The Forgotten People

My original intentions for this blog entry were to post Part-Two of 'Understanding PTSD.'
Part-Two of 'Understanding PTSD' will be the next blog entry to be posted.

But, after an extremely brief stay on a psychiatric ward, this week, from 29th May 2012 to 30th May 2012, I worded a blog post onto my Tumblr blog about what I have called, "The Forgotten People" - a term which I use to refer to those whom have been severely let down by the NHS mental health services after being given a diagnosis of BPD (Bordeline Personality Disorder), which is one of the most highly stigmatised diagnosis's among mental healthcare professionals.

The link to the original Tumblr entry, posted this morning, has been provided within this post. But, I will also re-post the Tumblr post The Forgotten People below, word-for-word. 

The Forgotten People

The Forgotten People

I’m talking about the people who have been Forgotten, or Left Behind by the mental health services; those free services which have been set up to help us, prevent us from hurting ourseleves, and help prevent the breakdown of our mental health.

These are the people whom, like myself, have - in a sense - been “Forgotten.”

People, like myself, who have been bumped from service-to-service in such a way that we have become reluctant to continue engaging with the mental health services.

As I’m sure you may have already suspected, I will be offering myself as an example of one of the Forgotten People.

I feel I have been “Forgotten” - let down - by the mental health services.

I have been under the NHS mental health services from the age of fourteen.

I began my journey with the services with the sunny utopia of the Child and Adolescent Mental Health Services -  where therapy seemed in abundance, and available were all manner of satisfying flavours of talking therapies. A child in a therapy service store…

Hmm… Okay, my metaphor fell flat there, but hopefully you get the gist of what I were, albeit very badly, attempting to say.

As the years have passed the amount of services available for me, have been dwindling, as have the quality of those services available.

As I approach 25-years-of age, many more of those free services, services which offer treatment such as drug counselling, are soon to be cut off from me too.

I have a borderline personality disorder diagnosis and have come to the shocking realisation that no-one is really willing to touch personality disorders as we are viewed as being “Too awkward to deal with.”

Like so many with BPD, I am regarded as a “Trouble maker.”

I’ll admit, I’m by no means an easy person the deal with, but certainly I do not wake up and go out with any intentions of making trouble, whatsoever.


And, I can safely say, that the same goes for the large majority of other people with personality disorder diagnosis’s.

Very recently, I was admitted to hospital (again), staying for the duration of less than 24 hours.

I was admitted in the evening on the 29th May 2012. Then, discharged during the afternoon of 30th May 2012.

The hospital felt that I did not need to be there because, and I use their words, not my own,  ”My bed could have been used for somebody else, someone genuinely ill.”

What?

I am genuinely ill!

Good-grief!

(Don’t worry, the account of this admittance to hospital is relevant to the subject matter of The Forgotten People.)

Okay, admittedly, I put on a “Sane Front” during my very brief stay in hospital; which, in my defence, I did out of, what I felt was, a need to not cause trouble and be regarded as a “Trouble maker.”

Not forgetting to mention the fact that I was not familiar with the hospital I had been admitted to and, probably more importantly, they were not familiar with me. I was taken to a hospital located in an entirely different borough to where I currently live.

I put on a “Sane Front.” 

Meaning; I pretended to be fine, and found myself heavily skewering the truth when speaking to the doctor on the ward, as I did not want to be under their thumb, as it were; as well as using my Sane Front being a way of keeping myself out of trouble.

I put on such a good act that I was were discharged after just one night, not even a full day.

Putting on a Sane Front had backfired on me!

When I was told that I was to be discharged and that  my CPN had spoken to the Ward doctor, I was also informed that my CPN had been contacted and that my CPN would be contacting the Forensic Team, in an attempt to get the help I need.

When discharged and informed of the action my CPN would be taking I felt sorely let down and my anxiety flared - at which point, I removed my clothing, which is something I do to as a way of coping with the claustrophobia of anxiety.

(My coping strategies and mechanisms are not great, to say the least.)

Also, part of me had hoped that behaving this way would make them see how much I need their help; I was unsuccessful, however, and the hospital staff then proceeded to threaten me with police action if I continued refusing to leave hospital grounds.

In regards to my CPN’s plan-of-action; here is the thing, I have already been assessed by the Forensic Team, whom told me that with regret they would be unable to help me as they did not feel their services would be right for me.

When the Forensic Team told me this, I was distraught, as I thought they were fantastic!

I screamed, cried and begged them to take me on, but they told me they could not do that.

The NHS are severely lacking in treatments for borderlines. With the NHS website itself only giving an idea of what treatments should be available, rather than what treatments are actually available.

Which is shocking, especially when you consider that expertise in personality disorders are essential in order to provide treatment. The stigma among mental healthcare professionals against borderlines is far too vast and common.

