it was all
those years ago. And I think that often, this makes me grateful for something
someone else may deem ‘small’ or ‘insignificant’ or ‘the way it should be.’
When I was sectioned in 2012, there was a discharge meeting with
my Community Psychiatric Nurse (CPN) and inpatient Psychiatrist where he
mentioned that he would recommend the community team look into referring me to
a specialist PD service out of the locality. And why would I have to leave my
locality? Because there were literally no mental health services specialising
in helping and supporting someone with a PD diagnosis! So, with the fact that
between 2009 and 2012, my records showed I had over 60 admissions to medical
and psychiatric hospitals, my CPN began arranging assessments with these
out-of-area hospitals. On my first one with the nearest service, they concluded
that they couldn’t accept my flight risk and that the community team should be
looking to secure hospitals, so I had an assessment with a long-term specialist
psychiatric hospital over 100 miles away from home. Upon hearing that the
medium secure ward/hospital operated on a very strict ‘therapeutic timetable’ and
that the average length of admission was 12 – 18 months, I refused to go when
they offered me a bed.
After another suicide attempt in the summer of 2012, the medical
hospital used the Capacity Act to put me on life support and administer the
lifesaving treatment which I had been refusing to accept. When I was brought out
of it and taken off the ventilator, the community team told me I’d be going to
the specialist hospital and honestly, being there a matter of hours, I ended up
already feeling more validated than I had the entire three years between my
first sectioned admission in 2009 to this one. I was never once referred to as
an attention-seeker or a drama queen or any other derogatory and condescending insults.
For me, this really illustrated the importance of mental health professionals
being knowledgeable, appreciative, and understanding of particular mental illnesses
which could mean that the service user needs more specific, specialist, and individual
help and support.
Whilst I was obviously beyond grateful for this change in attitude
and response, it was also kind of sad too. I mean, it really made me think
about the fact that all those times I had been badly treat by my local
psychiatric professionals, medical staff, and Police, could have honestly so
easily (and I’d like to think understandably too!) led to me succeeding in a
suicide attempt. Being treat poorly by the people – especially mental health
teams because they are supposed to be the ‘right’ people to help in a mental
health crisis – who were meant to be there to help and support you in your
darkest and most afraid moments, left me feeling really alone and dismissed. And
those thoughts and feelings can have such a huge power of anyone’s safety let
alone someone – like me – who is already unsafe! This also led me to think
about the fact that there were surely so many other people from my postcode and
locality who also have BPD and are being treat poorly; and it left me wondering
why I deserved to have this admission and receive the improved level of help
and support.
Another difficulty in being treat so much better was that I actually
also experienced a sense of frustration for two different reasons. Firstly, it came
from the notion that if this specialist PD service existed and if their staff could
have such a good response and understanding of this diagnosis, why couldn’t the
NHS Trusts and services back home also provide these potentially life-saving
qualities? I’ll never forget when one of the staff on the specialist ward said
to me “if you’d lived nearer here, you’d have been admitted after your first
suicide attempt.” Yet, because experiencing a good standard of mental health
services is becoming a postcode lottery, I had made three attempts and had over
60 hospitalisations in the space of three years. It made me start to feel
incredibly lucky to have made it through all those instances because if I hadn’t
– and that could have been a very real possibility on a number of occasions – I
would have never had this life-changing admission to the specialist hospital.
And, in all honesty, this thought has me questioning why my community mental
health team didn’t take the action to have me admitted to that hospital a lot sooner,
and I’m left with two possible answers/excuses – either it was about budgeting
and securing the funding or they genuinely didn’t know such services existed.
Finally – on the topic of ‘attention seeking’ – something I’m a
huge believer of around this issue/name-calling that many people experience through
their own mental health journey, is that even if you did have someone who
genuinely had no other motivation to self-harm or attempt suicide other than
for attention, they still need help! That’s still not a positive, productive,
or safe attitude or mindset. In fact, perhaps they need a different level of
help too because where there’s a more established rationale – like Depression
or traumatic memories or hallucinations – to engage in such behaviours and
actions, it can arguably lead to a much more straight-forward approach in terms
of providing any treatment, help, and support.
