I communicate with my Care-Coordinator on the telephone or videoconference. I can hear the other people in her office talking, and once heard a pigeon falling down her chimney when she was working from home.

@RelapseRover’s #MadCovidDiaries 29.10.2020

Navigating mental health support in a pandemic

I have only ever met my care coordinator (CCO) once in person, after I was discharged from a two-month hospital admission in March. It was a week before lockdown. I haven’t ‘seen’ her since and barely spoke to anyone in person apart from shopkeepers and emergency services for a couple of months. I communicate with my CCO on the telephone or videoconference. I can hear the other people in her office talking, and once heard a pigeon falling down her chimney when she was working from home. She occasionally responds to the people in her office and last week someone brought her a cup of tea in the middle of our appointment. It would be better if she went into a private room, as she would do if I was seeing her in person. It feels less private and secure. One week I was in the virtual waiting room and I didn’t appear on my CCO’s screen so she presumed I had forgotten. You wouldn’t miss me in the waiting room of the mental health team offices. They have finally changed the music in the virtual waiting room as it was ear crushingly awful. I miss the thinking I do while travelling to see a CCO and the processing I do on the way home. When the call ends, I am immediately back in my home and it feels like an invasion of my personal space. My previous CCO’s had never been in my house and it was strange to get my wallpaper commented on. The distraction of the cat on calls has sometimes been welcome when things get tricky though. Also, it is convenient. I can roll out of bed and go on a call not worrying about attending to hygiene or personal care as she won’t notice.

When I have seen the crisis team at the acute hospital they have been donned with scrubs, masks and aprons. I have no idea what their facial expressions are and it feels very clinical. Apparently, I have met the same person more than once but I don’t remember as they all look the same in scrubs and masks. Even though they wear PPE and we have sat 2m apart they have restrained me so I don’t know where that sits with the Covid restrictions. The addition of a security guard – which apparently is Covid related (I’m not sure how) is particularly distressing. I don’t contact the crisis team anymore. They don’t do home visits due to Covid and have called the police and ambulances when I have phoned them distressed rather than offering a visit. Police and ambulance crew are also all in masks. Again, I don’t know how it works when they restrain me. During an acute hospital admission, I was in isolation in a side room. I don’t remember having a Covid test but I must have had one as after a couple of days a nurse came to inform me that I was Covid negative.

I had another mental health admission in the summer. I was transferred out of county again as there were no local beds. One of the wards in my area has been closed down as it still had dormitories and wasn’t Covid-safe. On the ward I had to stay in isolation until my Covid test came back negative. All the staff were in PPE. We weren’t allowed visitors but that didn’t really make much difference to me as I was so far from home. I think patients were expected to stay 2m apart but I’m not too sure as I spent most the time in my room. All the meds were brought to us which was quite convenient. It was swelteringly hot and there was no outdoor access or 117 leave. I did see an amazing thunderstorm out of my window though. There was a big green pepper on the nurses’ office door which apparently meant the ward was Covid-free.

I started psychological therapy during Covid after a 2 ½ year wait. Initially we met over videoconference and about 2-3 months ago we started meeting face to face. She had to put a case forward to her manager to see me face to face. She had said that trauma therapy needed to be done in person and that the risk could be managed better. I often dissociate and this wasn’t picked up via videoconference when we started therapy. In person, I don’t have to explicitly state what is happening. Initially my psychologist sent assessments and outcome measures to me in the post to complete. I would send them back and then we would discuss them in the session. It felt quite distanced for something that is quite intimate. A set of assessments that I had completed and sent back disappeared with my name and NHS number on. We thought they had been lost in the post but they mysteriously appeared on my electronic record. I’m not sure how they made their way back to the mental health team offices. We are about to start Eye Movement Desensitation and Reprocessing therapy. I’ve read that this can be done remotely but I don’t think there’s much research into its efficacy this way. I worry that the new level 3 restrictions will interrupt this and just as I start reprocessing, my therapy will be halted. We are in level 2 in my area at the moment, but potentially the whole country will go into level 3 mid-December.

The psychiatrist has assessed me over the phone and I’m due to speak to him again next week. My CCO says he’s a luddite who can’t figure out videoconferencing. I’m not sure it would be much better in person really. Perhaps the only difference is that he didn’t comment on my clothes in the letter. My GP’s telephone appointments feel less strained as we had previous telephone consultations before Covid.

I’m on weekly meds pick-up from the pharmacy. Since the start of Covid, for some reason there has always been a massive que outside the pharmacy. This was OK in the summer but is getting a bit grim standing out in the cold and dark, usually in the rain.

When I went back to work after sick leave everything was different. We now spend half of our time working from home and half the time in the office in PPE. This actually works quite well in terms of seeing my care team. The occupational health assessment before going back to work was done over the phone too.

Despite all the barriers, I feel well supported at the moment with GP, CCO and psychological support. I know I am lucky to have received any support at all and to be seeing my psychologist in person during Covid. I’ve heard so many awful experiences of people being completely abandoned by mental health services during this time it’s heart-breaking. Service provision is so precarious and patchy and there’s no end in sight. I wrote a previous MadCovid blogpost expressing the fear of a second peak of Covid and being able to maintain some form of mental health stability through it. I hope I can hold on tight during this wave.

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