To my beautiful friend Sophie

To my beautiful friend Sophie

I was just 15 when I experienced my first mental health crisis. Despite the fact that I had been struggling with bouts of anxiety and self-harming behaviours for years leading up to that, the summer of 2013 was the first time in my life where I thought it would never get better, and I therefore reasoned that it would be better, and less painful, to end it now.

It was around this time that I joined the Instagram recovery network. For those of you who don’t know, it’s a whole little sub-section of the Instagram world in which (mostly) young people struggling with mental illness, create a sort of update diary on how they are and what’s happening in terms of their wellbeing. It can be very comforting to have other people messaging, supported, and relating to you.

The recovery network was toxic to me for numerous reasons. I subconsciously picked things up by reading them, I got upset when I read that my friends, the people who I had grown to know and love, were in a shitty place themselves. It did trigger me at times, but in those years when my mental health was neglected not only by mental health services but by basically everyone around me, it was solace. It was a private place where I could open up and let it all out.

Sophie Payne was one of the first people who I became friends with on the Instagram recovery network. We then went on to have each other as friends on other social media sites. She texted me when she was upset. She gave me advice about inpatient life and the general struggles of having BPD. I read her poems for her and sometimes gave her feedback (which was always, always positive. She was super talented). She was beautiful, brave, extremely talented, and above all, she was kind. She was kind to everyone who knew her.

Sophie was let down by mental health services. She had been inpatient many times and had sometimes been discharged before she was safe. In her last admission, she was waiting for a personality disorder unit bed (she was excited and hopeful to finally be able to recover properly), when she sadly passed away. In the unit that she was in, Queen Mary’s Roehampton, other people had died on the ward since 2010. It’s negligence. This could have been prevented.

Sophie was passionate and always voiced her opinions on problems with mental health services. Part of her really wanted to get better, and she wanted to help other people. She was really bright. She was insightful. When I was diagnosed with borderline personality disorder, she talked to me about it. She helped me understand.

It’s such a shock to lose a friend like this. When someone you know is sent back to inpatient, it’s distressing to know they are in a crisis, but you feel comfort. You feel like in the unit, your friend or family member will be kept safe. That they will be looked after. That they will be able to come out of the process much happier and healthier. You expect them back. Nobody should be able to take their own life inside the walls of a psychiatric unit. This is supposed to be the one place where psychiatric patients are indefinitely safe. This is the second time year that I’ve sadly been proven wrong.

Sophie Payne will remain to me always as a beacon of kindness and immense bravery. She fought (and won) many battles, and was always there to help support her friends. She was a fundamental part of the recovery community and someone who will be missed by all of us who were lucky enough to know her. You gave me hope Soph, and I’m so sorry the world couldn’t give you more.

Love always,

Rosie x

SAMARITANS UK 24/7 LINE – 116 123

 

 

Admission to a CAMHS psychiatric hospital: Transferral to PICU

Admission to a CAMHS psychiatric hospital: Transferral to PICU

TRIGGER WARNING – this blog post may be upsetting to those who are triggered by discussion of inpatient services, restraints and self-harm. 

Thursday

After two weeks of being on an open unit, I have now been transferred, which I am very upset about. Despite the fact that I’ve been doing alright over the last few days, a Nurse took me into the Low Stimulus Area and told me that I was about to be moved to a PICU, which obviously made me very angry and upset. I had to stay in the LSA and wasn’t allowed to say goodbye to anyone before they took me out the back doors to a van. It’s made me really sad because I have actually been making small progress and I didn’t want staff touching my belongings.

On the way to the new unit I did some word puzzles with a Nurse from the open unit, but once we were at the PICU she had to leave me there and I was escorted into a meeting, which was horrendous. I ended up being restrained onto the ward, having my physical observations checked when I was calmed down, and then being taken into a ‘Quiet Room’. Everything has escalated so quickly and this is a horrible place.

Friday

Possibly the only good thing about this unit is that the beds are comfy – I didn’t want to get up this morning. It’s ridiculous – I’m allowed absolutely nothing in my room, so I had to go to the Nurse’s station and ask for a toothbrush and toothpaste (what the hell would I do with that) and have someone pick out an outfit, and then give my smelly pyjamas back in. It’s ridiculous. 

My hair is greasy as hell and I probably really smell but I have no energy to get in the shower and there’s no time in the morning, plus I really value my time in my bedroom. I’m becoming really anxious about the onset of my period and being on 1:1, but at least here I’m on line of sight for the toilet, rather than someone being fully there. 

The staff here are really firm, there is barely any furniture and all the walls are blank. The manager is especially strict, she came and lectured me about the need to cooperate with staff. I really don’t like it here and I want to convince my tribunal that a different unit might be better for me. 

