Failure in Care Systems

How many tragedies need to happen before the NHS realise that its care services for mental health patients are far below satisfactory?

A man suffering from paranoia and schizophrenia stabbed a 25 year old mother in 2006 and today evidence has been shown that a number of failing in his care could’ve prevented this tragedy. The report (http://news.bbc.co.uk/1/hi/england/humber/8034521.stm) found that his condition was under treated and not effectively managed. He had even been assessed two days before the stabbing.

I, someone who has seen firsthand the failures in mental health treatment here, am not surprised in the slightest by the findings. My story, albeit not as extreme as this one, shows a number of failings and has led to many preventable suicidal moments.

Let’s start when I was hospitalised after my overdose in February. My answer to the question “If you had more painkillers on you, would you have taken them?” was “Almost certainly”. This led for the doctors to call for a proper psychiatric assessment which I had later that week. All good so far but this is where it starts to go downhill. The psychologist asked for an appointment at North End House, a mental health care unit where I could get long term treatment in terms of therapy, counselling, CBT, etc. After two weeks I still hadn’t heard anything. My GP sent a letter asking them again to make an appointment with me. I was still very suicidal and after a talk with my university tutor, he sent me for an emergency appointment with another doctor as it was obvious I was close to doing something very stupid. That doctor phoned and sent another letter to North End House asking what the hell they were playing at and low and behold a few days later I’m told that I have an appointment in a week or so. A full month after my overdose.

The appointment turned out to be another assessment and I yet again went through the ins and outs of my life, the whys and hows of February’s event. It was coming up to Easter at this point and I would be on my own in my house for a 4 weeks or so. I mentioned this, stating that I felt very vulnerable about it and would appreciate some extra support. The woman agreed and said they would get in contact soon. 4 weeks later. Nothing. I hadn’t heard anything from them over Easter and to this day I still don’t know how I got through it in one piece. It takes another week and THREE different doctors to finally get me an appointment. I get a half hearted apology saying that there had been some changes and my file must’ve slipped through the net.

Finally I was assigned someone and she is meant to be in charge of all my care. After a few late night phone calls to my crisis team (the only thing that’s actually a positive in the care system) and them assuring me that my care woman would phone the next day, it takes a week before she phones, the day before our appointment. During the first appointment she then leaves early saying that there has been an ‘emergency’. I was completely lost for the rest of the day. This was during my bad week (see previous posts) and I desperately needed some sort of support.

This week she is currently sunbathing in Portugal. Fair enough, I can forgive that, everyone needs a break, but I have been assigned no one as a backup. I feel failed, a burden that people can’t be bothered to look out for. More dangerously, I feel the need to prove that the system is failing. I want to make them feel guilty about how they treat people. My head is full of these dark, selfish, stupid thoughts at the worst possible time. I only hope, for their sakes as well as mine that I’m able to compose myself and keep these thoughts locked away because something needs to change. I can see plenty more tragedies to come is things carry on the way they are.

The Aftermath

I’m an idiot. As you can see I manage to stop the inevitable last night. I drunk, a lot, but I managed to phone someone before I was too far gone and right now I’m so grateful to that person for putting up with my drunken distressed rambling.

Last night was the closest I have come to doing something stupid in months. Looking back at it this morning, I still haven’t come to terms with how close I got. If I didn’t manage to phone, if no one answered...I wouldn’t be here, that I’m sure.

I’m feeling so bad right now. Not ‘I’m going to do something stupid’ bad, but an overwhelming feeling of guilt about what I even considered.

On Saturday a body of a young talented actress from my neck of the woods was found hanged. I spent today, after meeting with a member of the crisis team, reading the tributes left on a facebook group in her honour. The messages really got to me. The shock people felt after what had happened, that no one knew what she was going through, how they wished that she had just said something as little as “I’m not coping so well today”. I don’t want to cause people to feel like that and yesterday I came so close to doing it.

The problem is, when I’m in a mood like last night, I don’t think about all this, my brain just doesn’t comprehend the pain it would cause people. As I said before, it’s a blinkered state of mind. All you can think about is “I need to escape”. People who say that suicidal people are selfish, that they don’t care about others are frankly just plain ignorant. I beat myself up daily for thinking the things I do. This morning I was in tears about what I almost did, I’m in tears right now writing this. The worst thing is though, no matter how bad I feel about it now, I know that my depression will drag me down again. I know I will consider harming myself again. I know the black cloud will descend again and obscure my thoughts until I’m left with only one option and that is to get away.

It’s the endless feeling of it all, that’s what gets me. I feel beyond help right now. Beyond help and hopeless. But for now, I will have to live with it and hope that next time the darkness descends I will be able to fight it off.

