some stories and cases that ended positively

https://www.nsun.org.uk/psychiatric-hospital-left-me-suicidal-and-homeless-we-need-a-human-rights-based-approach-to-mental-health-care/

noisy and chaotic - very frightening. Alarms go off numerous times a day. Staff work very long hours in a stressful environment on low pay and they do not have much time to sit and talk with people. The turnover for staff working in these environments is high so there may be lots of people you don’t know working there and lots of agency staff. Your life is being controlled by strangers.

little privacy - didn’t have any curtains. small privacy curtain between your bedroom and wet room. Staff look through the window every fifteen minutes or every hour to do observations and can walk into your room at any time.

psychotic break: e.g. I thought I was in a coma, I thought the staff were imposters or rapists and I’d been hypnotised to think they were NHS staff. I didn’t speak to my Mum for months and I didn’t let the hospital talk to her because I thought she was lying to me and she was an actor in a television film programme and not my Mum. I thought I was in a virtual reality computer simulation that I couldn’t get out of.

after months of waiting for housing to come through, living in this chaotic environment I couldn’t see a way out and I wanted to be dead. I absolutely believe that the psychiatric ward environment contributed to why I felt suicidal.

no access to anything sharp - started banging my face against furniture and ligaturing (something that I started doing in hospital) - not allowed to go outside for 24 hours - more agitated and distressed - tried to kill myself more frequently

metal cutlery from the dining room and breaking it and cutting my own face with the sharp edges.

I only had a handful of sessions of actual psychotherapy in hospital because the ward kept saying I was going to be discharged, then housing would fall through and I’d have to stay for longer. (poor planning and communication) instead of psychological interventions I was regularly prescribed benzodiazepines. These medications make you feel numb and spaced out and are very addictive. They’re only supposed to be prescribed for a short time, but I was given benzodiazepines for five months. When I left hospital, I had to go through a supervised drug withdrawal to come off them. (inappropriate prescription of medications)

As is the case with many survivors of childhood sexual abuse, night-time can be a vivid and scary time. you’re not allowed to be in the main communal areas; the garden, the art room, and the television lounge are locked at midnight until 7 am.

distressed or overwhelmed on a psych ward at night - play cards with staff or do some colouring in the dining room. If you’re lucky the nurse in charge will be free to talk with you but they are often very busy and at night they cover more than one ward. On some wards I’ve been on staff sit in the office all night and only come out if the alarm sounds. In this kind of ward if you ask for help or to talk to someone staff will tell you to go to your room or offer you extra medication to sedate you.

prone restraint

it recreated entirely my experiences of being sexually assaulted. Once they have injected you, the staff abruptly leave, locking you in the room alone, confused and sobbing and ashamed and frightened with your clothing around your knees and your genitals exposed.

The haze of the medication, the desperate rearranging of clothing, the shock and shame and confusion, the staff staring at you through the small observation window.

To go from violent restraint and physical intervention, to smiling and pretending nothing has happened, is toxic, confusing, and incredibly damaging. For me, and for many people who have experienced abuse, this behaviour exactly re-enacts what it is like to be abused.

lack of supervision

In the five months I was in hospital I wasn’t referred to any external support to prepare me for when I returned to the community. Many times I was left sobbing on the floor alone or told I was making too much noise and it was distressing for other people.

Link House - The first evening I was there I heard another person who was staying in the house asking a support worker for some time to talk and I remember hearing the staff member say, ‘We have talked with you a lot already today’. I remember thinking, ‘these people are busy too, this is going to be just like hospital’. Then the support worker said to the person ‘I’m worried that you might be feeling a bit tired, I’m happy to talk with you some more but I wondered if you felt like watching a film together and sitting in the lounge with me whilst I do some sewing?’ I heard this and just thought, what is this place? Who are these people who have time to talk with you for so long and sit and watch films with you? It was such a different approach.

Looking at the hand painted stones, and crochet decorations and paintings I felt connected to all the other women who had stayed there before me. I remember the Manager said to me, ‘The way we see it, we are coming into your home for two weeks, not the other way around and as staff we try and treat it like that’.

(The support worker at Link House sat with me on the evening I arrived whilst I phoned the ward to tell them I’d been discharged without any emergency medication. The ward said it wasn’t their responsibility to prescribe medication to take home that wasn’t on repeat prescription and we should phone the Bristol Crisis Team. We phoned the Crisis Team who said it was nothing to do with them because I wasn’t under their care and I should contact my GP. We then phoned my GP, but the surgery was closed because it was the weekend. It was a difficult weekend without any extra medication. When I came down for breakfast on Monday I was agitated and asked if the support worker could call the GP again and it turned out she had already contacted my doctor whilst I was asleep and followed up about the prescription.)

