Being Propped Up: Support Services Can Work For People

I have realised over the past few days that this post is not going to write itself, therefore I have had to scrape myself off my bed and across the room to my laptop. Before I start though, I warn you that this won’t consist of any Booker prize winning literary prose. In fact it is more likely to be an incoherent ramble, but I shall press on.

The appointment with the CMHT on Monday was quite refreshing. It made me realise how much more the CMHT are willing to help me this time around. I was shown a draft copy of my care plan, which seemed accurate and highlighted what I need to do if I hit crisis point. One of the things that was suggested as a long-term approach was a referral to a new form of therapy starting in the new year called STEPPS, which is specifically for people with BPD. I am quite willing to undergo this, especially now Allison has reassured me that it won’t have the ‘competition’ element I have experience within group sessions before (we all know the one; I’m more depressed than you are, I’ve caused myself more damage than you have) and also that by agreeing to the therapy it doesn’t mean that I will lose contact with either Allison or the CMHT.

The session on Monday was one of the joint sessions with 2 CPNs, one of which is Allison; my care co-ordinator, and the other CPN (L) who acts as a facilitator. It is like a cross between psychotherapy and CBT, but in a much more relaxed fashion and without the awkward pauses. We talked about the weekend and I admitted to taking too much zopiclone and Nytol, although I didn’t at that point tell either of them about the suicide note I had written. I explained about feeling as if I couldn’t keep my head above water and they both told me that I can contact either of them when I feel I need to talk, and if they are busy/away then I will always be able to speak to the duty worker.

On Monday afternoon I ended up back in A&E. Somehow after the appointment I felt absolutely awful again, as if I had just lived a lie for an hour by not telling Allison everything that I wanted to say, so I cut myself. I had the same female F2 suture my wounds up as the time before last, and she seemed thoroughly concerned that in 8 days I had attended A&E 3 times and required more than 100 sutures. She wanted to contact the DSH team, but by the time she tried to ring them they had finished for the day and I wasn’t willing to see the Crisis Team. She wrote a letter for me to give to my GP, which I promptly opened as soon as I left the department, suggesting I need more psychiatric input than I am receiving at present.

On Tuesday morning I rang the CMHT in an absolute state and asked to speak with Allison, who was out on a home visit. The secretary asked if I wanted to leave a message or get her to call back, but I stated it wasn’t that important. Anyway, a few hours later she rang back and realised how bad I was feeling. I admitted ending up in A&E again, and that I hadn’t been entirely honest about the overdose over the weekend, and told her how bad my eating is at the moment. The crux of the matter is that she is now going to ring me daily, and I have been referred back to the Crisis Team so that they will contact me each evening.

I feel very supported at the moment. I have a CPN who is prepared to ring me every day, and is perfectly OK with me speaking to her more than once a day, and the Crisis Team ringing me out of hours every day and again are prepared for me to contact them whenever I feel I need to. I know this is what the CMHT and mental health services are meant to do, but it is the first time I have actually experienced them working together and to help me. I was scared at first when the BPD diagnosis was brought up by Allison that it would mean an end to her help and a lack of out of hours support, which is what happened in Newcastle. She reassured me though that although the diagnosis had to be written on my notes and care plan, she acknowledged that there was more going on for me at the moment, and I needed intensive support as I am in a severe depression at present with an eating disorder. It’s refreshing to realise that mental health services can see beyond a personality disorder to the co-morbidity running alongsde it.

I have to take the suicide note to the CMHT today as Allison wants to read it. She feels it will give her more of an insight into my mood and mind at present than talking to me does. When I mentioned it to a friend last night he seemed shocked, stating that it wasn’t my usual MO. It’s true, I don’t write suicide notes. I ring people, leave them voicemails and text messages, but don’t write notes. I think it is one of the things that has scared me recently that things have moved up a notch. The self-harming has reached a critical level, the eating is completely out of control and I am doing things that are detrimental that I have never done before.

I don’t know what the next few days will bring. Constant phone calls with the CMHT and Crisis Team are a definite, but everything else is unplanned and open to suggestion.

Ruth