I Am A Mental Health Worker And This Is A Letter To My Patients That I’ll Never Send By The Masked Avenger

Author Anoynmous

Dear Service User,

I am sorry I cannot offer more.

I am sorry I couldn’t call you back yesterday when you needed me and I am sorry I am not able to do more to help you.

I have worked in mental health for 10+ years and whilst I love my job it never gets any easier. 

I have books on my shelves and articles in files on the latest evidence based practice. I have ideas in my head for sessions we can do together and the passion to sit with you whilst we figure all this out. 

However, first you need to get to me and I need the time to deliver it all.

Referrals into mental health services are on the increase, this could be due to the ever growing pressures in society on everyone; from children to the elderly or the successful drive to normalize and promote mental health like never before, ripping down barriers and shouting from the roof tops that it is ok to not be ok.

So you gather the courage to call someone (which I know is so hard to do) and get help…

Unfortunately our pie is not getting any bigger, there is no more ‘money tree’ and we cannot afford anymore resources. So whilst we are able to see you, accessing treatment is entirely different. 
In the service I work in there are 30 practitioners for nearly 400 people on the waiting lists. No matter how you do the maths it is never going to fit. We try and change the service, we make it more lean, we shave things down to try and get everyone in but it is impossible. We have ideas of more we can offer but no money to fund it and no bodies to deliver it.

I want to see you straight away but there are hundreds of other people ahead of you.

I want to take it at your pace and see you for as long as it takes but I only have 8 sessions otherwise other people will have to wait longer. 

I want to be there to answer the phone straight away when you need me but I already have 6 other back to back appointments, before racing to collect my children from school. 

I constantly squeeze every drop of time to fit in more people but inevitably it all runs out as I cannot make 24 hours into 25. 

I want to offer you the therapy you need but no service, that I know of, is commissioned to offer it, which just really sucks.

I don’t know what the solution is but I want you to know that I am sorry because I feel just as frustrated as you. 

I know my boss, their boss and the bosses’ boss also constantly look for answers, but with an ever growing population and more needs becoming prevalent it is very hard. 

It’s not just us either; before, we could have referred you to other 3rd sector organisations which could have helped but they are just as squeezed as us and having to make equally hard and heartbreaking decisions. 

So please don’t be offended when we talk about self help materials or equipping you with the tools to help yourself, it is the only weapon I have at the moment to help you long after I have to reluctantly discharge and move on to the next case. 

Please don’t think I don’t care if my next visit isn’t for another 6 weeks, I hate this just as much as you do. I need you to understand that my intervention isn’t limited through choice , so all we can do in the short time we have is to teach you the skills I have to help yourself.

I need you to not miss any appointments as they count in my limited time and I need you to work with me as much as you can so that I can give you all I have. 

One day maybe we will have enough resources, but for now all I have is I am sorry!! 

We all deserve more than this, no one more than you. 
Please hang on in there, believe in yourself, take any support you can find and know that your wait isn’t because we don’t care, our pie just simply isn’t big enough.

From Your Practitioner. 

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Mental Health ‘Care’ is Not What you Might Expect By The Masked Avenger Anonymous 

Author Anonymous

* Please note trigger warning ( suicide) *


I’ve been detained under the MHA (Mental Health Act) twice within the last two years. I will describe my own experience of my last admission. 


I have 3 mental health diagnosis, an eating disorder in which I have a lot of fear foods plus an allergy to wheat and gluten, I have PTSD for which I can be triggered and recurrent depressive disorder. The latter means that my mental health fluctuates in waves going from a flat enjoying nothing mode in which I manage to function and maintain normal acts of daily living such as getting up and out of bed, washing and dressing and eating the foods I will eat. 

I have a fear of phones but keep in touch with my 2 friends and 2 of my children by text and I will talk to my GP on the phone.

 
In the low periods despite attempts to change I can’t gather the energy to get out of bed apart from loo trips. I don’t wash or dress, my eating varies and I withdraw from the world and push people away. I spend most of my awake hours crying, and honing down my suicide plan to the final piece as I lose all hope that I’ll ever get better and the emotional pain is so intense I’m unable to cope with it. 

