This Week in Mentalists (59)

This week in our round-up of writing from the mental health blogosphere: crisis plans, the concept of reasonable adjustment, some body bullying and an update of the Devil’s Dictionary.

Writing in the Margins of My MInd examines her crisis plan.

The crisis plan section of my CPA is woefully unhelpful. It has some helpful suggestions like “call a friend”, and some things that are useful if a crisis occurs out the right time (“call school nurse” – if 9-3 on a school day). There is nothing, however, for when a real crisis occurs and I need to speak to a professional. Sure, I can go to A&E, or I can attempt to get an appointment with an out of hours GP, but these things tend to be like banging your head against a wall, and when you’re feeling rough, having to advocate big time on your own behalf to get anywhere isn’t what you want to be doing. I’m known to mental health services, I’m known to be a risk – so shouldn’t there be a slightly easier and more direct way for me to get in touch when I need to?

In the same post, she also highlights the perennial problem of lack of out-of-hours cover for child and adolescent mental health services.

My therapist thinks that what I want is a “Dial-A-Nurse” service. I suspect she’s being a little bit patronising there. But why not, actually? I have friends with AMHS who get just that; a crisis team who will answer the phone and come out and see them. They may sometimes not answer the phone, they may not be the magical cure-all, but they are at least there, in theory, as a service. I can’t even get someone to talk to me on the phone when my crisis occurs at 11am on a week day. I know that comparing is stupid and hell maybe I wouldn’t even get a second look from AMHS (enduring? yes, but severe? depends who’s assessing) but it’s hard not to when I feel so royally screwed over for being 6 months younger than them.

The government has announced a ‘root and branch’ investigation into social work as a result of Baby P. Fighting Monsters isn’t impressed.

I do think there are lots of things that can be emphasised to encourage people into the profession – but most people have no idea what social workers actually do, apart from ‘get things wrong’. Again and again. But honestly, I didn’t go into Social Work to be appreciated, loved or even particularly well-paid (although some kind of half decent recompense is greatly welcomed). I also didn’t go into Social Work to be ridiculed and to have the scope of my job and profession investigated, criticised and changed every few years. Mostly by the Government.

There are vast areas of social work that take place outside child protection. There are vast swathes of social work that take place outside the statutory sector. Of course, these don’t tend to interest leader writers.

Protection of vulnerable is vital but there is more to the profession that being responsive to knee-jerk circumstances and tragedies. It’s a shame this same initiative wasn’t taken when the last decision was made to ‘transform’ social work.

Life From the Sofa points out that “reasonable adjustment” applies to mental health problems too.

But what about reasonable adjustments I hear you cry? Or perhaps not if you’ve never heard of them. Well, Gp surgeries are supposed to offer these adjustments to any patient with a disability. That means that, where possible, they provide a quiet place to sit and wait, an understanding that talking to yourself doesn’t mean you’re about to stab the receptionist, and flexibility when it comes to making appointments.

Unfortunately the computer at my surgery says no. So it looks like I’ll be staying up all night on Thursday in order to see my own doctor the next morning. He only works Friday at my local surgery and I’m really not up to making two bus journeys to find him at the other one. He is insistant that I see him rather than another doc, and this is the last chance I’ll have for a chat before Xmas, a stressful time for me. So this week I shall be going to see him armed with a booklet from Rethink, entitled Reasonable Adjustments and your local gp surgery. Perhaps between us we can persuade that computer to be nicer to me in future.

Marine Snow is a body bully.

I can see why my body might be pissed at me. Hell, I’ve never been particularly nice to it, have I? I’ve starved it, force fed it, purged routinely, burnt it, cut it, bruised it, overdosed it on laxatives, diuretics, diet pills, illegal drugs, alcohol, cigarettes. I’ve over-exercised, and not exercised often enough, it’s malnourished, maltreated and malfunctioning.

In the past nine months alone, I’ve starved it into child sized clothing, making it run on a diet of cuppa soup and sugar free jelly, pumped it full of psychiatric medications of dubious suitability, all despite its numerous complaints. In the past week I’ve gone on to cram it full of carbs, and forced it to expel them through a torn oesophagus and torn throat, and ripped away those aforementioned meds without warning. Then, this morning, to add insult to injury, it was given a dose of yet another chemical.
This is out and out body abuse. I am a body bully.

