Tag: Risk

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

Hospital

My friend has been admitted now (see my last post).

He was in much more danger than I realised. I’m not putting specifics to keep confidentiality and to avoid any unhelpful triggers for readers. ¬†He only told me after we had parted earlier. He didn’t want me to know and be scared. Then he went to A&E but didn’t go in. He was scared. He felt huge guilt too I think. He was confused and distressed and we lost contact and he was walking or lost in the hospital grounds I think. I got there as quickly as I could in a taxi phoning security to search for him. Thanks be to God for Security whose officers tracked his car. Thanks be to God that he did make it into A&E. I still don’t know exactly how.

Again I didn’t want to leave but he really preferred I did as his anxiety about hurting me (which he has never done) was so high. I spoke with the nurses and we all agreed is best for me to come back in the morning. He’s being cared for…he’ll be on a drip…he’s not alone…

I’m scared. He was so weak and drowsy and in and out of consciousness / awareness.

I’m hurting. Shaky. Scared. Exhausted. I don’t know what to do with all I’m feeling for him and the overload in my mind and chest. Hurts to breathe.

I know I have to accept right now I can’t do anything. The doctors caring for him can do something. God can do… more than something. Still I feel so horrible for everything I can’t do and all the good I see in him where he only sees what he calls poison.

I place him in your hands dear Lord Jesus. Hold him please tonight. Whatever happens now.

Ginny xxx

Descent into emergency

Kyrie eleison. Lord have mercy. Christ have mercy. Help us in our need dear Jesus, please, Lord hear our prayer.

6.45pm

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.

8.40pm

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.

9.15pm

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.

9.25pm

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….

Ginny xxx

 

 

Managing money with Borderline Personality Disorder

I am bad with money. I panic about it. I’ll panic for days beside being able to sit down to look at my financial situation. Partly this is because it’s usually so dire and it’s a constant background stressor in my mind that sends me to extremes of distress when my thoughts are in the foreground and that I block out at other times. I even find myself dissociating from it. Additionally, there’s the fact that I find it hard to deal with figures and hold them in my head and follow steps through when I’m budgeting. I always did find dealing with numbers hard, even before I was particularly ill.

However, with help, for example from my lovely support worker or my very close friend L., I can list out all my money coming in and my expenses and I can draw up a budget based on that – even though the outcome for months has been that I don’t have enough to meet basic expenses. It may not be workable but I can at least get things down on paper.

It’s very hard for me to get to that stage but that’s not the biggest problem. The biggest problem is when it comes to spending. I have been very bad with money and very impulsive and out of control and I really want to change that. I must change that if I’m to stay out of debt and all the spiralling material and mental consequences.

Even if I have made a budget plan, when I’m most ill I do not stick to it. Best laid plans to waste, as the saying goes… When I dissociate, or flip, I am no longer in control. It’s my responsibility and I don’t want to deny that but I’m not mentally in control. I make decisions and act on impulses and spend money rashly. I act on a temporary conpulsion to buy things I’d never normally touch. Sometimes I know it’s temporarily squashing down the unbearable feelings. Sometimes I’m buying a different life. Sometimes I’m buying for one of my “others” or it’s the “other” wanting and needing it and making the decisions. Often I’m too far gone to have any awareness of what or why I’m doing it and afterwards I see what I’ve bought and have only a dim recollection of why and when i did it.

Afterwards, infallibly, I feel terrible: guilty, disgusted, that I’ve been selfish, greedy, confused, angry with myself, scared, an absolutely unbearable feeling I can’t describe. There’s dread there. There’s shame – a lot of shame. There’s panic. There’s something more. Yet I still do it. There’s always the next time I lose control and dissociate and spend again. I’d call it a kind of manic dissociation that leads me to spending (it leads me to impulsively angry and needy actions too), as opposed to the frozen and numb dissociation that accompanies self harm or the safe dissociation of slipping away from this world into the imaginary one in my head. The manic dissociation is probably the most socially dangerous.

I really want to break this. I can’t stop the dissociation and impulsivity yet but I’m trying to find ways to reduce its impact. It’s become very important right now because, having had problems for nearly a year with my disability-related Benefits, with my support worker’s help we have now resolved the problems and I am due to receive some back-payment of money I should have received some time ago. This is absolutely great for me because it means that I can pay off my arrears and make a stable budget going forward and it looks as if finally I will have enough to live on! I am so so so thankful for this. It also means that I have a lot more money than I usually do (even if only temporarily til I pay the arrears). This is scary because I know that I cannot be trusted with it.

I texted my support worker straight away about the back payment and he’s going to call me this afternoon so that we can make a plan, pay the arrears and make an appointment to look at my budget again now that I’ll have a bit more money coming in. I’m hoping we can come up with some things we can do so that, at the times I’m being impulsive and not in control, I can spot this quicker and ideally, my access to money could be strictly limited at these times. I’m not sure how we could achieve that but maybe he will have ideas.

I know that ultimately I need to get to the root of what’s causing the impulsivity and learn to take back control of my actions at those times and stop the dangerous behaviour. I’m hoping therapy is going to help me find this, though it worries me I’m so far through therapy and still I don’t think I’ve changed in this area. Until I can do that I need to try to stay safe and be as responsible as I can.

I’m interested to know, if you or someone you know has Borderline, or indeed any other mental health condition, does it affect how you / they feel about money and how you / they can manage it? Is it an area you feel vulnerable or find stressful? In all the years I worked at a hospital and in the various services I’ve been seen in, it isn’t talked about very much.

Just recently I saw a useful self-help booklet at the PD Service I’m seen in, on these kind of issues. I’ll share here the booklet here later today or tomorrow (I think there’s an online version). It was about the first publication about managing finances which I’ve come across targeted specifically for patients.

Ginny xxx