2018 a (brief) review of the year

Some naughty elves decorated the office
A collage of pictures of Christmas decorations in the office

Before the earth makes that turn moving the UK into 2019 I thought I’d do a 2018 roundup post because it’s been a pretty intense year. At Christmas 2017 I said my goal for 2018 was to become permanent staff even if it was still on reduced hours but to have the security of a proper contract not a zero hours one.

The year didn’t get off the best start with my first trip to a&e of the year on the 2nd of January this was also the only visit to a&e all year, just over two weeks after this I started a new medication Lamotragine a mood stabiliser. I’m sure that lamotragine has been the biggest reason that I haven’t self harmed its almost like it’s turned something off in my brain that’s made me not want to self harm anymore.

My main goal for the year came true in May when I became permanent staff and took over running the youth service, in November I passed my 6 month probation so now I’m officially permanent staff running a service, managing volunteers a year after I said I wanted to be permanent.

A picture of a letter confirming that I passed my 6 month probation

I’ve been under the mental health service again this year slowly adjusting my medication and I’ve now come off the antipsychotics, reduced one of the medications I was taking for anxiety and only taking the bets blockers as needed. I’ve gone from taking 5 different medications for my mental health to 3.

For someone who often struggles with change there have been so many this year, changes with my job, and the people I work with, two of the people I was closest with at work both left within a few weeks of each other which has been hard and still hasn’t fully sunk in. The office is definitely quieter and I’m missing my verbal sparring partner, I’ll also the person who will always find something positive in everything who took me outside to the carpark to cry because she knew I wouldn’t want anyone in the office to overhear me.

I’ve also become closer to other people at work including two who started at the same time as me, I’ve been out for various drinks and social events (enough to maybe get a reputation) and I’ve had some lovely feedback and support from my volunteers.

As an incredibly indecisive person who struggles to make a choice when there are too many desserts on the menu I bought myself an early Christmas present and got my first tattoo covering some of my self harm scars something very permanent but positive and I love it so much.

A collage of pictures of my new tattoo a caduceus with the words omnes te moriturum amant above it

So 2019 will be off to a busy start with work but also starting with a huge milestone of a year since the last time I self harmed. Of course my love for a certain tv show about a certain grumpy dr has been in full force in 2018 (is a tattoo taking the fandom too far?) and I’ve spent my time off over Christmas working my way through Sherlock, 2019 is looking like a busy year for my fandoms.

Happy new year or happy January or happy Tuesday whichever suits you

Georgiesaurus ☺️🦖

Rocket Science

If you can’t here expecting a review of a lush  bathbomb then sorry to disappoint you this is a rant about mental health services, maybe try Lulu or Jen

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A blue rocket shaped bath bomb made by Lush cosmetics

I am not a frequent flyer, I don’t have air miles I haven’t been on a plane in years and the last time I went abroad was to Edinburgh by train. Despite this I and other in a similar are labelled frequent flyers or regular attenders (this is meant to be the better term) because we find ourselves in situations where our mental health has got to a point when we need support and intervention often requiring medical attention as a result of harming ourselves.

Self harm isn’t something people do for fun or because they enjoy being in a&e it’s because emotions become overwhelming (and this is a very simplified explanation of a complex issue) and as I’ve written before the treatment once you’re at a&e is often not pleasant or equal to the treatment of people going in for accidental injuries with long waits in loud and busy waiting areas and psych liaison who at most may give you a leaflet and discharge you at 4am with no way of getting home.

It’ll be no surprise that this latest rant is inspired by a crisis concordat meeting this morning, two hours of frustration at having to bite my tongue in frustration at the language used and throwaway comments about people with personality disorders and the triggering content in the suicide prevention information listing the age groups and sex of people who ended their life and details of methods chosen again separated by sex.