Personality Disorders are mental health diagnosis’s which need a tentative hand, a person whom is tactful, someone who knows how to remain professional and keep clear boundaries - sadly, this is not something which is available from the NHS for us borderlines.

The mental health services are all too willing to pass the buck; offload their borderline patient onto another healthcare professional; whom will do the same and duly pass their borderline onto another; and this goes on, like a never-ending game of pass-the-parcel.

But my life is not a game, and I am not a parcel.

Even when calling Duty or the Crisis Team, they soon hang up on me due to my bad language, which isn’t directed at them, well, definitely not at first.

My mouth is ”Foul,” expletives do tend to have a way of tumbling from it. I swear when I  am engaged in light conversation, or when online perusing forums, or when watching television, or during the throws of passion.
In short, I swear, a lot.

However, when  I am swearing, generally, it is not aimed at other people.

Some aspects of my disorder are beyond my control, and I often feel as though I am being blamed for my mental illness.

I long for the days of the Child and Adolescent Mental Health services.

The days of current, of putting on a Sane Front, as one of The Forgotten People, are eating away at me.

The wolves are no longer at the gate, they have broken through, and are now devouring my sanity with a furious voraciousness, ripping me apart, tearing me limb-from-limb, and I feel as though I am bleeding onto the snow, struggling to catch my final breath.

At this time, I am screaming out for help, but there is none to be found. So, I feel I have been forgotten.

I feel like a forgotten person. I am one of the Forgotten People.




The Forgotten People:
Original Tumblr post.

Using the term 'Service User'

"Service User" is a generic term used by many mental health service providers, particularly within the public sector, as a description of the people who use mental health services. But, amongst both the people using the services and mental health professionals alike, there are many who find this term too ambiguous and feel it carries its own negative implications or connotations.

Personally, I am indifferent to the term "Service User", but I was interested to know where issues with this terminology come from; what the alternative terms are; and what stigma, if any, is attached to this term.

Some of the issues I've heard stated with the term "Service User" include its ambiguity - some people feel it says nothing of the problems and issues faced by those with mental illnesses, and many whom are classed as "Service Users" feel this is inaccurate if they do not in fact use any mental health services. Other issues with the term include its implications that a person has a dependency on a service, as well as negative connotations of the word "user" - for example, this term could describe someone manipulating others, or a person who uses illicit substances.

However, at the same time; "Service User" is a generic term of a business-like nature, it may not be an entirely pleasant phrase, but, when used in the correct context, it is accurate terminology for describing a person who receives support from services.

There is alternative terminology to the term "Service User", which includes: "Client", "Patient" and "Survivors". But there is disagreement on which terms are appropriate.

The Mental Health Foundation defined the terms used to refer to those with a mental illness, such as "Service User", "Patient", "Client", etc., in regards to their literal meanings and why they are used by mental health services and professionals.

"Service Users" -- This is a 'popular term with service providers... used as a generic description of the people who use mental health services.'

"Clients" -- 'Emphasises the professional nature of the relationship with the mental health professional.'

"Patients" -- This is a widely used term which, according to the Mental Health Foundation, 'stresses the medical focus of the relationship between the person and the service.'

"Survivors" -- 'A term used to describe people experiencing/living through mental health problems and/or the consequences of a life event - such as sexual abuse... It is regarded as more empowering than the more passive "sufferer" with its connotations of "victim".'

The terminology "Survivor" is not to be confused with "Psychiatric Survivor"

"Psychiatric Survivors" -- According to the Mental Health Foundation, "Psychiatric Survivor" is 'A 'rights' based term used by mental health/survivor activists who assert that some forms of psychiatric treatment can e considered abusive. They campaign for reforms to end the powers of psychiatry to compulsorily detain people and enforce treatment against their will.'

The Psychiatrist (Formerly The Psychiatrist Bulletin) carried out a survey amongst mental health professionals to determine which terms they felt receivers of mental health services should be known as (from their professional viewpoint as someone working for these services). "Patient" was found to be the preferred term by psychiatrists and nurses. The term "Client" was found to be an equally preferable term as "Patient", in alternative to "Service User", by social workers and occupational therapists. "Service User" was found by the survey to be the most disliked terminology overall.

It appears to me that issue with the term "Service User" is down to its connotations and implications, rather than it actually being a derogatory term. Most of the terminology used to describe a person receiving support from a mental health service seem to be evidence-based - which, in my opinion, is how they should be.

"Service User" is a generic term widely used to describe people who receive support from mental health services, but, it can still carry negative implications and connotations; even though the terminology itself is not derogatory.

There are many terms and it is impossible to please everyone, but I think the important thing to remember is the term "Service User" does not describe an individual - in regards to their personality and personal characteristics - but refers to an "activity" in which they partake as part of their everyday lives.