"crisis team"

About: Devon Partnership NHS Trust / Adult mental health

(as the patient),

I have written before about my experience of the crisis team and today I gave it another try. I did not have much hope beyond keeping myself safe for the duration of the call. The person I spoke was at least kind even though I was not offered a follow up call let alone a visit which left me feeling like my crisis is really not taken seriously. I am wondering and seriously wanting to know what the crisis team is for and what their expectations are of what their function is as I feel so bemused after each call and only extreme desperation would lead me to call.

It is sad that there is not the willingness, training, capacity to shine a light in the dark places.....I realised after the call that what was making me want to die was the intolerable pressure of grief. What I needed, wanted was to share this and be supported in releasing a little of it! PTSD as a result of child abuse leaves in its wake much grief as much as for what was never there as for the pain of what happened. It saddens me in the here and now that there is so little compassion in this service and yet it has such potential to touch these wounds of darkness with a little warmth and light! I am glad I was able to at least chisel a little strength out of my own being:

Chiselling strength

within the pit of my unknowing

opening to the possibility of light

the darkness collapses in upon itself

receiving the warmth that chiselling brings

the physical act of carving defining by what is surrendered

and in the darkness there is grief

and in the grief there is the unburdening hope of release

and in the relinquishing of illusion

there is letting go

there is allowing

the burnishing of my truth

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Responses

Response from Devon Partnership NHS Trust

Dear Gianetti, thanks for leaving your feedback here. We are really sorry to hear that your experience of our Crisis service wasn't as you hoped it would be.

Would you be willing to get in touch with us so that we can look into your case further? If you would like to do this, please contact our Patient Advice and Liaison Service (PALS) on 0800 073 0741 or by email dpn-tr.PALS@nhs.net. We look forward to hearing from you.

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Update posted by gianetti (the patient)

My experience when I have challenged mental health professionals over their lack of care and/or professionalism is that they consistently tell me my perceptions are skewed by my illness or add another label to my diagnosis. There is no sense that I can be viewed a credible witness to my own experiences. People seemingly close ranks and bad practice is defended because the reality is the funding and the will to create a good service is I am told simply not there.

I am afraid of making any formal complaint for fear of being further pathologised and disempowered. In all truth these complaints about crisis teams are widespread throughout Britain and supported by independent research, but no adaptations have been made as a consequence. Is there any protection afforded to the complainant or would I be opening myself to further criticism and disempowerment for nothing?

I have been told when I have complained about the impact of government cuts in mental health support, for example, that I am only perceiving the system as bad because I was brought up in an abusive family system. I am afraid of what seems to be the Stalinist approach to dissent within the mental health system and that there is no interest in creating a good system per se. Rather they only seem interested in finding ways to execute further government agendas of efficiencies by taking people out of the mental health system and denying them benefits or care.

In brief I am afraid of the consequences of making any complaint when in truth I am already so on the edge of committing suicide it wouldn't take much to push me over. Is this a real complaints system or one that is simply going through the motions as a government PR exercise?

Response from Ruth McClelland, Communications & Engagement Officer, Devon Partnership NHS Trust

Dear Gianetti, our offer to look into your case, and to provide as much support as you need, is a very genuine one.

We would urge you to get in touch with our PALS Team as soon as possible. One of our senior members of staff will call you as soon as we have your contact details to listen to what you have to say.

You can contact our Patient Advice and Liaison Service (PALS) on freephone 0800 073 0741 or by email dpn-tr.PALS@nhs.net.

We look forward to hearing from you soon.

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Update posted by gianetti (the patient)

Parity of esteem is a term used, but not defined, in the Government’s most recent mental health strategy for England, ‘No health without mental health’. Building on the RCPsych definition, this report considers parity of esteem to mean ‘valuing mental health equally with physical health’. A parity approach to mental health aims to deliver:

• equal access to effective, safe care

• equal efforts to improve the quality of care

• the allocation of resources on a basis commensurate with need

• equal status within healthcare education and practice

• equally high aspirations for service users

• equal status to the measurement of health outcomes

• holistic, integrated care with mental health considered alongside physical health.

Source: Royal College of Psychiatrists (2013) Whole-person care: from rhetoric to reality. Achieving parity between mental and physical health. Occasional paper OP88. London: Royal College of Psychiatrists.

It is all rhetoric, targets applicable to getting physical health treatment are not applied to mental health treatment. Cuts not applied to physical health budgets are scathingly applied to mental health budgets. Crisis team budgets have been axed considerably which perhaps goes someway to explain the poor service they offer and the fact that they are not accessible when needed and do little when accessed.

What difference would a complaint from me make???

