Friday 8 February 2013

The Sixth Sense

"38 year old female, ? assaulted, ? pain after C-section"

I think it's fair to say that everyone who works on the front line of the ambulance or police service develop a sixth sense regarding the general public. You can tell when something isn't right, you can tell when someone is ill and the police can tell when someone is up to no good. It didn't however, take a well homed sixth sense to realise something was amiss with this job. It had come from the police and every bit of information we received had a question mark in front of it.

'UPDATE: ? Intruder in house, ? Partner on scene, sounds distressed'

'UPDATE: ? Baby on scene, ? sexual assault, police now on scene'

It all just seemed a bit odd! There was snippets of information but no real presenting complaint or firm idea of what we were walking into! Nothing new there! We pulled into the road and headed up to where the police car was double parked.

As we approached the front door, it swung open. One of the coppers was standing there and we shared the police / ambo look! The look that says 'Hi, how are you, glad your'e here, this is a load of rubbish, I wish I was at home, why do we do this job?' in one half smile, slight nod of the head and a aura of resignation! We walked down the hallway to the other copper in the living room. Again, we shared the look!

'Hi guys, this is Jayne. Jayne had a baby 2 weeks ago and today is scared that someone is going break into the house and try to get her pregnant again.'

With a rather smug, gloating look he backed out the room leaving me to do the questioning. Jayne was sat on a chair, rocking back and forth slightly, her strawberry blonde hair was tangled and messy and she had a very intense look in her eye. I introduced myself and my crew mate and asked how we could help. She responded in kind and introduced as to her 'partner' Eamonn, who was sat in the arm chair on the other side of the room. He seemed totally unmoved by the whole situation.

Jayne went on to explain how she had given birth to Layla 2 weeks previous, by cesarian section. Lying in a moses basket next to Eamonn was Layla. All of the commotion hadn't made her cry, she just laid there, eyes glued to the ceiling. Apparently, for the last day or so Jayne had become convinced that someone was trying to break into her house to impregnate her. She had a real look of fear in her eyes but constantly tried to reassure us that she 'wasn't mental'. It's always awkard to ask about mental health history but I had to. She denied any and said she only suffered with mild depression. On cue one of the coppers handed me a discharge summary from the local mental health unit. A quick flick through revealed that Jayne was a medicated paranoid schizophrenic who frequently suffered from manic episodes.

It was of little surprise but when questioned about it she vehemently denied it, telling us they were wrong. She said she had been bullied by the psychiatrist and they had a vendetta against her. She said the reason she was so upset today was because Eamonn was angry that other men were trying to break in and impregnate her. I told her that I was sure that he wasn't angry but she snapped back 'well he's not talking to me'. He had nothing to say to the accusation. The whole room felt the air of awkwardness at the silence that ensued. We didn't know what to do or how to act. Family disputes are often difficult to be stood in the middle and this was no different. Eamonn's apathy was overwhelming. He had no response to her accusation and just stared blankly towards us.

"Would you prefer it if Eamonn wasn't here? Or maybe come to the ambulance to talk in private"

"Yes, take him away she snapped."

With that, one of the coppers walked over and picked up Eamonn under his arm and walked out the room. As Eamonn's leg hit the door frame he let out a squeak. 

Oh......didn't I mention?!

Eamonn was a blow doll.........

With Eamonn gone, Jayne got up and walked over to Layla and begun stroking her face. I couldn't bring myself to play along with the charade of talking to the 'My Little Baby' doll and suggested we went to the ambulance. She refused and said she wasn't going anywhere as she needed to protect her house and her family. There is no training for this type of situation for us or the police. You just have to improvise, adapt and overcome. Jayne clearly needed help desperately but being in her own home our hands were tied in the short term. Section 136 was useless and Section 135 would take time so it was the old fashioned good cop / bad cop routine with me playing the role of good cop! She didn't have capacity as far as I was concerned but there were less restrictive options available to us. Her life wasn't in imminent danger so we didn't really have the option of removing her against her will. It would also cause her more distress and we didn't want that.

I explained that I wanted her to come voluntarily to get help and talk to someone. She said no. She said she wanted her baby back. With that she pulled up her top and revealed a wound. It was a healing wound from a cesarian section. Her notes hadn't revealed anything about a pregnancy or a baby. 

