I am so stressed and strained beyond the limit. I’m trying to care for my fiancé. I can’t. He’s yet again been discharged from A&E, this time with DVT having been told he could have a pulmonary embolism at any time. No plan in place. Vascular problems, tumour, hernia, unidentified lump in his stomach, knee operations, diabetes, hips going to need replacing… how much more, how much longer Lord? Why? I’m screaming and crying inside. How much worse he must be feeling. Again and again after every emergency and discharge we are no further forward. All the risk and pressure falls right back on us. I can’t do it. I’ve been overloaded for weeks or months. Way beyond the breaking point. I need it to stop. Already I’m drinking with my medication to try to get knocked out. I cannot cope with yet more emotion and pressure. Cutting, bingeing, purging, everything is worse. I have no mental health support now, nor does he, so what can I do? Time has slowed down. I’m hearing things. I need it to stop. Please God, I want to say I know you will answer and not turn away from us forever. But I can’t see You or hear You or feel You. It’s been a long time that way. Xx
WARNING – discussion of suicide, suicidal thoughts, emergency services
Am I expecting too much? I don’t think I am. Yet again I and my friend are being bounced around from service to service when he/we are most in need and so many opportunities for giving help missed. But I’ve certainly been made to feel I am asking too much and am a nasty person and more importantly, yet again my friend is left in avoidable danger.
In my local area, there is a specialist phone line for people in a mental health crisis, accessible via 111. This is a pilot, I believe, which may be rolled out in the rest of the country. According to information published about this crisis line, it is for patients, family, carers, friends and professionals, you can get an assessment of your needs, help, advice and visits, it is available 24/7, every day of the year. It is supposed to help you get more specialist help more quickly than if you have to go to A&E.
I phoned this line today because my friend is suicidal and today is a very “risky” day for him. He has specific plans and whilst there does seem to be a part of him that wants to keep going and not end it today, and I think it’s possible he will get through, I’m very worried about him. He was promised to get help from the crisis home treatment team, but he had one phonecall in which they told him to phone services if he felt worse. They have not assessed him or visited. The community service he was seeing haven’t put anything in place.
I wanted to get advice what to do and how to help my friend. I wanted to raise the alarm that he hadn’t had the agreed support and I was apparently the only person who is going to be with him today. I needed to ask some advice for me on how to cope because I’m getting very near another complete breakdown myself. I don’t know how to avoid me losing it and flipping out again when I want to be helping him.
So I phoned this line. First I was told nobody was available but brief details were taken and I was told I’d be phoned back in a few minutes. 1 hour 20 minutes later, having heard nothing, I phoned again. There was no record of my previous call. “You didn’t speak to me before, how would I know the details?” asked the operator. I went through everything again (painstakingly spelling every name and number about 6 times…) I was told that I had not been told I would be called back today. Er, yes I was, I was told I would be called back in a few minutes. “Oh no, we have 24 hours to respond.”
But we’re talking about someone potentially about to end their life here. Don’t you think that might necessitate an urgent, even immediate, response?! Isn’t this a crisis line?!
They made no assessment of the situation, would not listen when I tried to tell them the home treatment team input had not been delivered as agreed, gave no advice except for if he attempts to end his life, call an ambulance. What about any support that might stop him getting to that point? What about any professionals putting help in place? At the very least, any advice to me? At the moment I seem to be the only person doing anything today to keep him safe. I have no training, I do not know how to help him, I am ill myself and close to breaking point. I am terrified what is going to happen and whether he’ll still be here in the morning.
I tried to impress the urgency of the situation and that a call at some point within the next 24 hours was not soon enough seeing as he planned to end his life today. The so called crisis line told me that I simply had to calm down, that I had to realise they have plenty of other referrals to deal with, that they are very busy and it is not very nice for me to suggest they aren’t doing anything (not sure how I did that?), and when I insisted on speaking to a manager she continously talked over me and threatened to end the call. I was told that they had told me about plenty of other ways to get support. They had not suggested one single thing.
