To Theresa May.. regarding the Mental Health Taskforce

I have just read the Mental Health Taskforce published February this year in the UK. If you live in the UK, and care about the quality of mental health services then I urge you to take a look at the Taskforce and email your MP urging them to make mental health a priority.

To Theresa May,

My name is Annabel Swatman and I have a mental health condition called borderline personality disorder. I was displaying symptoms of my condition years before I was eventually diagnosed at age 18. As a 18 year old girl I had high hopes and expectations for my future; I was heading to university to study, with plans to graduate in 3 years and continue on to medical school. Instead, I have spent the past 3 years in and out of hospitals and emergency rooms, dropped out of university and with it dropped my plans for an academic future.

I have learnt through my involvement with the mental health services that there is simply not enough support available for people like me, and the support that is available is not as good as it needs to be. For example; after a crisis I experienced while studying in Newcastle, my GP referred me to the local CMHT (community mental health team). 3 months later, after no contact from CMHT and after struggling to cope on my own, I booked another appointment to see my GP and was informed that as I was no longer in crisis the wait for an appointment would be long, and when I eventually got an appointment there was no guarantee that they would offer any therapy, treatment, or support. I was devastated.

When I first came to the attention of the mental health services I was 18 and had made an attempt on my life. The hospital mistakenly referred me to the CAMHS (child and adolescent mental health services) who were unable to offer me support or treatment as I was 18 years old. This caused a delay to my access of a suitable assessment and to treatment. With the crisis team in my area unavailable for long periods of time over the christmas holidays and no understanding of my then undiagnosed condition or support for how to cope with it, I was left stranded with only a very stressed and concerned family to helplessly watch their daughter disappear. Inevitably, my condition worsened and I made a second attempt on my life. At this time the NHS were unable to offer me the treatment I so clearly needed, and felt content with giving me a list of numbers to call in a crisis. I am extremely lucky that my family were able to get me treatment in the private sector. Without the treatment my family were forced to pay for, I am not sure where I would be today.

The shockingly long amount of time it took for the mental health services to take notice and offer help, meant that I went so deep into my mental illness, it took months to climb out. I had to put my life on hold, which has had a knock on effect with all aspects of my life. If I had been assessed the first time I was taken to the emergency department for suicidal behaviour, and received the preventative treatment then and there, I believe I would be graduating from university this year with good prospects for the future. My parents wouldn’t have had to spend their own money in order to get the treatment their daughter needed. I would not have spent 6 months of my life as a patient in a psychiatric hospital.

I am asking for you to help transform the mental health services, for your constituents who up until now have been putting up with a lesser standard of health care, simply because their illness is mental rather than physical.

I have just read the Mental Health Taskforce, as I am sure you have too.

The Taskforce has so many brilliant recommendations that people in power can use transform the mental health services, that you can use to transform the mental health services in your constituency, for people like me.

I want good mental health support to be a local priority. As my MP, you have a role to play in ensuring the Taskforce recommendations become a reality in our area. I am asking you to:

• Write to the Prime Minister. Ask how he will be implementing the Mental Health Taskforce recommendations for Government, and what governance arrangements will be put in place to support the delivery of this strategy.
• Help raise awareness in Parliament by asking questions about the recommendations, or lead a Westminster Hall debate.
• Speak with our local NHS and CCG leaders. Ask how they will be implementing the recommendations on a local level.
• Read Mind’s Parliamentary briefing on the key recommendations of the Taskforce.

I hope that this is just the starting point, and that mental health in your constituency is a priority, as physical health has always been.

I look forward to hearing your plans for supporting the Taskforce recommendations.

With best wishes,
Annabel Swatman

10 Changes the Taskforce wants to see happen by 2020

If you don’t have time to read the whole document right now, here’s a handy summary taken from Mind;

  1. One million extra people provided with support for their mental health problem.
  2. 10 per cent fewer people take their own lives and everyone in a mental health crisis gets the right care, at the right time, in the right place, seven days a week and 24 hours a day.
  3. People’s mental health and physical health are treated equally – including people with severe mental health problems, pregnant women and new mums, and children and young people.
  4. All children and young people get the right mental health support, when and where they need it.
  5. Clear access and waiting time standards for mental health are in place so you know when you will get treatment.
  6. More people have access to the right talking therapy.
  7. Fewer people are sent miles away from home for mental health care – ultimately no one will have to travel for quality care.
  8. People who fall out of work due to their mental health are provided with personalised, effective and voluntary support to help them back to work.
  9. People who have had the worst experiences of accessing good quality mental health care, particularly people from Black and Minority Ethnic communities, get the help they need.
  10. Public attitudes to mental health have improved by a further 5 per cent.

