Suicide Awareness Month 2017

Suicide Awareness Month 2017

I want to talk about suicide and I want to talk about it now. By the time you’ve clicked on this link and read this sentence, another person in this world will have taken their own life. So many more will be thinking about it. It takes a lot of pain to make the decision that there’s nothing better than death, and it’s a decision that plays on the minds of a staggering amount of people worldwide everyday. It’s a decision that often ends in tragedy.

People think suicide is selfish. I think this is bullshit. ‘Selfish’ suggests that you’re caring about yourself and yourself only. When you’re suicidal, you care about yourself so little that you’re wishing yourself into non-existence. And often, you do care about the other people around you. You care about them so much that you feel like a burden on them, like the best thing would be for you to disappear. How can someone leave their family, leave their friends, leave everything? It’s hard to understand if you’ve never been suicidal, but the fact that these people have and love these things and yet still feel compelled to leave it all behind is so heartbreaking.

It’s thought that over 90% of people who committed suicide had a mental illness. Most will have had some contact with mental health services at some point before their death. Most will probably have felt uncertain about their decision at some point. I believe all of their lives could have been saved.

I asked over 230 people who do or have struggled with suicidal ideation questions about their own experiences. I hope you will find this really insightful and I hope that it can help you to understand it from the inside perspective.

Information about the participants 

  • 70% of the participants were aged between 18 and 25, however 16% of the participants were over 35 and 3% were under the age of 15.
  • The majority of the participants were female, however a number of participants were also gender fluid or non-binary, as well as a number of males.
  • The reason why the survey consisted of so many females is probably because not only is my social media base largely female, but because of social conditioning from an early age, men may be less willing to talk about suicide even when the answers are anonymous. This should be taken into account whilst reading the results of the survey.
  • 86% of participants reported suffering from depression, however most selected having multiple diagnoses. The other three most common illnesses noted were an anxiety disorder, a personality disorder, or an eating disorder. This is in line with what would be expected from a sample of sufferers of mental illness as these illnesses are more common with around 7% of the population suffering from depression.
  • When asked which of their illnesses they thought contributed most to suicidal ideation, the most commonly selected illnesses were depression, borderline personality disorder and PTSD. However, across the board there was variety with perceptions that any mental illness severe or untreated could lead to suicide.

Exposure to suicide

  • 75% of participants informed the survey that they had first become aware of what suicide was when they were under the age of 12. 45% of these were under 10, with 7% of those being under the age of 7. 7% reported not being aware of what suicide was until they were over the age of 15.
  • Common reasons why an individual had been exposed to the idea of suicide included: the media (particularly the news but also TV shows, films, songs and books), the social media website Tumblr, lessons at school and the suicide of someone who the individual knew. A large number of participants commented how they struggled with suicidal thoughts and wanting to die as their first memory associated with suicide.
  • A large number of participants reported having lost someone to suicide. This was in most instances an online friend (39%), a friend (37%), another child at their school (34%), a close friend (25%) and someone met whilst being cared for in inpatient treatment (24%). 21% had lost a member of family to suicide, with 9% having lost a member of immediate family.

How did the loss of this person make you feel?

When asked how they felt after losing someone to suicide, these were some of the answers:

  • Heartbroken and just clinging onto the hope that they’re in a better place.
  • Devastated for their family. 
  • Suicidal – I wanted to be with them and felt ashamed that my attempt had failed. 
  • I felt completely numb and empty. I couldn’t believe they were gone. 
  • Confused because I saw no warning signs and didn’t understand.
  • It broke me but eventually made me want to help others who have been at that point in their lives where they want to give up. 
  • Guilty because I felt like I could have done more. I felt like I was to blame and there was something I could have done to save them. 
  • Shocked and angry that nobody helped them, that services didn’t help them, that people are killing themselves as a way out because mental health services are so awful. 

If you could speak to this person now, what would you say?