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A quality that makes calling
someone an attention-seeker so awful and unfair is that it is completely invalidating.
I mean, it comes pretty close to calling someone a liar because you’re questioning
or accusing them of having either poor or just completely wrong, motivations that
are causing or influencing their actions, thoughts, and feelings.
I think that a huge contributing
factor to others being invalidating toward your mental health (in whatever
aspect) can come from their own opinions of what you might describe to be the
cause of your struggle. Something that can often be either a really helpful
thought process or a really bad one, is putting yourself in another person’s
shoes because whilst sometimes, it could help a person to have more empathy, it
might also leave someone making comparisons and thinking “I wouldn’t be that
upset if that happened to me.”
One time, when I was in hospital
having the antidote treatment for something I had done, a Healthcare Assistant
was asking me why I’d done it, and after deciding to confide in her and tell
her about the abuse, she turned around and said, “I was abused when I was
little, but I didn’t do what you have because I’m totally fine.” Honestly,
initially I couldn’t really believe what she’d just come out with and was a bit
dumbstruck before I finally made a – in my opinion – feeble comment of “well,
everyone is different.” It was one of those situations where if you just imagined
it, you’d think of a ton of points you’d like to make; but when it actually happens,
you’re at a complete loss for words! And this was so frustrating for me – not just
because I’m very rarely speechless(!) but also, because I worried that not
calling her out on the comment would mean she might make it to someone else in
a similar situation and what might they do to cope? Because it led me to refusing
to have the rest of the treatment; just because I didn’t want to see that member
of staff again!
Now, in case you’re unsure as to
why I would react that way to her comment… Throughout the entire six months of
abuse, I constantly felt weak – both physically and mentally/emotionally. I
mean, there was the obvious way of being literally incapable and just genuinely
not strong enough to overpower my abuser and actually prevent him from hurting
me; but there were also the not so obvious ways…
The fact that my abuser was consistently
providing me with examples that proved I was weak by telling me that someone
strong and brave wouldn’t be crying when I was crying. Or that they wouldn’t be
scared every time I was terrified. Thing is – I knew I very obviously couldn’t
trust the man because not only was he doing all that he was to me, but he was
also lying to everyone by being someone completely different in front of
others. Regardless of this confidence that he was untrustworthy, I still found
myself regularly believing and becoming convinced of all the false and untrue
things he was telling me about myself. I think that this was largely because as
a result of the abuse, I felt incredibly isolated – I mean, I had this huge
secret (because for so many reasons I couldn’t report the abuse immediately) that
left me feeling completely exhausted from the effort it took to keep it quiet
when it felt like it was the most important thing happening in my life. And
having to lie or omit things when talking to anyone meant I felt distanced from
people and that, in turn, affected (in a bad way) my relationships with my
friends, family, and all the other people who could have supported me had they
known what was happening.
Another instance in which a
professional was invalidating was when I was in the specialist hospital, and I
had been given unescorted ground leave (I was sectioned under the 1983 Mental
Health Act so your Psychiatrist has to approve and permit any time of the ward)
for the first time since I’d ran away on my last one and ended up on life
support. And I came back from it and said to one of the Nursing Assistants how
proud I was of myself and that it felt like an achievement, and she turned
around and said, “you don’t get a pat on the back or a round of applause for
doing what you’re meant to and should be doing anyway!” Fortunately, my Key
Nurse and the inpatients I was closest to totally agreed with me that it was a
huge step in the right direction, so I felt that their support sort of counteracted
that one invalidating comment.
That experience has actually ended
up being really positive because it helped me to develop a sense of pride and an
attitude that has meant I’m aware that sometimes in life, you might have to be
your own cheerleader! I learnt that whilst validation from others can go a
really long way for me, my mental health, and my safety, there are also times
when my own thoughts and opinions of something I feel I have achieved or
experienced really need to be sufficient enough to have that same positive impact.