Sometimes I look at the people sitting around the same table as me and wonder how they can be so oblivious to the blatantly obvious, do they really not see the link between the high numbers of people in Richmond who come into contact with the street triage team and the above average number of people detained under section 136 of the mental health act and the complete lack of crisis services in the borough? Are they actually surprised that people who are distressed or in crisis don’t want to travel an hour or more to an area they may not know to get support? And may not have the means to do so? It really isn’t rocket science or a difficult connection to make, I don’t exactly consider myself the sharpest tool in the box yet I can see it so why can’t they?

Aside from Mind since I’ve been a part of the crisis concordat (around 2 years now) and the outcome based commissioning program (coming up for 8 months) only one person has actually asked me about my experiences of a&e and the treatment I receive it still seems like a radical idea to most of the people involved to actually listen to someone who’s been in the very situation they’re talking about. Despite feeling like i’m banging my head against a wall (thanks Steph) and frequently coming away wondering if being there serves any purpose I still keep going if only to play my own version of crisis bingo.

All Roads Lead to A&E

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“If you’re struggling you can go to a&e”

“If you really need support go to a&e”

“There’s always a&e if you’re in crisis”

Have you ever sat in a busy a&e waiting area? I have, 35 times between January 2015 and now. It’s not much fun, long waits, uncomfortable seats and lots of sick people. Now think about sitting in that environment when you’re in extreme emotional distress, maybe feeling suicidal or wanting to harm yourself, it’s not a very nice environment at the best of times let alone when you’re in crisis.

Someone at a mental health crisis planning meeting recently said that everyone under a mental health service should have a detailed crisis plan drawn up in collaboration with them, their mental health team and carers/ family/ partner where appropriate; this seems like a sensible suggest except there are no crisis services. Mental health isn’t 9 – 5 people are more likely to be in crisis outside those hours when there are less things to do or people to see and when they’re more likely to be alone.

As I’ve said before I’m a regular at a&e a “frequent flyer” or “frequent attender” but I’ve never been pre crisis or because I want to hurt myself it’s always been afterwards. I’m used to it now I know the drill busy Drs and nurses on 12 hour shifts earning far too little don’t have the time, energy and often experience to sit down and talk about what’s wrong they often see stitching my arms up as an inconvenience when there are people who aren’t there because of self inflicted injuries. Sometimes I see the psych liaison which is more waiting usually on the “observation ward” a holding pen in a&e where people are dumped to avoid breaching the 4 hour rule, because there’s no a&e in my borough the psych team aren’t from my area or the services that operate in it, I’ve been discharged by the psych team in the early hours of the morning with no way of getting home and told to wait in reception until the buses start running, when I told them I was suicidal I was given a leaflet (it went in the bin as soon as I left).

When I was under a mental health team they’d let them know but now a letter gets sent to my GP and that’s it, no follow up, no further support, no one pretends I won’t be back again, my self harm has been described as chronic and not a concern because it’s been going on so long despite having permanent damage to my arms and recently a cut that took over a year to heal. I don’t see a&e as a place of support it’s not the appropriate place for people with mental health problems yet all over the country it’s the only option for so many people, the police and ambulance service are as frustrated by it as I am, although the police have some powers to take people to the minimal crisis services that exist the ambulance service has no option but to take people in crisis to a&e whether they want to go or not.

It may sound defeatist to say I’d only go to a&e after I self harm because I don’t see the point in going beforehand but the experiences I’ve had in a&e don’t feel supportive and often leave me feeling worse. At the last mental health crisis service meeting I attended a paramedic spoke about her frustration at not being able to take someone in distress to a more appropriate place than a&e, despite there being two crisis cafes and a crisis and recovery house covered by the mental health trust my borough comes under (though not actually located in my borough) only the police can actually take someone there the paramedics only option is to take someone to a&e whether they want to go or not.

A&e should be the last option not the only option it should only be considered after all other options have been exhausted or if someone needs medical attention it shouldn’t be a place people in distress are routinely sent to.

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