I read about out of hours services today and it led to me to thinking about my experience with crisis services in the past. The first time I encountered a crisis team or out of hours service my experience wasn’t great they seemed to totally misconstrue me and failed to help or support in any way. I can recall one time when they visited me at home and having decided that I was safe leaving me there in a crisis and in chaos. I was suicidal and desperate and so clearly losing time and switching, but they didn’t see that they just me as inadequate, dysfunctional and a nuisance.
They left me alone and still suicidal and so intent on dying that in desperation I tried to harm and then I dissociated, during which time I took off only to surface a few hours later some 60 plus miles from my home. I was picked up by the police for my own safety after they saw the distress that I was in and I was taken to a nearby hospital, they assessed me and admitted me to hospital.
Crisis at home had failed me, sadly it is often what happens, for me at least.
There was the occasion when I couldn’t live at home and had no where to go, I had been in hospital and discharged just a few days earlier but I had no place to stay. I had self harmed and the police had taken me for an assessment at the hospital, I sat waiting until the crisis team arrived and then they didn’t even talk to me except to give me a list of hostels. I hadn’t gone to hospital because I wanted a place to stay, I wanted to die, I had gone there by force and against my will and yet I was treated like I was a nuisance.
Then on one occasion I was at home and struggling, crisis care was put in place and so for a couple of days they visited me. I saw a different person on each day, I never saw the same person twice and after a couple of visits I was put onto telephone calls only. The calls would be brief, wanting to know how I felt and then not really being able to offer any guidance or support really when I said how bad things were. By day four I was discharged from the crisis team to my regular mental health team, I wasn’t any better yet the crisis team support was only meant to be brief. I guess it didn’t matter that it didn’t work, or that discharge to me seemed too soon, too swift. Two days later I was seen by my community team and they admitted to hospital, I spent six months in hospital on that occasion, so crisis clearly couldn’t help prevent my downward spiral.
The crisis team in recent times has just been telephone support, but if I’m honest I avoid calling them unless it’s absolutely dire. If Samaritans are not able to help and I’ve tried everyone else I can think of, then and only then will I call crisis, it is a last ditch attempt. The last two occasions have been pretty much the same really, I call, I say I’m struggling and they go through a list of techniques to try. ‘Take a warm bath, have a hot milky drink, try a nice walk or have you watched TV, tried to distract yourself?’ these are their usual lines.
They never assume I might have tried these things before, that I might have already thought of them myself. It never occurs to them that I don’t actually ring them when a crisis starts, or that they are usually the last person I try. It’s as if the staff manning these services are reading off a predetermined script and are unable to offer any person centred approach of any kind.
The last time I called I was desperately trying not to self harm, struggling with grief and the difficulties of accepting my trauma. I needed some help to try and keep me safe, I didn’t want wrapping up in cotton wool I just needed some guidance to help me, help myself. Some advice to point me in the right direction to prevent that slide back into harming. I was desperate not to self harm, desperately busting a gut as I fought to resist the urges growing ever stronger. I had already tried all their suggestions before I even called them. In the end the only advice was have another drink, try some art maybe and call back if your struggling still.
About an hour later I did call back, this time I got a different person who initially went through all the same familiar suggestions. Then I heard another phone ringing and the nurse on the end of the line basically told me she was hanging up on me as there was another call and she couldn’t help me. In the end I stayed safe but only thanks to the support of those on social media and then later my family. The crisis team didn’t even inform my local community mental health team that I’d contacted them and was struggling, how is that joined up care.
The crisis service were and I believe are unable to offer any support or guidance that is of use to me, after all they don’t even know my diagnosis.
In the past decade my encounters with the crisis team of two separate hospital trusts have shown me that their understanding of dissociative disorders is limited. Their ability to assist and offer support is limited, in fact for me they are not there in a crisis because they can’t comprehend me or my diagnosis and without that they appear to be unable to help when I need them most.
In the future when I call, if I call, I will explain what I need which is usually someone to help me mentalize things, someone to just listen, to know my pain. I don’t need pointers like a bath or a drink I just need five minutes of their time and for them to hear me. From now on I aim to take control of my interactions with Crisis services and hopefully that will educate them as we go. Maybe this way they can help me when I need it most, only time will tell.
Copyright DID Dispatches 2015