Service User...
I shall give him a name, let's call him Josh. Josh is called a 'service user' in various systems. The term service user is a status, rather than descriptor. The term could be seen as a prosaic, utilitarian description of a person using a service.
Nothing wrong with the term, nothing I can easily put my finger on.
Anyway, Josh is my son, and he doesn't have much choice about being a service user. Not because of legal constraints thank goodness, but there are subtle forces that create compliance, albeit very sensible and totally making sense to me reasons...
Nevertheless the transformation from a person into a service user isn't life enhancing. At worst it can be seen as a ceremony of degradation:
...
So if you are wondering what happens to service users when they leave hospital no longer under a section, in other-words, what happens to a person after they have been detained under the Mental Health Act, here is my account, please note this is my account not Josh's...
The sectioning was good, stabilizing and important. Josh was one of the most chaotic people at the start of his 28 days (28 days, one lunar cycle, just as if it really was lunacy!) By the end of the 28 days of Promethazine, being with other people whose view of reality was equally squawked, and being with staff who had seen worse, plus had each other for support...Josh was sent home older and wiser with a set of experiences too many people fear, but which created a safe foundation for him. He faced the worst, and it wasn't that bad.
His support at home came from the 'Home Visit Team'. I shall now re-write that accurately. Josh was visited twice a week for two weeks I think, by one or two mental health nurses, who referred to the psychiatric hospital as a place you want to avoid. Mental health nurses, the ones Josh was visited by anyway, are depressing, don't listen, and are keen to sound sorry. They are sympathetic. Listening to them talk made me feel depressed, and I was so glad not to be on the receiving end of their attentions.
In the third week Josh was handed over to Early Intervention (EI). This means that the mental health nurses stopped visiting, and we got one man who visits Josh alone once a week. He sounds as if he used to be a counsellor, he speaks to Josh as if he is a client. The EI man is positive, and his tone of voice conveys confidence, that Josh is fine, just a person who has experienced some really bad things recently, but it will get better. Up until last week the EI man was using a basic CBT framework. From last week he had asked Josh to decide, did he want Compassion Focus Therapy or another one, that reminded me of 'Dialectical behavior therapy'.
Josh chose compassion focus.
Since last week Josh has had to get himself to EI to do CRT.
CRT is Cognitive Remediation Therapy.
Josh isn't excited by this. CRT according to Josh, is like Dr kawashima's brain training.
The next day he goes back for talk therapy, which is to be based on his childhood. Unfortunately Josh does not want therapy, he feels uncomfortable, believes that they are trying to find something out...so the first and most important ethical criteria for therapy, is missing. The client is the one who changes himself, there is no magic revelation that sets a client free. The increase in awareness of old wounds and an increase in tolerance to negative affect don't always go together.
My aim is to become a solutions focus therapist, so of course I'd say something like the increase in awareness of old wounds and an increase in tolerance to negative affect don't always go together. Solutions focus is a very particular kind of talk therapy and just about the only one that doesn't see any purpose in talking about what isn't working...
In the light of my recent experiences, I can say without a shadow of a doubt that the only way I've not gone totally insane through fear and stress is by using a solution's focused approach to my own stuff.
Josh does not want to do talking therapy...
And that's where we are.
Except, he used Resperidone like aspirin, takes one now and then, not sure what criteria he is using. His behavior deteriorates when he doesn't take Resperidone, but if we point out to him that we think he needs it he is happy to take it. Personally speaking I welcome his choice to self-regulate, but I'm not sure he is self-regulating. As long as we have the tablets in the house, I'm OK about this...just about.
Meanwhile no one from mental health services has asked me or my husband how we are. We don't know what we are supposed to do if Josh becomes too far gone to be reached through reason. By that I mean, surely to goodness there is a better answer than having to phone the police!
From our experiences last time, phoning the police is the only option. Taking a person in crisis to A+E isn't ideal. Enclosed waiting room, being with lots of people some in real distress, all are stressed out and a person in crisis can easily snap out of it, or snap into something worse...
The police option is best for us. Josh said the cell was like being in the toilets at McDonald's, but the bed was comfortable. He was served an intimate body search, hot chocolate and a Frosties breakfast bar...My fear that being taken into police custody would automatically mean he got some kind of criminal record, isn't true on any level.
In theory there is a mental health team of CBT based psychology graduates who work with the police, whose main role is probably to persuade service user's to take their meds. How they are summoned is a mystery.
Sorry, my experiences have left me less than hopeful.