At Link House you have access to art and craft activities, puzzles, games and films 24/7. One night when I couldn’t sleep, I tie-dyed a dress with a support worker who was working the night shift. It was so lovely, and that dress is still very special to me.

I could come and go any time before 10pm. I was asked to let staff know that I was going out and when I was going to be back. If I was having a difficult time while I was out and about, I could call Link House any time and a member of staff would support me on the phone. I didn’t run away once; I came back on time and I felt safe staying there.

I was asked to keep medication and anything that could be used to self-injure in metal locked boxes in my bedroom. I could keep the keys to those boxes myself or leave them with the support worker. If I chose to hand the keys in to the Link House staff, I could ask for them any time of the day or night and they would offer to speak with me about what I was feeling but they wouldn’t refuse access to the contents of the boxes. This put me in control of my own body again. In hospital I was stealing scissors from the art room to hurt myself, hitting my head on the walls, pouring boiling water on my arms. In the two weeks I was there I had access to glass and kitchen knives, and I didn’t cut myself once. Using lock boxes is something that I’ve continued to do, so there’s a little bit of time and distance there if I feel like using self-injury.

the staff were clear and honest about what support they could provide. People are only allowed to stay there for two weeks so we made a plan together about how I wanted to use my time. That plan was built around how I was feeling and what I wanted to happen next. They treated me like a person not a patient. There were no alarms there and they didn’t restrain me or ever touch me. It felt safe and caring and peaceful.

They created a safe space where I could start to understand what had happened to me and make sense of my fragmented memories. My Sexual Violence Advocate supported me to contact the police.

being able to talk to people who really understand and know how to compassionately support people

I spent two weeks in Link House and moved on feeling like I wasn’t alone and there were places to turn to and people who wanted to help me.

I’ve seen many ideas and trends come and go within the NHS, cognitive behavioural therapy and dialectical behavioural therapy, group psychotherapy, apps, mindfulness, now it’s coproduction and trauma informed care. I think we need to talk more about the fact that mental illness is intimately political. Who you are in society hugely impacts your chances of experiencing mental illness, the way in which you are treated, and the kind of care you have access to, when you’re experiencing a mental health crisis.

Black - more at risk of being sectioned; more likely to be restrained

Trans - misgendered by services and detained in unsafe and harmful environments

LGBTQIA+ - being told by psychiatrists that their sexuality reflects an unstable sense of self and their personalities are disorders

People are being discharged from psychiatric hospital into homeless hostels

alcohol and drug addiction - refused access to community mental health services

autism and learning disabilities - put in seclusion for years with no access to outside spaces

Children - locked up in units and physically restrained numerous times a day

Sexual abuse survivors - arrested for phoning 999 to access support when they’re suicidal

partly issues of funding and staffing, and training, but they’re entirely human rights issues. The way we treat people who are vulnerable and from marginalised groups reflects on all of us. We desperately need a human rights approach to mental health care.

People accessing mental health care have been trying to say how damaging and broken the current system is for decades but until powerful people start listening and are prepared to have difficult conversations and hear some really challenging and unpleasant truths nothing will change.

please stop locking up survivors and holding us down, please stop diagnosing us with disordered personalities. Please stop hurting us. We are desperately trying to manage the devasting impact of trauma and mental illness. People are dying because of a lack of support and access to care.

listen to people using services, involve us in making decisions about how services are shaped to create safe places where we can heal and try to move on with our lives.

https://www.theguardian.com/commentisfree/2021/nov/20/treatment-nhs-psychiatric-ward-mental-health-crisis

regimented and controlled, monotonous schedule; I lost my autonomy. staff dictated when I went outside and for how long. They counted the cutlery after every meal before I was allowed to leave the dining room; any sharp objects I owned were taken from me and kept in the security cupboard. I was searched whenever I came back from going outside.

In the year to March 2021, there were 53,239 new detentions under the Mental Health Act – an increase of 4.5% on the previous year.

long hospital stays can lead to dependency and institutionalisation, rather than the autonomy and freedom people need to make long-term recovery.

Crisis in care: 8 million people are shut out of NHS mental health care because they don’t qualify as ill enough, and a further 1.6 million who do are sitting on waiting lists.

SSP - Art in Site

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