Saturday, 26 January 2013

Budgies Fly

“35 year old female hanging out of window, police on scene”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

Weird, right?! This is what we heard being shouted as we approached the building we called to. There was a couple of coppers standing on the pavement looking upwards and as we rounded the building's porch we could see why! With her head and torso protruding the from the window our patient was shouting over and over again:

“If you love something, let it go. If it comes back, it’s yours”

This alone made it a bizarre job, now add her throwing all of her possessions out of the window at random intervals. The pile of things on the floor was large and varied and ever growing. Every attempt to talk to her was greeted with the same response.

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

According to the police she had barricaded the door and they were now waiting for an enforced with the universal big red key. There was also a worry that whilst trying to kick the door in she would jump out of the window. This would not be ideal. We were already going to be late off, a trauma job would be most unwelcome!

“If you love something, let it go. If it comes back, it’s yours”

It was relentless, as was the constant stream of belongings. Clothes, furniture, paintings, photos, kitchen stuff, bathroom stuff, the list was endless. Then, a cage came into view. 

“That’s not got a bird in it has it?!” Said one of the coppers.

“Erm…..”

Before I could answer, the cage, complete with Budgie came flying out with a crash and a squawk. 

“I think it has!”

The cage was retrieved and the bird seemed none the worse for it. I think it was the furthest it had ever flown!

“If you love something, let it go. If it comes back, it’s yours”

One thing was for sure, the Budgie will not be coming back up! The pile below the window was gradually rising. The bedding was next, pillow after pillow, duvet after duvet, sheet after sheet. Then came the hamster cage! A cloud of saw dust filled the air. It was certainly a rude awakening for the poor little thing inside but again, didn’t seem injured! Laundry baskets followed, then CD after CD, one at a time.

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

As time went by, her voice was becoming more and more frantic. There was a white foam clearly visible in the corner of her mouth from talking for so long without a break. She looked possessed! As amusing and bizarre the whole situation was, at the end of the day this was a person having a very public, mental health breakdown. She wasn’t known to police, her neighbours said she was perfectly normal and a phone call to the local mental health unit didn’t reap any information. Shortly after the lava lamp came flying out of the window the enforcer arrived. Before they tried the door, we had a discussion about what to do. Section 136 was useless as she was at home, section 135 was useless as there was no magistrate order so all we were left with was us deeming her not to have capacity and take her to a place of safety. Ideally, that place of safety would have been the mental health unit but as per usual, they refused to accept until she had been to A & E. *rolls eyes* The problem with A & E is their powers to hold her are limited as they claim not to have the security and staff to restrain her. The police will only stay a short while because she would not be under section and it isn’t then a police matter. Anyway, we decided all those bridges could be crossed on arrived. For now, the door………

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it com………”

She vanished from the window. The screams and shouting meant they were in! A few moments later, she appeared in handcuffs. She was restrained due to her violence on entry, and her determination to get away meant the back of the police van was the safest option.

“If you love something, let it go. If it comes back, it’s yours”

And so it continued. I sat in the police van on route to hospital just listening to it over and over again.

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

As the doors opened at A & E, it continued. All the way down the corridor, all the way through to majors where we waited to hand over. The noise she was making meant it didn’t take long for us to be seen.

“Is she under section?”

“No”

The nurse rolled her eyes.

“Well we can’t hold her, are the police staying?”

The copper came over, “We can stay for a little while but will have to leave when the skipper calls.”

“She should be under section”

“She was in her own home. We are only here in the capacity to assist the ambulance.”

Nurses think every mental health patient should be under section, they know what powers police do and don’t have, yet they expect the police to be involved time and time again when in actual fact, it’s a health care issue, not a criminal one. 