I can see now that actually; it should be more important that you show pride
and acknowledgment of your accomplishments yourself than it is to rely on receiving
that from others – especially when that means mental health professionals! I
think that if you do focus on wanting that validation from others, it can be so
incredibly challenging, disappointing, and upsetting if that doesn’t happen,
and so, looking for it within yourself is a lot more reliable and productive.
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One thing I think everyone can take from social media – and which
I have especially learnt in being a Blogger – is that people are curious and,
to be honest, slightly nosey when it comes to the lives of others. I think you
could argue that really, wanting to know about the life of people who might be
so different to yourself and your own lifestyle, is likely the fundamental reason
why everyone is even online and using social media. I mean, I’d say that my
primary rationale for using the internet is to help others through my blogging
and content on my social media accounts; but I won’t lie – I absolutely love
looking at the lives of others and especially seeing how other, more popular
bloggers live.
It’s no secret that my ultimate idol and blogging career
inspiration is Victoria Magrath who created inthefrow.com
(as well as her YouTube
channel and social media!). I find her so influential because she seems to
have a work ethic that I’d like to think I have too – she recognises and
celebrates her achievements and successes, but she also always strives for
bigger and better goals and opportunities. She never rests on her laurels –
something which I believe a lot of bloggers do once they’ve reached a large
number of readers or have done a specific collaboration or created and sold a
product or published a book.
Similarly, to this quality in her work ethic and career, Victoria also
never seems to stop putting her all into everything she does, and she never expects
things to be handed to her on a silver platter. She works hard and so it leaves
me with the feeling that she is really deserving of every single bit of success
and opportunity that comes her way. And, again, this is something which I’d
really like to think I also demonstrate – hard work that helps to leave it
understandable to others when I secure amazing collaborations and reach huge
milestones. I hope that readers and my loved ones who support me and I’m NOT
Disordered, consider me as also being dedicated and as deserving of mine – and my
blog’s – accomplishments.
Aside from my own admission of being curious of the lives of
others, one comment that has been made a number of times when various people have
asked which country my blog is the most popular in and I’ve said that the
United States are usually that country – even more so than the UK on the many occasions
I’ve looked at the stats! Even though the people who have asked me about this
are from all walks of life and have hugely different roles in my life and in my
blog’s existence, everyone has always commented that perhaps it’s been this way
because the mental health care system/services are so different in America. They’ve
talked about the idea that maybe the country’s residents are especially curious
as to what it’s like to have the NHS when they’re having to pay for insurance
and are often left to foot a huge bill for accessing their healthcare services.
So, I think that when considering people’s genuine curiosity, it can
be somewhat understandable for people to ask someone questions – this becomes a
problem, however, when the questions become inappropriate (and this can be defined
in a variety of ways as it can change from person to person). For me, though, I
deem inappropriate questions to primarily be where someone is asking for
unnecessary details on sensitive subjects e.g. self-harm, suicide, and abuse.
And by saying ‘unnecessary,’ I mean that those asking for such details don’t
really need to know them. I mean, it was hard and horrible, but I recognised
that the Police certainly need to know a lot of very triggering and upsetting
detailed description in answers to their questions when reporting abuse. I also,
however, recognise that a random Social Worker assessing me in A&E or
somewhere really doesn’t need to know that same level and amount of information!
As I talked about before, for so many reasons I couldn’t report
the abuse straightaway and that meant having to tell lies or omit a lot of
things when loved ones or people who cared about me asked questions. Going
through six months of this silence and secret-keeping was so challenging –
especially because I have always been raised to be honest and truthful about
everything – that it meant I actually began to find being open and honest as a really
strange concept and mindset. It was kind of contradictory thought because
whilst the truth started to feel unattractive and unappealing, I was struggling
so much with lying and remembering the story I’d told to one person and what I’d
said differently to another. It was stressful; and that was definitely something
I didn’t need on top of all the difficult thoughts and feelings I was already
experiencing.
