Tag: crisis team

Please plan your crisis 24 hours in advance…?!

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.

Ginny xxx

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One of the most dangerous ways to react to someone with BPD who is asking for help when they are suicidal or self-harming

 

 

TRIGGER WARNING: fairly massive warning on this one that this post discusses suicide and self harm and issues around getting care in crisis…

Yesterday I was met with one of the most punitive, ignorant and dangerous reactions I have had from a medical professional. I wonder if people who react like this actually do not realise the genuine danger patients are in and how much further into danger this kind of reaction pushes us.

As I write this post I want to be clear that I am now safe and have received help and I am not posting this to alarm or worry readers about me. I’ve been seen in emergency services and eventually had very supportive care, which I will post about in due course. Please don’t panic about me. I am now safe and have had help. I just think what I experienced earlier is a massively dangerous issue that needs to be highlighted.

Yesterday I was absolutely unable to cope. The pressure of my housing situation, financial problems, threat of losing my flat, trying to discuss things with my landlord, my physical help, repeated errors from benefits services and other supposed sources of support, the lack of help over the past 5 months or so when I’ve been at my lowest points, the voices and flashbacks and nightmares – everything boiled over and again I was in the place where the pain and emotions and loss and guilt blocked out any ability to carry on.

I lost it and I was at the point of trying to end my life. I knew how I was going to do it. I had tried and tried but had nothing left.

I spoke on the phone to the GP Surgery. Somewhere, I guess some part of me was still wanting some kind of help or at least daring to tell someone. (They had called me over issues with a mess up over the prescription i should have had; I’d again been left without my medication. ) I admitted what I was feeling. I begged to see someone. I don’t know what made me do that, ask for help when the decision was already made in my mind that this was it now and I’d come to the end. But I did.

I admitted that I wanted to end my life and that I was self harming. I admitted that I had the tablets to overdose. I asked to be seen and that I needed help now, could they see me or get the crisis team? I said how all the mess ups with my prescriptions and benefits and no help in crisis were piling things onto me and making it more and more impossible to cope. I was having hallucinations and flashbacks. I had been asking for help for months. Now I could not go on anymore, I was going to end it. I needed help.

The GP spoke over me from the start. She told me that “you have to be extremely careful about how you are coming across” if I expected to get any medication. She then told me repeatedly, in response to me admitting that I was suicidal and self harming, that “that is not a fair threat to make to people” that “you will find I do not respond to threats” and that I am a responsible adult able to make my own decisions and there is no reason that I should take an overdose. She then announced that she was going to end the call and hung up on me whilst I was begging her to help me.

If Someone with Borderline, or any other mental health problem, admits to suicidal thoughts, plans or intentions, or self-harm, it is the most incredibly ignorant and dangerous reaction to treat them as though they are making threats in order to manipulate and must be punished accordingly. The stereotype that people with personality disorders or any mental health problem are manipulative, or that being suicidal or struggling with self-harming  is attention seeking,  are extremely dangerous. It is all the more dangerous when it is trusted healthcare professionals acting on the basis of these stereotypes when their patients have dared to ask for help, meaning that when we are in immediate danger we are dismissed, punished and rejected.

Experiencing suicidal thoughts is not attention seeking. Self harming is not to create drama or cry for attention. Admitting that you are in danger and want to end your life, that you are absolutely at the end of the road and can’t go on, that everything being piled on you is pushing you nearer and nearer the edge, is not making threats. The attitude shown by the GP today makes it impossible to ask for help when we are most in danger. I now know that if I admit to the terrible thoughts and feelings, I’ll be treated as though I’m manipulating people and will be rejected. If patients are treated like this, suicide and self harm is made something that must never be admitted to or talked about and for which help can never be sought. If patients are treated like this, all the feelings and events that have brought them to the point of suicide are dismissed in an instant, as our position is made out to be manipulative fabricated threats rather than complete brokenness.

Yes, I am an adult. Yes, I am responsible for my actions. If I self harm or attempt suicide, it is my action alone. If I cause myself harm that is done by me alone. That does not mean that the experiences and emotions behind my actions are not real, that I am not in danger,  that I am fake. No longer being able to carry on doesn’t mean I am manipulative. Asking for help and admitting to the horrible things in my head doesn’t mean I am making threats. Asking for help doesn’t mean the feelings that make me want to end it aren’t real. The fact that if I do something to hurt myself, it’s my action, doesn’t mean I’m not in danger and don’t need help.

