In January, I was referred to Stockport Health Minds by my GP. Healthy Minds were soon in contact with me, informing me that their service was over-subscribed, and that it would be quicker to gain access to mental health services via referral to Stockport psychological wellbeing.
I was referred to Stockport psychological wellbeing services on 24th January. They were soon in contact with me, in arranging a telephone assessment for the 12th February. However, the appointment was quickly re-arranged following the first having failed; again, due to over-subscription to services.
The assessment consists of oral questions which are asked over the telephone. This in ascertaining the type of talking therapy that would be best suited to the needs identified. On completion of the assessment, I was informed that my needs were too complex for their service.
This is usual for me. Post-traumatic stress disorder (with a prevalence of human on human trauma/abuse) requires high intensity cognitive behavioural therapy as opposed to the lower intensity cbt Stockport psychological wellbeing could offer.
I was informed that following the conclusion of the call I would be immediately referred to the Access Team at Stepping Hill NHS Hospital. Indeed, a mental health nurse from the team rang me the following day.
Following a robust discussion, and in compare with traditional notes through the years I had been trying to access support, it was her professional opinion that my symptoms had grown beyond the point of just being enough to see me referred to healthy minds in wait of high intensity cbt.
She went on to refer me to the Stockport Early Intervention Team; a service which intends to intervene people suffering with severe episodes of psychosis; or horrific trauma with symptoms ranging from paranoia to total distrust in people.
The service provides immediate day to day health and social support, at home or at-clinic. This, while also providing pathways to treatments. such as high intensity cbt.
The next day, a community psychiatric nurse from the early intervention team visited me at home. Our initial conversation focused on the traditional causes of my ptsd, my family history, and scenarios permeating in my life at present, leading to present-tense trauma.
Following a full induction to the service, what is entailed and what to expect, she informed me she would telephone me back to make the first of several follow up appointments with myself.
To my surprise, a further unannounced home visit took place on Tuesday 27th February. I was informed that my team had tried to telephone me but could get no answer. This was evidently likely given my mental health had deteriorated to the point of not being fully coherent within my surroundings.
It didn’t take long for it to be identified that I was at risk of self-harm: It having been discovered that I had taken too much medication over a period of two consecutive evenings prior to this home-visit. I was taken by my nurse to Stepping Hill A&E, where I had blood tests as well as a heart trace taken.
Tests found that I was within safe parameters, thus I was moved to a quiet room and visited by a social worker from the hospital’s RAID team. She took information regarding my background, through to my present situation and current feelings.
She sought to clarify what my overdose had meant to me; what was my intention? Was it for self-medicating symptoms which had gotten the better of me, or was it that I was seeking to harm myself? I had no easy answers and so a couple of hours went by in exploring the depths of my mind. I was as intrigued to find an answer as was she.
In conclusion of the session, I was prescribed Diazepam to help relax me in arriving at home post-discharge. Transport was arranged for me. My community care coordinator followed up events several days later in visiting me at home.
I met with consultant psychiatrist Dr Marks, on 8th March. He recorded detailed notes through our conversation. These, in relation to; my current concerns in my life’s context; my environmental and social factors affecting my life; my health and well-being; historical trauma and ptsd; present-tense trauma and ptsd; pertinent symptoms that I am experiencing in the present tense; family history, inclusive of health & social factors; mental health services history; treatment history; medication history; etc.
Prescribing me Risperidone, in desensitising my over-active arousal system in fending off perceived danger, we agreed to meet back in a month and review the progress I have made, or not as the case may be, since the introduction of this medicine.
The following day, I was visited at home by my new care coordinator, trained as a community psychiatric nurse; and replacing my initial care coordinator in the community who I had been dealing with thus-far. She guided me through the on-going care coordination process, following our initial induction and administration stages. In concluding our meeting, we arranged our second appointment together for Thursday 22nd March.
By the Tuesday of the next week I had overdosed off of the initial prescription of that I had been prescribed. I had woken up feeling breathless the morning after the night before. I was checked out in the home by ambulance staff; of whom, I had telephoned for assistance. The paramedics concluded that I should go to hospital for a fuller check-up; their initial tests had found that my blood pressure and pulse were not within normal parameters.
After several hours in hospital, the all clear was given, although, hospital tests had correlated with heart monitoring tests within my home. They said I’d be ok and that the remaining negative side effects from the medication overdose would dissipate naturally.
Thursday soon came by, although it was difficult in being well enough for my second appointment with my care coordinator. Never the less, we followed up from a telephone call that she had made to me, having received news of my A&E visit. She asked me how I feel, and why I had taken a further overdose.
Having given recent overdoses that I had taken a lot of thought, I can only conclude that I had been trying to numb myself from intensity of feeling; and in doing so, gamble with my life to take matters out of my own hands. This has clearly been to the detriment to my physical health, though is indicative of how stressful the preventative factors of the last few years have been in obstructing treatment that was ongoing in 2014. This treatment, regardless of new anxieties and trauma-based experience permeating my entire life since and through.
I answered the question with inquisition in my own reasoning. I sought guidance in nailing a concise point, though such a specific point proved elusive. However, we both concluded that the explosive nature of my ptsd triggers had turned inwards in an implosive way. A scenario which presented with danger, such as verbal or physical conflict, with any form of befriending was being read by myself as a threat. In recent years, my explosive fight mode response to threat had worn itself out. My trigger response to danger was now much more implosive, than it was explosive. I concluded that I could no longer control urges to self-harm.
We agreed to resume my Risperidone prescription via weekly deliveries. This, to avoid generating stockpiles of medication in the home, thus minimising the risk in my reduced control over self-harmful trigger-urges. This began the following day, whereby she personally dropped off my first week’s prescription. A further week passed before I met with my care coordinator again in dropping off my second week’s supply. This arrangement is to continue by mutual consent, until it is judged that I have made sufficient progress with my emotional stability as to be able to administer medicine in safe doses.
After several years of failure to access the first identified treatments that I would require from NHS mental health services, I am looking forward to making quick progress in this new-to-me service.
I feel rejuvenated with a health pathway that thus-far better fits my immediate needs. It is also better resourced in meeting challenges head on, negating any preventative factors in accessing treatments.
In summary, I am now in secondary care services. A registered outpatient, my physical and mental health will be regularly monitored, tested, and treated where necessary.