Just when I felt that I’d fully adjusted to this habit of not
being so forward and open, I found myself really needing to be in order to be
discharged from my detention under section 2 of the 1983 Mental Health Act. One
of the Psychiatrists who made the decision to section me after my first suicide
attempt, made it clear that a huge motivation for doing their decision to admit
me to a psychiatric hospital (after medical treatment) was because absolutely no
one knew or could even hazard a guess as to why I had done it. This meant that
I felt really compelled – actually, it almost felt compulsory if anything! – to
put into words why I’d made the attempt because I felt aware that without doing
so, the admission could end up being rather lengthy and I was absolutely terrified
at being there and surrounded by much older, very poorly, inpatients. So, I
finally told a member of staff that I was experiencing hallucinations and after
speaking with my Psychiatrist, I was finally discharged a week or so later.
It seemed, however, that
despite confiding this in them, it didn’t change things for me, and it
certainly didn’t get rid of the memories of the abuse; so, I made another
suicide attempt and found myself being sectioned again. When I kept escaping
from the psychiatric ward, the staff made the decision to move me to the
Psychiatric Intensive Care Unit (PICU) which was locked and secure with an airlock
at its entrance/exit and a walled outside area. One evening, I ended up talking
to another inpatient for the first time and somehow, we got talking about our
past and she told me she had been abused. This gave me some sort of… inspiration
– maybe? Because I couldn’t help but think that I didn’t want to get to
40-something (her age) and still keeping this huge secret and having with my
mental health continue to suffer. So, I finally told the staff what had
happened to me, and they promptly called the Police who asked me such detailed questions
that – whilst I don’t regret reporting it and would always encourage others to –
I honestly felt like I might as well have relived it all over again! However, I
do definitely recognise that the Police genuinely need to ask for so much
information in order to achieve justice in the best, most appropriate way
possible.
The other sensitive area of my life/mental health where I’ve found
people asking for unnecessary detailed information, has been regarding
self-harm and suicide attempts. I think that even if you have little to no
experience of inpatient and community mental health services, it shouldn’t come
as a surprise to hear that they aren’t always the healthiest of environments in
terms of service users influencing each other… The best (though obviously in a
bad way) example of this, came when I was in the specialist psychiatric
hospital and one of the other inpatients snuck a blade back in after her leave
off the ward. I wasn’t aware anything had happened until the staff stormed into
my room and sent me to the communal sitting room, where it turned out everyone
else had been gathered. The Ward Manager came in and said that the staff had
realised a lot of people were turning up with similar self-harm wounds and that
eventually, one person had come forward and admitted a blade had been brought
onto the ward but that they didn’t know where it was any more. It turned out,
everyone (excluding myself and the girl I was closest to) had been passing this
blade around each other for the last week or so!
So, the whole ward was put on lockdown, and we were all forced to
sit in the sitting room whilst the other communal areas of the ward and our
individual rooms were thoroughly searched by the staff with their metal detector.
I remember the room felt literally so tense and on edge as we all began arguing
to try and determine who’d been responsible for actually bringing the blade in and
when the person, we all suspected swore on her children’s lives that it wasn’t
her… Well, there was very nearly an actual, physical fight between us all! To
be honest, her saying that was despicable, but the part of the entire scenario
which I found the most disgraceful was the fact that all these girls who I
thought I knew and cared about, had handed each other a sharp item; knowing
full well what the next person would do with it. It came out that some had even
given the next person ‘tips’ on how to ‘use it’ most ‘efficiently’ and ‘effectively!’
