I wish he’d make up his mind!

Following my last appointment with the consultant psychiatrist who is in charge of my case, I was left with the impression that I was about to be cut loose from the service I rely on because I was ‘un-helpable’.  He also made it rather clear to me that he seemed to think that I didn’t even suffer from the recurrent depressive disorder I already had the diagnosis of.  However, on Saturday, I received the copy of his report and he now says that I do suffer from recurrent depressive disorder and that there is the ‘possibility of co-morbid personality characteristics perpetuating his constant low mood’.

I quite like his closing statement: “Overall, it was my impression that Myles Cook suffers from a recurrent depressive disorder, the symptoms of which are currently mild in the absence of antidepressants.  There is a likelihood of Myles Cook suffering from a co-morbid personality disorder with further immediate complicating social and financial stressors that makes his prognosis guarded, in particular, if he had a failed attempt with psychotherapy.”

I do have a couple of issues with his report though.  There are a couple of factual errors such as the fact that I lost my cat and that I fell asleep in one session of group psychotherapy.  Firstly, I almost lost my cat due to his ill-health but didn’t actually lose him. Secondly, I fell asleep in more than one session.

The other issue I have with the report is the idea of the depressive symptoms being ‘mild in the absence of antidepressants’.  Well, if going to bed every night not wanting to wake up the next morning and waking up each morning hating the fact that I’m still breathing is ‘mild’ then, perhaps, the word means something different in psychiatric circles.

I just wish he’d make up his mind about where I stand psychologically so, just perhaps, I might actually get some treatment that might help me.

Until next time…

On the assessment ward part 2

Please note: This part of my account is written from memory and not from what was written at the time.  The timeline may be a little screwed up but the facts are right enough.

I will begin the second part of my account of my stay in the Assessment Unit following my overdose last February with a step back from where I left off last time…

I had been escorted to my room where I had my bags emptied and the contents scrutinised.  Before I was taken to the Mental Health Unit I had bought a couple of bottles of Cherry Coke for my stay but as my things were being checked through I was informed that I might have them taken away from me as they might be considered contraband.  This was a big thing for me as I don’t like the taste of water and I don’t like tea or coffee.  Thankfully, they let me keep them but I was left thinking exactly what I was supposed to drink if they had taken my drinks away from me.

The room was cold but fairly spacious with a single bed, a bedside cupboard unit, a wardrobe and a washbasin in it.  The wardrobe had no rail or hooks on which to hang any of my clothes so I merely had to place them on the shelves so any pretence of looking even vaguely well dressed the next day was immediately destroyed.  In fact, there was a distinct lack of anything on which you could hang anything.  The washbasin had ‘buttons’ of a sort instead of taps and there wasn’t even a plug for it.  The windows were protected from being opened by huge sheets of transparent plastic so that, if it had happened to be hot, there would have been no way to open them.  I knew that most of these precautions were being taken to protect me from trying to hang myself or throw myself out the window but it also took away some of the little dignity that life had left me with.

I put my toiletries, such as they were, in the bedside cupboard with my Coke bottles on the top.  I felt like crying as I felt as if I were a convict but, to be quite honest, I was too tired and upset to cry.  Tears come very hard to me at the best of times and this was certainly not the best of times.

I climbed into the bed to find that the only covering I had been given was a single sheet and an extremely thin blanket with holes as part of the design, much like a potato waffle.  As I remarked earlier, the room was cold so my bedclothes gave me little warmth.  I couldn’t sleep because the light in the corridor outside my room was on and I couldn’t help but see the glare through my eyelids.  I had been questioned, violated and then left alone in a cold room with my dark, suicidal thoughts.  Hardly the best thing for someone in such a deep state of distress.  I thought that things couldn’t get any worse.  I was wrong.

The next morning, the inmates of the ward and I were woken up and made to go to the combined dining and activity room where the television was mounted on the wall surrounded by a lockable box to prevent the inmates touching the screen.  Thinking about it, I suppose we were lucky in that the box wasn’t locked whilst I was there but one of the female inmates was jealously guarding access to the television and we were forced to watch whatever she wanted to watch.

The staff, in one of their few appearances outside of their office, served the breakfast through the serving hatch from the kitchen, making sure that everyone had something although there wasn’t really much variety in what was offered.  Following breakfast, the staff cleared away the crockery and locked the hatch, leaving only a bottle of dilute-to-taste squash and some plastic cups for us to have between breakfast and our lunch.

I had woken up with a migraine so I quickly returned to my room to lay down with a cold flannel on my forehead only to find the door locked.  We may have been prisoners but our jailers did the opposite of their prison counterparts, keeping us from our rooms rather than locking us in.  I went to the office to ask for some Ibuprofen for my migraine, only to be told that they wouldn’t be able to give me any without a prescription from the doctor who wouldn’t be taking his rounds until later that morning.  In another bit of good fortune, the nurse I spoke to had pity on me and unlocked my door so that I could take the only measures I could to try to get rid of the migraine on my own.

