Mental Health Problems

No, not me, (although the people I work with will probably beg to differ) but the people I have been dealing with this week. The barking mad, or in political correct terms, mentally ill can be a source of mild amusement (as they place their cigarettes into a cup of water and wonder why they won't light) or in the majority of cases sorrow, despair and frustration.

We all walk a fine line of sanity which if through some sort of crisis or chemical inducement can cause some people to fall over the edge into a world littered with anti depressants and psychiatric doctors and stays in mental health units.

The only real difference between a person who is "sane" and "insane" is a letter from a doctor.

The police have a power under Section 136 of the Mental Health Act 1983 to remove any person within a public place to a place of safety who appears to them to be suffering from mental disorder and to be in immediate need of care or control. A person removed to a place of safety under this section may be detained there for a period not exceeding 72 hours for the purpose of enabling them to be examined by a registered medical practitioner and to be interviewed by an approved social worker and of making any necessary arrangements for their treatment or care.

The unfortunate fella we dealt with the other evening was in desperate need for urgent treatment!

At 22:00 hours we were called to a "man going berserk" on a train and was "having a mental breakdown" according to the source of the call. We arrived after about ten minutes and made our way to the train carriage which was a scene of total carnage. It looked as if someone had thrown the entire contents of a dustbin, shopping then mixed in their laundry for good measure. The windows and floor of the carriage were smeared in pizza, there were tea bags strewn every where and to top things off the passenger alarm handle had a slice of pizza stuffed into it.

There were officers already on scene trying to coax a man from a seat who had wrapped his limbs around the arms of a chair and was refusing to budge. He was ranting on and screaming but it was difficult to understand what he was saying. All the time he was holding a carton of milk which was rapidly being spilt all over us, him, the train carriage and anything else nearby. He gripped the carton tightly and refused to let it go, we needed him to release it as it was connected to the arm that was wrapped around one of the chair supports. Eventually we managed to prise it from his tight grip and released his arm from the support and stood him up.

He was shouting "I'm a cleaner, I'm cleaning this train, that's what I do, there's my mate who helps me, there!" pointing straight at me. The amazing thing is, all my colleagues actually looked at me as if he was telling the truth. A split seconds calm followed then once again the ranting started.

We removed him from the trashed train carriage and walked him down the platform to the stairs. I say "walked" but he wasn't moving his legs at the knees so looked more like John Cleese being helped from the location. We got him up to the awaiting van after he was trying to hold onto everything to stop him being removed. After placing him into the rear of the van we could still hear him ranting on to himself about anything and everything.

Arriving at the local hospital and a chat with the staff nurse in triage meant we could save having to endure walking him past all the other accident and emergency patients which would be embarrassing for him. We tried to get him out of the van but because he felt safe in there he didn't want to come out. Every time we asked him "Would you like to come inside and we can get you a brew?" or "Up you get, we've got to go inside now" he would turn the question around and say "Ah! but do you like films? do you use the internet?" which would completely throw our train of thought. Eventually after much persuasion and several times telling us that the pieces of dirty tissue in his pocket was given to him by God, he was led from the van and taken to the special room.

The trouble was the special room had disposable razors lying all over the place and one by one they were quickly found by us and thrown into the clinical waste bins.

The worst thing you can do with a mentally ill patient is agree with their rantings as you could be agreeing to them doing something dangerous or you could find that they either talk for hours about the same subject or worse, attack you. This man however, went through subjects quicker than master mind and you only had to slip in a word into the conversation and he would talk for ages about it. He overheard us mention something about the roof and before we knew it he was telling us everything about them. He was incredibly intelligent but talked so fast it was hard to understand him. He asked for a cup of tea and as we promised him one it was only right he got one. It was promptly delivered and he told me it was too hot. Not a problem, I said, there's a sink here, we can top it up with a little cold water if he gives it to me I'll gladly do it for him. He proudly stated he would do it. But, instead of going to the sink with the taps, he went to the sink with the shower head and turned it on! Not only soaking himself in the process he flooded the floor! I hastily tried to turn the damn thing off but to no avail! more and more water poured onto the floor and all he could say was "Don't worry, at least it's clean now!"

The nurses wanted to take his blood pressure but he didn't want to remove his coat explaining that he bought it for £17.99 and didn't want to lose it, instead he told the nurse his blood pressure and heart rates from the last time he was in hospital last week.

After listening to him rant on and on for 4 solid hours waiting for a Psychiatric Doctor to arrive and assess him. We were relieved by our night turn officers who arrived just after 2am. They waited with him until 5am when he was transferred to a mental health hospital under section 2 of the Mental Health Act where he was detained there. Unfortunately for them he got progressively worse as the night went on. He was foaming at the mouth and listing those he wanted to kill which understandably concerned our relief crew and the nursing staff as they were included on this list.

What annoys me with all of this is the waiting. We had been on since 1300 hrs that day and if the night crew hadn't attended we would have still been there until 0500 the next morning! And he was prioritised! He was already in a place of safety but some hospitals don't like the police to leave as you have a fully armed security officer standing in casualty in case it kicks off with another patient.

The patient is in desperate need of help and the longer they wait the more frustrated they get and therefore the worse they get and for our point of view, it's a unit that could be deployed to another serious matter.

There is way too much hospital politics which I hate getting involved with. I have been in a hospital where they refused to take in a section 136 as he was registered in another area!

I've been in a situation where a hospital psychiatric doctor refused to take in a patient who was screaming he wanted to die and was rolling around on the floor clawing at us! The doctor claimed he wasn't mentally ill and it was possibly the result of a tumour and to take him to A&E. When I explained he had already been seen and cleared by A&E and they told me to take the patient to him he went mad with rage saying "Well what if he dies!?" I said, "Well he's in the right place then isn't he!?" The patient was screaming and we had to raise our voices to be heard over him. The doctor said, "He's not mentally ill, there's nothing wrong with him, mentally." So I went back to the A&E Sister and explained the situation, "Well if he's not physically ill, or mentally ill, he's free to go then isn't he?" Good thinking Sister! I walked back to the doctor at the mental health unit and he stood there surrounded by his department security guards.
"You say he could be physically ill? Although A&E say otherwise" I asked
"Yes" replied the doctor
"However, you say he's not mentally ill?"
"Yes" replied the doctor.
"So if he's not mentally ill and A&E say he's not physically ill, he's a free man?" I asked
"Well of course he is!" Was the doctor's curt reply
"And you would say this is a public place?" I asked
"....Yes" the doctor replied hesitantly.
"In that case, he's free to leave of his own accord. Goodbye!"
and with that we walked away to the van leaving the man screaming on the floor of their mental health unit. The doctor came running up to us and apologised for his rude behaviour and pleaded with us to take the patient home.
Which of course, we did.