I genuinely struggled to comprehend how someone could live with themselves
after having not only encouraged someone else to self-harm but also, who provided
them with what they needed to do so! I mean, I’ll agree that sometimes
self-harm has helped me in the massively short-term, but I would never – and will
never – encourage someone else to use it as a coping mechanism because I
recognise the potential of it having a hugely negative and dangerous impact on
the person’s entire life and not purely their mental health and safety. And going
through this horrible experience really opened my eyes to the potential,
reality, and likelihood of mental health service users being a poor influence
on one another.
This influence isn’t always so obvious or outright though. Before
the admission to the specialist hospital, there were two other psychiatric
service users who I’ve met as inpatients, who seemed to ask for details on
self-harm and suicide attempts which – in my opinion – they really didn’t need
to know. And, upon me answering honestly and openly, the next thing I knew they’d
be messaging saying they’d done the same thing and were in hospital or that
they had taken more tablets or hurt themselves more times that I had disclosed
I had taken/inflicted. Fortunately, I didn’t seem to ever fall into this seemingly
‘competitive’ nature. I had no real need or urge to do something ‘worse’ than
another person had.
Even though I experienced these things before the specialist
hospital though, when my discharge after two and a half years as an inpatient
was being planned, and another inpatient asked me what I’d felt had been the turning
point for my mental health; I still answered honestly… I told her that when I’d
been granted some unescorted leave, I had run away, made a suicide attempted, and
ended up life support. Waking from the coma, I was then transferred to the PICU
– which was in the news when a patient killed another patient whilst I was on
the ward below it! – and spent days being sick, sleeping, showering with staff
staring at me, and crying before finally being allowed back onto the normal
ward. I explained that feeling so terrible sat there on the PICU on a plastic
mattress and still wearing a hospital gown, I had come to the sudden mindset
that – in a healthy and productive way – I did not want this to be my life any
more. I didn’t want to spend it running away from people, being sedated,
hospitalised, forced to stay somewhere I didn’t want to be, and feeling just
genuinely rubbish. It felt like a reality check. Well, to be honest, it felt
more like a kick up the bum!
Before I knew it, this girl was doing literally all that she could
on the ward (because she had no leave, she could have runaway whilst on) to be
transferred to the PICU. I stopped speaking to her because I felt so guilty, but
then this one time, I was passing her bedroom door and heard a funny noise, and
I went to continue walking but had this strange, sudden thought that if something
was wrong and I had ignored it I would feel even more guilty! So, I peered
through the observation window in her bedroom door and saw her basically in the
midst of a suicide attempt. She had locked the door, so I shouted for staff
whilst trying to kick the door down and when they finally came running, I was
pushed out the way and the next thing I knew the alarms were going off and
other staff were running backwards and forwards, bringing a blood pressure
machine and a cannister of oxygen with a mask. Then paramedics came and I started
crying with the genuine belief that I had killed her. That I was 100%
blameworthy for her actions.
Later that day, in our ward Reflection meeting that took place every
evening, this girl was well enough to be there too, and the entire situation was
faced with me crying and apologising and the other inpatients assuring me that
the girl in question was a grown woman who had made the decision to do what she
did and was therefore responsible for it. The staff joined in by trying to reinforce
the impact the girl’s actions had on everyone there and she ended up storming
out with a member of staff shouting after her “we’re never sending you to the
PICU when you aren’t genuinely poorly!”
After that experience, I found myself struggling to continue to be
honest and open on I’m NOT Disordered and actually, even in my social media content!
I worried that if I ever again felt that I’d been such a bad influence on
someone else, I might not be able to live with myself. And I might find it
challenging to recognise the other person has some responsibility if it
happened another time. It meant that when I found a Facebook group which encouraged
and supported utilising self-harm had taken a piece of my blog’s content and
put it out of context to appear as though I agreed with their ethos, I was so
furious! And I felt like a bit of a failure to have even just created a post
that could appear to have a hugely oppositional meaning that what I had
intended. And from then, I have tried to be so much more careful in the way in which
I phrase information about sensitive topics to try to thoroughly eradicate the
chance they could be misinterpreted and misused. I have, however, become
adjusted to the idea that this might never be 100% possible. You can’t regulate
the way every single person perceives your content – especially not when there’s
over 1.2 million of them! And I find so many benefits to blogging that outweigh
this risk, so I’ve come to terms with accepting it and always trying my hardest
to not let it occur.