SEPT - A Well-Oiled PR Machine

A few months ago, I was interviewed on Your Thurrock about the accusations levelled at South Essex Partnership University NHS Foundation Trust (SEPT) by Dr Blandford and I was said to be “defending” them.  Thanks to that interview, I have been told stories that would make your hair stand on end and the service I have received from Grays Hall Outpatients Department have led me to reconsider my opinion of the mental health provision in Thurrock.

Until recently, I was associated with local voluntary organisations and interest groups and, as such, couldn’t speak my mind as freely as I can now, without my opinions and comments reflecting badly on those groups.  Released from those associations, I can now give my honest opinions of SEPT.  Hold tight, it’s going to be a bumpy ride from here on in…

SEPT are a mental health provider who seem to be more efficient at Public Relations than they are providing a good service to the service users of Thurrock.  A well-oiled PR machine, SEPT publish a magazine called One In Four News that is really nothing more than a SEPT love-in and seems predominently concerned with the newly aquired areas of Bedfordshire and Luton rather than the South Essex area for which it is primarily responsible.  If you read their magazine, you would believe that SEPT has no problems but that is a false impression.  If you look more closely at the provision in Thurrock, you will find an alarming inconsistency of care.

SEPT make the claim in an advertising poster that they aim to have service users seen by the same doctor each and every time they go for an appointment.  This is a claim that they cannot back up in Thurrock as, for Grays Hall Outpatients Department at least, the staff turnover is horrendous.  Some service users are lucky in that they do see the same doctor each time but for an increasing number of service users, that is just a hopeful fantasy that will probably go unrealised because SEPT do not pay attention to the concerns raised.  And raised they were, at a “Take It To The Top” meeting, where the Chief Executive listened to the concerns service users had.  He said that there was a staffing problem in Thurrock and that a review was going to be set up but, months later, has anything changed?  Of course not.

I attended a SEPT Public Members meeting last month and I again raised this concern.  I was dumbfounded when the Trust’s Public Governor for Thurrock did not seem to know that there is a staff turnover in her area that would be comparable to the patient turnover in a hospital dealing with an outbreak of Ebola.  I have to wonder if she really is as worried about the quality of provision as she says she is.

At that same meeting, a service user, who always seems to be pulled out to support SEPT, said that she always saw the same doctor and that she got that through complaining to the Complaints Department.  She seemed to think that addressing the concerns of service users to the Chief Executive was a waste of time so why is SEPT so intent on running their “Take It To The Top” meetings?  The answer is clear – because they are nothing but another PR stunt.  I tried to put the point across that the concerns I was raising on behalf of service users had been put through the complaints procedure with no results but, as deaf to the sound of my voice as the people at SEPT I have talked to, my concerns were ignored and, most patronisingly, made out to be the ravings of a disgruntled individual.

The service that SEPT provide in other areas is not all that bad and I can say that from experience as I have to get most of my services (group therapy and access to the Employment Specialist) from the new Community Resource Centre, located in the Mental Health Unit at Basildon Hospital, due to the fact that, having worked with service users in this area, it would be almost impossible to be in a group that did not contain at least one person who already knew me.  In fact, I have to say that the service I get there is fantastic; however, for my outpatient appointments, I get my service through Grays Hall where, and I am not alone in this, I very rarely seem the same doctor twice before they are replaced with someone else.

It is this discontinuity of service that affects the chances of service users to recover or, at least, to live with their condition if recovery is not an option.  Going over the same story over and over again because the doctor seems to have neglected to read the notes or because they are a new doctor, just makes the problem worse rather than better.  A service user needs to be able to build up a relationship with a doctor so that they know each other and the doctor becomes someone the service user can trust, a tall order when the staff turnover is so high.  And when a good doctor comes along, they either leave due to burnout or because they are only assigned to this area for a short time.

Another problem is that of appointments.  When follow up appointment dates are agreed in a session between the service user and the doctor of the week, they are very rarely actually made by the Appointments Department.  I know from personal experience that agreed upon dates can be booked as it happened to me – once.  Most of the time, the service user has to chase appointment times, which is not always good for their mental health.  Why is this a problem?  Well, to put it in terms that a tabloid journalist would love, it means that there are some people who might not be taking their medication because they are not being monitored as often as they should be and, if even one of them is a possible danger to themselves or others, you are looking at a nasty headline.

SEPT has not dealt with the problems the problems in its provision in South Essex and, already, they have taken over Bedfordshire and Luton and are looking into providing Community Health services.  Is this a case of SEPT trying to control an ever-increasing slice of the power and funding in the NHS?  The answer has to be – yes.  Will they sort out the problems, the cancer growing in the heart of its empire?  Possibly, but how many service users will they be failing in the meantime?  That question has yet to be answered and it is one on which so much hangs, so many lives, so many broken psyches.  I await the answer with much anticipation.