Liaison Psychiatry & Home Treatment Team.

On Saturday 30th March at noon, I took a paracetamol overdose. It wasn’t a big overdose and I’m not going to go into the circumstances surrounding the overdose because they are not important and that isn’t what this blog is about. 

I had already accessed Duty Psychiatry earlier on in the week when my GP did an urgent referral. I had been unimpressed by the lack of compassion displayed by the mental health nurse and the student mental health nurse even though I was obviously in a mess. I’m not going to go into that into too much detail either. 

At 6pm on Saturday, I decided that I should probably go and get checked out at the hospital. I didn’t want to tell my family what I had done so I text my best friend – who really was the bestest friend EVER on Saturday night – and she came to pick me up at about 8.15. We arrived at the local hospital at 8.40 and I got registered and sat down with my best friend. We chatted for a bit which was nice. I was very agitated but my best friend was doing an amazing job of taking my mind off everything and keeping me occupied. I didn’t tell my family where I was going. I just told them I was going to chill at my best friend’s house. I wish that was the case. At about 9:50, we were finally called into the Majors unit by a staff nurse. She was friendly and offered to call my Mom. I said “NO” immediately. They respected by confidentiality. THANK GOODNESS. 

The staff nurse and doctor (a senior house officer) came and took a brief history from me, did my obs and took some blood. They also had to run an ECG because my blood pressure was really high. Afterwards, they sent me and my best friend to sit in another waiting area whilst they waited for the blood test results to be sent off. I could only talk to mental health teams after I was declared medically fit. They said that it would take an hour for the blood test results to come back. If my paracetamol toxicity was too high, I would have to be admitted and given an antidote. 

We passed the time by playing silly games and watching the countless drunks being brought in by paramedics and police officers. At about midnight, the SHO came back and told me that my blood test results were fine and that we just had to wait now for liaison psychiatry. My local mental health trust have a service called RAID which stands for Rapid Assessment Interphase and Discharge. It’s an award winning service which has received praise from the one and only Minister for Health, Norman Lamb. Well, my experience wasn’t exactly “award winning” in fact –  it wasn’t even half way there. 

Well the SHO said that somebody from the RAID team would be down to see me in about 10-15 minutes. By this time it was about 12:10. The liaison nurse from RAID didn’t come until well after 1am. We were sitting in this waiting room, I was getting more and more agitated and we were both getting exceedingly tired. We talked about the clocks going back and how, for the first time in our lives (however for the wrong reason) we would be seeing the clocks going forward and a whole hour of our lives would just disappear like that. I remember seeing a man at the nurses’ station who I reckoned could be the liaison nurse but he was spending a VERY LONG TIME chatting up the pretty nurses who were all VERY BUSY DOING OTHER IMPORTANT THINGS. Finally, at 1.30am (I remember the time now as he wrote it down on his hand as we begun the conversation), we sat down in a private interview room (which I imagine is the “bad news room”.) to have a chat about what brought me to A&E that night. So we started and as I explained what had been going on (& what had happened during the week for me to get an Urgent referral to the CMHT) he was very unsympathetic and rude… kind of tutting at me. I was not impressed at all. Then he said (and these are his exact words) “You don’t seem like you have a mental illness” and I’m just sitting there, opposite him like…. I took a paracetamol overdose 12 hours ago… my best friend sitting in the waiting room wouldn’t do that, she doesn’t have a mental health condition. She probably thinks I’m crazy because she had NO CLUE what was going on in my brain before today but I certainly didn’t need the liaison psychiatric nurse saying that I was basically attention seeking and didn’t have a mental health condition after all. Wait till my GP hears about this. She’s going to be astounded that somebody could be so insensitive. Especially when it’s in his job specification to be a sensitive person as you will be dealing with vulnerable adults & children. And I was feeling vulnerable. It was the middle of the night, I had tried to take my own life and I was very agitated and upset about the whole situation. When I told him about the circumstances which had made me take the paracetamol he responded with “I think that’s very unlikely” about symptoms that I was having. Not nice. At all. I spoke to him for about an hour. He came to the conclusion that I needed to be seen by the Home Treatment Team because I was “probably just going to go home and do it again”. So off I went, back to my best friend who was waiting patiently in the waiting room for me. Both our phones had run out of charge. My dad was expecting me home from my best friends house at about 11pm. Oops. The time change had happened so it now made it half 3 in the morning. Now we just had to wait for the Home Treatment Team to arrive at the hospital. 