  • I love you. Please don’t do it. It gets better.
  • My darling I miss you so much and I’m so sorry.
  • Please speak to me. You’re not alone. 
  • It’s not the answer.
  • I miss you and I love you so much. 
  • You are enough and will get through this pain. We can do it together. 
  • I am so proud of you and you will never understand how much I valued you.
  • I still love you and I always will. 
  • I’m so sorry. I should have done more. 
  • I’d tell them that they have the most beautiful baby girl they never even knew was going to be here. 
  • There’s always something better around the corner. 

Personal experiences of suicidal ideation 

  • Of the 230 participants, 18% were under the age of 10 when they first started getting thoughts about suicide. This really goes to show how CAMHS need to work on early intervention, especially with vulnerable children. This could save lives. 30% were between the age of 11 and 12 and 26% were either 13 or 14. This means that 76% had thought about suicide before they had even gone through puberty.
  • Common reasons listed for first having these thoughts included: bullying, traumatic events, the death of a family member, divorce, sexual abuse, being neglected, figuring out sexuality, difficulties in the home environment and a generally unstable childhood.
  • 90% of participants said that they did not tell anyone when they first started getting these thoughts.

Personal experience of acting on suicidal ideation 

  • 92% of participants had made an attempt to take their own life, with 67% having tried prior to this to tell someone how awful they were feeling and how much they were struggling. Please listen.

Perception of contributing factors towards suicidal ideation 

  1. Severe depression (84%)
  2. Untreated mental illness (74%)
  3. Being bullied or isolated (73%)
  4. Emotional abuse (72%)
  5. Pressure of exams (52%)
  6. Sexual abuse (46%)
  7. The loss of a loved one (40%)
  8. Physical abuse (40%)
  9. One or more psychotic episode (30%)
  10. Adverse effect of mental health medication (29%)
  11. Pressure of work (28%)
  12. Exposure to the suicidal ideation of others (27%)
  13. Financial difficulties (22%)
  14. Misuse of drugs or alcohol (20%)
  15. Parental neglect (19%)
  16. Being unemployed (18%)
  17. Prejudice faced for being in a minority group (13%)

Why did you feel like suicide was your only option?

  • I couldn’t think of anything else.
  • Lack of support from mental health services leading me to think that there was no hope.
  • I lost my best friend and couldn’t cope without her. 
  • I felt no joy in being alive and I felt like it was too hard.
  • I felt like everyone else was better off without me and that I was a burden. 
  • The pain was just too much. 
  • I didn’t know how to kill the mental illness without killing myself.
  • I was so exhausted and tired and I didn’t want to try any longer.
  • I was too scared to continue my life as it was. 
  • I had already lost everything worth living for. 

If professionals were involved after an attempt, what care did they put into place?

  • 80% said that mental health services were involved after they attempted suicide, meaning that 20% did not even have a risk assessment.
  • Many patients said that they were either sectioned or admitted to an inpatient ward informally, however a large number of others commented on how their life was put at risk multiple times before they were taken seriously and admitted. A considerable number of participants said that they received no help after, despite mental health services being involved.
  • Other treatment options were access to the crisis team/home treatment team, a referral to CAMHS or Community Mental Health Services, or being placed on medication.
  • 75% of participants said they had received psychiatric medication as a treatment to help reduce suicidal ideation. This was almost on par with therapy, which 74% had received in some form.
  • 62% of participants were or had been under an outpatient team and 61% had intervention from the crisis team at some point.
  • 57% of participants had been admitted to a psychiatric hospital at some point for their suicidal ideation. 2% said they had never had one appointment with mental health services, despite being in general for an attempt.
  • Participants voted therapy as the most helpful treatment for suicidal ideation, with inpatient treatment second and medication third. Many commented that no treatment so far had been helpful.

Why is there so much stigma against suicide?