 

Mind and mental health advocates here in the UK aren’t asking for much, and they have provided the government MPs with guidelines, recommendations and resources to help them achieve these goals. (If you’re interested you can take a look at the Mind parliamentary briefing here).

On the Mind website, there is an option to send your MP an email like I did asking them to prioritise mental health. I used the template offered but wanted to add my own personal story as well.

 

Thank you for reading,

Borderline Bella xxx

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New Year, New Crazy Me; My first inpatient experience

I was really struggling to find a way to describe the experience of my first day at the priory retrospectively. I found it not only hard to remember the facts, but also remembering how I felt at the time was incredibly difficult. I couldn’t convey the experience truly through my normal style, so I decided to write it as if it was an ongoing inner monologue from 2013. You can read this article here. The process of writing it and the feedback I have received made it a therapeutic and cleansing experience, enhancing my connection to and understanding of my younger self.

I stayed at the Priory Hospital for 2 weeks. During this time I explored some of the therapy groups, beginning to recognise the same people day after day. There were many staff members that I encountered daily, the majority were not in my favour. I have to emphasise that I hated the staff and the therapists because of where I was standing mentally and emotionally. I later discovered that they are all caring, kind and supportive people who are brilliant in their fields of work. One staff-patient confrontation sticks in my mind. Months before, my family members had booked a trip to the theatre. For some reason, I believed that I would be and should be allowed to go even if it was only two days after my admission. Numerous emotionally heated conversations culminated in a one-to-one meeting with the ward manager. He told me I would not be allowed to leave the ward, and I replied with nothing less than raw, unfiltered anger and disgust. It was so bad that I wasn’t able to properly look at him for the rest of this or any of my other visits.

I remember having an influx of visitors, almost every day. They bought chocolate and clothes and anything else they imagined would make my experience better. I feel like both parties in these meetings were ignoring and denying the blatant fact of where I was and why. Jokes were made (mostly by me), I would dismiss the importance of everything that was happening there. Although I was grateful for the company and the distraction, this probably wasn’t the best line of attack for two weeks in a psychiatric hospital, and maybe contributed to my lack of immersion in the therapy offered. During my second admission a while later, I put some boundaries on who could visit and how often.

I met my doctor after my first weekend; Dr Woolley. I wasn’t entirely sure what to make of him, a middle aged man with facial expressions and a demeanour like an awkward teen boy, but with marks of his age on his skin. He had a way of talking and looking at me like he was observing a dangerous animal, but with fascination rather than fear. At the time it is likely I was misinterpreting interest and concern. We talked with, and without my mother. I sat up straight with my hands neatly folded in my lap, nodded and smiled where appropriate and answered all questions with a considered and clean cut response. During my time in therapy I frequently confused observations about my detached demeanour and apparent logic based ideology as complements. I distinctly remember a point in one of our early meetings when Dr Woolley said something along the lines of ‘you appear rigidly rational’, my instinctive response was to politely say ‘thank you’ and smile, returning my gaze to my hands. This moment stuck with me because I found his response intriguing; he was quiet, looking invasively at me, amusement visible on his face. He asked why I assumed it was a compliment, I don’t remember my response.

I spent a lot of time watching Breaking Bad and reading the books family members had brought from my bedside, but at least 2 times a day I was expected to attend group therapy. Group therapy at The Priory involved sitting in a cold and slightly damp room, with paint or wallpaper peeling from the wall. Chairs were placed in a circle around the edge of the room, just the normal plastic chairs usually found at schools. Most of the rooms had a flip-chart whiteboard in one of the corners, rarely used, with the same old scribbles never wiped or cleaned away. There were rules for the groups, such as no leaving once the session had started, no talking over people and no hot drinks. Mostly the same people would talk each session, possibly the most confident or veteran patients in the hospital. It sometimes felt like you had to search really hard for something to share on topic, just in case they picked on you and thought you weren’t cooperating, when actually you couldn’t think of an example to share. During this first admission I found group therapy boring and pointless, and usually too early in the morning to fit in with my sleep schedule.

As I was admitted the Friday after boxing day, I spent New Years as an inpatient. New years eve was a strange event to experience in hospital. I did not want to leave my room and ‘celebrate’ with the other patients in the common room, despite the repeated invitations and coaxing from staff members. Not because I thought myself better than they were, I wanted to be on my own, I suppose to allow myself to forget where I was, but also out of some misguided protest. Speaking to friends on New Years, happy and drunk from the parties I should have been at, was the only memorable experience from that night. The few friends who knew the truth about where I was showed a great deal of love and patience by speaking to me that night. I was bored, angry and frustrated, and coming to terms with the fact that I would simply have to drop out of university. I stayed up late into the early hours of the morning, reading books, magazines and listening to music. I didn’t want to sleep, in hindsight the symbol of waking up in a psychiatric hospital on New Years Day was probably too much to handle.

