Mental Health Services in crisis

Eighteen months ago I suffered a manic episode after acute pancreatitis was followed by kidney failure. I required urgent inpatient treatment in a secure unit. I am not blaming the infection and water retention entirely as there are people who suffer acute infections who do not go off their head. But I am Bi Polar so am particularly vulnerable when I have physical illnesses. Also the drugs which keep me well could not be excreted during my kidney failure and built up to a dangerously high level.

I cannot fault the treatment I received and the kindness of the staff but I live in Dorset. However, I am well aware of the patchiness of mental health care. As a member of Depression Alliance I receive Single Step, the bi monthly magazine which allows mental health sufferers to air their views on their condition and how their recovery has been helped in a variety of ways.

I also have a profoundly deaf sister whose mental health condition has deteriorated in the last few years. She lives in Oxford. In July after several months of deep depression and worrying behaviour, she became aggressive during a visit by her step daughter, who called the police. My sister was taken away but not before she had apparently attacked the police officers. This was during the day and she spent several hours at a police station as did her husband before he was allowed home but she was detained. I understand that thankfully interpreters were present. During the night – I presume she was detained in a cell – my sister decided she wanted to go home. Amazingly she had not been sectioned so she was taken back in the early hours to her quiet residential street by two women police officers. Unable to rouse my profoundly deaf brother in law – surprise, surprise – ladders were obtained from one neighbour but finally a neighbour who held a key was roused. These very same neighbours had experienced considerable disturbance both that evening and on previous occasions when my sister became unreasonable and police were called.

The following day the GP accompanied by another doctor – presumably for the purposes of sectioning my sister – arrived at the house. My sister refused their admittance but eventually allowed her GP into the house then barricaded the door thereby blocking his exit. After some time the GP left. Soon after this my sister became distressed. Neighbours report hearing her sounding very upset and shouting at my brother in law in the garden. She then suffered a serious fall sustaining a large cut to her face which required stitches. My brother in law took her to the surgery and the GP sent a referral to the local hospital recommending that, in addition to attention to her injury, she undergo a full psychiatric assessment.

It was only that morning that I was advised of the events of the previous day. The psychiatrist relayed the facts as he had perceived them but I did suspect that he had been criticised for not sectioning my sister that evening in the police station. Later I realised that the lack of sectioning was linked to the lack of mental health beds in the area. Now it makes sense!

The following morning I was contacted by the A and E department of the local general hospital, the nurse telling me that my sister was refusing treatment and could I arrange for her glasses to be taken in so she could read what they wrote down. They had acquired a book of ‘signs’ they said and they were trying to use them. This, I told them, was useless as my sister is ‘oral’ ie she has been taught to lipread and speak, although her speech, especially when distressed, is not always clear. I spoke to a neighbour who went to ask my brother in law to take her glasses to the hospital. When I phoned later, she had received her glasses and had calmed down. They had managed to stitch her gash on her face but communication was still difficult. They were having difficulty getting her to stay on the A and E ward.

I immediately said I would travel up to Oxford to facilitate some interpretation. It appeared to me that interpreters had not been obtained for what was a very serious situation. The nurse was relieved to hear I would be arriving within a few hours.

When I arrived at the A and E ward, I saw my sister coming out of her side room. When she turned, her appearance was pitiful. Her face was black and blue and her clothes were blood spattered. But most alarming was the state of her wrists which were blackened, red and chaffed by, what she said, were the handcuffs she had been put in for several hours when she was taken away from the house.
The medics had been waiting for my arrival in the hope that I could keep my sister calm when they sectioned her. She has been resisting help via the inpatient system for several months and she has repeatedly shouted at me that she will not go into hospital. I warned the doctor that there may be a reaction. An interpreter had been obtained for the sectioning procedure so I was impressed that the communication was being assisted both by the interpreter and by me. It is a fact that my sister is calmer when I am present. By now it was early afternoon on the Friday.

What came next was a shock. There would not be a bed for my sister in a mental health unit until the Monday. We had 3 days to get through before she could be admitted to a psychiatric unit. Pressure on beds meant that they had to wait for someone to be discharged before she could be moved from the Accident and Emergency unit. I quickly realised that the staff in this emergency department would be hard pressed to cope with my sister in her manic state unless I was present. I stayed as long as possible with her, keeping her calm and talking down her angers and frustrations about family affairs and the health service. My partner drove me to a relative about 40 minutes’ drive away where I stayed overnight. The next day I travelled by train to Oxford and stayed all day in the emergency department providing support and calming my sister when she became agitated. I left in the evening on the Saturday, fairly nervous about how she would be in my absence. I explained she would have her dinner and then she could stay on her bed and settle down to sleep. I reiterated that she should not leave the ward – she had tried in my absence. I made her promise that she would stay on the ward while I was absent.
On the Sunday I arrived to find she had been moved to a mental health hospital but no-one was able to tell me where she was. It transpired her husband had been to the hospital and not found her so had gone home. I tracked him down at his son’s via mobile and by 2pm that day he knew where his wife was being held. To say I was disgusted at how this move had been handled and how he had been denied information is an understatement. I am speechless. I stood while sheafs of paper were shuffled with a multitude of names and their destinations written in barely decipherable handwriting. Whatever happened to computers?