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The first example of this point which – I think – would be the
most obvious thought upon reading it, is considering the communication and
online content which organisations or well-known individuals etc. put out about
mental health related topics/themes. And, particularly, when they’re referring
to specific areas of mental health which they have literally no direct
experience of. Producing content on a perhaps socially ‘trending’ subject or
theme that you have no real personal knowledge of, has the danger of really
bringing into question your motives for doing so. It can leave people wondering
whether you’re blogging about something to follow suit with everyone else with
the knowledge that any content referencing a trend will have a heightened possibility
for being popular than anything else. So, is an organisation or person ‘standing
up for mental health’ because they believe in it and recognise their employer’s
mental health or because they want to improve their brand awareness by any
which way possible?!
So, I’m NOT Disordered and my online content in general is largely
about being honest and open, so there was one year when it was an Awareness
date around Diabetes and one of my best-friends has this, so I began creating
content around it, but then I sat back and realised “do I really know what I’m
talking about?!” Like, I could do all the research and write from the point of
view of being a friend to someone with this diagnosis, but really; is that
sufficient? Is that going to help as many people as it might if I share a post which
is directly created by someone with Diabetes? And I think I have this mindset
because I’ve seen the damage content can do when it comes from a source lacking
in education, knowledge, experience, and understanding. I’ve seen posts about
Personality Disorders by charities that are more focused on particularly supporting
someone who is suicidal, and their lack of all these really important components
had a direct impact (which I also personally experienced) on an increase in
stigma and discrimination around those with this Disorder.
It actually reminds me a lot about that very first point in this
post about attention-seeking, because I fully believe those in the mental
health NHS Trust and Police who made such comments and gave me such labels, and
treat me so poorly, did so off the back of having a lack of training and empathy
around Borderline Personality Disorder. Like, I actually don’t think they were fundamentally
terrible people, just uneducated and unwilling to recognise that they needed to
improve on that before they should feel qualified and capable of having
anything even remotely to do with the help, support, and care for someone with
the Disorder that they knew – and seemingly cared – so little about. And
perhaps, experiencing being on that other side, has really helped me to develop
an appreciation and understanding about how important it is to involve those
you’re communicating about.
This leads quite nicely into the second way in which this point is
true; and that is when it is regarding professionals talking to one another
about a patient or service user who has little to no input on their
conversation. Of course, I appreciate that there are instances where speaking
about someone without their presence is necessary or appropriate; but going
into those communications the person should have already had somewhat of a
contribution. And this is actually something I’ve struggled with recently when
I was on the caseload of my local Crisis Team because I saw them one night and
we discussed that my discharge from them would likely not be until the
following week when my Community Psychiatric Nurse (CPN) returned to work. The
following morning (not even 24 hours later though!), I received a call telling
me I had a Transfer of Care meeting the following day to be discharged from the
Crisis Team to the Community Team! I literally couldn’t believe it! And the
poor Admin lady on the phone didn’t have a clue what was going on; she’d just
been told to ring me and give me the time and date!
After a lot of going back and forth on the phone, the Crisis Team
apologised and voiced the concern that in their MDT (Multi-Disciplinary Meeting)
service users were being discussed with very little involvement of the staff
who have actually worked with the person. They said that the ‘higher-ups’ were
looking at things on face value and thinking ‘she’s back on her medication, we
can discharge her’ rather than considering the fact it takes time for the
medication to build back up in your system and how beneficial for continuity of
care it would be to handover to my CPN rather than a Duty Worker who would only
then have to go and handover to my CPN when she returned! To be honest, it takes
me to this thought I have that when you’re sectioned or restrained or sedated;
these professionals make this massive decision about your life and then they
finish their shift and it’s you who has to live with it.