The physical health lady came back and examined my bruised head and basically said that I need to go to hospital because there’s too much fluid on my head. I was taken to minor injuries first, but then we were sent to A and E where I had a CT scan. My eyes are really blurry and everything hurts.

Saturday

Today has been a tricky one. I woke up early to get in the shower, which was awkward because I got naked into the shower, only to realise that it wasn’t working, so I had to tell my 1:1 (fully naked) that the shower wasn’t working, so then had to put my clothes on, and walk down the corridor to have a shower in a spare bedroom. It was worth it because now I don’t feel so disgusting and my hair is no longer greasy as hell.

I had an incident after breakfast so I was taken back into my room for a bit. My face is actually looking slightly better this morning, although I have been getting some blurriness and some double vision. 

They let me have my colouring books and pens for a bit but I ended up having a massive lapse because my 1:1 left me alone in the bathroom. I’m fighting so hard but the opportunities are too much to resist, so I’m angry I guess, but also happy. I then demanded to talk to Mum, smashed my head in the phone booth, was taken out of the booth to ‘calm down’, before being finally allowed to talk to Mum and tell her how shit everything is here. This place is making me ill – the level of support is just stupid. I feel like I am absolutely losing it.

I also had no lunch and no dinner today as I didn’t even see the menu, so nothing was given to me. I then asked if I could call my Mum (to complain about not being fed) and they were like ‘no phone calls at meal times. You can’t rely on your Mum all the time’. 

Mum and Dad came to see me this evening and they were not very happy about my treatment, and were adamant to see a Nurse. One came and basically told them that I need to cooperate and communicate more with staff, which I am going to try really hard to do. 

Sunday

My head is BANGING. From the top of my hairline to the middle of my skull, it feels like it’s being compressed by a heavy weight. I don’t know. At least its numbing everything else. 

I’ve been pacing up and down all morning and I’m quite scared because when I saw my reflection in the big bathroom mirror I looked pretty vile. 

Some patients have been playing JustDance on the Wii, but others were playing basketball IN THE LIVING ROOM which was really quite irritating because the constant banging kept jolting me. Eventually everyone got so worked up that two patients broke down the door to the seclusion and office corridor, and had to be restrained back. 

I’m really tired and my head really hurts.

Monday

I went down to Education this morning and it was actually alright. The teacher dude said he was going to get in contact with school and get them to tell me what extra work I can be doing. It’s going to be hard continuing my A levels because we only have 2 hours of Education per day. One teacher was moaning that he was being made redundant because they needed a qualified maths teacher. 

I refused to go to Community Meaning because I was really upset and everyone was shouting really loudly. However, in the afternoon I went to Occupational Therapy group. 

I haven’t cooperated very well today and I’ve had two major incidents which involved being fully restrained. Another patient was dragged to seclusion with about 10 staff, and one patient threatened to beat up another because there was an argument about a missing stress ball. 

Tuesday

I hate every fucking thing about this stupid place. I want to die and really do not give a shit anymore. I absolutely do not care about myself and the only thing that is making me slightly rational, is the thought of my Mum. Why is this place like a prison? 

Staff aren’t even nice most of the time. I don’t need to be here. I don’t want any of these people laying their hands on me.

I stayed in bed for ages this morning because a man was on my obs and it was really awkward. I find it so creepy that they just watch me sleeping. I eventually got up to go to Cooking Group, where I was faced with the challenge of cutting up a potato with a plastic knife. I had an incident and had to be taken back onto the ward.

Mum and Dad came for ward round, but I wasn’t allowed to attend which makes no sense. So I went back to the lounge and kept going to the toilet because even on 1:1 if you bang your head quickly whilst the toilet is flushing then they won’t notice because of the noise. Plus, my 1:1s aren’t very reliable and sometimes just let me go to the toilet on my own, forgetting that they are meant to watch me. 

I’m really unhappy because it’s difficult for me to write to people now because all my contacts have to be ‘approved’ by the social worker. I WANT MY MAIL FOR FUCKS SAKE. 

Other patients are shouting and hurling chairs around, finding bits of glass and swearing. 

I don’t like who is on my 1:1 so I’m going to go to sleep now. 

Wednesday

I am so annoyed. My period started last night so I asked a Nurse discreetly for a sanitary towel, and she started off on some ‘risk assessment’ bullshit. WHAT THE HELL. After contacting the on-call Doctor (for fucks sake), she eventually gave me one thin towel. MATE. What an absolute cow.

I woke up again this morning and could barely see because my eyes had puffed up so much. However, I still went down to Education and then was taken down for a gym assessment. This involved a 20 minute interval session on the watt bike, crunches, sit ups, planks, squats and activities involving the exercise ball. It was tiring and pretty difficult to do sports activities without a bra on (risk assessment, again). 