And that's that!
Nothing wrong with the term, nothing I can easily put my finger on.
Anyway, Josh is my son, and he doesn't have much choice about being a service user. Not because of legal constraints thank goodness, but there are subtle forces that create compliance, albeit very sensible and totally making sense to me reasons...
Nevertheless the transformation from a person into a service user isn't life enhancing. At worst it can be seen as a ceremony of degradation:
...
a formal or informal ritual that is used to eject an individual from a group and to rid that individual of his or her identity as a member of the group. Used to deal with people who subvert the norms of society.
So if you are wondering what happens to service users when they leave hospital no longer under a section, in other-words, what happens to a person after they have been detained under the Mental Health Act, here is my account, please note this is my account not Josh's...
The sectioning was good, stabilizing and important. Josh was one of the most chaotic people at the start of his 28 days (28 days, one lunar cycle, just as if it really was lunacy!) By the end of the 28 days of Promethazine, being with other people whose view of reality was equally squawked, and being with staff who had seen worse, plus had each other for support...Josh was sent home older and wiser with a set of experiences too many people fear, but which created a safe foundation for him. He faced the worst, and it wasn't that bad.
His support at home came from the 'Home Visit Team'. I shall now re-write that accurately. Josh was visited twice a week for two weeks I think, by one or two mental health nurses, who referred to the psychiatric hospital as a place you want to avoid. Mental health nurses, the ones Josh was visited by anyway, are depressing, don't listen, and are keen to sound sorry. They are sympathetic. Listening to them talk made me feel depressed, and I was so glad not to be on the receiving end of their attentions.
In the third week Josh was handed over to Early Intervention (EI). This means that the mental health nurses stopped visiting, and we got one man who visits Josh alone once a week. He sounds as if he used to be a counsellor, he speaks to Josh as if he is a client. The EI man is positive, and his tone of voice conveys confidence, that Josh is fine, just a person who has experienced some really bad things recently, but it will get better. Up until last week the EI man was using a basic CBT framework. From last week he had asked Josh to decide, did he want Compassion Focus Therapy or another one, that reminded me of 'Dialectical behavior therapy'.
Josh chose compassion focus.
Since last week Josh has had to get himself to EI to do CRT.
CRT is Cognitive Remediation Therapy.
Josh isn't excited by this. CRT according to Josh, is like Dr kawashima's brain training.
The next day he goes back for talk therapy, which is to be based on his childhood. Unfortunately Josh does not want therapy, he feels uncomfortable, believes that they are trying to find something out...so the first and most important ethical criteria for therapy, is missing. The client is the one who changes himself, there is no magic revelation that sets a client free. The increase in awareness of old wounds and an increase in tolerance to negative affect don't always go together.
My aim is to become a solutions focus therapist, so of course I'd say something like the increase in awareness of old wounds and an increase in tolerance to negative affect don't always go together. Solutions focus is a very particular kind of talk therapy and just about the only one that doesn't see any purpose in talking about what isn't working...
In the light of my recent experiences, I can say without a shadow of a doubt that the only way I've not gone totally insane through fear and stress is by using a solution's focused approach to my own stuff.
Josh does not want to do talking therapy...
And that's where we are.
Except, he used Resperidone like aspirin, takes one now and then, not sure what criteria he is using. His behavior deteriorates when he doesn't take Resperidone, but if we point out to him that we think he needs it he is happy to take it. Personally speaking I welcome his choice to self-regulate, but I'm not sure he is self-regulating. As long as we have the tablets in the house, I'm OK about this...just about.
Meanwhile no one from mental health services has asked me or my husband how we are. We don't know what we are supposed to do if Josh becomes too far gone to be reached through reason. By that I mean, surely to goodness there is a better answer than having to phone the police!
From our experiences last time, phoning the police is the only option. Taking a person in crisis to A+E isn't ideal. Enclosed waiting room, being with lots of people some in real distress, all are stressed out and a person in crisis can easily snap out of it, or snap into something worse...
The police option is best for us. Josh said the cell was like being in the toilets at McDonald's, but the bed was comfortable. He was served an intimate body search, hot chocolate and a Frosties breakfast bar...My fear that being taken into police custody would automatically mean he got some kind of criminal record, isn't true on any level.
In theory there is a mental health team of CBT based psychology graduates who work with the police, whose main role is probably to persuade service user's to take their meds. How they are summoned is a mystery.
Sorry, my experiences have left me less than hopeful.
And that's that!
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