what do to when your emergency care plan means nothing?

Question

I am under the care of a mental health unit & have been for a long time.  Because it is associated with the hospital & I have had several psych ward admissions & ED presentations for self harm I am know & it is known I have the care plan (in fact they know me by my voice when I call).

My psychologist has been away sick for 2 weeks & my psychiatrist on holiday for the past week, so basically all those who know me haven't been around.  Last night I called the acute team in a crisis situation.  Instead of looking at my care plan & actually helping, the person I spoke to instead expected me to remember the meds I'm on, the doses & how much I'd taken.  Even after admitting I'd cut significantly & the cuts were still bleeding out of control & I'd take more than the prescribed doses of medication already, got told to take more & hopefully I would fall asleep - the last thing I wanted when the crisis was triggered by a nightmare.

Then today, again care plan not taken into consideration by those who are supposed to be helping, calls not returned until several hours later & not one person has done/said anything at all to help.

So where do you turn when you can't turn off the suicidal thoughts, when the cutting that usually helps no longer does so you cut more & deeper in a desparate effort to try to do anything, using the mindfulness & distress tolerance techniques you know are making the thoughts worse & no one is around who is willing or can actually help.

Squiggler · Accepted Answer

Bronnii, IIRC you're in the UK - I apologise if I'm wrong.

It's a well-known fact within services that the CRHTT are notoriusly useless when it comes to a crisis and anything they say they'll do, they either don't or they change their minds without informing the patient. What they say and what they document they've said are two different things in my opinion. I can't stand their inadequacies.

As Lulabelle suggested, you need to take your existing care and crisis plans to A&E. It would help if you phoned the CMHT before you set off and inform them of where you are going and why. This is because when you get to the  hospital they will contact your CMHT for the latest information and if everybody knows where you are then it'll make the process a lot quicker as the CMHT will be expecting the call from the hospital and can have your notes to hand.

Ask to speak to the duty psychiatrist. You might have a long wait but please stay and bear with it. You need to tell the psychiatrist how you're feeling and ask him to assess your injuries so they can be treated properly - you might require stitches, as you know.

MH services are forever telling people to use distraction techniques because it's tried and tested that this is the best way to try and overcome feelings of self-harm or suicide, however I would always argue the case that it is not possible to distract oneself from distressing throughts continually throughout the day and night - you can't put a little plaster on a gaping wound because in the short term it might help but long term it's not dealing with the problem.

I've found (from both a personal and professional point of view) that nursing staff are much more empathetic if you're straight up with them and honest about what the problem is. Sometimes, particularly people with personality disorders or traits, thereof, are treated with little respect or empathy in hospital because often staff immediately label them as 'manipulative' or 'playing games'. Don't sugar-coat words - tell them with honesty, clarity and conviction:

1. What the problem is
2. How you want them to help
3. What you feel is best for you and why

Please feel free to email me or add to your question if I can be of any further assistance. I hope you start to feel better very soon.

Anonymous · Answer

Hey, Man i totally feel for ya. I know what it's like.. to struggle with ED as well as self harm. Unfortunetly this is Such a common problem, and it's a pain in the butt, becuase no one treats it as an illness and takes it seriously enough. Don't ever be afraid to Demand what you need. It's important to be assertive. I'm so sorry that you've had a tough go and that it seems as though the one's that you need to be there for you, aren't available to help you out. Must really feel like your doing this all on your own. 
SOmething that has always helped me was calling a distress center... all though it dosn't really help that your crisis line isn't doing much for you. Please don't ever feel scared to go to the Emergency at your Local Hospital. They will be sure to help you, and follow your plan. I really wish you all the best. sorry if i didn't help you much. i really hope things get better.

? · Answer

I don t think those people know your real suffering. I know you see your self in a n impossible situation and you are at least now but you will not get out if you continue to be so panicked and cut your self. You will not be able to get a job. I wish  so much I could talk to you more but you will never accept that. You can t trust me even you have nothing to loose. I can t think of you too much because it is so painfull what I read about you and affects me because I had also so much pain in my life. I would feel better if you talk to me but you wont.

Lulabelle · Answer

You have to actually go to hospital and let them see how much distress you are in.  The hope is that one of the emergency room staff will recognise you, and then advocate for you with the mental health team.

This is a really frustrating part of being a mental health service user, but sometimes out of sight is out of mind.  It will be a lot harder for them to pass you over and ignore you if you are sat there in front of them.  So please, get yourself to hospital.  Stay safe :)

? · Answer

pondering HE won't be able to even clarify it, i do no longer think of any human beings are going to be waiting to. the sole factor it incredibly is certain is that Congress won't ought to take part in it, and something human beings would be screwed in an uncomfortable place.

what do to when your emergency care plan means nothing?

5 Answers