I was asked to sign my care plan, but it was a load of bullshit and had no input or consideration for what I had said, so I refused. My head is hurting so much that I’m actually crying from the pain. 

I saw Mum this evening and she passed on messages from my friends, and asked if I wanted to write to them.She also cried because she said that the best day of her life was the day I was born. 

Everything kicked off at dinner time, so the rest of us had to go and sit in the middle lounge with our dinners. We were in there for so long that some of the patients fell asleep. 

Also, I’ve finally spoken to some of the patients properly. Everyone is shocked that I am 17 because they presumed that I was 13 or 14. They seem really nice, but everyone here is really unwell. 

This documents my first week on a psychiatric intensive care unit. This again was a very difficult time, and thankfully it all goes up from here. I hope you found this article interesting and insightful.

My top 10 favourite books about mental illness

My top 10 favourite books about mental illness

10. I Was Here – Gayle Forman (2015)

This book tells the story of a young girl’s struggle to understand her best friend’s death. Despite the hard evidence (be warned – this book may be upsetting to some readers), Cody refuses to accept that Meg was depressed or committed suicide, and instead looks for something, or someone, to blame for taking her friend away. This heartbreaking novel therefore explores the complexities of mental illness and suicidal ideation, and the unbearable grief of not understanding why.

9. The Silver Linings Playbook – Matthew Quick (2008)

The Silver Linings Playbook tells the difficult story of a grown man who is coping with his separation from his long-term partner and subsequent stay in a psychiatric hospital. Pat engages on a journey of recovery in order to regain his ex-wife’s love, but ends up finding new ways to express himself and deal with his illness, particularly through his new found friend, Tiffany. I really like this book because unlike a lot of other stories about mental illness, it’s pretty hopeful and shows that although life continues to be difficult, it can get better.

8. The Catcher in the Rye – J.D. Salinger (1951)

Although some readers do not associate this book as being explicitly to do with mental illness, the book makes multiple references to the character’s breakdown and eventual stay in a unit after being expelled from his school and subsequently running away. Holden Caulfield is an odd but an extremely likeable protagonist, and his inability to fit into a certain model of societal values is very striking to those who feel like their mental illness or disordered way of thinking makes them alone. This remains one of my favourite books of all time.

7. The Perks of Being a Wallflower – Stephen Chbosky (1999)

Despite being more commonly remembered now for the 2012 film adaption, The Perks of Being a Wallflower remains a fantastic book not just about the general difficulties of teenage life, but mental health issues such as post-traumatic stress disorder, anxiety and depression. It follows Charlie’s passage through a year at high school as he struggles with the haunting memories of his friend’s suicide and the abuse inflicted upon him by his troubled Aunt who since died. Eventually Charlie is admitted to a psychiatric hospital, and the story ends on a positive and hopeful note for the future.

6. Suicide Notes – Michael Thomas Ford (2008)

Although this book certainly has some problematic elements, the title being one of them, I felt like this was a fantastic and eye-opening depiction of suicidal ideation. The book begins with Jeff waking up in psychiatric hospital after attempting to end his own life and being sectioned for 30 days under the Mental Health Act. The story then follows Jeff as he becomes accustomed to life on the ward and slowly puts together the memories that he is repressing that caused him to want oblivion so badly.

5. The Shock of the Fall – Nathan Filer (2013)

I found this book exceptionally insightful for me because it explores a mental illness that I don’t relate to, schizophrenia. Focussing on the protagonist’s guilt over his own brother, Filer explores the contributing factors towards Matt’s breakdown, and his struggle to recover within a strained mental health system. I feel like this is a particularly good read because not only does it offer insight into a range of factors for mental illness, but it offers a view into both inpatient and outpatient care.

4. It’s Kind of a Funny Story – Ned Vizzini (2006)

This one of the books about mental illness and hospitalisation that has stuck firmly in my mind over the years, somewhat sadly due to the news of the author’s tragic suicide in 2013. Although reading years ago I felt like it was problematic that the protagonist was only admitted for 5 days after entering the emergency department with suicidal ideation, later experiences only tell me how this is actually pretty realistic and this isn’t the fault of Vizzini, but the fault of the system that cannot afford to invest long-term inpatient care for many people. I also find it uncomfortable reading about another patient who had cut her face and thought it was a ‘cliche’ but again, after since being admitted to psychiatric hospital myself, I feel like the levels of desperate shown in the patients in the book is so sad but pretty spot on.

3. Norwegian Wood – Haruki Murakami (1987)

This is possibly one of my favourite books of all time, and one of the best that I have read that explore mental illness. I particularly love it so much because it defies the ‘love heals all’ trope. Among other storylines, it follows the protagonist’s relationship with the emotionally troubled Naoko who is severely depressed and is hinted at to be struggling with some kind of trauma. It was very interesting to read a book that describes mental health in a culture so different from my own, and is utterly heartbreaking whilst also being enlightening.

