THE Assessment

*Trigger Warning: Explicit discussion of suicide attempts, self harm and suicidal ideation*

 
For 6 months now, my care has been focussed around and towards a long-term placement in a pilot therapeutic-community-come-recovery-house-come-something-all-of-its-own. The placement would be tailored towards high risk patients with long term complex needs (e.g. me), providing 24 hour CQC approved specialist support as an alternative to lengthy admissions (for others) or death  (for me), to provide a safe/supportive/structured environment to work on the tough stuff, and to work towards building a future that consists of more than just never-ending emotional torment and pain. My initial care coordinator was on the ball and we were banging on their metaphorical door with a referral back when the project got going in August  (due to open in September). Intensive support was needed, I was losing my grip on life in a very real way, and local crisis (and therefore also inpatient) services had decided I wasn’t considered suitable for their help. Things moved sluggishly, my poor care coordinator was left managing my case alone, part time, for an hour a week, fighting for help from other services who refused point blank to get involved, ignoring her and my consultant’s experienced professional opinions. The placement was delayed and delayed and delayed some more, landing at the now potential start of April, but probably later. Meanwhile, I have been identified as needing intensive, specialist, 24 hour support and in the interim have…an hour a week.

My hope decreased even further than the seemingly bottomless pit it had fallen down some while earlier, and I decided to put us all out of this misery and end my life. 3 days later I came round in intensive care, my only support (care coordinator) removed from me and replaced for reasons that still no-one can explain whilst I was unconscious and on the cusp of death, and an ‘assessment’ from the crisis team that determined that they would offer me no support and consisted mainly of a senior practitioner repeatedly telling me to make a complaint if I wasn’t happy: I was to be left with nothing, worse off than before I attempted to end my life. That night I hung myself. Being in ICU, although I was discovered with no output, their expertise got my heart started again (3rd lot of CPR in a year). Again we were told that there would be no support, but the ICU consultant said he would section me if I left (which I was desperate to do, to end the pain) and, because of that, the mental health teams were forced to put 2 days of visits in place before an immensely traumatising Care Planning meeting (I have PTSD from mental health treatment and CPAs are a huge trigger) with a room full of strangers discussing how this was my fault, and how they would renege on the promises made whilst in intensive care.
That was November. Since then, there has been another serious attempt and several other stays in general hospital due to intense self harm (likely with severe and long term implications) with the hope that that would accumulate to death. A secret pact was uncovered that denied me the assessment and support that anyone attending hospital or presenting with a mental health crisis is entitled to (and is, in general, required to have), meaning that even serious attempts pass by with no assessment, no crisis care, nothing but changing care coordinators from extremes of completely ignoring self harm/suicide to “I’m going to tell your mum” (until she was reminded of the law). No trust. No one fighting alongside me as my old care coordinator had been (although a very kind support worker took on far more than she should and has provided me with more support than she ever should have), and no one fighting for this placement or even aware of what it was or who I was. I should be grateful: the Quality Director got involved and made then apologise, then apologise again after more devastating mistakes, then again after apparently negligent/cruel decisions; but she herself admitted that I have been subject to far too much trauma at their hands, that I have been the one they learn from their mistakes with too many times, that I have been let down so much it’s almost farcical.

But all the way through, I was being told to hold on for this assessment. 6 months later, there has finally been movement: I’ve had a 3 session, 5 hour, 6 weeks of constantly panicking and producing 20+ pages of proof of how hard I’ll work assessment – ending, in some ways unexpectedly, today. It has been gruelling. I’ve wanted to give up. My distress has increased, my strength decreased, and the monster in my head has grown to such a level that it is almost impossible to ignore.

I should be relieved and grateful: in 4 days time I will have a final answer as to whether this thing that has been the focus of 6 torturous months is going to be approved.

4 days until I know if there is any hope for the future.

4 days until I know if there even is any future for me.

4 days trying to fight the powerful monster screaming at me to end the pain – that, as pathetic as it sounds, we can’t tolerate the wait; that we can’t stand going through being told that it’s the end of the line.

Wanting so badly to knock myself out and not face this, have done with it…for a few days…forever.

Wanting so badly to hang on and give myself that chance which I’ve never allowed myself before: to really live, to not be an entirely selfless puddle of despair, to work on me, to find and/or build a ‘Molly’.

Terrified that I’m not strong enough for the latter.

Terrified of allowing hope for the former, only to have that crushed, to experience more torment and pain before the inevitable grisly end.

Terrified that this powerful argument goes on inside me but ‘other’ to me, out of my control.

Completely bloody terrified.

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