  • People don’t understand. 
  • People don’t expect them to succeed.
  • People joke about it all the time. 
  • Because there are so many attempts for every completed so people think it will never work. 
  • They think if you confide in them they you won’t actually do it. 
  • People think that it’s selfish or attention seeking. 
  • They don’t know how to help so they just brush it to the side.
  • They think if you really were suicidal, you would have just done it. 
  • Some use suicide as an empty threat. 
  • From the outside, it often looks like they have nothing to be ‘sad’ about. 
  • Generally people don’t know what to say. 
  • People get confused between non-suicidal self-harm and suicide attempts. 
  • Others are more comfortable believing that no one is capable of taking their own life. 

How have family reacted to your suicidal ideation?

  • They were sad but not surprised. 
  • They were shocked and really angry.
  • My Mum was devastated.
  • They were really confused and kept asking me why. 
  • They were dismissive and almost tried to deny it. They couldn’t believe it. 
  • They called me selfish. 
  • Just went on like normal and pretended that nothing happened. 
  • They didn’t get it because I was high functioning. 
  • My parents threatened to kick me out. 
  • They didn’t know and they still don’t know now. 

How have friends reacted to your suicidal ideation?

  • It really upset them. 
  • Confused, worried, but supportive.
  • They didn’t know and it took me a long time to finally talk about my past.
  • They didn’t know what to do so they just stopped talking and hanging out with me. 
  • I didn’t have any friends at the time. 
  • They felt like I was being a negative influence so their parents kept them away from me. 
  • They seemed upset but also that they didn’t really care because it hadn’t worked.
  • Some blamed themselves and wished they had known how to help. 
  • They thought it was for attention or that I was being over the top. 

What things should you never say to someone who is suicidal?

  • Other people have it worse.
  • Suicide is selfish.
  • Just get over it.
  • Snap out of it.
  • If you wanted to do it you would have done by now.
  • You don’t actually want to die.
  • You have a life other people would be grateful for. 
  • You’re attention seeking. 
  • I would never forgive you if you did that. 

What things have been helpful for you to hear when you have been suicidal?

  • ‘I love you. I’m here for you. It’s going to get better’
  • ‘You’re loved and valued’
  • People listening without judgement. 
  • Others stories who serve as proof that things can get better.
  • ‘You are not alone in this’ 
  • ‘You’re important, please hold on’ 
  • ‘I’ll be here for you no matter what happens. I’m not leaving’ 
  • ‘The feeling will pass. You’re alive and you’re wanted’ 
  • ‘You’re at rock bottom. It only gets better from here’ 

What do you wish that other people understood about being suicidal?

  • Just because I am still here and still alive doesn’t mean I’m not struggling with it everyday. 
  • It’s not selfish and it’s not easy. 
  • It’s not something that you can just get over.
  • I am in so much pain and your ignorance is making it worse.
  • This is the point where I really, really need help. 
  • It’s not all inpatient admissions, it’s being turned away by services because nobody takes you seriously.
  • I don’t necessarily want to die, I’m just tired of living. 
  • Please do not shame me for trying to get the help that I need to stay alive.
  • This is a heavy load to carry around. 
  • It is a symptom of a treatable illness, and I will get better.
  • It isn’t easy and it’s not something that I’ve ever wished for. It’s torture. 
  • You never know what is going on in someone else’s head. 
  • We need help, and reassurance, and support.
  • I am terrified to die, but my illness also makes me terrified to live. 

What warning signs should loved ones look out for?

  1. Actively looking for ways to seriously hurt themselves e.g. stockpiling tablets
  2. Talking about death, both in a negative and a positive way
  3. Becoming increasingly withdrawn from friends and family
  4. Making threats to harm or kill themselves
  5. Complaints of feelings of hopelessness
  6. Lack of concern about the consequences of any actions
  7. Increased self-harm
  8. Losing interest in things previously enjoyed

How do you think that mental health services can help improve care for people who are observed to have suicidal ideation?