On this occasion my care coordinator had visited me and said that she would be requesting a MHA assessment and left the house. I paced around crying having found my first hospital admission awful and not wanting to go again. I wanted to take my overdose to end my life but thought the MHA crew would appear and save me and I didn’t want to be saved.

Eventually at 8pm, eight hours after my care coordinator had left, I managed to phone the out of hours team to find out what was going on and I was informed that the MHA assessment was booked for 10am the following morning. With this information I believed I had the time needed to end my life and took most of the tablets in my bedside drawer. A mixed overdose of about 8 drugs but including tricyclic drugs I’d previously stored at a time I was prescribed them. 

I lay on the bed fully clothed in clothes I’d been in 24/7 for several days. I didn’t expect to wake up. I remember nothing from that moment to waking on a ward in the medical hospital. 

It transpired that the 2 doctors and AMHP had arrived and not being able to obtain entry asked a neighbour (who has been nasty to me since I moved here so I avoid him) to climb in my bedroom windows and let them in. They couldn’t rouse me so I was taken to hospital where I woke later. It was a couple of months before discovering my neighbour had been in my bedroom and was aware as he gleefully told my daughter about it. 

What happened after…

So the MHA assessment took place in the medical hospital at 2am the morning after I was found and I was detained under section 2. I remained in this hospital for a further 36 hours as there were no beds. My bed was an observation bay right by the nurses station, the lights were on full there all night but I wasn’t allowed to draw the curtains for shade so I could sleep so I didn’t manage to sleep at all in that light. 

I was then transferred to the psychiatric hospital acute ward and shown my room. There I stayed in bed, still fully clothed completely covered in a sheet apart from loo trips for over a week. I cried the whole time and if I slept during the night I don’t remember it. I was aware of every hourly check from staff looking through the bedroom door all day and all night. 

Once or twice people put a plate of food on the bedside table and left it there but the food was all my fear foods as was everything in the canteen so I ate practically nothing during my whole stay. 



After a week and a bit I asked whether it would be possible to be taken home to collect some clothes as I’d been wearing the outfit I’d been detained in day and night since. I asked every day but was told there were no available staff to do so. On day 12 I went to the ward manager’s office and said how long I’d been in my clothes and how I needed things from home. Within an hour a member of staff took me and I collected night clothes, another outfit and toiletries. After this time I started to go into the lounge occasionally but was frightened of 3 ladies on the ward, 2 of which had major anger problems and 1 was extremely unwell and very unpredictable.

One of the ladies with anger issues later told me she didn’t want to be discharged as her partner was violent and she had nowhere else to live so every time discharge was talked about, she’d deliberately kick off meaning her discharge was delayed. She assured me she’d be there months. 

The canteen was terrifying for me. I’m frightened of men and the dining room was shared with the male ward. Many of the men behaved badly making obscene suggestions as well as throwing chairs etc. 

There was no food I could eat anyway so sometimes I’d grab a banana from the fruit bowl and immediately go back to the ladies ward. This satisfied the staff I was eating and the staff in the dining room could tick me off their list. Sometimes I’d take a bite of the banana but usually didn’t and would bury it under paper towels in the bin back on the ward.  
One teenager cut herself so badly during the night she was whisked off with the 2 qualified members of staff to A&E in the adjacent hospital. They never returned so no one could have medication and the following day the consultant was at the main hospital too. The teenager never returned, I’ve no idea if she survived. The things from her room were bagged up and taken away from the ward. 

Apart from a mindfulness session every weekday morning nothing else was on offer. I didn’t go to the sessions due to fear of the men but I have done mindfulness to death in the community and despite hours and hours of practice find it never helps me at all. But for some reason mental health professionals think it cures all psychiatric ills and it’s the only therapy I’ve been offered in the community in my 7 years with them. 