I would expect more from a crisis line. I would expect immediate response when someone is suicidal. How can it possibly be okay for them to say, sorry we’re too busy? I would expect the promises in their literature about getting assessed, supported and visited by mental health professionals to be fulfilled. There is no mention in the literature that they may do nothing for 24 hours. I would expect professionals to be ensuring my friend’s safety today, not me. I want to be there for him, I want to listen, be a friend, offer comfort and encouragement. I am happy to stay with him when that helps, as I will today. But I should not be the only one doing something to stop him ending his life. Is it really too much to ask? I don’t think so. He has asked for help and so often been turned away. This has been a pattern for him just as it was for me in my care. If harm comes to him today in my opinion it will have been completely preventable. That is not to blame services for the state he is in, but they have failed to provide support they agreed to, could have and should have.
I don’t know why I keep on having some hope in services that they’ll do what they promise. I’ve had enough demonstrations to the contrary. I’ve given up on help for me but I don’t give up so easily for a friend. I suppose it’s natural to have some trust in those we believe are there to help and protect us and that instinct doesn’t disappear quickly even when it’s proven wrong. If I could expect the total absence of support it wouldn’t be so distressing. I’m not looking for sympathy though it probably comes over that way. Just very angry, bitter, lost and scared.
I have wanted to post but not been able to find what to write. I’m sorry it has been nearly a month. Even this post I started nearly a week ago. I don’t know quite what’s making it so hard to express how I really am.
My friend’s health continued to deteriorate. I was fighting desperately to get him help as the danger he was in increased. Everyone in a position to keep him safe seemed oblivious to tune dangers and I could see how close he was to the edge but with no professional’s help I could not do anything more than what I can as a friend and that is not enough. It’s terrifying to be the only one knowing and believing the risk and I know that sounds like I am very arrogant thinking I know better than the doctors, but time and time again now I’ve known what’s happening or going to happen, the doctors have done nothing, refused even to listen to my concerns, and the thing I’ve known will happen, happens. The toll is greater each time. He has liver damage, blood clots, he’s starving himself, he is barely even drinking anything, there’s much more I wish I could write but it’s too personal to him for me to feel I can share here.
I don’t know how to carry this knowing.
I cannot save him alone. What someone else can give you, or trying to carry on for someone else, will not ultimately be enough to keep you safe or even alive. (I know this from my own darkest times, when I’ve been irretrievably low, hurting myself and planning to end my life, and someone close to me – who didn’t know the half of it – screamed at me, look what everyone is doing for you – why isn’t this enough for you? The answer is a post for another time but I know if he continues it must not be for me, not just for me in any case, so I alone cannot save him.
I can pray. I can try to give comfort. I can try to give compassion. I can try to show I love him and that he’s a good person not as he sees a problem, a burden, someone who frightens people, is bad, is not wanted, is no good. I can try to help him find some ways to build a safe, stable home and life. We can find short times of hope, happiness and laughter together. He has an immense capacity to love others, care for them and about them, to rejoice when they are happy, to fight to help them when they are hurting and share their pain. But none of that can he do towards himself.
He may die. He may end his life. I don’t know how to hold this knowledge and all the feelings that come with it.
I have been in crisis myself in the last few weeks and was in hospital for a couple of days. Then I had help from the crisis team at home for a week. When crises come I still flip out and instinctive reactions and thoughts take over along with the hallucinations just as much as they ever did before I had therapy. My “little child” gets out and she really isn’t very nice sometimes. It’s scary. I feel like a failure.
I’m realising that my mobility has got a lot worse in the last year. I’m particularly weak physically at the moment. I was diagnosed with POTS a little while ago (a heart, blood pressure and autonomic nervous system disorder). I’ve a lot to learn on how to manage the symptoms. Being very faint, muscle spasms, digestive problems and poor circulation have been hard to deal with this month. I’m now very fortunate to be in touch with a pain clinic at the hospital and there are some good possibilities from what they can offer, so I must be hopeful.
I really will try to post more regularly again and share happier news next time.
God bless you.
Kyrie eleison. Lord have mercy. Christ have mercy. Help us in our need dear Jesus, please, Lord hear our prayer.
I feel so scared and powerless right now.
My dear friend is in complete crisis. I’m so scared he isn’t going to make it. I don’t want to tell all his business here. That wouldn’t be right. But he’s been through some horrific things and his mind and body is in utter pain. He could die, through what’s happening to him physically and the risk he’s at mentally.