When they finally arrived, I was never introduced to them. In fact, the only person who I was introduced to through the whole night was the liaison nurse. That was the only good thing about him! I have a feeling one was a psychiatrist and the other a nurse. Their phones kept ringing when they were talking to me. The lady (who I think was the psychiatrist) kept asking me lots of questions and the man (who was a nurse I think) kept tutting and shaking his head at the woman asking me questions. They obviously had no clue what each other were doing. I was speaking to them for about 30 minutes and then they told me to go and sit back in the waiting room whilst they discussed me with a consultant and then they would come back and tell me to go home. As I was leaving, the man asked the woman if she was Section 12 Approved and I could feel my eyes widen… Was I really sectionable. From what I told them in that room, I wouldn’t really have been surprised but even though I was so agitated and obviously suicidal, I still had Mental Capacity. I would have chosen to go to hospital voluntarily if that was what they had suggested. So back to the dreaded waiting room I went, not knowing if I was going to be sectioned or not. My best friend was fed up… Really very tired. We had been in A&E for over 6 hours. About 10 minutes later, the original liaison nurse came and told us that I should have gone home when I’d finished talking to the  Home Treatment Team. I said to him that they told me to wait here while they spoke to someone else and then they would tell me what the plan was and then tell me to go home. He just said “Go home”. My friend thought he wasn’t very nice either so I was glad I wasn’t on my own. We finally left the hospital at about 4.15am. 

I had no idea what to expect from the Home Treatment Team. No one ever told me that they would call me to check that I was okay. But they did. Lots and lots yesterday. And I kept unintentionally missing their calls… 

I finally spoke to someone from there this afternoon. They shall refer my case back to the CMHT tomorrow. Well woopdedoo to that. I cannot wait. 

 

The main problems of my experience were: 

  • waiting around for hours and no one checking whether I was okay. In fact, once I was declared medically fit, the medical staff didn’t really care any more. This grated with my best friend as well – she was unimpressed that they didn’t check on me.
  • the unprofessionalism of the liaison psychiatry nurse. Yeah, he wasn’t nice. At all. I’m sorry but after suffering with my mental health for over 2 years and then having to go to an A&E department because I’d overdosed on paracetamol (which is probably one of the worst ways to die) and THEN he had the nerve to tell me that he didn’t think I really had a mental illness and that I was just attention seeking. Brilliant. I shall remember those words for the rest of my life. 
  • The lack of communication between the liaison nurse and the HTT. The HTT told me to wait and they’d come and tell me to go home but the liaison nurse told me to go home before they’d come out of the room. Therefore I had no idea what was going to happen to me from then on. They obviously had to have a plan in place. It was just a shame that I wasn’t made aware of it. 

To look on the positive side of things, my medical care was almost exemplary. The nurse was lovely, the SHO was okay too. And now my best friend, who I cannot stress enough, really was the bestest that night, knows just how poorly I am. 

 

I just wanted to say a big THANK YOU to all my lovely Twitter followers who were all so lovely over the weekend… You all really made a big difference!! 

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3 thoughts on “Liaison Psychiatry & Home Treatment Team.

  1. No pleasing some people. It was free, it was 3am, you took the overdose in the first place and then demand unending sympathy and constant check ups?

  2. I’m appalled but not surprised at your treatment. The last 5 years has seen 100’s millions of £s pumped into MH care which has been utterly wasted. Your case is so typical of the treatment people receive. My thoughts are with you and my heart goes out to you – it is all I have to offer. You are welcome to browse our website and contact me by email if you think I could help in any way. No charge, nothing hidden, just a little compassion.
    Steve Flatt

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