On Mental Health Crisis #2

On Mental Health Crisis #2

Mental health crisis #2 openly discusses the topic of crisis. There are also references to suicide that some readers may find triggering. If you are in the UK and your need is urgent, please call 999. If you need support, please call 111, option 2, or Samaritans freephone number, 116123.

Introduction

‘Like any other health crisis, it’s important to address a mental health crisis quickly and effectively. Crises can be difficult to predict because, often, there are no warning signs.’[1]

This post follows on from my previous post. In that post, I discuss my five-year-long mental health crisis that has arisen because of living with undiagnosed facial pain for so long. This post discusses the dismal response that I have received from the mental health services. I will be recounting my experience with the two most recent community mental health teams (CMHTs) and my experiences with two crisis teams.

Image of a man, who is in distress, with two of his friends putting their arm around to him, to show him their support.

This post also raises the question as to why statutory mental health services fail so many patients. It calls out for the English government to pour more money into non-statutory support services in order to provide a safety net for vulnerable patients, who, like me, have been left with no support.

CMHT 1: Fife

Image of The Firth of Forth in Fife. Purpose of image is to show the area in the UK where I had a poor experience of mental health services in relation to my mental health services.

My experience of the mental health services in Fife was unjust and devastating. I moved to Scotland in January 2020. The motivation behind my move to Fife was to look for medical help for my facial pain. Naively, I thought that I might get a better response from the medical teams across the border.

I arrived in Fife five months into my mental health crisis. I have already blogged about how a psychiatrist in Fife, who had never met me or spoken to me—I didn’t even know who he was—went into my records and wrote a discriminatory letter about me in December 2020. His letter said that I have “factitious disorder” and that I am making up my facial pain to feed the “need to have a sick role.” He sent that letter to multiple agencies.

Image of a woman, who is visibly in distress and shock. Purpose of image is to show how I felt when a psychiatrist in Fife wrote a discriminatory letter about me, which created obstacles to me getting medical treatment for my facial pain.

In Scotland, they have a medical recording system called Sci Gateway. Any medical professional across all of Scotland has access to a collective database of your medical records. The head and neck surgeons who my GP had referred me to could see the psychiatrist’s letter. His letter thwarted my whole reason for moving to Scotland: to get medical help for my facial pain. Two head and neck surgeons stonewalled me after he published his letter. His letter also led to systemic mental health discrimination, which I fell victim to.

This incident was a cruel injustice. A mental health professional who I had never heard of completely thwarted my chances of being taken seriously by the medical teams and getting medical treatment for my facial pain. I fell into a more serious mental health crisis after this.

CMHT 2: North Yorkshire

Image of an area of Scarborough. Purpose of image is to show the area where I had another poor experiences of mental health services in relation to my mental health crisis.

I didn’t think anything could be more unjust than my experience with the mental health team in Fife, but my experience with the mental health team in North Yorkshire has been even worse. My CMHT colluded in an underhanded manner with the cover-up about my facial pain. They then put the responsibility for their complicity onto my shoulders.

I arrived back in Yorkshire from Fife in February 2022. I was still in crisis. Even when the CMHT in North Yorkshire accepted me onto their caseload, they only saw me once every three months, (if I was lucky). On more than six occasions, I turned up for an appointment, and the MH clinician wasn’t even there. When I was actually seen, the “mental health nurse” told me that I need to “reframe” the way I view everything, that I “don’t like what I’m hearing from surgeons,” and that I need to hear some “hard truths.” She never specified what those “hard truths” were.

The Psychiatrist

Image of a psychiatrist sitting opposite a patient. He is taking notes as his patient talks.

I only saw the lead psychiatrist of my MH team twice in two years. I confided in the psychiatrist and told him that I had seen on my medical records that my GP had written: scan abnormal, to be expected, no further action. Within two hours of telling him this, I could not log into my TPP System One account. My GP practice had locked me out. When I got a new password, I saw that the GP practice had amended that comment. They had added: no review applicable to that record.