2. Prozac Nation – Elizabeth Wurtzel (1994)

I love this book retrospectively after reading it a couple of years ago and since struggling with mental illness at university myself. I feel like this book offers real insight not only into modern double standards for women, but the unbearable pressure that is placed upon students to exceed and push their academic limits in order to get the best grades and continue up the ladder. This book is about atypical depression rather than BPD but I felt like I could relate to it on a level of both as Elizabeth struggles with her own unstable identity.

1. The Bell Jar – Sylvia Plath (1963)

I read this book for the first time when I was 11 years old, when I was on holiday in Spain with my family. Of course, there were things I didn’t understand and I’ve read it many times since, but I feel like this book changed the way I saw the world. Esther Greenwood’s struggle in a man’s world that determines her primary status as wife and mother rather than person is still very relevant today, and is often untouched upon by readers who see the text as purely about her going insane with no thought to the contributing factors. I always felt like this text gave me some hope in that despite the description of suicide attempts and hospitalisation, there is an implicit mention of her future husband and child, but of course this is tainted by Plath’s own death just weeks after the publication.

Why CAMHS inpatient services need more funding

Why CAMHS inpatient services need more funding

Out of interest, I had a look through the CQC reports for CAMHS units in the United Kingdom. Although most were rated overall as ‘good’, many of these were actually rated as ‘needing improvement’ for their level of safety. Some wards, including wards that I have been previously on, have even been labelled as ‘unsafe‘. It’s quite clear that funding is insufficient for CAMHS, and here are just some of the things commonly noted down in the reports that really prove that:

  • Lack of separate male and female areas – the bed crisis means that there simply isn’t enough space to keep males and females separate. Although wards are meant to have female-only areas, most CAMHS units don’t have this, and many have unisex bathrooms. This breaks the code of the Mental Health Act.
  • Seclusion areas not meeting standards and not being recorded properly – some units were reported to have inadequate seclusion areas, some with bathrooms that could only be accessed if a staff member came in and unlocked the door. Patients reported a lack of dignity, and units failed to show records for reviews once in seclusion.
  • Patients not being informed of their rights – some patients were not explained to them properly what being sectioned meant, and in some places informal patients were not aware that they could leave.
  • Risk assessments and care plans not up to date – due to strain on staffing, the administration in units is often pushed to the side, despite this being important for patient care. Without proper risk assessments and plans in place, patient’s wellbeing is put at risk, and it is more difficult for MDT to come to decisions about leave and other advancements in care. It was also found that many units failed to make adequate discharge plans.
  • High turnover of staff, with agency staff who had never worked on the ward before and had received minimum training – many units have had to cope with the difficulty of not being sufficiently staffed, and having to call in untrained members of agency staff. It takes time for staff to become accustomed to the ward, and incidents are more likely when there is a high level of inexperienced staff.
  • Leave and activities cancelled due to lack of staff – disruptions to the therapeutic programme due to strains on staff are common across the board, with patients sometimes not being able to access their rooms, outside areas or education areas due to staff not being available.
  • Untrained staff using prone restraints and other inappropriate restrictions – a prone restraint is when a patient is restrained with their facedown. This should not happen, and if it does it must be recorded. One unit was reported to have used emergency ties and soft handcuffs to restrain a difficult patient. Medical reviews were often not carried out after these incidents.
  • Poor level of staff knowledge about the Mental Health Act and low levels of mandatory training and safeguarding – a recurring theme in reports on CAMHS beds revealed that many staff were untrained, with some not understanding basic concepts such as the Mental Health Act.
  • Patients being far from home due to a lack of inpatient beds in a crisis – many patients are sent to units hundreds of miles away from home due to the lack of bed availability. Once they have been admitted to this unit, it has been noted that it is unlikely for them to be able to be moved.
  • Comments and complaints not being documented or dealt with – the CQC reports reveal that many units have no proper system in place for patients, parents or staff to submit complaints, and that there is often no follow-up procedure once these have been put into place. Reports also show that patients are often unable to access basic information about the care they are being provided.
  • Facilities left damaged or broken for long periods of time, including broken or absent defibrillators – units across the country are so strained that basic equipment can be left broken for months. One unit had no defibrillator and thus failed to perform an emergency drill. Others had shower facilities that were unsuitable for use, problems with fridges that meant medication would go out of date, and dangerous ligature points which were left unnoticed until the inspection.

 

CAMHS units save lives, and inspections and recommendations by the CQC and other examining bodies means that they are improving all the time. But what we can be sure of here is that cuts to mental health funding means putting the lives of children inside these units at risk. Lack of funding means strained staff, not enough time to fill in important documents, broken equipments and faulty, desperate procedures. We are lucky to have this service and there are so many wonderful things about it, but we must keep it going.