“Well when you leave, if she decides to walk out we won’t be able to stop her and we will be calling you back”

“If that’s what you have to do then that’s what you have to do”

We took the patient into the quiet room and left her there with the two coppers. As we walked off down the corridor all we could hear was:

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

Well, that was another day, another dollar and only two hours late off. I know it’s said a lot by ambulance staff but every day really is different. As for mental health, I really have no answers! I was happy that we got her to a place of safety but was it a suitable place of safety?! I just don't understand why no part of the health service will take responsibility for mental health. The mental health unit won't accept her, the A & E will make no real attempt to keep her in despite the powers the Doctors have to section. Everyone would much rather let her leave so it becomes a police problem. What do the police do with a mental health patient in need of help? Call an ambulance! What do we do?! Take them to A & E. This woman is ill and needs help. She is not a criminal. It is NOT a police issue and the NHS as a whole should stop relying on the police so heavily to help with mental health. The services, the staff, and the facilities are there. USE THEM!

13 comments:

  1. I don't know how you do it, I'll admit I have mental health issues myself, and it felt like I was being passed around. It seems I was.

    Social workers, gps, psychs, crisis team, all of them wanted to pass me onto another team.

    ReplyDelete
  2. Ideally a Mental Health Act assessment should of being called for and if they couldn't make the flat in time assess at A+E. Not sure about the procedure on your patch but i would expect a patient like this with no mental health history to be taken to A+E first to ensure she was safe and rule out any possible physical health issues behind her behaviour. Too late if she collapses at the psych unit if like ours its on the outskirts of town with no A+E

    ReplyDelete
    Replies
    1. It's what we did but there was a flat refusal by MH team to speak to us!

      Delete
  3. It seems mental health remains the poor relative in health services. I know its all be said before but when are we going to get proper emergency cover for mental crisis - someone breaks their leg or has a heart attack then we have paramedics who can not only give first aid and transport but are authorized to give certain medicines and make certain tests in treating the problem. However when it comes to mental health it all too often ends up with experienced ambulance crews who know what needs to be done but legally cant do it, police who may or may not have the same understanding, A&E units with neither the staff nor the desire to do it and mental health units not immediately accessible.

    Oh for the day we see proper funding that means every A&E has staff, facilities and procedures to effectively process mental health crises, when ambulance staff have their full mental health competences recognized, and mental health units are properly funded and provided so the person having a mental health crisis gets the same response as the person having the physical crisis.




    ReplyDelete
    Replies
    1. Ah proper funding! There's an idea!

      Delete
  4. How sad it is to see that little or nothing has changed in 15-20 years. Back then I worked in an Emergency Admissions Unit (half of our then local A&E dept). We had numerous regular patients, one in particular I will always remember. He used to present twice a week having taken an overdose, nothing huge, usually 10-20 paracetamol or similar. Sometimes he'd get a bed for the night, others he'd be below treatable limits and be discharged straight away. Mental Health teams were asked to see him regularly, sometimes they came, sometimes they didn't. They never accepted responsibility for him. We got to know him quite well, and would try and explain what would happen if he kept doing it. He always laughed and winked, thought we were fobbing him off. One day he was with us someone said to him, "one of these days you'll wake up dead", we all laughed at the expression, as did he. A little while after that, after taking well over 300 overdoses, one morning he did just that.

    The cost in ambulance, A&E and other NHS time must have been huge, thanks to a system that let him down completely. But the biggest cost of all was the waste of a human life!

    ReplyDelete
    Replies
    1. Good old Care in the Community! What a great idea that was!

      Delete
  5. Mental Health provision on the NHS is appalling, and as you say the NHS is not taking adequate responsibility in this area. As a Police Officer I deal with mental health issues on a (all to) regular basis. You're aware that 136 can only be used in a public place, so of course where the person is not a public place, our role is to protect those involved and to prevent a breach of the peace. We'll help as much as we can, but we too have limited resources and many other responsibilities.