  • Support them and check in on them on a regular basis. 
  • Offer them the option of an admission. 
  • Set up support for points of crisis before they actually happen. 
  • Keeping them safe in hospital if there is any uncertainty. 
  • Providing a healthy medium where inpatient assessments are done more thoroughly so that patients aren’t institutionalised to the point where they can’t cope on their own, but also that they aren’t left with no help when they need it the most.
  • Regular support from a key worker. 
  • Having a 24/7 text service as many people struggle to phone crisis teams, or don’t have access to them. 

How do you keep yourself safe now?

  • I realised that my life is important and started actively looking after it. 
  • Keeping myself surrounded by other people. 
  • Using the crisis team as much as I can when I’m struggling. 
  • Distraction techniques.
  • Using PRN medication to calm down. 
  • Keeping regular appointments with services and frequently checking in with my GP. 
  • I try to keep my house a safe place with as little danger objects as possible.
  • Practising self-care routines.
  • Keeping busy so that I don’t have the time or energy to act on these thoughts. 
  • I’ve learned to recognise my own triggers.

And finally. The most important question. What are your reasons for staying alive?

  • My pets.
  • My partner and my family. They don’t deserve to lose me. 
  • Hope for the future.
  • To prove everyone else wrong.
  • To get my degree and carry on making victories against the odds.
  • Christmas, birthdays, nice meals out, nights out. 
  • Because I believe that happiness is waiting for me somewhere. 
  • To not let my little sister grow up without me. 
  • Seeing the sunset/sunrise. 
  • Beautiful views, hot summers, cosy winters, parties, graduation. 
  • Finding my own place on this Earth. 
  • Yummy food I still need to try!
  • I’m not going to let the abusers win. 
  • New reasons of my favourite shows and new books by my favourite authors being released. 
  • To eventually help others. 
  • To carry on learning and growing as a person. 
  • The prospect of so many opportunities.
  • Ice creams, hot tubs, face masks, bath bombs, bubble baths, crappy TV shows… 
  • Belief that things can always get better.

Thank you so much to everyone who helped me to put together this post. It’s definitely been the hardest thing I’ve ever put on my blog, and I hope that it is insightful. We need to talk about suicide and we need to pull together to change attitudes and save lives.

If you have been personally affected by suicide or feel distressed, please contact Samaritans 24/7 on 116 123 (UK). 

 

 

 

 

 

 

 

How to support a friend who has been admitted to psychiatric hospital

How to support a friend who has been admitted to psychiatric hospital

In the first quarter of 2017 (January-March), there were just under 18,500 psychiatric beds available across England for people in crisis or needing long-term support for their mental illness. This is despite the fact that in every year, 1 in 4 (or over 16 million adults and children) struggle with poor mental health. This means that for every mental health bed across the UK there are roughly 865 people suffering from a mental health condition.

Of course, not every one struggling with a mental health issue needs to be hospitalised, but 865 is still a staggering number. If even 3 in each of these 865 per bed were in crisis, only 1/3 of them would receive the treatment that they needed. It’s a horrifying statistic, and for many people, there’s just no bed available. And if there’s no mental health bed, you can’t even be legally detained under a section.

I guess in a way I have been lucky to have been cared for properly when I was in crisis. If anything, getting admitted to hospital highlights an adequate response to being unwell. I was ‘lucky’ (I sure as hell didn’t feel it at the time) to be recommended for a mental health act assessment and then sectioned in order to keep me in hospital. I was ‘lucky’ to have been transferred to a PICU (the only bed in the country was in Sheffield, a huge relief considering I could have been sent anywhere) instead of being discharged for self-harm that staff just couldn’t cope with.

I have had direct experience of being treated for in a psychiatric hospital. A year of my life has been spent inside the walls of 4 different hospitals. It was the best thing for me each time I was in, but the experience itself was no fun. You can read more about that in my previous blog posts documenting diary entries from when I was inpatient aged 17.