This is a screen shot of my medical records, which shows an entry that my GP practice amended 18 months after they initially made it. This tampering of my records was prompted by a psychiatrist who told the GP practice that I had seen their comment which revealed them failing to act on an abnormal scan of mine.

The underlined wording in red is the amendment that the GP practice made to the record 18 months after it was initially made.

It was the psychiatrist’s sneakiness that I found so sinister. He must have called the GP practice within minutes of me leaving the clinic. But I clocked him. I saw through his sneaky.

Image of a woman holding a snake, looking directly through the snakes tail. Purpose of image is to show how a psychiatrist who I dealt with at my CMHT behaved in a sneaky way, but to show how I saw what he did.

The psychiatrist could have helped me. He could have questioned my GP about why they had ignored an abnormal MRI scan. He chose instead to protect the GP. This is how the cover-up culture works. It’s one thing to be complicit in the falsifying of my medical records. It’s a whole other thing to then put the responsibility onto my shoulders: to tell me to “reframe” it. Cruel doesn’t touch the sides. It’s corruption at its worst.

After my CMHT discharged me, I went to A&E on May 17th 2024 to get help with my suicidal feelings. My GP practice then deleted that visit to A&E from my medical records. On 10th June, 2024, when I back to A&E, the psychiatric liaison officer told me that I could not go back to A&E for support again. They told me self-refer back to agencies who they knew had closed my file.

A playmobil image. I shows a small person on the floor, with their hands up by their head. They are being squashed by a corkscrew. Purpose of image is to show that I feel betrayed and hurt by the dismal response I have had from mental health services re my mental health crisis.Image of a man holding up a placard that says, 'What Now?' Purpose of image is to show how the mental health services have left me with nothing and nowhere to go regarding my mental health crisis. My CMHT has discharged me and a psychiatric liaison officer told me at A&E that I cannot go back to A&E for help with my suicidal feelings again.

In their discharge letter, the CMHT said, ‘Felicia thinks that NHS bodies are colluding with each other.’ The psychiatrist giving my GP practice the heads up to amend my medical record was colluding with them. When my GP practice deleted from my record that I went to A&E for suicidal feelings on May 17th, it was to cover for the CMHT, who they knew should not have discharged me. If this isn’t colluding with one another, then what is it?

Shut Down Again

Image of a closed iron gate with a lock around it. Purpose of image is to show how my CMHT refused me any help for my mental health crisis even after a psychiatric liaison officer re referred me back to their care.

In August, 2024, I went to A&E for the third time this summer to get help with my suicidal feelings. I saw a psychiatric liaison who referred me back to the CMHT. The CMHT did another assessment in November 2024 but said that they cannot provide me with any help or signpost me to other support agencies. I asked them what I should do regarding coping with my suicidal feelings.

‘Your suicidal ideation is chronic, but we can’t help,’ they said. ‘It’s your facial pain that is causing your mental distress, so your facial pain needs sorting. That’s not our responsibility, I’m afraid.’ I felt sickened and angry that she downplayed my struggle with suicidal ideation while smirking.

Any talk of suicide should always be taken seriously. Most people who attempt suicide have given some warning—but this isn’t always the case. If someone has attempted suicide before, the risk is even greater.

www.nami.org

Crisis Teams

‘Crisis resolution and home treatment (CRHT) teams were introduced in England from 2000/01 with a view to providing intensive home-based care for individuals in crisis as an alternative to hospital treatment.’ [2] They act as gatekeepers within the mental healthcare pathway, and are supposed tom allow for a reduction in in-patient admissions. They are also supposed to reduce out-of-area treatments and support earlier discharge.

Jacobs and Barrenho conducted a study to investigate whether the introduction of crisis teams and home-based intensive treatment teams actually reduced the number of in-patient hospital admissions. They found no evidence that crisis resolution and home treatment policy have made any difference to inpatient admissions. They rightly state that there is ‘a need for more research on the policy as a whole.’[3]

I am not surprised by their conclusion. I have been under the care of two different crisis teams during my mental health crisis, and my experience has been appalling. One team caused me harm, and the other tried to pass the buck back to the CMHT. An inpatient hospital admission would have been much more helpful.