"Where is your baby Jayne?" I said with real concern!

"They took her?"

"Who took her?" The copper said.

"Social services."

With that she handed me her hospital notes from the maternity unit. Twelve days ago she did give birth to a baby girl called Layla. She had been having frequent psychotic episodes since her partner, Eamonn, had left her and the baby had been taken away due to Jayne's inability to care for her. Clearly though there was no one caring for Jayne! Something as traumatic as having your child taken away would leave anyone distressed but for a paranoid schizophrenic already suffering manic episodes was a recipe for disaster. She certainly wasn't in a position to be left alone at home! What were they thinking?! 

Luckily for us, the fear of being put in handcuffs and taken away meant after some convincing she was willing to go to the mental health unit voluntarily and seemed keen to get some help. She refused point blank to go to A & E saying she'd rather die, so we decided to present to the mental health unit uninvited and deal with the staff when we arrived! 

As was expected they kicked up a stink about her needing to go to A & E first. They also wanted to know why she wasn't under section! It is as if they have never read the mental health act! After much arguing they eventually accepted her. Being reminded by the police that their choice to discharge her are a two night stay was a) irresponsible and b) the cause of us being here, swung it our way. We left Jayne in their 'care' hoping desperately that she would get the help she needed.

This job had two sides to it. The funny and the sad. It's extremely hard to keep a straight face when introduced to a blow up doll and a 'My Little Baby'. What do you say to that?! We certainly had a good giggle about it afterwards and I have no doubt it would be the talk of the mess room at the police station! It certainly was in ours. Some situation you have to laugh at purely because it's how our much vaunted black humour works. It's how we all rationalise the stuff we deal with. We are also well aware of the upsetting side to this job. The woman who's husband has left her, who went through the trauma of giving birth and having her child taken away. Having that mother and baby bond destroyed. Then the pain of being shipped back to her house. The house she shared and had expected to raise a family. The house with the babies bedroom as the constant reminder of what had happened. Pure torture. That alone would be enough to tip the most stable of people of the edge. She had been abandoned by the system, left to fend for herself and unfortunately for her, she had only been able to find solace in a blow up doll. This job was a stark reminder of just how much work is needed to bring mental health care up to the high standard of the rest of the NHS. 


  1. You 'lot' have my utmost admiration

  2. I want to say Im surprised by the 'lack of care' but Im not, just sad for everything she has had to go through, I hope she is now getting the care she needs,

  3. I cannot begin to express how angry the "adult unable to care for child because of needing care themselves but not getting it" makes me - does anyone stop to think about how the adult needing care feels? That they are aware they are supposed to be providing it but are unable to and feel as guilty as hell about it? That the removal of the child is seen and felt as punishment?

  4. In areas where there proper mental health care has been commissioned, there would be a mother and baby unit capable of caring for even the most unwell mothers and their babies. Does this area have no such unit? For all its shortcomings, there is such a unit in my area.

    Since pregnancy and childbirth are known triggers for manic episodes, it seems perverse that this mother was not offered admission in anticipation of the birth. Especially in light of the recent break with her partner, another known trigger.

    What cruelty - for both mother and child - that this woman was not offered the care she needed. Had she been, the mother and baby bond may have been preserved. Or the separation may not have been so traumatic for the mother.

    A diagnosis of schizophrenia is not a lifelong indelible label of "unfit mother". Instead, it is a recognition that extra help and support may be required, especially at times of high stress.

    This mother and her baby have been terribly let down by the system.

    Ps I'd suggest not calling someone a "medicated schizophrenic". You might instead say that her records show she had been diagnosed with or was being treated for schizophrenia. People are more - much more - than their diagnoses.

  5. What a sad sad story, that poor mum was probably suffering from post natal depression too.
    I can't begin to understand how frail she must be, and sincerely hope she get's the help and understanding she will need to recover.

  6. It speaks volumes for our mental health provisioning that the most surprising aspect of this story for me is that you actually managed to get the MH Unit to accept her from an ambo. Are you sure this wasn't a hallucination yourself? ;)


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