I’m terrified of manipulating or hurting people I care about. That’s why I hide my self harm and did not tell anyone for years, why I usually don’t ask for help after overdoses… I’m scared that people may feel responsible for saving me… and the self-harm itself started in order to punish myself and hurt myself to turn it all in and not let the horrible things in me hurt anyone else, and overdosing  is sometimes about utter pain and sometimes utter rage and loathing at myself and fear of who I’ve hurt.

People who are self harming and/or on the point of attempting suicide are not nasty manipulative frauds, they are in massive pain and massive immediate danger. They do not need punishment and dismissal. They need a place of safety and compassion and they need desperately for the hurt and the danger they are in to be believed.

It is terrifying to admit to things like how close you are to suicide or that you’re overdosing. I never say it to friends (though two friends have sometimes guessed) because I do not want to make them feel responsible to keep me safe or worried I’ll do it again. That’s one thing.  But it has to be possible to admit it to healthcare professionals, if there is to be any way to get help.

Yesterday, my life was saved by a police officer who recognised the danger I was in, and by the emergency team who assessed me when he took me to them, and by the mental health workers at the safe haven I was taken to. I owe them my life. Thanks be to God.

The safe haven is a new organisation that has been running for just two weeks in my local area and I think massive good is going to come of it. I’ll post more on that going forward. Please God can that be the support other people find when they are in the state I was in yesterday, not reactions like the one I got from my GP. Sadly I think I’m not alone in what I encountered. And this isn’t the first time. I’ve encountered similar and worse lack of recognition or response to the danger I was in, and accusations of making threats or being manipulative,  from within the personality disorder service and in crisis teams.  If i am ever recovered enough to be able to somehow try to help other sufferers or explain to people what BPD is like and how to help someone in crisis, tackling this would be a massive priority for me.

Ginny xxx

Crisis Plans

Last week, after the really distressing meeting on Tuesday, where I completely lost it and just screamed and screamed, I had another meeting with the same CPN on Thursday. It went quite well although I am still reeling from Tuesday. I never lose it like that when anybody else is around. I do that alone at home, usually at night, usually cutting myself before I can reach that point, because it stops some of the noise in my head for a while and quiets the fury and hurt. On Tuesday all my control methods didn’t work and the worst of me exploded. Since then I’ve been feeling both raw and outside myself at the same time.

We tried to come up with other ideas for what to do when I am extremely distressed when I am on my own, other than always turning to cutting or overdosing. The problem is that no matter how harmful those things are, they do “work” to stop the feelings (if only by stopping me being conscious!) punish myself, so bring down the emotion and enter a state of numb nothing for a while, or at least explicable pain.

One of the things we came up with was the Rescue Box, which I’ve posted about previously. I’ve committed to making that up this week.

The other things my CPN suggested were: putting my head under cold water eg cold shower for 20 seconds, to shock the body and so bring down the emotion (a bit like the lemon juice idea!), starting some activities that would give me more social interactions and so leave me on my own less, developing a relaxing routine for evenings (which I’ve got out of the habit of), and sorting out my dodgy internet access so that I can have more contact with people via blogs and similar, as well as making use of online resources for relaxation and mindfulness.

I’m not very sure how this is going to go. I’m starting with small steps, making up the Rescue Box this week and getting in contact with my internet provider.

A large part of the problem for me is that all these techniques are great ideas but I too quickly reach too high a level of distress to be able to use them. When I’m in that state, or when I have more of the psychotic symptoms (which tend to accompany higher distress), it’s as if the part of my brain that would reflect enough to try one of these techniques just shuts off. I have an overwhelming need for someone else to keep me safe and almost hold me and ground me and prove something exists beyond the fear and distress. But the PD Service seem absolutely against anything that would lead to me not being on my own in these situations (like being referred to the Crisis Team who’d come to see me at home, or being admitted when I’m overdosing etc). I’m not entirely sure why. They are written into my “crisis plan” as ways to keep me safe when I can’t keep myself safe, but when it comes to it they are withdrawn or refused. This is something I’ll be talking more to my 1:1 therapist and/or Care Coordinator about.

I guess I have to learn to discover earlier when the extreme feelings are coming – at the moment they spring up at me from nowhere and that’s terrible. It feels very out of control. There’s no doubt that as I’m experiencing more emotions, I’m becoming less stable.

I’ll post an update on how things are going with trying these techniques.

Ginny xxx

Time to pack it in and leave, I think

So the last couple of hours have brought me absolutely beyond all hope.

I’ve been led on a cruel dance by all the so called emergency out of hours lines.

