Saturday, 30 March 2013

Preventing errors = preventing illness

Recently I had to see my new GP in a different practice as I swapped, to seek advice. Just like last year I had to battle with the receptionist to stress the urgency of my need as I was aware that I had been angry for over a week, couldn't sleep, wasn't eating properly, hadn't washed or changed my clothes. I was tempted to let rip and in retrospect perhaps I should have because I am so weary of battling to get access to the support I need when I need it most. I was almost at the point of just giving up altogether and trying to heal myself entirely on my own for things I have no way of knowing how to heal myself on rather than endure the humiliating, distressing and extremely stressful ordeal of trying to get to see the doctor of my choice i.e. the only one I felt comfortable with talking to.

Perhaps I should have yelled at the top of my lungs that I was mentally ill and for all she knew I was about to commit murder. I finally did got a phone call from from my GP who openly admitted to his lack of knowledge on mental health, so I was able to instruct him as to exactly what I required and he carried out my instructions but how ludicrous! Would a cancer sufferer be expected to do the same, or someone with tonsillitis or any other type of ailment. On the other hand it is no surprise that I know more than him as you will see if you read on.

Fortunately he followed my instructions and everything is in hand again because luckily for me I can articulate my needs because I know what they are, but... what would have happened if that had not been the case or I was a first time sufferer? Why is it that mental health conditions are continually shoved to the bottom of the queue by an unqualified receptionist for emergency appointments at the first point of contact and that General Practitioners still know so little about mental health themselves?

As sufferers we need to be responsible enough not to waste a doctor's time, but as sufferers when we are in a state of crisis that is a totally unrealistic expectation to impose upon us. As sufferers are we any wiser than a GP in prescribing which medication to use? 

It is neither ethical nor helpful if the medical profession to be working in the dark in this way, however, it's not really surprising that first line services (Primary Care Trusts/GPs) are ignorant about what patients need when the whole of the health care profession itself is so woefully lax in preventing mental illness among their own staff.

The statistics on health and social care professionals suffering from mental illness and committing suicide show that they are at higher risk of problems than just about any other profession you can think of. You can either 'cut it' or you can't seems to be the universal perception when often the conditions under which they work are frankly unreasonable, e.g. long hours without a break, swapping from days to night shifts continually with not enough time for their body clocks to adjust, low pay, not enough time for the mountains of forms they have to fill in and log jams caused by often long winded and ill thought out, clunky, inefficient administrative systems.

When the Care Quality Commission (CQC) makes it's assessments of services it's remit does not have provision to look at the psychological needs of the staff that provide any form of care. This can result in the best staff burning out, leaving the weaker and less dedicated staff to 'hold the fort'. Is it any wonder then that abuse cases hit the headlines as without diligent alert staff there to protect vulnerable people, abusers have free reign to enter into theft, neglect, physical, sexual and emotional abuse for ANY kind of service at all.

In the three months that I was sectioned (over ten years ago now), three members of staff were suspected of abuse and suspended immediately pending investigation. The mental health facility I was in about eight staff for 40 patients on days and less staff on nights on the main ward. Three staff were also allocated to the Intensive Observational Unit (IOU).

It is a miracle to anyone can recover when surrounded by other distressed and sometimes very violent patients and with such unsavoury characters working there. One was allegedly grooming female staff into having sex, another was standing guard while their colleague (a female) had sex with a male patient in the Intensive Observation Unit. It is perhaps among sufferers of mental illness that the fear of whistle blowing and not being believed is highest but, we are there to get better, not to accumulate psychological problems.

In an emergency you could call the police, but I suspect if you are sectioned it's pot luck as to whether you would be believed. However, there is also the CQC (Care Quality Commission, Citygate, Gallowgate, Newcastle upon Tyne, NE1 4PA Phone: 03000 616161) for any form of abuse or concern you wish to report. They are duty bound to respond as they are the body that regulate health care services in the UK.

How do we prevent abuse from health care providers?
In my view, in order to safeguard against abuse and illness I believe we should ensure all health and social care employers have to abide by work time directives and Employment Laws as this is not at all common practice. This should be monitored by the Care Quality Commission as part of it's normal inspection process along with psychologists to do regular checks on the staff who work in health and social care. In addition regular surveys on staff morale and stress levels as well as surveys from service users regardless of illness or disability about their care would I think help.

All staff in all sections of health and social care desperately need to be educated about mental illness if only to safeguard their own health let alone be better equipped to help us and, they need to be vetted more stringently before entering embarking upon their careers in the first place. It is alarming that an independent care home or even an NHS service can have fewer mental health awareness induction initiatives or psychological checks on new staff than a charity such as MIND or AgeUK but sadly it is often true.

Such things cost money though don't they? Well, according to HMRC (the taxman to you and me) we as a nation are owed an estimated thirty billion pounds, but according to according to the Tax Justice Network and PCS we are owed £120 billion pounds by... tax avoided, evaded and uncollected. I think a slice of that pie should definitely go toward better training, better staff, more stringent safeguards and oh yes more education on mental health!

Perhaps if more of us were employed we'd be able to sort it including many a long winded, inefficient, clunky administrative system. Is it any wonder that I have trust issues to get sorted?

Just my opinion though, you don't have to agree.

PLEASE NOTE: Written in a calm mood, not an angry one. We can only sort problems by getting to the root of them and through collecting ideas for the best solution.

A soul-to-soul felt thank you

I would like to say a thank you to the thousands of honourable health care professionals who literally risk their health in order to help all of us, be it on mental health or for anything else. Without them I would not be able to pick myself up again and again and again. It is for you that I dedicate this article. This is no way alters the fact that we need reforms to educate, improve systems and safeguard your health.
Thank you for being there and THANK YOU for doing what you do under such trying circumstances. It really shouldn't be this way, I hope one day it will become easier and safer for all.

PS: Since publishing this there have been interesting developments but confidentiality forbids me to say what, but I can tell you that globally Russia and USA are taking more interest than the UK at the moment. Typical.

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