Sticking with the subject of bodies, Mentally Interesting: The Secret Life of a Manic Depressive reflects on body dysmorphia disorder.

The people who know me say I don’t see myself right, but to me, I see myself too clearly, and their image is muddied by love. Nobody tells me I’m ugly. Nobody points out my ridiculous nose. My friends and loved ones just sigh, “But you’re ill”. There are photos of me on the internet but they are not me. There are hundreds of them, mostly ones I’ve taken myself (and I do have a life, just people know better than to take photos of me, it usually upsets me a lot). I show people, because that is an image that I have control over. Those sites themselves are absurdly pointless boredom catchers. Still I worry that they look and think, how ugly she is. I shouldn’t care. I don’t want to care, and for the most part, I don’t- I am totally unaffected by compliments or even criticism, so why do I panic so much? It is deeper in me than that and I have been fighting it for such a long time.

I know that I have Body Dysmorphic Disorder. They are right. I know that, technically, it’s imagined ugliness, just an anxiety disorder. I cling to my clinical little terms because they’re easier to understand, that it goes beyond hatred. The fact that people are surprised that I could have such a low opinion of my looks, surely means something? Why doesn’t it mean something? I listened in Cognitive Behavioural Therapy. I have been trying very hard to put what I learned into practice. I know that I can’t look like this hideous creature in my mind because if I did people would say more than they do. I do have my moments of overwhelming confidence. I still make love, I still have sex, I still leave the house when I feel up to it, I have friends, I still stand strong and smile with my bad teeth. I am a slightly arrogant, self possessed person and I bet that no one who met me would ever guess I felt this way and that makes me relieved. And personally, it irritates me incredibly when people put themselves down which is why I try not to and I find confidence hopelessly attractive. I can fake it. But I look like this. Am stuck looking like this. And I have reached the realisation that I could be 7 stone, 6 stone, 5 stone and it wouldn’t make a difference. So what do I do?

Teenage Misanthropy gives a mental health-themed updating of the Devil’s Dictionary.

Britain – A small, wet country hanging off the edge of Europe. National sports are binge drinking, assaulting police officers and vicarious grief. On the plus side, we’ve got Nectar points.

BUPA – Formerly the British United Provident Association, now one of those orphaned acronyms that don’t stand for anything. Also a healthcare provider for people who can afford to pay for it. Standard of care is variable, universally crap when it comes to anything mental health-related.

CAMHS – Child & Adolescent Mental Health Services. The part of the NHS which deals with anyone under 18 classified as being anywhere between ‘a bit weird’ and ‘completely snooker-loopy’.

CBT – Cognitive Behavioural Therapy. Has something to do with training your brain out of depressive thinking. Alternatively, where CAMHS send you when they don’t want to have to do anything for the six months you’re on the waiting list.

Chavtown – The nearest part of London proper to me. Primarily composed of 16-year-olds with prams and Croydon facelifts.

The Cockroach Catcher drinks to evidence-based medicine.

Three doctors went to a bar to conduct an experiment. The first drank brandy and ice, the second whisky and ice and the third gin and ice.

All developed a bad hangover the next morning.

They came to a conclusion: ice was the culprit!

The Wife of a Schizophrenic looks back on the past.

It’s been five years this month since the last time Mr Man was in hospital. Over those years Mr Man has gradually improved and there are things he can cope with now that he couldn’t cope with back then – simple things, like answering the door when someone knocks. He still has his off days, but he seems to have improved even more since he stopped taking his Clozaril and had his Abilify increased back in July, simply because he is more able to occupy his mind now that he doesn’t feel so drugged.

He’s not been feeling very good for the past couple of days though. He tries to carry on as normal if he has plans to go somewhere, but the rest of the time he tends to sleep more to try to escape the voices.

Tonight I heard him moving around in the bathroom more than usual. Despite the fact that it has been five years since he last cut himself, I found myself rushing up the stairs to make sure he was alright. I still worry that this will happen, even after all this time. Will I ever be able to let go of the trauma of the past?