For more information about CQC and Mental Health:

http://www.cqc.org.uk/what-we-do/services-we-regulate/mental-health

 

Admission to a CAMHS psychiatric hospital: week 1

Admission to a CAMHS psychiatric hospital: week 1

This is my first ‘true to life’ post about being a young person in a CAMHS psychiatric hospital. These are actual extracts from my diary, with only grammar corrections and removal of names. I hope you find it insightful to read my journey to recovery.

TRIGGER WARNING – Because this is at the very start of my admission, this post may be upsetting to some readers. It contains some mention of self-harm, suicidal thoughts and restraints. 

Wednesday 

I had zero sleep last night due to being worried that I would be sent to a hospital really far away from home. The Doctor said it was a possibility and I would be very lucky to get a ‘in area’ bed. I looked up all the hospitals in ‘my area’ and even ‘in area’ could be anywhere in the East Midlands. It made me feel pretty shit. I don’t want to be alone. 

Luckily, NHS England notified the ward that there was a bed at the local unit, which meant a) not going to one of the shitty hospitals I had seen on the CAMHS bed map, and b) I’m going to be close enough to home to be visited. 

The day involved a lot of waiting around for the unit to be ready, and a lot of tears. I’m not sure if I want to do this, but I don’t have much choice. 

I got to the ward mid-afternoon and had to wait in a locked waiting room for ages before being seen by a mental health Nurse and the consultant whom asked me lots and lots of questions. I was really awkward and anxious and I couldn’t stop scratching my face. They then made Mum leave and I had to have all my physical observations done. 

As I was walked down to the clinic room, I saw another patient going into the bathroom with a member of staff. The psychiatrist introduced me to her, but she didn’t say anything. She explained that this patient was on 1:1, but I would be on 10 minute observations for now. 

Most of the patients are younger than me, but I’m not the oldest. There are a few of us who are 17, but most are around the 15/16 mark. The youngest is 13. 

Dinner was really lonely and difficult. I feel like I’m a fake and I shouldn’t be here. It’s been really hard and I’m still so, so scared. I can’t stop banging my head everywhere, it’s getting really bad, and it’s so hard to get to sleep. 

Thursday

Everything I write now is completely affected by the fact that my head is pulsing like mad due to banging it so many times. 

I was woken up at 8 and had to be at breakfast for 8:30. Quite a number of patients have eating disorders so were finding eating difficult, but others were refusing to drink even water. 

I wasn’t allowed to go to school today so I stayed in the lounge with staff and watched a movie. I had a chocolate milkshake for ‘mids’, which is mid-morning snack time. 

An incident happened this morning with another patient, but we don’t see anything (I’m glad) because all the doors automatically shut when the ‘pins’ (the alarms) go off. Another patient reassured me that it was OK and that it’s usually over with quickly.

This afternoon I’ve been doing a bit of schoolwork, but I had to go and see the advocate and talked to her about pressure from school. There are voices inside my head telling me to hurt myself and it is really hard. I have an absolutely terrible headache.

A patient was discharged today, and another was provisionally discharged on a community treatment order. We had group DBT which was alright, but slightly condescending for those of us who are a bit older.

I have reached a proper low tonight and eventually was calmed down by a Nurse. I did some word searches with a HCA and now I am going to brush my teeth and hopefully go to sleep. I am scared and sad and my head wrecks. It’s very, very tricky in here.

Friday

Today I woke up feeling sweaty and disgusting. I have 0 motivation to shower. A HCA caught me head banging so I think she might be concerned, but nobody else has said anything, despite the fact that my face is completely bruised.

I met the Occupational Therapist this morning, and she asked me questions about what I liked doing with my spare time and stuff, which seems a bit silly considering where I am now.

I’m still not allowed down to the school, so this afternoon I went into the Art Room with another patient and some staff, and I made a glittery new sign for my door. Two patients have gone on weekend leave today, and someone else has been discharged, which I thought was surprising because they seemed quite unwell.

Afternoon snack was horrible because a health care assistant was pouring random amounts of milk which was really upsetting people, and other patients still aren’t drinking. I have now swapped rooms with a patient on 1:1 so that she can have her own room, and I am now sharing with someone. 

Mum and Dad came to see me today but I was really grumpy because I’m tired and my head hurts like hell. After they left, another HCA did some word searches with me and I did a relaxation session with a counselling volunteer. 

I feel like I have to hurt myself and my suicidal thoughts are quite suffocating tonight. I’ve been pacing up and down the room, banging my head and scratching my face trying to get it to go away. I don’t know what I want. 

Saturday

I had an alright night of sleep last night, but a HCA caught me self-harming again, so I think they’re suspicious and that worries me. 