Response from Sam Holden, Patient Experience Lead, Patient Quality and Safety, South Devon and Torbay Clinical Commissioning Group

picture of Sam Holden

Dear Gianetti

I am really sorry for all the problems you have clearly had and that your experience has been so poor.

I appreciate that you feel that you haven’t been listened to before and that your concerns have not been taken seriously. I would very much like the opportunity to speak to you about your concerns in confidence. I work for the organisation that is responsible for buying mental health and other health services locally so we are removed from the organisations that provide the care.

Access to mental health services is a really important part of the work we are doing at the moment and so the comments that you have made are really useful to allow us to try and make changes to services.

I’d like to speak to you so that I can understand your concerns a bit better, help you with any questions that you might have and see if there is anything we can do that might be able to help you immediately. Some of the concerns you have raised sound really bad and so I’d like to check that you are ok and see if we can give you any other support you might need. if you like, we can also help you make a complaint if that’s what you’d like to do.

I appreciate you might not want to speak on the phone, so please do feel free to email me at patientfeedback.sdtccg@nhs.net or you can call me on 01803 652 578.

I really hope that I’ll be able to help you.

Best wishes

Sam

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Update posted by gianetti (the patient)

dear Sam, I am touched by the seeming sincerity of your response and will call you ASAP...many thanks!

Response from Ruth McClelland, Communications & Engagement Officer, Devon Partnership NHS Trust

Dear Gianetti, we are pleased to hear that you are getting in touch with Sam. We would reiterate that we will do everything we can to help you and would be pleased to hear from you. Our PALS freephone number is 0800 073 0741 or you can contact us by email: dpn-tr.pals@nhs.net

Best wishes.

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Update posted by gianetti (the patient)

After another poor experience calling the crisis team, where there was a total lack of empathy and I was told the crisis team was there for "practical solutions only" and I should call the Samaritans, I did email pals but was met with a standard letter giving me another another number to call etc.

I have lodged my concerns with the community care medical secretary as the duty social worker was busy and I made a point of asking for clarity about the role of the crisis team. I have asked this before but only receive the answer contact us when in a genuine crisis but not when you have overdosed.

I mostly get a sense that they simply don't want to engage with me or my crisis. The usual practical advise is to watch telly! I have not called Sam yet because I am exhausted with the efforts I have made and being met by a wall of indifference is flattening.

I did speak to someone from health watch who seemed really engaged and said they would call me back but never did! I spoke to someone else at the CAB also part of health watch about other issues.

The bureaucracy is seemingly endless and confirming of my lack of faith so far… but I remain open to being proved wrong.

I am amazed at how many people have read this particular post which suggests to me a larger issue is here for a lot of people?

Response from Sam Holden, Patient Experience Lead, Patient Quality and Safety, South Devon and Torbay Clinical Commissioning Group

picture of Sam Holden

Dear Gianetti

Sorry again for the problems you are encountering.

As above, I am more than happy to speak to you to understand and help you with the issues that you have experienced.

I remain happy to speak to you on the phone or by email if you prefer. If for any reason I am unable to take your call, please either leave a message or send an email and I will call you back.

Please do call me on 01803 652 578 or patientfeedback.sdtccg@nhs.net

Best wishes

Sam

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Update posted by gianetti (the patient)

Have spoken to Sam, who was empathetic and is looking into this issue…

Response from Ruth McClelland, Communications & Engagement Officer, Devon Partnership NHS Trust

Dear Gianetti, we are glad to hear that you've been in touch with Sam. We look forward to hearing from you or Sam so that we can understand your issues fully and agree together the care and support you will be offered and make sure it meets your needs.

Best wishes.

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Update posted by gianetti (the patient)

I did write and phone Pals but just received a phone call and a standard email telling me to call a different number....(this happened last time I phoned Pals)....And when you have been through a traumatic experience it's not helpful to have to repeat it all within the same organisation! It just feels like being passed from pillar to post!

Thank you for your encouraging thoughts...though...and I get the set up is not your fault....but it does feel designed to put off complaints and discourages further disclosure!

Update posted by gianetti (the patient)

Just to say I had a good experience talking to Sam Holden, I was not referred to a different person or phone number.

I was listened to and the issue/s are being taken up with the people concerned. I have confidence that Sam will get back to me with further information and help me navigate the system as it stands, as well as that changes in the crisis system will be made.

I felt empowered and understood and believed and respected… which is all I ever needed in the first place from my crisis care.

Response from Sam Holden, Patient Experience Lead, Patient Quality and Safety, South Devon and Torbay Clinical Commissioning Group We are preparing to make a change

picture of Sam Holden

Dear gianetti

Thank you for your kind comments. I was really grateful to speak to you on the phone and thank you for your time.

As we discussed, there is a lot of working going on locally with regards to changes to the Crisis service. Much of this based on feedback from patients and service users. These changes would see a triage and signposting support service with advice and support and the opportunity to talk to someone who would be able to help. I am happy to keep you updated with progress on this.

