Susannah Goddard blogs about her experiences of speaking in parliament about her experiences of crisis services.
Deciding to speak out
Like so many I have spent a lot of time trying to protect myself by not disclosing my mental health status - terrified of being exposed as the 'unhinged one/the nutter/insert your own stereotype' in the room.
And for most of us the idea of talking publicly about very personal and distressing experiences is an anathema. The stigma attached to mental health is so great and the issues so painful.
So to speak to Ministers and talk frankly about my own experience of crisis care needed some thinking about. Because after all there was no point in doing it unless I was prepared to say it as it was. No frills, no dressing it up, no softening of the detail to make it easier on the ear.
My first thought was why put my head above the parapet because, truth be told, it felt risky on a number of fronts. I had to decide whether to waive anonymity (I had the choice not to). If I did so I could no longer hide.
In the end the decision was relatively simple: I had no relationship with mental health services to jeopardise (cuts had seen to that), my family wanted me to speak up and, as was pointed out to me, how much worse could it get? Plus I knew that my experiences were neither 'isolated incidents' nor the exception, but instead they had become the rule in crisis response.
In the run up to the proceedings Mind supported me with throughout the preparation. I had full licence to say whatever I wanted, however I wanted, and without censor. That was the clincher in deciding to appear. To say it as it is – rarely do you get that opportunity and by then I knew from feedback that my account was an accurate and powerful indictment of crisis care failings mirrored across the country.
On the day
I had some anxieties about how to manage (medication or not, what to wear, would there be a 'comfort break', did I make the right decision not to read from a script?) but the process was greatly eased by those around with shared concerns.
My greatest worry was that I would have to persuade Ministers that yes, this is how it really is, it was allayed by forceful testimony from the emergency services and acute hospital trusts all stating the same, all singing from the same hymn sheet.
I am not naive, I know there is often much talking and change is slow, but was it worth putting my head above the parapet? Absolutely.
It is the only time I have ever felt heard, that I have ever felt validated. In itself a very sad reflection on mental health care.
What crisis care was like for me
When you have mental health needs and if you experience severe distress, the standard response is usually along the lines of "you are ill, we are the experts, therefore we will give you a diagnosis and put you on a pathway to recovery."
You also get a new title: Service User/Patient/Person with lived experience. Once on the chosen pathway you are told that you will now be able to access talking therapies, personalised care packages and something called 'Crisis Care'. So, sorted then.
Except that the harrowing reality for many is that this simply does not happen. You are just as likely to spend your time being bounced around services cut to the bone with inherent communication failings, no continuity with the risk of deteriorating into a terrifying state of crisis.
And so goes my story, a familiar one to many who have been part of the mental health system. Despite little mental health training or expertise, nowadays the police are often the equivalent of a crisis team. It didn't matter how many times or for how many hours they attended my home requesting crisis service input - it never materialised. From Crisis Services standpoint if the police are there then the crisis is contained, so why come out? No matter the potential for escalation.
Detention under the Mental Health Act
Another huge concern for me is how people are treated under Section 136 of the Mental Health Act. In my experience, one of two things happen:
Scene 1: You get taken to an NHS Place of Safety, get assessed and get discharged without follow up because, well because there is nowhere to admit you to. Repeat.
Scene 2: There is no NHS facility available, you get detained to a police cell, no follow up. Repeat.
The practice of Section 136 detention to cells when you are in severe distress and terrified is unacceptable – there is no other situation where someone with a life threatening physical illness would be confined for 72 hours without access to assessment, medication, care or treatment. Yet this is the accepted standard in mental health.
Only in mental health would someone be criminalised for being ill.
It is almost impossible to describe what I felt like when this happened to me, except that my level of absolute terror was escalated to the point where the most distressing and intrusive symptoms were now pushed to the forefront, shutting down communication and greatly increasing my risk.
The 'like it or lump it' response from my crisis service caused significant harm. The refusal of mental health trusts to admit they cannot provide even barely adequate out of hours crisis care fails the most vulnerable people in society.
To me, mental health professionals staying silent when people's lives are at risk is unforgivable and that's why I support Mind's work towards better mental health.