I won’t leave him on his own right now. He’s massively distressed. He’s too scared to go to A&E tonight. I’m trying to insistently but lovingly persuade him to speak to the out of hours services to see if he can get to another place of safety, or to speak with his GP. Please God he is going to see the GP in a short while in an evening clinic they have. Please God we get there. He is letting me stay with him now. He so did not want me to at first but I could see the danger. Please God, please may he still accept my company and please may he get somewhere safe tonight. (There are very concrete reasons I can see he’s at risk but they are not my business to write here.) I’m in his car waiting for him whilst he’s speaking to someone who he felt he had to go see about an issue that came up earlier; I don’t think this is going to help any right now for him but he really felt the need to do it and I didn’t want to force him not to. Please God please may he come back soon.
I’m barely hanging on myself. I’ve been losing the grip the past week especially. Dissociating, losing time, self harming, huge panic attacks and flashbacks including physical sensations.
A neighbour has started being aggressive and verbally abusive. He’s been pressing me for money for months. He’s been doing the same to other vulnerable people on the estate. He’s been citing endless disastrous circumstances but it’s now coming to light that something else is going on. I’ve sensed things wrong for a while but now it’s becoming clear what he’s telling me does not add up and isn’t the whole story to say the least. It’s getting out of control. I believed and wanted to help him to get help, supported him with getting referred for a support worker and foodbanks. Now it seems nothing is true. I’m afraid for a vulnerable person he lives with. I’m going to have to contact the police I think.
We have spoken to the doctor and are waiting to hear if my friend can get into a safe place with support. There is no space at the moment. Even if he does it is only open til 1am. We’ve gone back and forth with the doctor and out of hours services. All doing all they can but of course there are these limits… and in the end I don’t know who can keep him safe when he’s as far down as he is now, hating himself and hurting himself so much and so afraid of everyone. I’m ripping apart inside. I’ve been where he is, or similar. I know perhaps I cannot do enough. I care for him deeply as a friend. I wish I could rescue him but know despite all the love I can give perhaps I cannot.
I didn’t want to leave him. He has gone to the hospital. The doctor was worried for me and said I should not go with him. He insisted I not go with him. He promised not to hurt himself and that he’s going there. I couldn’t do anything else especially since it’s his car and I can’t drive. We are keeping in touch by text. I believe his promise but I know from being there myself that when you are going to end it, that blackness and blank terror and loss and self revulsion and pain overrides everything, no matter how firm and true and faithful your promises. The doctor told me to go home because she was worried for me but I so did not want to leave him. I cannot save him in the end but I can be there.
He is at A&E now. The situation is far worse even than I knew but thanks be to God he is there. Thanks be to God he’s going to be taken care of…dear Lord I pray he’s met with compassion there as well as getting the physical medical treatment he needs. Please Lord, please can they still help him. Please enfold Him in your love, whatever comes now, if it’s the end or not, please show us Your saving help. In the darkness of pain and not knowing, danger, even death, You are our certain hope and Saviour.
Mother Mary, St Joseph, please offer to your Son in the way most pleasing to Him, everything I offer, everything I do, everything I pray….
I still can’t figure out why I’m crumbling so much trying to support my friend. Partly it’s because the trauma he’s suffered and needs to talk about is so close to my own experiences and I don’t know how to cope with my own emotions about my trauma, and bad as I feel about this, I can’t always cope with someone else’s experiences, the even stronger emotions this gives rise to in me and the overwhelming emotions they are also feeling. It’s as if I absorb the pain and feel it 3 times over – my own pain and distress, my pain for them, and their pain and distress.
But this isn’t the only reason. When there’s no link whatsoever to my experiences I’m still feeling panic, dread, boiling frustration (inappropriately), unease, fear… and terrifyingly, too many emotions that are too close to those I felt when I was caring for my mother (who was also my main abuser). My conscious feelings towards my friend are nothing like what my feelings towards my mother were so why are these experiences occuring? Very raw feelings, as well as flashbacks, hallucinations and panic attacks are increasing. For some reason the situations with his health deteriorating out of control, hopes for things being understood resolved and treated then being delayed time after time, his near desperation, his rapidly overtaking weakness and physical degeneration, even his need for me, is triggering the feelings I had when I was with her. This scares me. It’s nonsensical. He’s nothing like her. The situation is not the same. Yet I can suddenly feel just as desperate to escape. I don’t know why because he is generous, good, caring, honest, he wants to help me, he does not judge me, he worries for my wellbeing and he supports me greatly in the faith we share.