The PD service secretary refused to even phone any of the clinicians. She told me all kind of rubbish and lies, like that she couldn’t put me through to anyone else in the hospital, she didn’t have a telephone number for any of the clinicians or anyone else in the service, she refused to get me help, she pretended the crisis team didn’t exist, she shouted over me. I called 111 the out of hours service, since it was after 5. They refused to get me an appointment face to face or telephone. They said my own gp still needed to see me. They were not responsible til 6.30. They refused to make me an appointment after 6.30 or refer me to the crisis team. My own gp put me through to the duty doctor. She refused to visit me because it was too late in the day. She refused to refer me to the crisis team because they wouldn’t accept a referral without her seeing me which she’d refused to do. She then hung up on me whilst I was speaking.  The so called emergency out of hours mental health line went to answerphone 3 times. I finally got through. They had none of my messages. They talked over me constantly and said nobody world come to see me and just go to a&e. I’m too ill to go out of the house and what’s the point of going to a&e? They just send you back out a few hours later. What was the point of the line then if they don’t offer help? If I wanted to go to a&e I’d have gone. The woman actually agreed yes it’s fairly pointless, she just tells people to go to a&e.

I am desperate. I have done everything I’m told to. I have jumped through every &*$/€(# hoop. I even trusted them. What do I have to do to get help? Every single thing gets taken away. How much sicker do I have to be before they’ll help me? Before they stop talking about building my resilience? They’ve taken every bit of my resilience away and finally pushed me over the edge.

I’ve been thinking for some time about just packing up and going away somewhere else. Going off to the other end of the country. Somewhere else I can live hidden, preferably under a different name, nobody else knowing all this $#@/!&£* inside me, nobody pulling me apart and cutting and cutting deeper, nobody tricking me, and it’ll be numb but it’ll be some pretence of normal, it’ll be numb and fake but I’ve seen what trusting gets you, nobody will come near to me again, the real and the screaming and the desperation and hurt, I’ve been shown what that deserves, I’ve had it. I think I should just choose the numb.

What do you do “out of hours”?

I really needed crisis support on Friday but didn’t get it. After therapy group I was spiraling down and out of control, then a number of bad events came snowballing, knocking me further down. I had a brief conversation with the duty line at the hospital and was supposed to get to speak to them again later in the afternoon but they didn’t have time. I was in pieces, cut and was on the edge of the very dangerous place I cannot take a single step more and decide to end it. Thanks be to God I didn’t but I took a higher dose of my tablets than I should to knock me out and stop the hurt (not really an overdose as it wasn’t over the maximum dose of anything, but I took more than I’m prescribed and everything together).

I’ve been fighting through this weekend as I’m working. What I want is numb, stay at home, stay under a blanket, no more feeling, no more thinking, no more hallucinations, no more noise in my head, never have to speak again, never do more harm, someone to hold me, to go to the dissociated place, forget everything I have to fight through and just stop and be allowed to need it to be no more, stop, sleep.

What do you do when you feel this and you can’t get help? It’s the weekend and/or evening. I couldn’t get help from the hospital on Friday. There will be nobody available until Monday and who knows if they will have time then to see or call me.

I could go to A&E but I wasn’t sure what they’d do, and it’s not really an emergency and there isn’t an instant solution. I need more help day to day. I could call 111 the NHS out of hours line, but they tend to tell you to go to A&E if you admit to self harming or being suicidal. They’d probably take my tablets away too. When I’ve been put in touch with a community crisis team before I’ve actually found it really unhelpful. They did not (in my uneducated opinion) understand BPD. What they said piled on the guilt and made me closer to ending my life and they were determined to show me I didn’t need (or deserve,  I feel) any help and Iwasn’t genuine. If i got that right now I would go through with ending it.

Part of the problem needing help out of hours is having to try to explain your whole story – trauma, abuse,  flashbacks, hallucinations, voices, BPD, hurt, fear, desperation and needing to end it – to someone who doesn’t know you or the therapy you’re having. It’s too frightening to do and the cost of being misunderstood too great.

I promised a friend that if it got to the worst I’d go to A&E before I did anything. I would,  I’d keep that promise.  I made it only because she would be more worried about me and stressed if she thought I wouldn’t. I would go at that point, out of honesty to her. Even though having reached that point I’d not want to be stopped.

What do you do when you need support out of hours and can’t see your GP or your usual clinic / hospital team? I’d be interested to know what others do.

I know a lot of it may involve other coping strategies not going to someone else for help. But what about when it’s bad enough they don’t work?

Ginny xx