But in this post I wanted to offer some advice on how to help support a friend or family member who has been admitted to hospital. It’s not rare and many people have a mental health crisis at some point in their lives. Here’s how I think you could help:

  1. Don’t push to visit unless you’ve been explicitly asked – getting admitted to a ward can be a very unsettling experience and it can take some time for anyone to get used to the environment. Whilst seeing friends can be a massive comfort, it can also be a little bit too much too soon. Give them some space.
  2. Instead, write to them. Send them post – getting snail mail is really exciting when you’re detained in hospital. Not only is it a reminder that someone actually gives a shit enough to sit down and write an actual letter, but it helps them to stay connected in their own time. Sending photos and little positivity cards is also a good idea.
  3. Remember special holidays – I can tell you now, being in hospital on Christmas Day 2015 was utter shit. It was absolutely miserable. I was lucky that my family were able to come and see me on Christmas Day, and brought presents from all my friends. People from school also sent me cards which was really nice.
  4. Find out what they are and aren’t allowed on the ward – in the open units I’ve been in, patients have been allowed pretty much anything other than the obvious sharps and conventionally dangerous items. However in PICU, the rules can be very strict. The majority of patients aren’t allowed rubbers, socks, anything plastic, more than one teddy, anything that could be ligated with, or anything that could be broken. Don’t send them anything they could use to hurt themselves.
  5. Educate yourself on mental illness – take some time to try to understand your friend or family member without being judgemental. The stigma against mental illness is phenomenal, and honestly it meant so much to me when my friends read up on BPD and were able to talk to me about it and how they could help.
  6. Don’t blame yourself and don’t feel responsible – in a mental health crisis, being on the ward is the safest place anyone can be, when treated properly. Don’t waste time worrying about how you could have done more to prevent this from happening, but instead keep showing this person that they’re loved and cared about and that you will be there for them every step of the way.

There are plenty of services where you can talk about your own struggle with mental health issues, or to vent and help yourselves when coping with someone close to you struggling.

The 24/7 helpline rang by SAMARITANS is 116 123.

 

 

Oh shit, I don’t think my brain is functioning properly

Oh shit, I don’t think my brain is functioning properly

 

Today is just one of those days. One of those days where getting out of bed feels like an overwhelming effort. One of those days where my thoughts are lagging, all excitement gone. One of those days where it feels like I’m always going to be like this.

It isn’t an unsafe day. In fact, the days when I am at the highest risk of serious self-harm or suicidal ideation are days when I’m manic for longer than a few hours, or when my mood is swinging rapidly. Today is just a shit day with nothing to show for. If I can’t find the energy to drag my sorry butt out of bed, I certainly don’t have the energy to do much else, including hurt myself.

Contrary to common belief, self-harm takes a lot of bravery. It hurts and despite how crap I might be feeling, it does scare me. You go too far. You begin to worry about the pain. Doubts kick in. Everything crumbles. I’m not brave today. I’m weak and I’m vulnerable.

On days like this, all I want to do is be asleep. It’s the easiest thing. When I’m asleep, I’m safe. I’m out of it, in a little dream world where things can be scary, but not in the way that I know with my mental illness. I can’t remember ever having a dream in which I self-harmed or killed myself.

Today, my head hurts. It’s pounding. Everything is too loud. I think about how loud it is, and I start spacing out. Am I a real person? Is anyone else real? Was my brain always going to be like this, or did something happen? I am slipping.

Today, my stomach is sinking. I have no hope for the future. I can’t even see tomorrow ahead of me. It’s just a black hole. I have nothing in the future. I am stuck in the present, with these thoughts lagging around me. It makes it hard to breathe.

Today, everything is grating on my nerves. A harsh word, an accident, and everything is fizzing. I have this dull anger which is directed at nobody apart from myself. It feels like I’m trying to scream, but I can’t, so it just comes out as a whisper.

These days don’t last forever. For all I know, I could feel better in a few hours. The sinking feeling is temporary, despite how permanent it feels in the moment. I am not drowning. I can breathe and I can live, despite what my brain is telling me.