Why does his need for me scare me so much too? He tells me I’m the only person he trusts to tell certain things or to give comfort. I am thankful and sort of honoured that he trusts me but I don’t want to be the only person. That isn’t safe for him. I am only one person. Yes, I care, I pray, I do not judge (well, wish not to, with God’s help), I can empathise deeply; but I’m only a normal person. I can’t keep him safe, heal him, I am not the total good he thinks I am. God gives hope. God gives safety under His care. I am only one person. I am thankful he trusts me but I don’t want him to trust and confide in me and not the doctors or other professionals who can help. If I’m honest, I cannot be the only person because it isn’t safe for me either, as well as for him. I cannot be the only person who knows when he is in danger. I cannot carry that or keep him safe. I cannot be the only person he can turn to because despite my best desires I cannot infallibly be there and there will come a time I don’t do the right thing or the thing he most needs or that I hurt him unintentionally and I don’t want him to be in danger then.
Which brings me to: what time or mental or emotional resources can we protect for ourselves? He needs me desperately and constantly. As well as practical help, there is rarely more than a couple of hours that I’m not listening, emotionally supporting or encouraging him or at least trying to. I might be coping more stably, or having lower levels of the currently overwhelming emotions, if I had more breaks, time separate from him, time to meet my own daily tasks and duties, time to keep my commitments to others, time to pray, time just to rest. But what would he do then?
When is it okay to protect time and mental resources for myself? The Lord is with us always. He always listens, always answers and always holds us in His Heart. Jesus gives His life for us. We are called to emulate this, to join in the sacrifice He made and pour ourselves out in love. If I’m to follow Him, to offer my life too, then I need to be there for people in need, always not only when it’s easy or convenient. I have felt the hurt myself of people I’d counted good friends cutting off or cutting back contact when I got more ill and being alone when I most needed contact with friends and to know I wasn’t going to be left for my weakness.
So I just cannot limit my availability to someone in desperate need. But I’m crashing up against my own physical and emotional limitations. What is the loving response? Admittedly my friend is not my only calling and responsibility. I have a calling to my family, my volunteer work, to run my home responsibly, to manage bills and finances and so on. In a way I have a responsibility to my own health and wellbeing too, though that’s hard to admit. Though that’s a fight in my head to. I should deny myself to reach out to bring God’s love to others. Then again the Lord created me, wants me, loves me – perhaps not only so that I can be denied and weakened? At the moment every responsibility except to my friend is falling to the side. I have no reserves left for anything else. That really does not feel right. I feel more guilt for it, especially not having the energy for family, for contemplative prayer or for treating my home that I’m blessed to have with due care so everything is in disorder.
This is all very uncomfortable and I’m so tired. I need to seek guidance.
I’m failing so much as a friend. My friend R is going through a terrible situation, or many terrible situations. Daily there seems to be the next piece of devastating news.
He needs me. He trusts me.
I so want to be there. Be generous. Love. Hope. Be patient. Do every practical thing I can and be there and listen. Be warm and somehow say something, pray something, still be there when he’s losing strength.
I’m scared. Scared I’m watching him die.
Why am I failing in compassion? Right when it’s most needed? Why am I feeling dread and frustration and exhaustion? Struggling with freezing when I want to respond compassionately? Like my brain is just shutting down in overload. I need to be there but I’m overwhelmed with pain for him, but also overwhelmed completely by his need.
I’m scared I’m the only one he trusts, only one he speaks to about certain things. It’s dangerous.
I can’t be this.
Why am I getting unable to respond or even angry? Explosive inside? I’m failing at the most important things in friendship, love and compassion.
My chest hurts. Something is rushing in my ears and I’m dizzy. I thought I was going to faint earlier….
When I signed up to the programme of treatment I am in at the moment, it was to include weekly group MBT therapy, fortnightly individual therapy, monthly care coordination and support available from a duty team.
With no warning, monthly care coordination has been stopped and changed to quarterly. Having expected to see my care coordinator yesterday as we’d previously booked, this was cancelled and my next care coordination is not to be until the end of September, which will be about 4 months since my last appointment.