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I feel like making assumptions is something you should never choose
to do in life; and especially not in any communication related to mental
health. Now, I had actually been going to include another point of a ‘red flag’
being when someone flippantly uses a phrase or word that is important and
valuable to you such as ‘duty of care’ or ‘capacity.’ But in starting to write
about assumptions, I realised that actually, using such words without thought
or care as to what they really mean to another person, is pretty presumptuous too!
When the abuse began, even though I had all these reasons why I
couldn’t report the abuse straight away, I still desperately wanted to tell someone,
so I changed things. I changed my behaviours. My attitude… All in the hope that
someone would sit up and say, “this isn’t like Aimee, I wonder what’s wrong!” So,
I started having daily showers that would last an hour or more because I felt
like absolute filth after being touched when I didn’t want to be. I became rude
and rebellious at school because I was so angry at everyone there for not noticing
what was happening to me. Then I began engaging in self-harm, but literally
everything was explained away as me being a typical fifteen/sixteen-year-old
teenager going through ‘a phase.’ I was labelled a rebel, a drama queen, and an
attention-seeker by other pupils and the teachers and those comments and the
bullying that then started, just gave me more and more reason to slip further
away from everyone and to continue to keep my dangerous secret.
When I finally reported the abuse to the Police a few years after
it had ‘ended,’ they interviewed many of the people who had been around me
during that time and literally all those who could have witnessed and stopped
the abuse said either: “I wondered if that was happening…” or “I didn’t see it,
but I can believe it happened!” Obviously, their suspicions and beliefs weren’t
evidence enough to prosecute my abuser, but – of course – if they’d actually
acted and stepped in when they were ‘wondering’ whether it was going on, then there
might have been the evidence, and he might have not been able to walk out of
that Police Station with just the ‘accusation’ on his record! In fairness, the
Police voiced their frustration with the statements and even apologised to me for
the fact that none of them had stepped in and protected me – but it obviously
wasn’t their wrongdoing to apologise for, and all those who were actually responsible,
didn’t make any effort to say a single word to me!
Aside from the attention-seeking labels from professionals when my
diagnosis of Borderline Personality Disorder began being used in my notes and
records, another large and detrimental assumption professional have made around
a fundamental aspect of my mental health has been about the treatment for it.
After numerous psychiatric hospital admissions and right around when I noticed my
diagnosis being mentioned, the mental health professionals began stating that a
pretty huge guideline on treating people with a Personality Disorder is to
avoid hospitalisation because it’s found to have been statistically unhelpful. Ironically,
I agreed that ultimately being sectioned and admitted to hospital had never
been a fantastic experience – only in so far as short-term that it kept me safer
that I would have been if I’d been left to my own devices in the community. However,
even in those circumstances, professionals started ranting and raving about
taking responsibility for my actions and that I needed to recognise the
importance of managing my own safety and gaining control over the unsafe and
risky actions I was using as coping mechanisms.
Around two years later, I had made a suicide attempt and had accepted
the antidote treatment in A&E but the cannula that was used for the treatment
to be administered broke and when they couldn’t find another good vein for a
new one, the Doctor decided I needed to have a central line put in. Having
previously had one, I knew everything that entailed – an incision in your neck,
threading all these tubes and things right down into your body and stitching it
in place – and so I refused to let them do it. Over the course of five hours, I
had numerous Doctors come in and ask me questions before leaving and then
another would come in, and another, and another… The next thing I knew, below
the curtains that were drawn around my hospital bed, I could a ton of feet gathering,
and the curtains were pulled open, I was restrained and was given an injection in
my leg. After that, my memories are of a lot of whiteness and the notion that I
kept standing on platforms and then falling off them(!).
