When I was discharged from hospital last year, I wrote a post on the positives of the experience. It seemed churlish at the time to complain, I was admitted completely suicidal and unsafe, I was discharged fairly psychotic but at least functional. However, there are a number of things about my stay that continue to upset and haunt me. Mind have been talking a lot recently about the standards of crisis care so I thought I’d share my feelings on why it didn’t really work for me.
It all comes down to communication. I suppose the main purpose of hospital, certainly in my case, was to keep me safe by physically removing the chance for me to do anything. It could have done so much more. There are few opportunities in mental health services where you are around professionals all the time and while the staff to patient ratios aren’t good, they’re a damn sight better than those in the community. This should lead to plenty of opportunities for talking which may not fix anything in itself but can at least be therapeutic. I’m aware the nurses aren’t trained in psychology, I wasn’t expecting therapy but they should have a high level of empathy (otherwise why on earth are they doing the job) and the ability to listen.Unfortunately, that was never the case.
It took three days for my lead nurse to introduce herself to me. It’s not that she hadn’t been in the previous days, in fact I don’t know what it was, but apparently I wasn’t worth the time. I’m just a BPD manipulative timewaster, why should she bother talking to me? Worse, that 2 minute conversation was all I had with her the entire 10 days I was an inpatient. The other nurses weren’t any better, I don’t remember having a proper conversation with any of them. At one point I was given a form to fill in detailing my exercise habits. Apparently I was to complete it and then we’d have a discussion about it and see if there were ways to improve my lifestyle. Sounds good. Except for the conversation never happened. I submitted the form and heard no more about it.
I am not good at asking for help, in fact I’ve been known to let things fall apart completely and still not say a word. One day while there, things came to a head. Something deeply upsetting to me was happening in the real world, it’s not relevant what but suffice to say it’s something which deeply distresses me still. I sat and ran it over and over in my head for hours not daring to speak. Eventually something convinced me to head to the nurses office and ask if anyone could spare me five minutes. The nurse in charge sounded deeply frustrated by my request but sat me in a room on my own and told me someone would see me. Eventually another nurse came in, it was difficult but I shared what was upsetting me. What I wanted and needed was to discuss it, for someone to help me rationalise my fears and to see a way through it. Instead, I was offered 5mg of PRN diazepam to calm me down. No discussion, no advice just the offer of pills. Yes, the diazepam did remove the immediate anxiety but it didn’t go any way towards addressing what was really the matter.
The other thing with hospital, it’s full of ill people. Now that goes without saying, I was one of them, still am one of them. I remember being asked by another patient on my first day what my diagnosis was. The amount of sympathy I got from him and others about the rubbishness of a personality disorder diagnosis was deeply touching. A woman was admitted when I’d been there a few days. She was obviously deeply psychotic and for whatever reason became convinced that I was her daughter and that the staff had imprisoned me and were trying to poison me. At medication time she’d come up behind me and knock the pills from my hand in a bid to ‘protect’ me. In the communal areas, she’d sit beside me and stroke my hair and my hands and tell me how she would always love me. If I tried to move away, she’d burst into tears and grab at me to try and keep me close. I know that none of this was her fault but at the same time it was quite overwhelming and upsetting for someone as fragile as I was. I know that in a way I had to put up with it, she wasn’t harming me and had as much right to the space as I did. I always felt though when she was talking to me that I should contribute, to try and help in some way. I couldn’t though, I didn’t know how, I didn’t know whether to correct her or go along with it. Again, no member of staff did anything to help other than restraining her when she was after my meds. It would have been so helpful if someone had taken me to one side, explained a bit of what was going on and give me some idea how to deal with it.
I’m worried this post sounds like I’m being petty and whinging. It just seems that 18 months later, I’m back where I was before I was hospitalised. I don’t know if there’s anything that could have prevented this but what I do know is what I miss most in everyday life is someone who I could talk to about the deep and dark things in my mind. It seems to me that if that can’t be provided in the intense inpatient setting, it’s unlikely it’ll be managed anywhere else.