I could write a lot about how badly the actual communication of this decision has been handled. Actually I did but I deleted it. It probably doesn’t do anyone any good, not me or the service or anyone else, to shoot off into an angry tirade. I’ve been trying to process this through since we (ie all of us in the therapy programme) got letters telling us a few days ago. My emotions are pretty out of control and shooting to extremes at the moment independent of this which is making things harder – ironically, partly because there is so much going on all across my life and I can’t hold it all together; I could have really done with some help from my care coordinator. I’m trying not to just rant in anger here. However, I do think that some of my feelings are shared by other people in the programme and I do think this reduction in appointments is a much greater loss than the hospital realise. There is a huge gap in care here and it’s getting wider.
We weren’t involved in the decision. We were informed afterwards in an impersonal letter. We were informed that this would be best for us. There was nothing personal about the decision. Surely everyone’s needs in terms of care co-ordination may be different, at different times in their therapy, according to what’s going on in therapy, their health across the board, and all areas of their life? The approach being taken isn’t responsive. It’s just a blanket decision.
My views are certainly being influenced by what I observed and experienced when I worked in mental health services in the same mental health trust in which I’m now treated, but I wonder if the source of this reduction in appointments is actually largely to do with funding cuts and staff shortages? Conversations I’ve had with my care coordinator have given me more than an inkling that my suspicion is correct. If this is so, it would have hurt a lot less if this explanation had been given plainly, rather than it being couched in claims that the service think it’s better for us to have less coordination of our care.
Leaving this aside, nobody actually discussed the matter with us whilst deciding what would be best for us. We didn’t get to give any input about why care coordination is important for us, the help we need, the effect this withdrawal of support would have, what our needs are and how they might best be met. We committed to the therapy programme expecting one thing and now this has been changed. We’re expected to stick with the programme and commit to it but they are free to change it how they choose. This is by no means the first time this has happened and what we have trusted in has been changed or taken away. Support we desperately needed, which was insufficient anyway, has now been withdrawn further.
All these things combine to make us feel hurt and powerless and unheard by those we should be able to trust and undeserving of support. I posted yesterday about how when I discussed the changes on the phone with my care coordinator (after I’d chased several times for any explanation of how the decision was made and what’s happening in practice with my appointments going forward) he told me the service thinks this is the best way to challenge us to be more independent, and how much this hurt and how little the service we should be able to trust actually appreciate what we are facing.
Separate from the emotions this brought up, the withdrawal of these appointments doesn’t just affect the appointments themselves; by the very nature of what care coordination is meant to do, it will have an impact on our wellbeing across the board and I think this is where the proverbial baby well and truly has been thrown out with the bath water. It seems the clinicians who have made this decision do not realise what a loss this will incur.
First, on an immediate practical note, it will have a knock on effect on our therapy appointments. We have been told that the clinicians have decided it is most appropriate for us to get help in therapy appointments rather than care coordination. The focus of a care coordination appointment is utterly different from a mentalisation-based therapy appointment . Therapy appointments focus on emotions and interpersonal situations, looking in depth at particular relationships and specific interactions, our emotions and thoughts and our understanding of what is in our own and each others’ minds. It’s not so much about events and information and our circumstances as focussing in depth on our emotional experience and thought patterns. This is totally different from what is covered in care coordination – such as building a care plan, reviewing mental and physical health, looking at input that may be needed from other health professionals or support workers, looking at social and financial problems and stability, monitoring risk and safety issues, communicating with the range of professionals and others involved in someone’s care… the list goes on. If this is now to be squashed into the therapy appointments, either the time for therapeutic work will be greatly reduced or the problems we needed care coordination for won’t be addressed.
This is all the more important since the length of time for which one can be seen in the service is now strictly limited. The service was set up to be a lifelong service, recognising the fact that we may likely need help outside of particular therapy programmes across many years. Now this has been stopped and after we have completed a particular therapy course we are discharged whether or not we are coping or safe or recovered. When time is limited and so soon we will find ourselves alone again or at least without specialist support, whatever state we are in, it’s all the more important that whilst we are with the service we can get help pulled together across all the areas of our life that our mental health affects and that affect our mental health.