Writing these feelings doesn’t make me feel significantly happier but breaking out from the nothingness of this cage my brain has made does evoke a small sense of release. This might be a bad day, but I am not a bad person and I will continue to fight as hard as I can to stop my illness from doing bad things to me.

emotions running high 3

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

 

 

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

 

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 truth about anti-psychotics

The truth about anti-psychotics

For the past two years I have been on and off anti-psychotics. When I was detained under section, from summer 2015 to the summer of the next year, I had no choice in the matter. However, as I’ve gone through my own recovery journey, I’ve come face-to-face with some real misconceptions about these drugs, as well as stigma from friends and family who I have confided in about being on this medication. So, I wanted to sets some things straight.

Anti-psychotics aren’t just for psychosis 

Although sufferers of schizophrenia, psychosis and other ‘psychotic’ disorders are usually treated with these drugs, they are not the only ones and the prevention or minimisation of psychotic episodes is not their sole purpose. Being prescribed this medication alone does not mean that you have been diagnosed with a psychotic illness.

Many anti-psychotics, quetiapine being an example that springs to mind, are used to help with irritability, agitation/restlessness, or insomnia. They are often used in small doses to help patients to relax, or to get to sleep.

Another use is for severe depression, particularly for those who have been resistant to conventional anti-depressant such as SSRIs. In many cases they work brilliantly, especially for those who are difficult, or whose depression can manifest in violent or problematic ways.

You can live a pretty normal life on anti-psychotics

Contrary to common belief, being on anti-psychotics isn’t a treatment solely reserved for those in inpatient care. Many people in the community are on these drugs long term, some of whom you might not even realise have serious mental health problems. Struggling with psychosis, or another condition that requires these drugs to be used, doesn’t mean necessarily that you’re a danger to yourself or to anyone else. It’s just like taking any other preventative medication.

Being on these drugs doesn’t mean that you will put weight on. And if you do? It’s not forever 

I will admit this to you. During the time that I was on olanzapine, I gained an obscene amount of weight. It was terrifying and I a lot of the time, I felt disgusting. But in reflection, the drug itself didn’t make me put on weight. Most anti-psychotics don’t decrease your metabolism and don’t increase the amount of fat stored. They just increase your appetite. So if you can stick to the same diet that you were on before, nothing will change.

The issue with me was that whilst I was on olanzapine, I was pretty much stuck in the same hospital lounge all day, and eating did become a source of activity. The combination of complete lack of exercise, boredom and shitty hospital food meant that I did gain weight. But, as soon as I came out of hospital, despite still being on olanzapine, I lost the weight incredibly quickly.

I don’t regret being on olanzapine because when I was experiencing stress-induced psychosis and severe depression, it helped me. It got me out of hospital and to the point where I could be safe and stable in the community. And I would choose my mental health regardless of short term weight gain any day of the week.

Be really careful with alcohol

Anyone who is on anti-depressants will have been told by Doctors that you have to be careful. This is even more so if you are on anti-psychotics. To the extent that ignoring medical advice is dangerous.

I really wouldn’t recommend getting drunk on anti-psychotic medication. Two drinks on a full stomach and I personally have been fine. But get properly drunk and it’s a complete nightmare for you, and for everyone around you. It’s messy and it’s extremely difficult for your friends when you’re completely losing it and nobody knows what to do and whether someone needs to call an ambulance, or the police.

Not to mention the fact that there’s an awful hangover. Be sensible.

Don’t try and come off them on your own 

One of the most common mistakes with anti-psychotics is the urge to just stop taking them, because you feel like you don’t need them anymore. You might presume that the ‘comedown’ would be a bit like suddenly coming off anti-depressants –  a headache, nausea, mood swings, irritability. It’s not.

Coming suddenly off a high dose of anti-psychotics can induce severe episodes of psychosis, even if you don’t suffer from psychosis and weren’t prescribed them for this reason. It suddenly shifts the dopamine in your brain and can cause serious problems. It’s best to come off them gradually, preferably with the advice of your Doctor.

Picture from – https://theamazingworldofpsychiatry.wordpress.com/2010/10/11/review-meta-analysis-of-antipsychotics-and-cognition/