Before mids I was really struggling with my head telling me that it had to be every twenty minutes, which was pretty demanding. But shit. Staff have noticed my black eye (which pretty much makes me look like I’ve been beaten up) so I’ve been put on 1:1 which is really, really shit. I now have no privacy and I feel completely crazy. 

Before Mum and Dad’s visit, staff had to calm me down and stop me from self-harming but luckily I was able to control it. 

Mum said that my friends might be able to come and see me at some point, but I didn’t like talking about school. I don’t even know what my Y13 timetable is. I’m just trying not to think about the consequences of missing so much. 

I want to hit my head against a wall. I want to cut. I want to sleep. I want to have a wee but I’m reducing my water intake because I’m on OBs. 

A Doctor looked at my head and although she said that I seemed alright, she told me about the complications of doing it (brain damage) and it has just scared me even more because now there’s two different things telling me what to do. 

Sunday

I managed to get to sleep OK last night. It was really warm, so I opened my window, much to the annoyance of staff sat on my observations. 

I woke up on time but had to wait for a female member of staff to come onto my OBs so that I could get changed. Breakfast wasn’t so good, I almost immediately got taken out and had to be calmed down. 

For the rest of the day I sat colouring and watching the music channel. Mind numbing stuff. I have my own room again now, but I feel awful because I had to swap with another patient and she really wanted her own room. 

When Mum and Dad came I was allowed on Facebook and it was kinda upsetting because nobody had messaged me. I am really worrying about school. 

Monday 

Today has been a really tricky day and I am feeling overwhelmed and pretty hopeless because I don’t want to be so messed up anymore, but I can’t get it out. I just have to live with it and the consequences.

I slept with the duvet on last night despite it being really hot, because someone was watching me on my OBs all night. This meant that I woke up really sweaty, so I dragged myself into the shower which was pretty humiliating with staff watching. It wasn’t actually that bad, I just turned the other way. 

After breakfast I was feeling really low so I was taken into the art room, which is my favourite place on the unit. There’s a really, really nice Frozen painting in there that someone did. We then had a ‘care plan group’ in which we had to write down our goals for the week, and how my week has been. I wrote down loads and I actually liked the activity because I’m so much better at expressing myself when I write. 

Then I had a meeting with the advocate in order to prepare for my CPA. She’s really nice but she didn’t listen to me all that well. At the CPA there was myself, Mum, the advocate, a secretary, my outpatient worker, a student nurse and the occupational therapist. They told me that my behaviour is unsustainable and that I should be gradually taken off high OBs when I’m ready, and that my next CPA is in 4 weeks time. 

However, after mids shit really started going down. The voices in my head were so loud that as soon as my OBs turned away, I was off. Before I knew it, people were on me and the alarms were ringing and they took me (in a not very dignified way), to the low stimulus area. They had to calm me down with a lorazepam injection, which was not fun and made me feel really embarrassed because there were men in there.

When I went back into the lounge after calming down, everyone stared at me but I just went back to colouring, and then Mum came to visit. I’m sad because my sister isn’t allowed to visit me because she’s under 16. 

Tuesday

My face is looking better today. It’s ward round day, so there was no school this morning. I’ve been colouring but it’s becoming so stressful because I keep forgetting what page I’m on. It’s the same with my reading books. I’ve been told I’m not allowed to do any schoolwork for now. I’m trying to think positively. It’s not the end of the world. I wrote down a list of stuff I need to do for school anyway and it really calmed me down. 

I had ward round this morning with the consultant. She thinks that I have OCD but my community team have never mentioned this before so it’s confusing. She is also having me assessed for a section in order to be kept safe. This made me really angry and upset, and caused a whole round of incidents and having to be calmed down and reassured.

I had a chat with a nurse after dinner, and we talked about self-harm but also about school and anxiety. She made me feel like I’m not a fake and I do deserve to let myself get better. I also saw my Mum and rang my brother, who pretended that he didn’t know who ‘Rosie’ was which was strange. Mum just says he’s dealing with things in his own way. 

I am really distressed because incidents are kicking off all over the place with other patients and just the sound of the alarm is escalating my thoughts.

Wednesday

Last night did not go well. I was sat in the lounge struggling so badly, when I overheard staff talking about other patient’s self-harm. There were incidents kicking off between two other patients for ages and I feel really guilty in case I had triggered them. 

I started crying and crying and was taken to my room with 2 members of staff for a chat, but shit went down and I lost it and I had to be restrained, taken to the LSA and given lorazepam again. 

After breakfast this morning I did more word searches, coloured and watched the music channel. I was feeling pretty shit because I knew I was about to have my assessment. The assessment was with the consultant, another psychiatrist and a social worker/mental health specialist. They asked me about the overdose, how I’ve been feeling over the past few days, about suicidal feelings, and self-harm. 