When I finally really woke up and felt grounded, the entire thing
was explained to me… Apparently the five hours had been because they were
struggling to find two Doctors agree that I didn’t have capacity so that they
could force the treatment and the only reason they finally reached the
agreement was because I was becoming more unwell medically. Then, they told me
that the whiteness and falling was all because the Anaesthetist – even unknown
to all the other staff – had sedated me with Ketamine! The other Doctors and
Nurses and Healthcare Assistants only discovered it had been that medication because
I’d apparently gotten really aggressive!
The entire experience meant that when I was finally discharged and
after chatting things through with my Community Psychiatric Nurse CPN) and
Psychiatrist, they had me sign an Advanced Directive (basically a document that
you can create and sign whilst you’re well to say what you’d like to happen if
you become poorly). My CPN and Psychiatrist were concerned that because Doctors
made assumptions as to what a person without capacity should/would say or do, I
had become closer to dying purely because I didn’t really fit that status quo. So,
my Directive states that because when I’m well I actually do love life; if I
say I want to die and if I’m refusing potentially life-saving treatment, it
should be assumed that I don’t have capacity and I should be treated against my
wishes. It also states not to use Ketamine for sedation!
In all honesty, because professionals always adhered to it, I do
think the Advanced Directive was one of the few things back then to have really
saved my life and to have had a huge impact on my mental health journey on a whole
too. However, it shouldn’t really have even had to have been created, because
the Doctors shouldn’t have been making anything that even remotely resembled being
an assumption in such an important and monumental situation. Like, if ever
there’s a wrong time to do that; it was then!
The final example of an assumption being made in a pivotal
moment/stage of my mental health journey, has been fairly recently and is in
terms of my new diagnosis of psychosis. Last February, I was sectioned in the
midst of psychotic episode, but when an increase in my antipsychotic medication
was requested, the Psychiatrist’s response was; “people with Personality
Disorders don’t benefit from medication; you just need more therapy!” Thankfully,
my Mum was at the meeting where this discussion took place, so she gave me the
support to not just run out of the room feeling totally hopeless and dismissed.
She raised the point that in life – and particularly in mental health care/services
– people shouldn’t be put in boxes and defined by some sort of majority-based statistic
that is driven from a research study that took place at the other end of the
country! It’s unfair and – in my opinion – ignorant.
Later that year though, I was put under the care of the Crisis
Team and saw a different Psychiatrist who agreed I wasn’t struggling with Personality
Disorder symptoms any more and he increased the antipsychotic medication so
that within around a fortnight, I was better. I barely had the strange thoughts
and beliefs (sometimes referred to as psychotic or intrusive), and when I did
have them they weren’t in my head for as long and I felt they were more easily for
me to ignore or dismiss them and recognise how unrealistic they were. And
whilst I was obviously so grateful for that, I’ll always wonder; if that first Psychiatrist
had increased it at that time, would anything I did between then and the actual
increase have happened? Because in all honesty, I did many things that could
have likely meant I might have died in that time. And when an assumption could
cost a person their life? Well, that’s – put simply and honestly – dangerous
and negligent.
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1.
Recognise the difference between hearing someone and actually
listening to them.
2.
Validate. Validate. Validate.
3.
Don’t pigeon hole people and deem everyone with the same diagnosis
to be exactly alike.
4.
Be aware and cautious of speaking about a person within earshot of
them.
5.
To be honest in writing your thoughts, feelings, and experiences;
write like no one will read it.
6.
Always treat others how you would like yourself or your loved ones
to be treated.
7.
Prepare yourself emotionally in case someone discloses sensitive
details or information.
8.
Never make assumptions – even if that means asking a difficult
question.
9.
Be mindful and respectful of people having different opinions on
the same topic.
10.
Find inspiration and tips to talking about mental health online
before you start talking about it.
For updates on the Mental Health Strategy and other news from Newcastle
Upon Tyne Hospitals NHS Foundation Trust, here are all their links:
Newcastle
Hospitals NHS Foundation Trust (newcastle-hospitals.nhs.uk)
Facebook: @NewcastleHosps
Twitter/X: @NewcastleHosps
Instagram: @NewcastleHosps