 

Two weeks after my arrival at the Priory, my doctor and I had agreed about my withdrawal from university and my discharge from the hospital. The plan was to continue as a day patient, I was to be under the hospital care during week days in order to undergo therapy. I left that day still detached and in denial, remaining a day patient for 5 weeks before my second admission.

Thank you for reading,

Borderline Bella xxx

A Day In The Life Of BB; Waking Up In The Priory

I wake up from a long deep slumber, I’ve been sleeping in a large comfortable double bed. I’m not at home because my room is only home to a childlike single. The room I’m in is similar to a medium starred hotel room, the kind I imagine that business men and women crash into after a long day of city work. It has a desk and an ensuite, and a beautiful large window. Theres not a feel of ‘ikea’ about the furniture, so it must be a nice place. I didn’t sleep well, and feel quite drowsy. Frequent interruptions from the staff disturbed me at regular 30 minute intervals. I soon learned that this inevitable annoyance was less invasive if I slept with my face uncovered by the blankets and facing the door. This way had the downside of the hallway light hitting my face every time the door opened, but at least the stranger night staff felt no need to gently peel the cover away from my face, and peer their own right against mine. I did consider whether I would rather have a pulse monitor on, at least then the rhythmic beeping would announce my ‘aliveness’ for me, and I might be disturbed slightly less. However, this is not a hotel, or even a hospital with heart rate monitors. I am sitting in a private psychiatric hospital called ‘The Priory’.

Evidently, I have slept passed breakfast, but this causes me no disappointment. I am thankful that the nurses allowed me to sleep in as I have very little motivation to leave the bed, let alone the room. I faintly remember being roused in the morning at the change of shift, to ask what I would like for breakfast. I replied nothing, I wanted them to stop waking me up and disturbing me. Beside me, rather disturbingly on the bedside table furthest from the door, is a tray. There is a banana, an apple and a pastry. I don’t remember anyone bringing this. It feels violating that anybody and everybody can walk into my bedroom. I make a point to remember where I am and try to forget the idea and the comfort of personal privacy.

I am nervous to go to the bathroom, as I haven’t yet checked whether there is a lock on the inside. I also must time my shower perfectly. Based what I learned about the staff behaviour last night, I doubt anyone would think twice about barging in while I am in the shower, and I am not sure whether a verbal affirmation would convince them that I am, indeed still alive.

I walk back into my room and change as quickly as a pubescent high school student in the filthy crowded P.E. changing room. I wish people would knock. I make my bed. I don’t eat the food, but contemplate what I am supposed to do with it, would the mystery room service person return to take it back? I am not smoking at the moment, currently I cannot remember what drove me to stop as there is nothing I wouldn’t do for a cigarette right now.

The day is passing slowly, nothing eventful occurs. I am beginning to recognise the faces that pop through my door, there appears to be a repeating pattern. A few of them make half hearted attempts to rouse me out of the door, to meet the other patients. I have no interest in doing so, I would not know how to behave around them. I am not depressed, I am disgruntled at being here. A nurse comes in to visit me and have a little chat. Ive been having a lot of those over the past couple of days. He’s a middle aged man, with a face that I cant read. His lips are slightly too large for his mouth and it affects his London accent more than mildly. Im straining to understand the questions, but he seems friendly if not a bit patronising. The conversation is inconsequential. My doctor is not working this weekend and nothing about my treatment and care can be changed until he returns. I am not allowed to leave for any reason.

There is nothing to do here, I have spoken to my mum, or she came to visit. There really is no difference. I could get my books out and start revising, but i’m not in the right mind set. I’m agitated and stressed, this would all be a lot easier from home. Lunch has come and gone, I snuck downstairs and picked at a salad. I sat on my own and exuded no signal of wanting the people around me to join. Dinner is going a similar way. The food hall has such a mixture of smells it’s making me feel unwell, like all the bright and beautiful colours mixing together to form sludge. Nobody stays here for dinner unless they are inpatients. There is a long table opposite me, reserved for the eating disorder patients. Its empty, but I am here early. There are small bundles of people who appear to know each other, some are talking and some are simply using other peoples company to guard themselves from prying eyes and loneliness. Its not busy here, and mostly women. There are a few people who visibly appear unwell, through the pain on their faces and the outfits they have managed to put on, but mostly the people here appear like I do. Entirely normal.

Theres a television in my room that I am looking forward to getting back to, so I eat my meal quickly with my head down and make my way back to Upper Court, my ward. In order to get inside I have the press a button on the intercom, and wait while it makes the most grating and inconceivably annoying noise. Eventually the noise will stop and I will step inside, turn up the stairs and then into the first door on the right. My room. I am lucky that I don’t have to walk past the nurses station, or any other door in order to get back, I do not want to talk to anybody. Not today.

My first day has ended. How many more?