After the assessment I had to see a general health Doctor to look at my head and eyes, and my outpatient worker who just wanted to know how I was. She said that when I’m a bit better she’ll be able to take me out on leave for a drink or something. 

They then came back and told me that I was now under a section, which has really annoyed me because I was really honest with them. I’ve been kicking off and having to be calmed down non-stop after that. I just feel like well whatever, they didn’t listen. I just don’t want to be here anymore. 

My best friend came to visit me this evening, but she got really upset because of how unwell I look. I then had to see another Doctor who looked into my eyes and basically said there was no damage, yet. 

My bed has been moved into the middle of the room, and I have to sleep with my arms out of the bed which is really annoying. I feel so stuck and hopeless and I don’t know what’s going to happen, but I feel like I’m not even me anymore. 

This is the end of my first week in a psychiatric unit. I was placed on 1:1 and sectioned. This was the hardest time of my life, and I’m happy to say that things would get so much better than this.

Overcoming panic attacks on train journeys

Overcoming panic attacks on train journeys

So this past weekend I’ve been in Birmingham with my best friend, Victoria. It might not seem like a big deal to others, but it was a pretty big deal for me to get on a train, alone.

The last time I had been on a train was in October when I had travelled to Boston to visit my friend, Lauren, who was in hospital there. It was a lovely trip (in the end), but I got really, really lost and ended up crying on a random street pavement miles away from the unit wondering a) why I hadn’t brought my portable charger and b) was I ever going to get home?

But it’s not so much that I’m scared of going places on my own. It’s just that being on a train is a really draining experience for me because it’s difficult for me to stay calm. Stuck on a train, surrounded by sweaty strangers, with the doors locked until each stop, I always feel like I’m trapped. And if there’s anything that sends my anxiety into Beast Mode, it’s feeling trapped.

Here are my top 8 tips for surviving a train journey with anxiety:

  • Get to the platform well before departure time 

This isn’t so ideal when the train isn’t beginning its journey from your station, but it’s always sensible to avoid a rush if you can. Check the board for updates, and try to get on the train as soon as possible so that you can get a good seat.

  • Have your tickets to hand 

I always worry about losing my tickets and having the embarrassment of being escorted off the train by an angry ticket collector. This is an unlikely possibility, but I always make sure I know exactly where in my purse the ticket (not to be confused with the collection receipt or seat card, which are conveniently the exact same shape and colour).

  • Choose some calming music to listen to on the journey

I always make sure I have space on my phone to download a good set of tunes off Spotify to listen to on the way. ‘Calming’ music can mean different things to different people – sometimes listening to badass songs makes me feel more confident.

  • Try to sit in the Quiet Carriage 

On all trains, there should be a Quiet Carriage. This one is usually next to First Class, but it can differ. In this carriage there won’t be (or shouldn’t be) any noisy families or aggressive bunches off to a football match. This is the place where I feel most comfortable, and where I don’t feel pressured to talk to the strangers around me (sorry).

  • Keep texting your friends and family

Like I wouldn’t be anyway. Just talking to my friends about they’re up to or something completely random really distracts me from the fact that I am stuck and can’t get off the train until it stops.

  • Download some fun games on your phone 

Recently Victoria has introduced me to a really fun app called ‘Episodes’, where you basically ‘play’ a character in a TV series (my favourite is Pretty Little Liars) and get to make different choices in order to twist and turn the outcome of the story. I love these kind of simulation games and find them a good way to detach from reality for a short while.

  • Don’t be afraid to talk to the station staff 

When I was struggling on Friday, a kind member of station staff approached me and really helped me out. She helped me to calm down and assisted me onto the next train, putting me in a quiet area near the front of the train. She explained to me that they treat anxiety like a physical disability, and if you talk to a member of staff before you board the train, they will do their best to make you feel more comfortable.

  • Take medication as a last resort 

It’s tempting to ask for PRN (emergency medication to calm you down – usually diazepam) from the GP in order for me to be able to go on trains, planes and ferries, but it’s not a long-term solution. If anything, it reinforces it. I become dependent on it and feel like I can never go on any journey without taking it. If pushed to the limit, I would take it as a way of completing my journey, but I try to avoid being dependent on benzodiazepines.

      Me and Victoria spending time with her puppa, Harlyn 

The difficulty of presenting mental illness in mainstream media

The difficulty of presenting mental illness in mainstream media

Recently there has been a lot of controversy on my news feed about To The Bone. For those small few of you who don’t know, it’s a depiction of a young woman’s struggle with anorexia nervosa and attempt to work within a sort of ‘halfway house’ in order to avoid being sent back to an inpatient unit or becoming fatally unwell. For many people, it seems like a ‘mental illness follow up’ to the hit Netflix series 13 Reasons Why, which explored different elements of mental health: depression, self-harm and suicide.