And these areas are broad. Several of us in my therapy group, myself included, have multiple mental and physical health diagnoses. Most of us have many unmet needs at any one time. Some of this is because of rules that you can only be seen in one service at one time. I’ve posted before on how unfair that can feel – for me one thing this rule means is I’m not allowed any help with my PTSD and trauma following the abuse I’ve been through, because I’m being seen in the PD Service. I know other people who were forced to choose between being treated for their life threatening eating disorder or their personality disorder. Multiple mental health diagnoses are often closely related but I, and I’m sure many others, have had big difficulties trying to find the way through the care and treatments they need and I’m regularly promised help that is then the next minute taken away. Someone needs to pull all this together and make sure communication happens and that help promised is actually delivered. It is too hard to do this on your own when you’re seriously ill and all too often you are bounced between different services, each telling you that another service is meeting your needs when actually nobody is.
Physical and mental ill health tend to cause disturbance and instability to a lot more than health. Just a few examples from my own experience – and all these are shared by other members of my therapy group – are losing your job, being made homeless or having to move from your secure home, having nowhere stable to live, having no money to meet essential expenses of food and rent and bills, falling into debt, trying to navigate the system to claim sickness benefits or help with housing costs whilst working part time – and being met by mistakes and delays at every turn and waiting weeks on end to receive any money, consequent trouble with utility companies, landlords, over or under payment of tax and Benefits, filling out form after form, having less and less contact with friends and having no resources (financial, or in terms of emotional strength) to keep in touch with the little positive things that can keep you well, relationship breakdowns, addiction, crises, losing control and ending up in trouble with the police or other involvement from emergency services… I could go on and on.
It just isn’t possible to sort out all of these things on your own especially when you’re struggling with the daily pain of the BPD itself. You desperately need someone to get you access to help and guidance, to be familiar at least to some extent with the systems you’re struggling through and to know what help is available and refer you there. This help has never come, for me, from the PD Service, and with so little care coordinator input going forward, it’ll be even scarcer.
Yes, a lot of these things are parts of everyday adult life but the fact is by the time most of us eventually get seen in a specialist service like mine, we have struggled without the help we need for years upon years and are very near the end of the road. (Potentially, very near ending our lives, or already having reached that point because there is nothing but pain, dark, utterly spent, utterly trapped, self disgust, I could go on…) Yes, we have to be able to function independently. But we are silently screaming how right now we can’t. We need help. We desperately need to be heard that we need help. Every time we have tried the very hardest we can and there’s yet another loss, obstacle, more and more piled on us, our risk increases and we are less and less able to be independent and more and more locked into our compulsions to overdose and self harm and try to numb and control the utter desperation and silence the painful scream for help inside us. If someone hears us, guides us, gets an understanding of what is happening across our lives, pulls the pieces together and gives some continuity, as our care coordinator could, then we can start to gain strength and start to find some kind of stability that might eventually allow us to heal.
I am incredibly fortunate that I have a support worker (from a local social service, not from the NHS) who is helping me with so many things that I’d have hoped my care coordinator and/or support workers from the PD Service would have done. The response from the PD Service was to brush me off saying everyone has to deal with these things and I did not qualify for any help and one appointment with a care worker who did not know anything about most of the areas in which I needed help. Thanks to my current support worker, I have not been evicted by my landlord, I have been helped to fill in the complex application forms for disability benefits, I have had support to go to assessment appointments, I have had help learning to budget, I have been able to access the correct advice and information from all the services involved (housing benefits, the council, the Jobcentre, disability services etc), I have someone on my side who understands the difficulty I’m going through at the moment in the police investigation into my abuser, and I have some social support which will help me use my time constructively to keep getting better and eventually learn how to get back into work.
In no way did the lack of recognition, lack of coordination and lack of support I received from the PD Service make me better or more able to function. In no way has having a support worker made me less independent or worse. I am now self harming much less and have not overdosed for weeks. I’m able gradually to do a little bit more and then more, because I have some sense of stability and safety and someone who believes me. With his support I’m not alone going through the things that distressed me to the extent that I couldn’t cope and could only hurt myself.
This support is desperately needed. It is very sad that it is so hard to find. Given that the therapy programme is so good, and I know it is such a privilege to be able to undertake it, it is sad that the support towards staying safe and being well and stable, is so lacking. It is much harder to grow and make use of the therapy from a place where you don’t feel safe or heard.
