Trigger warning: Mental health, self-harm.
As I recently asked my psychiatrist why I was still not allowed to be given my mood stabilisers a month at a time rather than a week at a time, he casually clicked his pen and said, "Oh, it's because of the cutting", and wrote a brief letter to my GP that I must hand to him myself explaining that he now believes I am in a safe enough place mentally to be trusted with the responsibility of having 28 pills in my possession at any given time rather than 7. It has been a year since my last mental health crisis. "They conflate cutting with poisoning" he said, and asked me if there was anything else I'd like to talk about. This appointment lasted all of 20 minutes, and it's some of the best care I've received since I first was given a name for my sickness five years ago: Bipolar Affective Disorder I, with Paranoid and Borderline Personality Disorders - the latter of which, a diagnosis given to difficult women who refuse to settle down. I have the best psychiatrist in the area, and so I understand that when he says words like "cutting" or "poisoning" in that laissez-fare way, he isn't not caring, he is simply doing his job with the amount of compassion fatigue I would expect from a consultant psychiatrist who has a roster of patients with ever complex conditions, most of which do not have a cure or any solid, proven treatment. As I left his office, a little shaken, I started to think about why I was seeing him in the first place, and what led me here to this cocktail of drugs and regular meetings with this man. It was a whole Summer ago, and I hadn't been very well.
I was living in Manchester alone, and had just come out of a difficult break-up with my partner which was caused, in part, by my increasingly bizarre, obsessional, self-destructive and aggressive behaviour. Something was up, and despite me raising the alarms to my local mental health services, nothing was being done. The break-up was the catalyst to what they call a mixed episode. I remember it in short bursts; hearing angelic choruses of classical music bursting into my room at 4am with the sun, seeing diamonds and gold thread woven into the leaves of the trees outside my door, crying non-stop, hearing voices, losing weight, throwing all of my things away and then buying more things, making small fires, hiding for days on end and then conversely spending days on end barely at home, hopping from house to bar to flat to club to avoid having to sit still. There was one point my best friend had to come over to take care of me and all I did was sleep for 18 hours. There was another point a week before where a different friend came to visit me because I told him he absolutely HAD to, because I'd seen something very funny on YouTube. When he arrived at my house at half one in the morning I was laughing over and over again at a clip of someone in a sitcom falling over. I laughed for over an hour. I started to suspect something was wrong with me, and so I took myself to hospital. When? The night of my book launch. I thought, I will get the book launch out of the way, and then finally hand myself in for treatment. Only it didn't work like that. I waited in A&E for 10 hours before I saw a psychiatrist and was given a small, blue pill by a nurse to "help [me] to calm down". I don't remember but my best friend tells me I was walking up and down the corridors and shouting. When the kind doctor finally did come, she told me she needed to admit me, but there were no beds, so she'd send me home that night and I would wait for no longer than two days whilst they shuffled around and found a place for me on one of the local wards. That never happened.
Ten days passed and my condition got worse and worse. I was being treated by Crisis Resolution Home Treatment Team, who advised me to try to sleep, came to my house three times a day with diazepam, told me to calm down, and trusted me to take the pills and go to sleep. I hoarded the pills and went out every night instead, often ending up right back in A&E with more wounds, or with a well-meaning friend at my side at the end of his or her tether with me, worried for my life. I remember being told: "This isn't a matter of getting you better, it's a matter of keeping you still with us". I paid no attention. Under the care of the NHS, I saw no psychiatrist again, no nurses visited, only social workers, I was offered no bed in any hospital (except for one in London), my medication was not reviewed. In my final visit to A&E, I remember going to the bathroom whilst waiting for a nurse to come back who had disappeared for an hour or so. I was probably two or three minutes. When I got sent home, my back door had been kicked in by the police and a letter had been left on my sofa saying they were concerned for my safety after I had absconded from hospital and was being considered a suicide risk. I had gone, I will stress again, to the bathroom, where nobody bothered to check. The police never came back, nor did they refund my landlord for fixing the door. Now, please don't think I am attacking the NHS. I am in current training to be a nurse myself. I am attacking austerity and cuts. How could I have been treated? How could any of us be treated? When there are pay freezes and job cuts and longer shifts, how can anyone get their job done properly? And where do we put mental health patients when wards are being shut down? Well, there is a place. On the final day, I was told a social worker would come to visit me at 6pm. Suddenly, I get a phone call at 3pm asking me if I could be at home in 10 minutes, so I said yes. Without warning, a psychiatrist, two social workers and a nurse are in my home asking me what I want to do about my medication, and asking me if I'll take the bed I'd been offered in London. I knew what this was. This was a potential sectioning. However, I had been passed a leaflet a few days previously for a place called Crisis Point, a safe place for patients who would normally need hospital admission. It was near to my house, and they had a place free. I decided I'd rather stay there instead, and so within half an hour, my care co-ordinator (one of them, I had several, I never had time to get to know any one of them) drove me there.
It was an inconspicuous building in a normal suburb that didn't have any signs outside saying what it was, there were hanging baskets outside the door and flowers in the garden. I had an assessment lasting an hour or so and was told by a kindly woman: "You're in". I cannot tell you the relief I felt in that time, knowing that all this would finally pass, and I would be given time to heal in a safe space where no alcohol was allowed, no drugs, and no other self-destructive behaviours. Being at Crisis Point was like staying, not at a hospital, but with family who live far away. It felt like I'd been sent away to a Scottish isle to recuperate from a sickness in solitude, even though the place itself was only a couple of miles from my own home. On my first night, I was given a manicure. Over the next 11 days I was given music therapy, art therapy, hypnotherapy, I learnt quigong, and I got better. I was sent home a new person, someone who had recovered from psychosis and mood swings, and I moved away from Manchester to Yorkshire, where I met the psychiatrist I mentioned earlier and whose care I have been under since.
The moral of this story is that we need more places like Crisis Point when the NHS is in such crisis, especially for mental health patients. But without funding, Crisis Point wouldn't exist, and without austerity and cuts, Crisis Point would not need to exist. However, it does, but it only has six beds and is not a nationwide initiative. We need to do all we can to keep these places afloat, because the government won't. It doesn't have to be money, it can be exposure, volunteering, anything. Whilst people are dying at mental health hospitals in the uk, places like Crisis Point are absolutely imperative. They are essential when you need a turning point.