Crisis Team 1

Image of a boarded up door. Purpose of image is to show how a crisis team got the police to kick down my door as part of a welfare check during my mental health crisis. The police left my door boarded up after and I could not gain entry to my home. The crisis team told me I would need to 'sleep rough.'

My first contact with a crisis team was in West Yorkshire in 2019, when my mental health crisis began. When I first fell into a crisis in 2019, I did make a suicide attempt. I spent three nights at a hospital in Kent after my attempt. My local crisis team assured the psychiatric liaison team in Kent that they would give me a bed on my local ward in West Yorkshire on my return. The hospital in Kent sent me back home in an ambulance. When I arrived back, the crisis team in West Yorkshire told me that there was no bed.

They then sent the police to kick down my door as part of a ‘welfare check.’ I returned home at midnight to find that the police had boarded up my door. I phoned my crisis team and told them that I could not gain entry to my home. Their response was criminal. The lady who answered the phone said, ‘You’ll have to sleep rough. That’s consequences for your actions. You shouldn’t have done it.’

It felt like persecution.

Image of a man lying on the floor. Another man's hand is holding the man's head to the floor. so that he cannot move. Purpose of the image is to show how one of the crisis teams who I sought help from for my mental health crisis hurt me. Their treatment of me felt like persecution. This image shows the essence of persecution.

Crisis Team 2

Image of a woman, standing holding a placard. The placard says, 'Volunteers Needed.' Purpose of image is to illustrate the non-statutory sector, and how underfunded it is. The post calls out for the English government to pour more finding into the charity sector, so that there is a safety net for patients who mental health services fail.

The response that I have had from the crisis team in North Yorkshire has been equally poor. They visited me at home for three days in 2022. I had just arrived in North Yorkshire, having been living in Fife. They referred me back to the CMHT. My GP was concerned about my welfare and referred me back to the crisis team in 2023. They visited me at home again. This time, they told me to ‘distract myself,’ but it’s challenging to distract yourself when you are in a suicidal crisis.

The crisis and home-based intervention teams decide whether or not to admit a patient onto a psychiatric ward. They do whatever they can to refrain from this. However, if a patient is in the throes of a mental health crisis, an inpatient admission is often the best thing. The 24/7 support provides a safety net that patients need when they are in crisis. In my experience, the crisis and home-based intervention teams do not offer this safety.

Signposting

Image of a woman, standing holding a placard. The placard says, 'Volunteers Needed.' Purpose of image is to illustrate the non-statutory sector, and how underfunded it is. The post calls out for the English government to pour more finding into the charity sector, so that there is a safety net for patients who mental health services fail.

A common action that mental health services take when they decline to help a patient is to ‘signpost’ them to non-statutory services. Non-statutory services refer to local charities that offer mental health support in the community and national helplines like Samaritans and Campaign Against Living Miserably (Calm). Community mental health teams sometimes signpost people to the local authority. ‘Where support is not available under The Care Act, local authorities provide information about non-eligible needs.’[4]

The reality is that most areas in England have few third-sector agencies that provide support in the community. In North Yorkshire, there is one charity in Scarborough that provides support. The only other non-statutory service is Supporting Victims which provides counselling support to people who have been victims of crime. That’s it.

There are many more third-sector agencies that provide mental health support in Scotland. SAMH, Breathing Space, and Housing Support are just a few to name. The Scottish government pumps a lot more money than the English government does into funding non-statutory services. I was extremely impressed by the third sector in Scotland.

Non-Statutory Support

Image of a woman, standing holding a placard. The placard says, 'Volunteers Needed.' Purpose of image is to illustrate the non-statutory sector, and how underfunded it is. The post calls out for the English government to pour more finding into the charity sector, so that there is a safety net for patients who mental health services fail.

If a CMHT declines to help a patient who is in a mental health crisis and ‘signposts’ them to the community, and there are no alternative agencies who can help, the vulnerable patient is left with no support. This puts a vulnerable patient at risk.

