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A&E just didn't want to know
Posted Wednesday 28 November 2012
Please read carefully, you might find this blog triggering.
Imagine you are at your lowest point and on the verge of taking your own life. All you want to do is escape. I got to this point about 4 years ago and it was then that I had my first experience of psychiatric care for those in crisis.
I had made a suicide attempt and then stopped answering calls from concerned friends, which led to them contacting the police to locate and help me. I was cornered by two male police officers from the armed response team of my local police force. They were kind to me and I was then passed to another pair of police officers who continued to look after me and question me about many different things.
I was told they were going to take me to A&E as a voluntary patient, otherwise they would have to section me and I "...would not like the place where you would have to go as it is really horrible." This scared me into accepting and we set off in the police car to A&E.
When we arrived at A&E, we checked in at about 10pm and sat down to wait it out. The police and my parents were with me. Fear of being hospitalised was now coursing through me as my anxiety rose sitting in the very crowded A&E waiting room. I was then called to the triage area where a nurse asked why I was there. When I responded by saying I had made a suicide attempt, I was asked what I expected from them and quite honestly I couldn’t find an answer. I already felt that I did not deserve anything from them and this just totally flummoxed me. What could I expect from them, when I knew I was worth nothing?
I returned to the waiting room where the male police officer with us decided he could entertain me with card tricks. He was amazing towards me and I will be forever grateful to him, and the female officer with him, as they helped with my anxiety in the situation, to some degree.
My wait continued until just before 1am when I was taken through to the majors area. My chat with the doctor was very quick and I was told I’d require blood tests and to see a nurse from the psychiatric team. I had to wait until about 1.30am before I saw the psychiatric nurse who took me off for a chat.
As we sat down in the room, the first words the psychiatric nurse said to me were that I had not been serious about suicide and therefore they would not admit me. He asked me a bit about my background and when I explained I was a student teacher, he started asking me about his children’s education. Within 10 minutes the conversation was over and I was told to wait for my blood tests and then see my GP in a month. My blood tests came back just after 2am and I was discharged home.
I felt stupid and alone. If it was possible, I felt worse than before I was taken into A&E. I really wanted to prove I was serious. I was already planning another attempt. I knew there was no point now in telling a professional as they would just say I wasn’t serious about dying. The only thing that actually stopped me was that my friends and family decided to keep a close watch on me and took me to my GP sooner than was suggested in A&E.
I wonder what may have happened if I hadn’t had their support. Could I have tried again and been successful? Would my death have been seen as unpreventable because of my mental state? Was it something I said that made them feel I wasn’t serious? Who knows the answers but the poor care I received could have led to a very different outcome for me. This is why I’m supporting Mind’s campaign for better crisis care.
Joanna
Like Joanna, too many people tell us they can't get help when they desperately needed it. That’s not acceptable. That's why we're campaigning for excellent crisis care for everyone.
22 Comments
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This is such an awful account I don't know what to say other than it is important that these stories come out in the open but they really need to be heard in a wider arena than this rather esoteric space.
It has been my observation over many years that if a person asks for help there is little chance of getting a response from services - but if someone complains about you, then there will be a response and sometimes a very heavyhanded one with deprivation of liberty happening so quickly the detainee scarcely knows what's happened to them.
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I, like you Joanna, would also have been stumped about what we should expect when we present to the health service in a crisis situation. Hope you are ok.
So if its not a daft question, can someone from mind give me an idiots explanation of what I should have a right to expect when presenting say at an A&E in crisis? It seems to be that they make it up as they go along depending who deals with you? So what should be the proper protocol and what should we expect to receive?
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I've been taken to A&E countless times in the past 18 months with severe self harm and suicide attempts I have been taken voluntarily and on occasions under a s136 the majority of the time the question I get is 'and what do you expect us to do' to which I am stumped isn't it their job to know the answer, there have even been times where I have admitted that if I go home I will repeat the attempt yet still I've been sent home with no help or support and low and behold within 12 hours I'm back in A&E. the nurses state they don't know why I bother with the cmht and crisis team as they don't so anything to help me. Yet again I am reaching a point of no return I have asked for help before it gets to bad and yet again nothing being done I'm left with nothing what is the actual point of the crisis team??
