A is for...

In the interests of attempting to post something, well, interesting, I've decided to attempt a new series. I don't know whether it will actually interest anyone, but I figure it stands a better chance of doing so than me simply whinging about my health/education/peers/family ad infinitum.

Anyway, all it really is is a slightly tongue-in-cheek ABC guide to medium secure mental health services. I'll try and do one letter per post, hence giving me 26 posts worth of material. Of course, there's a fair chance I'll get bored around the letter M or so and abandon it, but hey, lets think positively. I'll endevour to make them vaguely entertaining (as well as informative; it'll be like Sesame Street but without the drugs for inspiration), but am basically assuming that because it's an area that interests me it will interest everyone else too. I may be wrong, but it's my bloody blog, so tough.

I'll still intersperse the interesting stuff with rants and whinges, I'm sure.

(Speaking of which, I have Fresher's flu. I'm not even a Fresher, but their very presence has infected me. Not happy.)

So, onwards with A...

Abscond

Patients, for some reason, are not always entirely happy to be locked up. Sometimes, they try to run away. Occasionally, some are desperate enough to attempt to climb the 20ft fence whilst pissed-off staff cling to their ankles and try to pull them back down. More usually, however, patients escape whilst out on leave. Some patients will gradually gain the trust of the staff and consultants and obtain unescorted leave, only to hop on the next bus to Scotland (and occasionally, ferry to Amsterdam) and not come back. Others – less patient patients, who don’t want to wait the several years it can take to get unescorted leave – just decide that they can run faster than their escort and leg it when they are distracted. If said patient has been on the unit for longer than a few months, they are almost certainly much bigger than they were (antipsychotics are a bitch for weight gain) and in that time will have done no more exercise than it takes to throw a cushion at someone who tries to change the channel while the X Factor is on. They therefore usually get rugby-tackled by some now very irate staff and are hauled physically back to the unit, where they lose all their leave and are subject to much head-shaking and what the hell were you thinking?’s.

If they do escape, most are located within a few hours; usually passed out under a bush somewhere in the hospital grounds with an empty bottle of gin. Others get dobbed in after a few days by family or friends, who gradually realise that having an escaped, unmedicated, psychotic criminal kipping on your sofa is not as much fun as it sounds. Still others bring themselves back when they run out of money.

Basically, absconsions (a word that only appears to exist within NHS policies) are much more common than you might think, particularly in the summer when the weather is nice and the bushes are dry. The media isn’t usually told until a few days later, if at all.


A is also for: Alarms.

Staff and visitors to the unit have to wear personal alarms on their belt. This is pretty common on mental health units, I gather, but there are a variety of types. Some have different mechanisms: if you press the little button, it means you would appreciate some assistance with a difficult situation; if you yank the alarm apart (it’s in two joined parts, it’s not vandalism), it means you are having the shit kicked out of you and need to be rescued immediately. They all communicate your location to others in some way; either by a pager system or by flashing the info up on a panel on the wall. Newer alarms are even fancier; they go off if they come off your belt, and some go off if the mini-spirit level inside indicates that you are horizontal. So basically, if you are on the toilet and it falls off or if you forget you’re wearing it and decide to get comfy on the sofa, you might get a surprise visit from the response team. Who will either (a) laugh hysterically (if you are on the toilet) or (b) swear at you (on the sofa). Even fancier ones now come with GPS, apparently, so that you can track your staff throughout the shift. This highly specialised, very expensive bit of kit is allegedly to improve staff safety...and not at all to do with seeing who's sneaking out for a crafty fag behind the metaphorical bike sheds.

Our unit regularly used to run out of alarms to give people, simply because they break so often and are expensive to replace. I used to enjoy telling people that the bit of plastic they had just dropped in the loo was worth £200.


Alcohol

Is banned, although it doesn't stop friends and families trying to sneak it in. When a patient gets leave, it's sometimes specified whether they can drink or not. If they can, it's usually limited to a couple of units...but by that point, their tolerance is so low, you get 15 stone blokes getting pissed off 3 units. Which is funny.


Antipsychotics

Drugs used to treat...well, lots really. As wikipedia says about Chlorpromazine (the first antipsychotic); it effectively treats schizophrenia, severe mania in people with bipolar disorder, and uncontrollable hiccups. Basically, they control some of the weirdness like hallucinations, with varying success. They also have a huge range of side effects. Some people love them, many others hate them, and most find them somewhat beneficial but would rather they could remain conscious sometimes and like, poop occasionally whilst taking them. On my unit, the majority of patients are on these medications, along with mood stabilisers, antidepressants and about a million drugs to counteract the side effects of the other drugs. I have a love/hate relationship with them; I've seen them work miracles, and I've seen them do fuck all, and I've seen them do some scary shit (see: oculogyric crisis). I've also seen the way Big Pharma manipulates their usage and distribution, and it's not good.

It's worth bearing in mind that people on certain sections (eg. s3, s37) of the Mental Health Act can be forced to take medications for their mental illness. There is no more horrible feeling than restraining someone and sticking a needle in them. Unless they have just broken a chair over your colleagues head, of course, in which case it is somewhat less horrible, although not very PC to say so, so nobody tell the NMC I said that.

Ok, that's enough for A. I've probably missed something obvious, but Mr Door will be home soon and I need to cook his tea.


EDIT: Suggested by Quacktitioner...

Airlock - A term that sounds really high tech, secure and reminds you a bit of 2001 the film until you realise it's just two doors with a gap inbetween.

Anyone anymore? :o)

EDIT 2: And finally, something serious and actually useful from There and Back :o)

Advocacy

Advocacy in all its forms seeks to ensure that people are able to speak out, to express their views and defend their rights. Historically, individuals experiencing mental ill health have often not had their opinions and ideas taken seriously and have not been enabled to make their own choices.Advocates work with service users, safeguarding their rights, empowering them to make informed choices about their care and treatment and take greater control of their own lives.This can include:

· providing support if service users wish to comment or complain about a service they are not happy with
· supporting mental health service users with Mental Health Act Tribunals
· attending Care Plan meetings or other meetings with service users
· assisting service users in accessing services.