During my weeks on the ward I only ever saw one qualified nurse in the lounge, sitting and talking to patients. She’d bring her laptop in to write up her notes on Rio but would talk to patients alongside this. She was really nice, I’ve heard she’s left now which is sad. The only times I saw qualified staff was at the hatch to the medicine room as they dished out tablets. Apart from those times they stayed in the ward office and we never saw them. I had a named nurse who I never met. 

There were 2 or 3 health care assistants who were visible and about the ward, they were all male but we’re quiet and calm so I was able to cope with them with no problems at all and one in particular was kind. 

I was discharged feeling no better. At home my dining table was covered in piles of thing labelled with who they were to go to, and 3 envelopes containing letter to my children. 

On my discharge notes it said I’d spent the first 10 days asleep in bed!! So all those days I’d cried day and night barely catching snatches of sleep, I was apparently asleep the whole time. 

The thing is no one ever talks to you or asks you anything so they guess and assume and that’s the basis of their paperwork. My diagnosis was even better, it was factitious disorder which totally shocked me once I’d looked it up. Fortunately both the community CMHT (Community Mental Health Team) and my GP said that was total rubbish. CMHT told me that hospital consultant is renowned for his bizarre and incorrect diagnosis. Useful. Not. The only thing that kept me sane there was my weekly phone call from my GP. She’d listen to what was happening, how I was feeling and what was being said and she’d spend 30-45 minutes helping me make sense of it all and help me see things from a different perspective. Ironic really that the only helpful member of staff during my time there was my GP back at my surgery! To me that ward is nothing but a holding cell. 

Therapy would be good as would be some interaction with qualified staff or your named nurses. And it seems when someone is detained and needs a bed, the patient on the ward they deem to be the least risk is immediately discharged, better or not, to make room for the new arrival. Because I was quiet and not disruptive, that was me.

I hope one day that I’ll be offered some therapy from the community team. But I’ve asked for CBT or a psychological assessment several times and the answer has always been no. I want to leave CMHT as I’ve found little helpful and they’re not proactive but my GP encourages me to stay with them because with my recurrent depressive disorder I get low, and when I get low I get very very low and lose all hope. But I have no intention of going back into that hospital again, no help is available there and the diagnosis you come out with is fictitious in itself.

This was written for you by a Masked Avenger. A Masked Avenger could be any one of our regular writers, a group of writers or a guest writer. Written to bring you uninhibited truths that need to be told.

If you would like to submit an article to the Masked Avenger please email us at: the-avenger1@hotmail.com

The Truth Behind Closed Doors of a Psychiatric Hospital: By The Masked Avenger Anonymous

Author Anonymous

Have you ever wondered what goes on behind the closed doors of a psychiatric hospital, where the purpose is to keep patients at a vulnerable time safe from harm and well cared for with medications, occupational therapy? I am about to give my insight of the hospital from my teenage years and from various stays including the most recent last year.

Getting admitted

Firstly to actually even get admitted you are pretty much in for a fight with the mental health services, I have before begged for admission due to being suicidal in 2015 to the Kent crisis home treatment team only to be told ‘you do not meet the criteria’.

I know on a personal level just how difficult it is to get them to listen. I was age 16 when first admitted a long long time ago now. The hospital was actually run so much better back then even though it was still absolutely poor in comparison to the care you would expect to receive, but back then you were allowed to smoke in the smokers lounge ,a right that prisoners in the UK still have in some prisons. Sometimes it is deemed that you need to be sectioned as I was 3 times last year.

I felt there was no dignity at all.  I was left sleeping in a corridor on a hard rubber sofa with no pillow or blanket and woken up at 7 am to say they had a bed for me in brighton priory… the experience of being in the priory a private hospital was a different world to the NHS experience.

The Staff

I am not saying all the staff are as useless as a chocolate teapot you get one or two that take the time out of their day to sit and talk with you about how you are doing but this is very very rare.

When becoming an inpatient at Littlebrook Hospital now you are made to have your bags searched and items listed this is as much for admin purposes as it is to check whether you have anything in your bags that can harm you i.e razors , tweezers , tablets. However on all admissions last year I was able to ‘smuggle in’ items on the banned list by putting them various zip up compartments which were not checked. Very ‘thorough and safe’ indeed…

 

If they called breakfast and you were not up you simply missed out altogether meaning that you went until lunch time at 12.30 before eating, which when you are on medications is not good at all and can cause adverse effects.