Perhaps I’m overreacting. Perhaps I’ve had an unusually bad experience with my care coordinator or when I’ve been in crisis. Perhaps I’m incredibly dependent. (Well, I think I definitely am.) Probably I should focus more on the fact I have the support I do. I know many services have much less support available. It just seems to me like a big and widening gap and that things could so easily be different.
If I recover enough to ever work or volunteer in this field, I’d like to work on trying to bring together patients’ access to the support that’s out there and bridge the gap of all the unmet needs that are stopping us from having a stable life whilst we’re working through our therapy programmes. I’m sure this would increase people’s security in their recovery.
There have been several cases in the news recently, in particular two this week, of children suffering unfathomable cruelty at the hands of their parents / caregivers. Much has and will be made of the failings on the part of social services and social workers. How could the horrors and suffering go unnoticed and why were concerns not followed up, staff nor taking a more joined up approach, so the children could slip through the net?
I don’t doubt that there certainly were failings in the services. I’m not denying that. I can’t imagine the guilt the workers involved in those two cases are feeling right now. I’ve suffered myself and so did my mother and so have several other people I care about, because of failings in the organisations that should give support and protection, which let us fall through the net without intervention in times of crisis and without promised follow up or communication across different services. Sometimes the services involved have seem totally unaware of the harm this causes and unwilling to take responsibility. That hurts even more. Fortunately I have never suffered anything approaching what the children in this week’s cases did.
I’m not trying to deny that there were failings and I don’t want to hurt anyone who has been through similar experiences. However I think the somewhat understandable jump to publicise the blame attributed to the social workers and agencies masks some important points.
First, the perpetrators of the terrible abuse the children suffered were their mothers, father’s and family members. That’s the greatest horror. It is terrifying that as humans we are capable of inflicting such suffering on another, let alone on one of our own family or our own child. It’s particularly horrific that a mother can do this to her own child. It so negates every good and nurturing thing a mother is. It means no relationship and no home is immune to evil actions and absence of love.
Secondly, that is such a frightening fact and we want to know why. How and why can a person do that? What does that mean about what’s possible? About our human race? That sounds like an overly broad concept really. But I think it shakes us. Can we conceive that our world is one where what should be the safest and most protective relationship, mother and child, is used to inflict fear and hurt and pain? We don’t want to. We at least need some explanation. It’s easier to label the failing of a particular social worker or agency, because that we can understand. That we can name. What brought the abusers to use their own children that way, we can’t.
Thirdly – and this is something that’s hard to explain but significant to me as a survivor of childhood abuse – these horrific abuses can and do happen in secret and undetected. Trying to come to terms with what happened to me and questioning over and over whether the things I can remember done to me are true, I’ve often doubted myself and told myself it must have been my fault or I must be mad and inventing it all, because at the time nobody else realised what was going on and nobody intervened and people thought my family was normal (er okay maybe not but they didn’t often suspect the full truth). These two tragic cases in this week’s news show the awful fact that abuse much worse than what I suffered can indeed continue in secret. Therein lies the abuser’s power to control, manipulate and deny.
Fourthly, no more resources are coming for social workers and care and protection teams at the moment. The little glimpses I’ve seen from my work in hospitals, psychiatric services, care teams and so on has shown me loud and clear that there simply are not enough hours in the day and not enough people on the ground to have the contact and communication and time to spend directly with children, families, patients in need, as well as following the ever more extensive proformas and completing paperwork that is required to meet the rules and regulations (which are supposed to ensure good care is happening but at the same time take you away from doing it).