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I have been aware of inadequacies in A&E departments for many years and refuse go there in a mental health crisis, although the mental health service's advice is still to go to A&E even if you have no physical issue. If they are telling service users to go to A&E then the emergency departments, particularly the triage nurse, should have mental health training and awareness in order to give correct priority in for patients in crisis.
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Thank you for your replies.
Nick although I am not from mind I believe that what we should expect at the very least respect and to be treated rather than sent on our way without any help or information of what to do next.
Some useful links for what you want to know might be:
http://www.mind.org.uk/help/medical_and_alternative_care/crisis_services
http://www.nhs.uk/CarersDirect/guide/mental-health/Pages/emergency-mental-healthcare.aspx
Joanna
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I have had a similar experience. My bf dragged me to the go after he foiled my suicide attempt. The doctor referred me to the community mental health team who after a single 15 minute chat told me I wasn't serious about suicide and that I wasn't sick enough to warrant their help. i only sought extra help through concerned friends nudging me to. Luckily a local charity offered counselling sessions for a minimal fee and I was helped to climb out of the black vortex I was in. Without those concerned friends I would have attempted again and heaven forbid succeeded.
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My 26 year old daughter with well over ten years of mental health problems and alcoholism, took an overdose and drank half a bottle of whisky after her boyfriend finished with her. I phoned for an ambulance and the paramedic who arrived was extremely understanding and kind. However, on admission to A@E at our local hospital, my daughter was treated with disdain. She was largely ignored by all the staff except the tea lady who offered to get her some chocolate.The young registrar on duty was on the verge of being "cross". He was definitely irritated and it took him a while to say to me that if my daughter wanted to kill herself then there were many better ways than with paracetamol!! I couldn't believe what he was saying. He had absolutely no empathy whatsoever with my daughter's medical needs. He was looking for a broken leg, or a heart attack. He just didn't get it - I was very upset. When she was finally sent home, I later found out that the "mental health psychologist" who she had never seen before, and who had none of her notes, simply took her off the antipsychotics that she had been taking for over seven years, declaring she didn't need them.
Unfortunately over the last fourteen years, this is just one story concerning the lack of proper care and attention that my daughter has had at the hands of the NHS. I worry that if doctors are not being trained properly about mental health issues, then what hope is there? -
I actually find this appalling. In my case both the police and NHS staff have always been really supportive so it's really sad to read this account.
I suppose a lot depends whether you have an established diagnosis and care plan as to how people handle you.
That should be no reason not to treat every case as " serious" and on its own merits.
Bet there are countless tragic stories about people who were not taken seriously. -
Hi Nick, We think that anyone turning up to A&E in crisis needs to see someone warm and empathetic, who treats you with respect. You should not be left to wait for hours; a mental health crisis should be treated with the same urgency as a physical health emergency.
Some emergency departments have a psychiatric liaison team in place to assess people’s mental health needs, provide short-term treatment and support, and link them into longer-term care if needed. In some hospitals this is available 24 hours a day. We are also involved with the Psychiatric Liaison Accreditation Network and they have a set of rights – such as being seen in a private area - and quality standards (http://www.rcpsych.ac.uk/workinpsychiatry/qualityimprovement/qualityandaccreditation/liaisonpsychiatry/plan/informationforserviceusers.aspx) to improve people’s experience.
If you have self-harmed and turn up to A&E there are NICE guidelines about what you should expect http://www.nice.org.uk/CG16 (Section 1.4) such as a separate, quiet room with supervision and regular contact with a named member of staff to ensure safety. Hope that helps, take care -
So sorry to hear you had to go through this. I'm afraid my experience of being in crisis is no different. I hit rock bottom last Easter - my birthday is normally a trigger for me as I am adopted. I phoned the number my MHOT had given me - I got through to a recorded message which told they'd call me back, but there was no instruction to leave a contact number, so I hung up to await my return call. Ofcourse it didn't come. So I called the alternative number she'd given me - which went straight through to the main hospital switchboard - the receptionist then argued with me about not being able to leave a message on the Crisis team phone. This was getting me nowhere, so I hung up (in tears of distress and frustration), finally I got through on the main switchboard number to somebody who was prepared to listen - she kindly took my details and assured me she'd get the Crisis team to call me. I got a call the following DAY! They promised to call me back the following day - this didn't happen, and when I did finally get a call my family had gone through the worse 5 days you can imagine. I just wanted it all to stop, and suicide really did seem like an option.
