Monday, 18 February 2013

I'm just a Fire Starter

"25 year old female, mental breakdown, setting fire to her room"

This had all the ingredients to be 'one of those jobs'. By that, I mean a job needing diplomacy, co-operation from mental health services and patience. It may also need police and fire, the latter of which I could happily do without! Mental health jobs kind of excite me in a weird way. I know that it will be tough to deal with, I know I will end up getting frustrated and wound up by the lack of options available to me and ultimately I know I'll probably end up blogging about the shoddy mental health care that patients have access too! Then again my fascination with mental health and psychology makes me gluten for punishment!

We pulled up outside to see a police car parked up. As we got out Trumpton pulled into the road, sirens blaring, causing curtain twitches galore to appear in their windows. Bear in mind it was 2am. There was absolutely no need for sirens on residential streets, but that's 'pet rescue' for you. As we approached the front door one of the coppers came out. 

"Evening ladies, she's upstairs, I'll send Trumpton back to bed!"

It's as if he was reading my mind! I headed up the stairs and followed the noise that was coming from one of the rooms. It was a halfway house for people recently discharged from the local mental health unit and there was an office at the end of the landing with a rather fed-up looking woman sitting inside. She just pointed at the room where the noise was coming from with a shake of the head. 

The police explained that she had been discharged for the mental health unit about 6 hours previous and had been 'freaking out' ever since she arrived here. She had been setting fire to documents and her mediation and was doing so because the voices in her head were telling her to do so. I made various attempts to talk to her without success. I like to think I can talk to mental health patients, some can and some can't. Normally I am able to, but sometimes patients either won't engage at all or will only engage with people who have gained their trust. In this case, she wouldn't engage with anyone. Stupidly I turned my back to talk to my crew mate and a water bottle came flying across the room and got acquainted with the back of my head. No cut, no lump, no harm done, but still.....uncalled for!

The police were savvy enough to know that jumping on her for assaulting me would have been of little benefit so it was ignored. She was scared, unsettled to say the least and was surrounded by police and an ambulance crew. We were all there to help her but I imagine it didn't feel like that. She said she wanted her case worker and that he was back at the mental health unit. As far as we were concerned, that's where she should be and as she had only just been discharged the plan was to take her back. With that suggestion she frog marched herself out of the room and downstairs towards the ambulance. I simply followed! That was easy!

Once on board we convinced her that it was in her best interest to let us check her over medically so that the unit would have no qualms about accepting her. She was medially fit as far as I was concerned. No alcohol in her body, no unauthorised drugs, no injuries, nothing! Excellent! Off we went, police in toe! 

So, there we were, 1 x patient, 2 x ambulance staff, 5 x police officers and 1 x mental health worker from the half way house. All 9 of us bundled into the lobby of the mental health unit. Behind the security glass that would rival most banks was a collection of staff. We were ushered round to the door to hand over. I explained what had happened and why we were her. Her response:

"She's not coming in here."

"Why not?"

"She's been assessed and discharged. There is nothing wrong with her mentally. It's just behavioural problems and attention seeking."

"We are called to a young woman, discharged from a mental health unit hours previous who states she is hearing voices and is setting fire to her room. She has anti-depressants and anti-psychotic medication. She clearly does have some kind of mental health problem and that is why we are here."

"Well she doesn't. I assessed her myself, we aren't here to sort out peoples behavioural problems."

"But you are here to help sort out voices in someones head."

"She doesn't have voices."

"She says she does."

At this point, one of the coppers took over.

"We believe she is suffering a manic episode, the employee at the mental health half-way house agrees. If she doesn't have any mental health problems why are you putting her in a building for people recovering from mental health problems?"

After a brief pause..... "She'll have to go to A & E first. We can't accept her until she has been cleared by A &E"

"A minute ago you said you couldn't accept her because he hadn't got anything wrong with her! We have brought her here to you, this is the most appropriate place for her and the fact you discharged her less than 5 hours ago, to me, makes it a failed discharge. I suggest you re-assess her because your initial lack of diagnosis has been found wanting."

Another brief pause...... "Bring her through."

HURRAH!!!! Oh the joys of a mental health unit! To be fair, I knew it was never going to be easy! With my blood pressure suitable raised and my mood suitable lowered we trundled off to the ambulance so I could have an expletive filled rant in private! Good times!


  1. I dare your trolls to point the finger at you on this one. Well dealt with Mrs Ambo, and well blogged!

  2. This isn't the first time I've heard stories like this from ambulance crews and its really upsetting to think that not only do they seem to not give 100% to their patients but also disregard the assessment of other health care professionals.
    I dont envy you having to deal with this at all and as a prospective student para, I do hope some things change in this department by the time I start!

  3. I love your blogs! I just have to say, as its not the first time you've written it, that the correct phrase is 'glutton for punishment', not 'gluten...', which is, nonetheless, rather amusing. We knew what you meant...

    Keep 'em coming!

  4. Why is it that on your blog, Inspector Gadget's, PC EE Bloggs etc I see stories and comments from people like yourself about having to deal with people who are obviously suffering some mental illness but who have been chucked out into the real world with no support! And always the people doing the chucking out are the ones most people would think & expect to to be the people best suited by training & workplace to help!

    Is it that MH units are staffed by people with no interest in having people with MH problems brought to them?

  5. I recently had to stay in a mental health unit as an inpatient. I saw no evidence of patients being given the opportunity to talk to staff, and certainly no evidence of the staff actually seeing the job asa vocation, like staff in the main hospital next door!

  6. I just found your blog, and although I am a paramedic half way around the world I find the stories so relatable. Love what you told the staff about finding their initial lack of diagnosis lacking! I've wished I could think on my feet/ was good enough with words to tell people my thoughts like that.

  7. Another great blog Ella. It infuriates me that MH services time and again fail the people they claim to care for. My experience is that such services offer only closed doors as apposed to openess to treatment.
    One can only hope the culture of MH services changes very soon.

  8. You have mental health half-way houses where you work? Wow. Where I live, there's nothing like that. You're just discharged back to an empty house and left to get on with it. Sink or swim.

  9. Hi there. Just a thought - Did the hospital not have an on call bleep holder responsible for gate keeping all admissions?
    If so a call to them may have resulted in the smooth facilitation of admission instead of approaching the ward directly where the staff nurse may ............. may have been trying to avoid having to complete admission paper work.

  10. Felt it's about time I commented since I've lurked for ages :-)

    Long Term mental health in this country seems virtually non-existent. They discharge once medication kicks in and fail to watch the individuals long term. The patient can then believe they are fine until they have another 'episode' or they fail to then take their meds feeling they are now 'better'. My family has been stuck in the never ending circle of admission-meds-discharge-relapse with my brother for nearly 18 years now. Sometimes I question my own sanity with it all.

    Until the stigma is dealt with and more funds put into early diagnosis and long term help I don't think this issue will get any better. If anything it will get worse


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