 

If you requested medication to help calm you you could wait hours or sometimes they would forget altogether. I was psychotic last year and convinced I was being spied on I refused food nor was given supplement drinks for a few weeks on my first admission. I would stay in my room at meal times and nobody would try and encourage me that it was safe to eat.

Putting it bluntly the nurses simply do not care. I would punch the walls of my room a lot they would see me doing so but would leave me to it even to the point my hand was swollen so much I was taken to A&E.

 

The hospital is supposed to be a place of safety and rehabilitation but this is definitely not the case here.

At most I will call it a holding cell until the psychiatrist deems you fit for discharge.

 

The food

The food at the hospital is vile and nasty and served without care. Breakfast is fine as it is cereal and you cant go wrong with that , well unless you don’t wake up for it and lets face it at 7am when you have been given night time medications at 10pm…depending on it the nurse in charge actually starts it on time or if there is a delay from someone on the ward having an episode who is really going to be awake for it.

 

When I was in as a teenager they actually made you get up and go to breakfast lunch and dinner and offer supper too but the care seems to have drastically fallen in 15 years.

 

The lunch and dinner are to be avoided at all costs. This is an actual dinner from 2016.

Blog photo fod I looked for the budget info which was unavailable but it it is widely known that more is spent on prisoners food than a person in hospital. It was like a game of guess the meal. When you are trying to recover mentally you do not want to eat anyway so the food could go a long way in aiding recovery of the patients. You are also watched like a hawk with knives even though they are as blunt as anything.

They count all cutlery (yes even the spoons ) in and out of the trolley.

Occupational therapy

What therapy?

You would go days and days with nobody being there and they deemed that having newspapers, tea and biscuits on the ward as occupational therapy.

 

Back when I was 16 you actually had two sessions Monday to Friday that you were encouraged to attend. Now the staff are more then happy for you to lay in bed all day and leave them to sit in the office eating whatever luxury items they had brought in with them and drink endless cups of tea and coffee.

 

Pretty much the only staff on the ward where those who were on eye sight for the patients needing one to one care, this is supposed mean you are watched 24/7 but even then I know of patients who managed to cut themselves or ligature themselves whilst on one to one watch.

 

Ways out for those desperate to escape

 

There are a few ways out of the hospital without discharge some I witnessed and some I did myself while on section last year.

 

For some they literally break free kicking the fire escape doors , for others they may injure themselves needing treatment in hospital (often with items brought in; some ladies I know of swallowed smuggled in razor blades and cut themselves. I on the other hand hit my hand repeatedly but never ran from hospital as my treatment was actually pretty quick).

 

For others they bide their time and wait for escorted leave and just run off only coming back if found by the police. No matter what where there is a will there is a way out. The staff don’t care either way they just care about their wages and cups of tea.

 

Discharge

They will discharge you when they see fit and no matter what you say will change this. They have their own set agenda when it comes to discharge and pretty much always you do not get the follow up ‘care’ that they state in your discharge plan.

Its like ‘lets see who is the least at risk so we can ship them out and make way for the next vulnerable poor soul. ‘

To sum this up, Littlebrook Hospital is a disgrace to vulnerable and at risk people.

The lack of care, food and medications is astronomical and the place is worse then a prison.

You have to wait days for a review , you cannot smoke in there causing a lot of people to kick off and react as the staff are now not even supposed to give you supervised leave so you can smoke. I know smoking is no ideal but for a huge amount of mentally unwell people it calms them.

 I have been hospital free for a year and I can only hope that my mental health does not decline so much again that I have to be admitted


This was written for you by a Masked Avenger. A Masked Avenger could be any one of our regular writers, a group of writers or a guest writer. Written to bring you uninhibited truths that need to be told.


If you would like to submit an article to the Masked Avenger please email us at: the-avenger1@hotmail.com