Lived Experience Forum

[NikNik]

Hi all,

This seems to be NSW specific, however I still thought it would be worth sharing this article.

I hadn't heard of Project Air before, so it is great to hear there personality disorder specific initiatives.

What do you think - is this a big leap forward?

Nik

[-karma-]

I like the look of the training provided, and the fact that it takes a pronged approach.

The fact sheets could be useful...

Interesting.

[kato]

I was just reading through this article, and i understand about the risk assessment stuff, i have ben through it at a hospital, where is was not admitted because they didn't have room and i was not a risk.

This particular paragraph irks me,

Risk assessment checklist:

Includes Basics of a risk assessment: Is the person thinking about self harm/suicide? Does the person have a plan to self harm/suicide? Does the person have intent to self harm/suicide? Does the person have access to the means to self harm/suicide?

I agree with needing to assess the situation, except from my expierence, when you ask someone bluntly in the ER of a Hospital when they are in crisis, 1. It peeves them off, because it almost comes across like they arn't taking the fact that you are there seriously. 2. It creates more stressors for the patient to just go into flight mode, which if that occurs increses risk of self harm. 3. The lack of empathy when going through this by the er receptionist person, also creates more friction that the reason you are there is not important, and then you have to wait upwards of 3 hours to even be seen by the psychiatric triage nurse, again intensifies the feelings of not being taken seriously and to flight.

If you are lucky and have someone calm with you, to reassure you that it is all normal and the way it works, it is quite distressing.

There needs to be a better way, of asking those very important questions, but no shit, they ask them just blandly, and that they are not taking you seriously, is the impression given.

I think it is great that they are pushing for more, but there has to be a clear and concise method of ER intakes, that does not cause so much distress, when already in crisis.

I understand the system is massively flawed and staff are over worked under paid, and there is not enough beds for people who in crisis, come into the ER, it is easier if they can be heard and then dismissed, with here have something to calm you down and if your still not feeling well in the next couple of days, ring the catt team, who unfortunately again, over worked, and only come when severe crisis.

Crisis - someone at severe risk of self harm/suicide

Crisis - someone who is bordering on such thoughts, and gets ignored/missed because they seem alright in the risk assessment, all of a sudden are in severe crisis.

I have written two types of crisis, the latter is the one that gets brushed over which causes more harm then good.

I have no research to back this, except my own expierences, and i have heard it is better at some other hospitals

it for me is a key factor that needs to change, the first person you speak to, is not the understanding one, they are tired and over worked, ER ward reception person, i don't know there actual title sorry

[Rick]

@kato @-karma- 

Hi Kato,

And here we see the nail hit on the head. This is why engagement in services by we MI is low.

It comes down to how the service is actually provided.

I won't speak for anyone else, but for myself I have found that trying to get across what is happening in my head is actually hampered by the clinician I am talking to. I have found it thus for 30 years, Longer if you count childhood suppoed interventions.

Going through assessment can be very much like an interrogation. This  is course is often triggering. I have on more than one occasion after having  tried to explain my suicidality have simply walked out and gone home because I was actually safer at home. Noone to ask interrogative questions.

Is this simply being oversensitve?

Perhaps, but what do you expect? I am  acutley mentally ill and my cognitive reasoning could well be impaired. If I was capable of being reasonable I would'nt have shown up to be assessed.

These days I will not go to hospital willfully. My doctor has on occasion given me an ultimatum"either present at the MHU or I'll have to have you taken there"

Still tho within a day I'm lying my head off about how well I am so I can get the hell out of there. Why? because you can train staff all day long but if their engagement with patients is almost nil then who is looking out for me? Just Me!

Sorry for the heat, but I really hate MHUs. Each time it has been to no gain. 

[dwoods77]

This may be a trigger for some people....


God I hate the questions they ask, especially "do you have a plan". what kind of question is that... if I go into an ED my plan isnt to die its to somehow get relief from the thought of killing myself... I wouldnt present myself there and look for help if I didnt want some kind of intervention

[Alessandra1992]

The questions are asked primarily to determine priority of access. So whilst you do not have a plan, the next person may have and would therefore take priority..
Anecdotally I have been informed and read about certain diagnoses like BPD are rarely admitted because "it's behavioural" and therefore can't be assisted...
Sounds prejudiced to me and one day someone will sue hospitals for refusing service based on a diagnosis but in the meantime, it's still sounds as though there isn't much support available in an emergency department...lack of beds? Lack of funding? Lack of peer workers?

What improvements could we make if hospitals services were codesigned with our input?

[kristin]

Hi @NikNik 

Thanks for sharing, an interesting article. A step forward for sure. How big?

One wonders how much change his $600,000 will buy? Using the figures mentioned it works out to just over $100/admission. The article doesn't give us enough info to work out how many people this is, but clearly these poor souls are pretty desperate for help as it suggests high re-admission rates. The article also doesn't mention the rate of admission refusal - which is probably also high given the stigma.

So I have to say it looks a bit more like a bandaid on an open wound from here. Pardon my political cynicism!

Cheers, 

Kristin

[dwoods77]

Allesandra, I just think the "do you have a plan" question really is answered for them when you either present yourself to ED voluntarily or if you are brought in involuntarily without ever having to ask the question.
If you present yourself at ED your going to be fairly desperate for help as any person with suicidal ideation will tell you its pretty confronting to front up in an emergency room in front of many people.
I dont pretend to have the answers, just know how it feels when I have been asked that in the past. my last experience was horrible, the nurse was asking me in a voice loud enough for the whole waiting room to hear...

[kristin]

That sounds like a painful experience DW. Have you read the SANE report that came out late last year? I think you will find it resonates with your experience. Fortunately I have been so afraid of hospitals (and especially psych wards) that I will do anything to avoid going including somehow get myself through the intense overwhelm of ideation.

I agree with you that presenting is a loud cry for help without being put through a public emotional wringer too.

Hope for better help endures...

Kind regards, 

Kristin

[Alessandra1992]

It sometimes seems that the staff at hospitals have no idea how to interact with people in crisis. It's far too common for people to be turned away or for people to leave because the hospital isn't working.. And there is still stigma towards people with certain diagnoses...I have known people who have been turned away because they were not ill enough...based on a quick assessment in ED..so how can we influence change in ED? Is there training that could be mandatory for all hospital frontline staff of understanding how to ask and listen to people without embarrassing or humiliating the person seeking help?