We agreed that we’ll stay in touch and I will come back to you about the specific questions you raised in due course. I hope that I can work with you to help bring about improvements in the service going forward.

You have my contact details so please do not hesitate to contact me.

Best wishes

Sam

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Update posted by gianetti (the patient)

I have written back to Sam regarding the current absence of crisis care. Despite there being a crisis plan in my care plan, my coordinator still does not know who will replace her or when I meet receive support. The duty workers have not returned my calls and the crisis team tell me to call samaritans and samaritans tell me to call someone medical as the extremity of my anxiety is hard for them to cope with!

I am delighted that that there are plans to change crisis care in the future….but I m concerned about surviving now….until the autumn when these changes may take place and the safety net that is supposed to be in place not functioning at all currently……My direct payments are enabling me to purchase some of the support, I am not receiving from statutory services but these are due to be cut as from next week and I have just been told my needs do not need the eligibility criteria for a complex needs assessment despite the fact that this assessment is supposed to be eligible to every one…..and not supposed to take place over the phone! I have contacted Sam about this and via email and hope to hear back from him. It is very helpful to have somewhere to go with these issues as it can feel like you are alone in a Kafkaesque system in an Orwellian universe!

Update posted by gianetti (the patient)

If I did have the courage to try a crisis team again I have found out (re inspection of mental health services last July) in Devon 75% of people thought to be of danger to themselves were sent to spend a night in the cells as opposed to a place of safety in a hospital of elsewhere… So now all trust is finally broken.

A traumatised person feels suicidal because of abuse and trauma, gets locked up in the cells. Surely this should be front page news? There is no "safety" net!

Update posted by gianetti (the patient)

Sam is organising a meeting regarding my difficult experiences with the crisis team.

I am hopeful and very scared but it seems at least an opportunity to give voice to my concerns….I just really hope the meeting is constructive and leads to positive changes in the way the crisis team responds. My hope is for greater empathy and support….and that all the people who phone are treated with dignity and respect and have their crisis taken seriously and are met with compassion.

I am afraid to hope because I think this would require changes in orientation, training and funding and a real willingness to put the service user first….I am not sure that commitment is there but I want to have an open mind and allow myself some hope without setting myself up for disappointment…..At the very least I will stand for the dignity and truth of my own experience and those who have had similar experiences to me. I am afraid the response might be detrimental and punitive and undermining, but I have to risk this….and the dangers for me are far greater in being a passive victim.

Update posted by gianetti (the patient)

I have now had some positive engagement with PALS and Health watch as well as the quality care commission and see that they are working together on this.

I have now at last been allocated a coordinator…I will hopefully have an opportunity to raise my issues regarding the crisis team and the systemic problems I have an encountered! It is scary to complain but sometimes it is the only way to get heard and it may help others and that is comforting and empowering!

Update posted by gianetti (the patient)

I have now had a positive experience with a member of the crisis team, it touched me and I am glad this is possible. I risked because I felt so out of control and scared of myself I felt I had nothing to lose. My complaint is also being investigated.

I am still scared but also hopeful this can be constructive for all concerned.

Response from Sharon Berkhout, Communications Manager, Devon Partnership NHS Trust

Dear Gianetti,

Thank you for taking the time to share your feedback and for being brave in sharing your concerns. I'm glad to hear you've had a positive experience with the crisis team and I hope it continues.

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Update posted by gianetti (the patient)

I am awaiting the date for the meeting regarding all the issues raised here…It is of course always hard to synchronise diaries etc…I am with a lot of fear…I realise I have many question about the crisis team but this is only one component of my experience of mental health care. I see it as mostly failing because of a lack of clarity about what it is there for….My care coordinator said it took him two years to figure out the really good function it has in say getting medication to those who need it to avoid hospitalisation. I need acceptance, connection and assistance in kindling self compassion in order to help me not harm or kill myself….Is there a willingness to provide this generally or only very occasionally? It seems many people want this and don't get it…but not just from the crisis team but from mental health professionals and services in general. I am afraid of being thought foolish at this meeting for wanting what to me seems so obvious, I.e. all mental health services and NHS services generally to treat the people they see with dignity, respect, care and compassion. Am I naive in thinking this should be the priority? It also seems to me that if mental health services especially cant be provided with these qualitative values inherent in their application, then the service is no longer service and therefore it should be acknowledged that service cannot be provided at all…."FIRST DO NO HARM!"

Please wish me well while I anticipate this meeting…..I am finding the anxiety overwhelming at times…yet I am not sure I can bear not to try even if what I have to say is obvious and/or might not make a difference! Life is a risk! Risk is better than dust!