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A&E staff often have no training in this. Mental health staff sometimes don't take suicide attempts seriously until it is too late. What would convince them, I wonder? And would they put up with someone they care about being treated so cruelly? If not where would they take their relatives and how do we access that service?
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Dear @Sherienne and @Rasksha, I'm so sorry to read about how you were treated so poorly just when you needed help so desperately. I do hope you are better supported now but if you wanted to find out about other local services you could try our infoline. Email info@mind.org.uk or call 0300 123 3393 (9am -6pm). You could also give your feedback through Patient Opinion - http://www.patientopinion.org.uk/. Sadly long delays and not being taken seriously is something we hear too often and in our research for this campaign. We’re encouraging people who’ve had experiences like yours to take action to stop this happening in future. If you feel able to, perhaps you could write to your MP? http://e-activist.com/ea-action/action?ea.client.id=1705&ea.campaign.id=17334 Thanks again for speaking out and sharing your story. Take care,
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I have had similar experiences a couple of times that I have been taken to A&E. Each time I was made to wait hours to see either a doctor or psychiatric, both of which made me feel stupid and made it clear that they were very busy and I was wasting their time. I was never offered further help and discharged myself each time..the doctors and nurses never questioned if I would be safe if I left the hospital.
I have found that with nearly all nurses, doctors (hospital and G.P) either have two attitudes to the reasons I have been admitted to hospital; either they are patronizing; "you are young, you have your whole life, what can be so bad about life at your age, you'll grow out of it", or they just don't believe or understand how you feel; "you're wounds are only superficial, so they aren't that bad, you cant really have meant to hurt or kill yourself, you don't mean it" etc.
I know that there are medical professionals who do have the right attitude and do provide the right care for these circumstances, but unfortunately I have yet to come across any and with the experiences I have had makes me reluctant to be treated or admitted as I just cannot se the point.
P.S One trip to hospital was because I overdosed on my medication; when they doctor found out what I had taken, he told me that I hadn't done it right and told what to use which would have worked better. Not sure my mum, who was sat next to me, was too impressed with him.
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Yet another person here who has been treated appallingly by A&E numerous times. I think as soon as they see that I've been there many times, they think attention-seeker, not serious. I was recently sent home from A&E on 2 consecutive nights, ending up picked up by the police and taken to hospital where I was sectioned on the third. If it hadn't been for the police I wouldn't be here.
Left alone to wait for hours, only to see dismissive, disinterested Psychiatric Liaison staff who clearly don't think I am serious. I had felt it was me, maybe I was just overdramatic, a timewaster...exactly as Joanna says, you feel unworthy of help when suicidal so being asked what you expect from services is so insensitive and unhelpful.
I think they do assume that anyone asking for help is attention-seeking, when it is often very difficult to do, with the illness telling us we don't deserve to live, we are battling ourselves. It's very frightening. Making what might be a last attempt to get help only to be turned away only confirms that we're right, we are worthless. It takes a lot of strength to keep fighting. I'm here because of friends and family, not services. No-one deserves to be told they're not really ill and don't need help.
