@Chlowinfield1’s #MadCovidDiaries 22.8.2020
TW: Self-harm
I wrote most of this blog during my first overnight stay in A&E for mental health, and my first A&E visit at all since Covid. I haven’t written much recently, the depression has got so bad I can’t seem to think of coherent words, but I needed something to focus on whilst there. And I wanted to acknowledge an example of a physical health team dealing brilliantly with a mental health crisis.
I always knew therapy would be hard, but I’m still unprepared for the physicalness, rawness of it. The teeth chattering, violently shaking, streams of blood soaking into the blanket you use to cover your clothes, rawness.
It was less than 5 minutes since the Skype session ended. If we’d still been face to face, the lull whilst I went for a walk or waited for the bus would have stopped me, allowed me to think about what happened rather than fall straight into self-destruction. As it was, the cuts didn’t look quite bad enough to need treating, but mum insisted on A&E anyway because experience tells us if therapy triggers something I’m unlikely to be safe over the weekend.
When we arrived Kolo, the unofficial A&E cat, was already in one of the chairs so I stroked him and took photos whilst we waited to be called. Animals and especially cats have a calming effect on me so he really helped.
The first person we spoke to was the nurse at the triage desk nurse. Mum mentioned that I’m more comfortable with females when distressed and he instantly offered to write on the notes for me only to be seen by women (it worked because I only saw female staff the whole time I was there).
Next I was called in by an HCA (I can’t remember her name) and E, another nurse. They were both lovely and put me at ease straight away. I said I was sure the cuts were superficial and didn’t need treatment but they spent a long time cleaning them up anyway. “How would you score the pain from 1-10, 10 being the worst pain you’ve ever experienced?”. I said 2 but even so they offered paracetamol and kept checking they weren’t hurting me. Whilst E cleaned the cuts she asked a lot about what had brought me in today, was everything okay at home, did I want to talk about anything that had happened. She kept joking that she was just nosy but it all felt very caring and not at all intrusive. She said she could tell I didn’t want to say exactly what happened in therapy that upset me, which was fine, but to come and find her if I changed my mind.
A bit later I asked mum if she could find the nurse so I could tell her about therapy. I really thought they’d stop being nice once they found how much of a minor thing had set me off (basically a drawing I scribbled on a scrap of paper 5 months ago). Instead, everyone wanted to listen and insisted there was ‘no such thing as a stupid reason to be upset’ and ‘you should see what I’m like when I get in a state over something!”.
It was several hours wait to see the doctor and I was struggling not to curl up in the corner on the floor or start crying again. I was glad I stayed in the chair though because, F, the consultant was lovely. F said the nurses had told her roughly what happened in therapy and she thought I was ‘entirely reasonable’. She said to only tell her as much or as little as I wanted. When I mentioned an additional thing upsetting me was the prospect of the therapist wearing a mask when we went back face to face, F instantly removed hers so I would feel more comfortable talking to her. She said she normally tells people they must stay in or must go home, but was happy to give me the choice. She trusted me to leave, but said she could see I was ‘still very much in fight or flight mode’ and if I thought I would feel safe in hospital overnight, I could stay and speak to the mental health team in the morning.
I’ve never stayed in for mental health problems voluntarily before. My first reaction was definitely that I shouldn’t be wasting their time when I could be at home. I knew I’d probably get distressed again as soon as I left though, and F insisted staying in was a good use of resources if I felt safer there, so I opted to stay.
Me and mum went to buy snacks from the vending machines before she left (my eating disorder tends to take a back seat when other things escalate so I’ll eat food without weighing it 6 times) and I had a goodnight cuddle with Kolo.
I kept expecting someone to label me ‘attention-seeking’ or warn me I shouldn’t be here with the current situation with Covid. Instead it was all offers of hot chocolate and reassurances that I wasn’t causing anyone any trouble. I spent the night in a side room, A&E seemed very calm, you couldn’t have guessed we’re in a pandemic if it wasn’t for the masks and extra hand washing.
The mental health team saw me at 9am the next morning. They checked why I was there but said they were surprised I was kept in overnight. They said they ‘wouldn’t be offering a full assessment’ because I’m ‘already so well-known to services’. It’s good practice not to ask someone to repeat their entire history but I think they could have asked a bit more about why I was in A&E and if I’d be okay over the weekend. One of them said she knew the therapist and I wondered if she was reluctant to talk to me about therapy when it involved her colleague…
Overall, it was a much better experience than I’d imagine in A&E at the moment. The general A&E staff went well beyond expectations and did a much better job of dealing with my mental health problems than the mental health team. Throughout the pandemic I’ve noticed that other health professionals are often a lot more understanding about how difficult it is not having therapy face to face than the therapist herself. Hopefully I won’t ever need to attend A&E for serious self-harm, or for a mental health crisis again, but if I did I wouldn’t hesitate to come back. Thank you, E, F, all the other staff whose names I didn’t know – and of the course the wonderful Kolo – for physically, but more so psychologically, putting me back together last night. 🙂
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