I have been ‘signposted’ back to my local authority, who refused to help me. The CMHT also gave me a number for the crisis team, but I can never get through to them. They have left me with no support. There are not enough charities in England to pick up the slack from CMHTs, bar a few national helplines, bar a few national helplines. If community mental health teams continue to ‘signpost’ instead of helping mental health patients, then there must be non-statutory support available. It’s not fair to signpost patients to community services that don’t exist. It’s like leading someone to a swimming pool with no water.

Image of a woman, standing in an empty swimming pool. She is holding onto the rail. Purpose of image is to illustrate how dangerous it can be when mental health services signpost patients to charities and third sector agencies that aren't there. It's like leading someone into a swimming pool with no water.

Conclusion

I am not alone in my experiences of the mental health system. My feed on X (formerly Twitter) is full of posts from people whom mental health services have failed. I read so many posts from patients who are in need of help and support but whom the MH services have dismissed. One lady recently posted about how her crisis team hung up on her when she rang them for support.

In 2020, Sir Simon Stevens, the previous chief executive of NHS England, said, ‘The NHS is delivering on its pledge to improve mental health support.’[5] The NHS is not delivering on the pledge. The mental health system fails too many of us. The gap between these words on paper and the reality for patients like me is too big. It needs bridging. Health executives need to put these words into action.

But, why are services that mental health teams provide generically so poor? Is it because they do not have the resources to meet the heavy demand on services? Or is it due to a lack of compassion and empathy? I don’t know. However, if statutory mental health services continue to fail so many patients, then the English government must pour more funding into the third sector/non-statutory services to ensure that there is a safety net for patients.

Image of a life buoy in the middle of the ocean. It is there to help people in danger, who cannot keep afloat. Purpose of image is to illustrate that if mental health services fail patients like this, the government needs to put more funding into the non statutory sector, to ensure that there is some support available for vulnerable patients.

I feel abandoned and trodden on by the mental health services. At the very least, the mental health services could have communicated to the medical teams about how badly my facial pain is affecting my mental health. They have not advocated for me at all. They have remained silent, which is a form of complicity. The word that best describes the response from mental health services to my mental health crisis is betrayal. And it’s hurt.

Image of a black sign that says, 'There comes a time when silence is betrayal.' Purpose of image is to illustrate how the mental health services have not told the medical teams how much mental distress my facial pain is causing me. Their silence is a betrayal.

A Tribute

I want to extend a heartfelt thanks to all of the non-statutory organisations that have helped me weather this storm. I have been heartened and touched by their kindness. It’s thanks to you all that I have made it this far. All of the charities mentioned in this post that have a hyperlink are charities that have supported me during my five-year-long mental health crisis.

I don’t think that charities get enough recognition for the extraordinary work that they do in communities around the UK. I have experienced nothing other than dedication, kindness, and integrity from every worker and volunteer I have come into contact with. You are my heroes and heroines, and on behalf of myself and the thousands of others whom you help, a massive thank you.

Image is of the words; Thank you for your kindness with a picture of some flowers underneath. Purpose of image is to thank the non statutory services who have helped me through my mental health crisis.

Foot Notes

[1] The National Alliance on Mental Illness, (NAMI), Navigating a Mental Health Crisis

[2] Jacobs R & Barrenho E: The Impact of Crisis Resolution and Home Treatment Teams on Psychiatric Admissions in England. Feb, 2011, The British Journal of Psychiatry: the journal of mental science.

[3] This quotation is taken from the same source as footnote 2.

[4] Care Quality Commission: The State of Health Care and Adult Social Care in England, 2023/24, www.cqc.org.uk

[5] NHS England: Mental Health Crisis Services Rolled Out Across England, March 2020, www.england.nhs.uk

Photo Credits: Prawny on Pixabay. Alexsi Partanen, Jose P Ortiz, Burkhard Kaufhold, Jametlene Reskp and Masaaki Komori on Unsplash. Tima Miroshnichenko, Tom Gill, Timur Weber, Pavel Danilyuk, Julia Cameron, Olha Ruskyth, Jeff Stapleton, Brett Sayles, CK Lacandazo and Mart Production on Pexels.

Blog Authored By Felicia Kate Solomon

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