There should never be a death due to negligence by services, but sadly there have been, and will continue to be. -
Hi I have been diagnosed with borderline personality disorder anf have had many attempts of ending my life and only recently i have just come out of hospital due to a overdose its disgusting how the phsyc team at hospitals treat people who are suicidal and okay nurses dont know much about mental health and are mainly there for general health but its sad that when i took a overdose that some nurses have to judge you or think your attention seeking or that your wasting there time and jumping into conclussions about your personal life which i find very rude some are helpful and some arent but i did not like how i was treated when i then had two phsyc men come to my bed where i had drips in to then have to patients when that i knew from my past which gave me aniextys to then talk about my past and all my confidental stuff where then once i had spoke to these two phsyc team men two patients who where beside me heard every detail about my reasons my past which where very confidental stuff to them saying we heard all of that which made me anoextys go up a high amount so much for we take patients confidential stuff seriously this was not at all the right place to be talking about my personal stuff at all it was very dogusting and after i was able to go home they had to speak to my father but i had one physc who was there before to then having a women who was very very rude and to be honest paid more attention to her job then care about the needs for me or my feelings and it really got to me and started crying luckly a kind nurse came to surpport me i have had alot of experiences in and out of A+E after tying toend my life and never do they take it seriously at all i mean they just send you home say that your have a follow up which then only happens after 2 weeks it really is horrible the way its not taken at all seriously just makes you think if anyone cares and makes you even more low
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Thank you again for the replies.
I am so sorry that so many of you have been through similar experiences. Maybe now that so many people are sharing their stories of poor crisis care, something will be done to improve it.
Joanna
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Hi Holly, I’m so sorry to hear that you were treated so badly. Being treated with respect and dignity came up quite a bit during our research. We heard some great examples of caring and supportive staff who people thought had helped turn their lives around. We’re encouraging people who’ve had experiences like yours to take action to stop this happening in future. If you feel able to, perhaps you could use our tool and write to your MP? http://www.mind.org.uk/crisiscare. Thanks for sharing your story with us, take care
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Hi JoLullabye, I’m sorry to hear you had such a distressing experience - that's so irresponsible and it isn’t acceptable. I'm hope you're being better supported now, and our infoline info@mind.org.uk / 0300 123 3393 can also help you find support if you need it.
We’re not able to pass feedback on from here directly so have you asked the provider what their complaints procedure is? This page has resources if you want to take action – http://www.mind.org.uk/help/rights_and_legislation/how_to_complain_about_health_and_social_care. Take care -
Dear ButterflyWings, I'm so sorry that you were treated so badly. When you turn up to A&E you really need to be treated with compassion and helped. I really hope you are getting the help you need now but if you wanted to find out about other local services you could try our infoline. Email info@mind.org.uk or call 0300 123 3393. You could also give your feedback about your experience through Patient Opinion - http://www.patientopinion.org.uk/
Too many people are having similar experiences when they need help and why we need to make sure that everyone gets the support they need. We’re encouraging people who've had experiences like yours to take action to stop this happening in future. If you feel able to, perhaps you could write to your MP? http://www.mind.org.uk/crisiscare Take care -
when my brother (who had never been mentally ill before) took the courage to admit to his GP (5.30pm) he was going to harm himself and then completed a PHQ 9 questionnaire "Do you feel your family would be better off without you and that you may take your life" - Answer: Yes.
I believe he was expecting to be kept safe that night. but he was then told an urgent referral would be made "in the morning" -my darling brother went home and took his life that night. I will never know if they had helped him more that evening, if he would be here now. They say the crisis period is usually a shortish timescale, by then, I could have had the opportunity to talk, to support and to help him - but I didn't know and I wasn't given that chance. I think about that every day and it's been several years now. -
It's so frustrating to hear the things that some doctors say. I just don't understand how they cannot see anything wrong with the approach they take with patients and that just a few words can have a major impact on someone who is already unstable.
For people who are not professionals to see that there clearly are problems with the care system, it just goes to show how oblivious the staff are. Just because mental issues are not physically apparent, they seem to think it's okay just to ignore it and look over it.
Well it's not.
They don't just go away and it's about time the crisis care team realise before it's too late for any more people.
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Dear Elly, I'm so sorry to hear about your brother's death and the questions you have had every day since then. I hope you’re being supported by friends and family, but do remember that the Samaritans are there to listen 24/7 on jo@samaritans.org or 08457 90 90 90.
We think that when people’s lives come crashing down in a mental health crisis, they should get help, urgently. It sounds like your brother didn't get the support he needed, when he needed it most. Too many people have shared similar stories with us. We're asking people who have had experiences similar to yours to email their MPs with their stories through our online tool: http://www.mind.org.uk/crisiscare so that we can stop this happening in the future. Thanks for sharing your story with us, Take care, Taryn from Mind
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