    As soon as that person has arrived at Hospital, or a place of safety, they then become the responsibility of the NHS. The trouble is that hospital staff are loathed to make any effort to keep the patient in the hospital, because they know if the patient goes missing they only need to call us and then it's our responsibility. People in the police simply can't say 'No' - unfortunately when every other organisation has failed in it's responsibilities there is only one organisation left, the Police. If we fail too, the whole thing becomes our fault. If missing high risk patients continued to be the responsibility of the NHS then I would imagine that cases of them going missing would fall massively. The NHS just will not spend the money to put the adequate security and staff training in place. Not enough money? Rubbish - there is money there to pay huge amounts, to huge amounts of managers.

    Then again it's not just keeping patients in the hospital that is the problem. A few months ago I took over a constant watch for a lady who had been bought in to hospital under mental capacity. I had a conversation with her and she had in fact been a mental health nurse a long time ago - she had a decent job, a decent family life, money, a car and a decent home. She knew something was wrong though, she knew that her mental health was deteriorating. She made attempts to get help, she didn't want to end up like one of her patients. The help was not forthcoming though. Why not? Because she had a job, she had a decent family life - because she could hold that down they wouldn't take her seriously. Guess what happened to her job and family life when her mental health deteriorated further? At that point she finally received some help, a bit late don't you think?

    I think a huge part of the problem is the fact that there is no immediate readiness of help for mental health patients in the NHS. Time and time again we take a person under a 136 to a mental health assessment unit, the various mental health teams are informed that we're on en route. It's a good 45 minute drive (they're never close by are they?) and even once we've arrived we're still waiting a good few hours until anybody turns up. Even when they turn up they request that we stay in case the patient becomes volatile. Even if we give them assurances that the patients has been fine for the last 3/4 hours, they still don't want us to leave. Technically we could just leave, we've handed the responsibility over so have no reason to stay if we're happy that the patient won't cause a problem. The trouble is that on occasion the patient may become a problem later on, and if something went wrong and if we didn't stay we'd get the blame for leaving the mental health workers alone. With all due respect, they're mental health workers, and they should be equipped to deal with mental health patients without police assistance. We've done our bit - we've identified a person who is suffering from mental disorder and to be in immediate need of care or control, we've taken that person to a secure mental assessment unit where they should receive that care or control, so why can the NHS not live it to it's mental health responsibilities?

    The only part of the NHS who truly understand that it's not a police matter, and truly make efforts to help us and take responsibility, in my opinion, is the ambulance service.

    ReplyDelete
    Replies
    1. Thank you for the comment! Nothing to add! Youve said it all! The NHS needs to wake up and realise whats happening!

      Delete
  6. Entirely agree - we all end up stuck between the old rock and a hard place! I too have spent many hours wondering what to do for the best in conjunction with the police in the case of a mental health patient. Don't even get me started about alcohol? Mental health units will not accept a patient who has even had a drink - even if we all confirm that they have full capacity and don't present a threat? They have a lower breathalyser limit than the police but then how is it fair then to take them to A&E?
    We do try and not ring the police until we absolutely have to but then ambulance staff can't put themselves at risk either?
    Difficult situations where both police and ambulance staff are left carrying the can? More referral pathways needed to get these patients more help.

    ReplyDelete
    Replies
    1. The problem really is the lack of referral pathways!

      Delete
  7. I'd like to see solid referral pathways for ambulance mental health (apparently there are murmurs of it happening soon), and an NHS Constabulary, the railways have their own police, the parks get their own police, the military get their own police, so why not us? The NHS is large enough to warrant it. Every A+E would have a copper on guard, able to act as a deterrent for anyone bringing violence into the ward. Mental health teams and the ambulance service would be able to call upon specially trained officers to help with violent or uncooperative patients outside hospital and stay with them throughout. No idea where the money would come from though.

    ReplyDelete

I love comments! All bloggers do! If you have something to say, agree or disagree I would love to hear it! I will reply to all! (or try my very best!) If however, you're a troll, save your breath!

Due to an increase in spam I moderate comments but ALL genuine comments will be posted. See above exclusions!