Even worse was the fact that the foreign nurse who told me where my sister was could not pronounce the hospital name correctly and she offered no help as to how I could get there. Actually I don’t think she knew. A physiotherapist tried to help me by googling the mental hospital so that she could give me directions. After many google tries and her puzzled face, I gave up and said I would go to the taxi rank and get a taxi to the hospital by giving the name.
Which is what I did. When I arrived at the mental hospital no-one would tell me the ward my sister was on as it was private information. I wanted to scream. My brother in law had not yet arrived but he is profoundly deaf. How would he get directions? Eventually they did tell me, in a whisper, where she was but directions were sparse.

By now I was feeling faint with hunger. It was 2pm and I had spent the last three hours trying to find the hospital.

But it was Sunday!! The cafe was closed and the corridor leading to some self service machines was barricaded and out of use. I did get some directions to a nearby cafe which turned out to be a 45 minute walk into the nearby shopping centre. I eventually found a cafe and ordered some food and a coffee. Why this could not be available on site for visitors to the mental health unit I cannot understand.

When I eventually found my sister she was in a side room and calm. Surprising, as I expected she would be protesting but, like many with mental health problems, she knew the way to get discharged quickly was to be quiet, eat her meals and not cause any trouble.

The staff member I spoke to told me that they thought there was more than just a Bi Polar episode and they were going to have her assessed by the elderly care unit. A week later she was interviewed with an interpreter and other staff and discharged.

Three months later and after a brief ‘high’ when she faxed me good news every day, she has descended once more into deep depression. I have emailed her GP twice asking that she be seen. I was amazed that, having been seen by a doctor who deemed her needing ‘help’, she was not told to return if she did not feel better. At my practice a depressed person is asked to come back in a week or a fortnight so that their condition can be monitored. This does not seem to be happening in Oxford.

I am at a loss as to what to do. I do not live in the Oxford area and do not understand how things work there but from what I have seen I am not impressed.
Two years ago my sister was referred for BSL counselling. BSL (British Sign Language) is a medium my sister can work with although she was not taught by this method at school. She has learnt sign language since leaving school and this counselling would help her immensely. No-one seems to be chasing this up and we go on with no help.

My brother in law does not understand depression and both he and my sister are in a state of denial inasmuch as they do not want to talk about the difficulties that have caused the police and ambulance service to be called several times. In fact, only the police have been called, when, actually my sister required paramedics, an ambulance and admittance to a mental health unit immediately. Not to be kept in a police cell and then allowed to go home, get distressed and take a tumble out of the garden doors on to the patio sustaining severe injury.

So when I heard a 16 year old girl had been kept in a police cell because a mental health bed was not available I was not entirely surprised.

David Cameron!! What are you doing about mental health? I shall be asking strong questions of our Conservative candidate on this matter but, then, he never replies. His last reply came in October to an email I sent in July about the Disabled Students’ Allowance restrictions. How disgusting is that?
What next? I visit my sister and find a tearful, depressed individual who is lonely and getting no help. In our area there are courses for those with depression or Bi Polar Disorder which help those sufferers to cope with their conditions. Surely this should be possible for my sister with an interpreter present.

I know interpreters are thin on the ground and I do feel more funding should be available to encourage people to train in this area. I was pleased that every day while an inpatient my sister did have an interpreter for doctors’ rounds and consultant interviews. For that I am thankful but I should not have to be thankful. It should be the right of every deaf person to have this facility. They provide interpreters for the Poles and other East Europeans who come to this country so why not for a deaf woman who has lived all her life here and contributed to the health service via national insurance.
I know there are cuts to mental health services. This is an example of a situation which became quite bizarre because of lack of help. The scar on my sister’s face should not exist. She should not have been allowed to go home that Wednesday night from the police station. She should have been detained for her own safety.

I would like the luxury of time to ask the authorities to explain the events of July 2014 but my time is taken faxing encouraging messages to my sister, finding information on the internet, printing it and sending it by post.




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