I Can't Go On

I am really struggling right now. Really struggling. It feels like a skeletal hand has gripped my pathetic heart and is squeezing it until it causes bitter tears to mark my cheeks. Add to that the overwhelming feeling of hopelessness and loneliness, multiply the feeling by about 46.2 and you get an idea of how I’m feeling.

I’m really worried that I may do something and yet I can’t bring myself to phone the crisis team. I’m on my own, enough alcohol in the house to knock me out, sleeping tablets and razors. And writing this is just working me up into a panic. I know I’m going to work myself up so badly soon that I won’t be able to stop myself from doing anything. That is how it works, that is how it always works. I go into some kind of blinkered state where all I can think about is harming myself and I HAVE to do it. I can’t stop myself, I watch my body do the things it does and I have no control.

I know I need to phone. My mobile is on the table next to me yet there feels like there is some force stopping me from picking it up. I just can’t do it.

I’m wishing for someone to ring, someone to stop me but it won’t happen. It’s almost 1AM here, no one rings me at this time, no one will read this in time.

I’m scared.

Please. Anyone. I need someone right now.

Numbing the Pain

Last night, I am ashamed to say, I resorted to drinking. Ever since my overdose two months ago I cut out all alcoholic beverages from my life. One, because I felt that I needed to show my housemates that I was making an effort to recover and two, I hoped it would cause my medication to finally work. My housemates never knew about my depression until my attempt in February. I have had many years of practice in hiding it but even my skills couldn’t hide an ambulance outside the house. They reacted very badly to say the least and phrases such as “You’re burdening so-and-so” and “You need to think of others” and my personal favourite “You’re not even trying, you need to try harder” were going amongst the ranks faster than a labour party email. I thought that if I cut out alcohol all together they would see how much I was trying. Don’t think it worked.

Yesterday things just got too much and I found myself drinking the little alcohol in the house before taking a trip to the shops and buying some more. I feel like a failure. I am a failure. I lasted two meagre months. And now, the numbing effect of drink seems appealing once again. I always knew that once I cracked I wouldn’t be able to control myself and now I’m afraid of what I may do. I’m on my own, no one nearby to stop me. I need to distract myself and it really isn’t working. I just need to last till tomorrow. I have an appointment with my doctor in the morning, I just have to last till then. 14 hours, 5 minutes.

Shit.

Is Suicide in Japan a Socio-Cultural Phenomenon?

A friend earlier today discussed her current essay titles and one of them grabbed my attention. Is Suicide in Japan a Socio-Cultural Phenomenon? It is an interesting topic. For me, someone who often has thoughts of suicide and has a history of overdoses and self harm to my name, I put suicidal thoughts purely down to my depression. The thought of my actions being down to society and culture doesn’t even cross my mind, but of course, society and culture is very different in Japan.

Japan has long been providing social studies on suicide. Take the suicide bombings in the Middle East for example. This can easily be traced to Japan’s “Kamikaze”, the suicide air attack squad at the end of World War II. Tracing back even further and we have the samurai’s, the Japanese warriors. In order to protect the samurai from being killed by executioners, a form of suicide, hara-kiri, was committed. This wasn’t seen as some sick, heartless sacrifice as many in the western world would perceive it, but a privilege in society. Another form of suicide, shinjyuu, was committed among intimate people such as between lovers or families.

Here, suicide is seen by some as a selfish act, an act that goes against many religious teachings. By others, it is perceived as a last resort, an escape. Rarely is it seen as an act of good. Suicide in Japan however is seen as an act of individual dignity, of freewill, and has a long lasting cultural association with saving family fame, a noble act almost.

In this modern day and age there is more pressure on Japanese, especially men, to make money and be successful. In these days of recession, economic slump and high unemployment, this is becoming harder to do. It comes as no surprise then that statistically men are more likely to commit suicide in Japan than women. Failure isn’t an option for them and suicide is often attempted in a bid to get life insurance for the family. With the invention of the internet comes arise of suicide pacts in Japan, thus bringing a new phenotype of “group suicide culture”. Suicide is fine as long as people do it together.

I personally see suicide in Japan as a socio-cultural phenomenon. Despite many policies being proposed to help reduce the suicide rates, they are treating the suicides as a mental health issue. In fact, many psychiatrists are arguing that past suicides were due to depression and are urging people to regard suicide as a product of pathology. Even though I agree with this, I don’t think this is the way to go about it. For someone who is depressed a mental health hotline and counselling can prevent suicide, for someone who is under financial strain it will not help.

Japan is developing a vocabulary of motives associated with suicide permitting the Japanese to believe that they have no other choice but to die. As a result, they are resisting mental health efforts such as medication for depression. In order to move Japan away from the “nation of suicide” you first need to change the society. Allow more aid for those in financial difficulties, for those who are unemployed, change the pessimistic outlook on life. Then concentrate on the mental health aspect. This may seem like an indirect route, but personally I believe it is the most secular way to reduce suicide rates in Japan.