People have subsequently accused Netflix of capitalizing on the romanticization of mental illnesses so commonly seen on sites such as Tumblr. The site has been accused of putting vulnerable lives at risk by portraying such sensitive and ‘triggering’ issues. It seems to be virtually impossible for Netflix, or any other label, to ‘get mental illness right’.

The unfortunate truth is that those who are most affected by these issues are the ones most likely to become upset or outraged. Having suffered with issues seen in these shows myself, I found myself getting annoyed because ‘that wasn’t like my experience’ or ‘I don’t want people to think that’s what depression is’. I was worried that these films would cause more issues. That they would make suicide seem romantic, or anorexia seem beautiful.

This isn’t the right way to look at it. We have to face these issues. We can’t hide away mental illnesses. They can’t carry on being ignored, shoved into the back of people’s minds. We need people to understand the scope of suffering that rushes through someone when they are dealing with these things. We need to get people talking about mental health, we need to get people showing support to others, we need to get the conservation started. And this is what these TV shows are doing.

  • It is always going to be an imitation. 

What we see in shows is never, ever going to be the real thing. It doesn’t matter if the actor has struggled with this issue in the past: they are putting on a performance. They are being directed and no matter how much emotion goes into it, it’s always going to be artificial. That is the case with all TV series and films, over all issues. But with mental illness, it’s hard to get it right without it being ‘real’. This has to be accepted.

  • Mental illness affects everyone in different ways. 

No one person has the same experience with mental illness. Even with the same illness, people experience different symptoms. You might not understand how sexual harassment, bullying and loneliness could push someone to commit suicide and lash out at everyone else (because you know, mental illness isn’t always sweet and nice), because that wasn’t how you felt. Maybe you were pushed to the edge by something else. But that doesn’t disqualify other people relating to Hannah Baker.

Similarly, no two of my friends or family members with anorexia are the same. People have different triggers, different perceptions, and different attitudes to their illness. Some people do use humour to lighten a shitty situation. Some people are angry and bitter. Some people seem happy on the outside but are actually keeping a harrowing storm within.

  • People also have different experiences with treatment. 

This is especially true with services in different parts of the world. Many people from the UK have kicked off about these two series, complaining that the depiction of treatment ‘wasn’t realistic’. However, this is assuming that everyone in the world has the same healthcare as those of us who live in the UK. This is obviously wrong. When money is so much more closely involved with health services in the US, things are bound to be different. The section system that exists here is not the same as there. In some ways, you can’t be forced to get better.

  • It’s impossible to go into complete depth. 

The presentation of mental illness at any one point is only the tip of an iceberg. A whole life full of events and thoughts can contribute to an illness, which would clearly impossible to present in a film or even in a long TV series. It would be time-consuming and boring to go through every single factor of a complex illness. This is therefore up to the viewer to understand what could have possibly contributed, and to get that all characters in TV shows are to some extent, simplified.

  • To sugar coat is to reduce, to present realistically is inevitably to trigger.  

It’s a lose-lose situation. If you don’t show the triggering and unpleasant elements of mental illness, people say that it’s not realistic and that it’s romanticized mental illness. That it’s not offering a rounded view of an illness, and is belittling those who struggle.

On the other hand, if you show the illness completely unfiltered, you may then be accused of triggering viewers, or blowing things out of proportion. This may be seen as detrimental to viewers.

Most TV series and films depicting mental illness come somewhere between these two extremes, and are thus condemned both for sugar-coating and for triggering.

 

I know a few years ago I would have found 13 Reasons Why unbearable. I would have fuelled my depression and urge to self-harm on it. It would have validated me. But that was a projection of my illness. And I didn’t have 13 Reasons Why so I ‘fuelled’ my self-hatred and despair on other things. And unfortunately, there are always going to be other things. We can’t stop talking about mental illness in case it ‘gives people ideas’. That’s not how it works.

But please, Netflix.

  • Please put detailed trigger warnings on films and episodes.

It’s not that difficult to simply alert people of the nature of what they are about to watch. This doesn’t mean putting ‘This episode/film may be upsetting for some viewers’. TV shows and films, specifically those revolving around mental illness (and are hence more likely to attract vulnerable people), need to have more detailed trigger warnings.

It wouldn’t take much to have at the start of the episode ‘This episode/film contains… (insert list of the most common triggers)’. They could even put the timings on so people can still watch.

  • Please show us that people can get better. 

The reality of mental illness is that people do die. People do die of complications, people do take their own lives. But please give people some hope to hold onto. Show us characters who battle through and come out the other end. Show us that not everyone is a sad story and that we can get better. Stop this love story nonsense, and give us characters with real inner courage. Give us male characters battling the emotional conditioning of our society, give us characters who aren’t conventionally attractive. Give us people, as real and as hopeful and as you can.