This is no new or ground breaking feeling. I think most people in nursing or caring services have been saying this for years. But it’s still frighteningly swept under the carpet and denied by those in power. When I worked in a service that supported teenagers and young adults with mental health needs and social support needs, I would take the minutes of clinical team meetings. In one such meeting, changes to documentation for care planning and recording were being introduced, which would require nursing staff to (a) spend much longer away from patients, sitting at computers completing databases and reports and (b) in many cases require nursing staff to spend already limited professional development time on training in IT packages, not in patient care. Of course, the aim of all these whizz new care planning systems was supposed to be a magical improvement in compliance with regulations about good care. However, nobody could answer who was going to be delivering the care during the time that the already over stretched nurses were completing the compliance paperwork. I wonder whether there’s a box in the risk assessment screen to record the increased risk caused by the fact the nurses and carers are filling in the [expletive deleted] risk screen instead of assessing the patients? 😉 Time and time again there was no answer to this impossibility. In that meeting, one or two nurses directly asked, how in the same shift with the same staff, were they to fit in their work with their patients, as well as completing the new compliance activities being introduced. How could they do both? Which was to go when the time ran out? In my eyes the response was appalling. The nurses were told that was an unacceptable attitude to display and there was simply no choice and the compliance work was to be done. This came from a senior clinician who I had greatly respected and her response was totally at odds with her usual very reflective approach. Of course I don’t know the history with that particular member of staff who asked the questions and perhaps there was more to it than that, but there seemed a forced denial of the impossibility of continuing to provide good care and the level of presence on the ground with those we are caring for, which is so important if we are to prevent tragedies like the children who slip through the net where abuse and suffering goes undetected.
I left the service I mentioned because more and more changes were taking clinicians, and support staff like myself, away from being able to maintain the personal contact with patients. (I’ve since regretted leaving, I’ll admit.) Clinicians left too, at least in part due to stress and sadness around similar issues. They were a great loss to their patients, in my opinion.
A little later I worked a temp cover role as a secretary for the legal team that supported my local county council’s child protection services. Round about this time I thought about training as a social worker. I didn’t in the end. I thought I’d find far too many situations where my hands were tied and too many times bureaucracy stopped me doing the good that was needed.
I cry for the children that suffered and for those who so want to be present on the ground to help those at risk but who are taken away and whose voices are silenced when they highlight the lack of resources and impossibility of meeting the demands of keeping children safe in the field, and complying with everything that’s supposed to be ensuring children’s safety. One thing is sure and that’s that it is far too easy to be silenced – again both in the case of the victims and the carers pointing out the shortage of resources to help them. Let’s keep on speaking out.
The doctors and nurses who looked after me when I was in hospital for my operation last week were fantastic. I owe them huge thanks. It was really busy on the ward the two days I was there, probably all the more so because a lot of surgeries had had to be rescheduled from the previous day. From my arrival, they were sensitive and compassionate. I was there because of my physical health but they knew about my mental health as well and we discussed it during my assessment when I arrived. The nurse taking care of me took time to be really aware of how both my physical and my mental health issues were affecting me and to enquire about whether I was getting the help I felt I needed and would be supported once I returned home after the operation.
It was a minor op but still daunting to me. The nurses and doctors’ compassion, communication, availability to answer questions, even simply their general presence, genuinely doing all they could to help, made such a huge difference. One nurse even taught me the instant ice trick!
I wasn’t an emergency, an urgent or complicated case, thanks be to God. They treated so many people in those two days, most of whom I’m sure needed much more care than I did. Yet they still had time for me.
I am so thankful for these people who give so much.
I really don’t know if carrying on with therapy is a good thing or not at the moment. I am more broken now than before I started this route and know more certainly that I’m on my own in it. I can’t keep trying to fight through day to day, to go to work and to keep going to therapy. I’m starting to wonder if it wouldn’t be better to just push everything back down again and live in my imaginary world. I functioned better day to day when I was anorexic and numb to everything. There isn’t enough support outside therapy to keep it going.
I keep on hanging on to things desperately, for them to be snatched away. The only times I’m not alone are when I’m faking it, even if I’m doing a bad job of that. When I can’t do it, when I am on the point of taking my life, when I am cutting, when I am terrified by the flashbacks, I’m on my own every time. Apparently I’m not allowed anyone there. Apparently I “wouldn’t qualify” for any social care support, and no family or friend wants to be a carer for me. I know they have no responsibility for me but that still really hurts.
I am thankful for my friends. I am not trying to be ungrateful. They do much more than I could ever ask. I know they can’t be there. I know often they are there when I can’t possibly believe they would still want to know me, after I’ve lost it and screamed and snapped.
Trying to keep going used to help. But now I get closer and closer to complete breaking point every day.
I’m going for another appointment at the hospital tomorrow for my 1:1 and I think I’ll tell her I’m thinking about not carrying on therapy. Things feel very very dangerous and close to the edge right now.