Patient stories: 2019
Trevor tells his story from 6 years ago when his life was very different from today. Trevor is a 50 year old man from Wimborne who is passionate about sharing his story to help others.
Trevor shared that he has had two challenging mental breakdowns in his life. The first episode was when he was living in London in 1990. He believes this was due to overworking and taking on too many commitments. At this time he was working full-time with Queens Park Rangers football club and additionally carried out training and scouting for talented players. He was also studying at the time and doing lots of extra practical work. During the summer holidays Trevor took on more work coaching youngsters. He was then referred to mental health services in London and eventually moved to Dorset in 2001.
Trevor said work pressures caused him to be off work for 11 months due to mental health issues and he was concerned he was not stable. Trevor was under the Wimborne Community Mental Health Team (CMHT) at this time and they referred him to St Ann’s. Trevor was admitted to AAU Seaview in November 2013 and again in May 2014.
Trevor felt that the Seaview team were dedicated to helping him and others. The support that he received was not just through medication but was from implementation of interventions. These interventions were walks around Compton Acres and doing meditation exercises. He explained he would enjoy going on walks with the team and there were lots of stimulating things to do on the ward. There were board games to play and plenty of activities that made the experience interactive. Trevor was very enthusiastic about the ward and said the whole experience was positive, even down to the food. He made it very clear that he did not have any concerns about the services he received at St Ann’s and there was nothing about his experiences that was negative. Trevor considered himself very lucky and the service provided at Seaview was exactly what he needed and in his best interest. He always felt safe on the ward.
The team were always available and ready to talk to him and very approachable and always welcoming to his family who visited him on the ward. He expressed that it takes a very special person to work in the difficult environment he stayed in, with people going through some extreme cases of mental health. Trevor said it was touching how they helped him and how caring they were. He had trust and confidence in the care that he received; and felt involved in the choices about his care. Trevor felt he built some meaningful relationships with the staff on the ward as they would tell him when they were next due to be on shift. He felt he got to know the staff well and had many personal conversations with them.
Trevor explained that it was important to him to get his medication was ‘right’. This was a significant aspect of his care on the ward. Trevor felt that his GP had not given him the right medication, which he believed negatively, impacted his mental health and sent him over the edge. The staff on Seaview ensured his medication was monitored closely and ensured he was on the correct dose which amplified his trust in the staff.
Simple things really helped in his recovery. Trevor explained that going on walks to Compton Acres across the beach and visiting the Jazz Cafe with staff, was a highlight. Once the staff felt he was ready they allowed him to go with other patients unaccompanied by staff. On another occasion he went out with a patient visiting Sandbanks hotel to enjoy a hot drink and a chat. These activities helped ease him back into normality. During this time Trevor demonstrated that he was stable and confident, convincing the team at St Ann’s that he was ready to go back home. The first time he was admitted to Seaview Trevor felt he was not ready to leave St Ann`s. However, the second time he felt he was ready to be discharged and felt he was involved in the discharge process.
Trevor thought the transition from St Ann’s and coming back home the second time he was discharged was better than the first time when he was referred back to Wimborne & Purbeck CMHT.
The first time he was discharged home he did not feel he could go outside. He explained he felt agoraphobic and coming home felt a little overwhelming. However, Trevor found going outside and taking pictures of wildlife and nature as suggested by his Doctor really did help him deal with the issue. He would set a timer for five minutes on his phone and go out and take pictures and then come back after the time was up and write down what he saw and how he felt. After 2-3 weeks he was out walking on the beach and enjoying taking photos of wildlife and this was a breakthrough with Trevor’s recovery. St Ann`s stayed in contact with Trevor and touched base with him on how he was doing now and then.
Trevor explained Wimborne CMHT was very good, very consistent and reliable with appointments. There was a counsellor to speak to and would listen to how you were feeling. He was discharged from the Wimborne CMHT Team in 2015. Trevor is not taking any medication currently and has not seen anyone since then. He is now back at work and enjoying his photography and walking around Dorset.
Trevor summarised ‘St Ann’s and Wimborne & Purbeck CMHT helped me in my recovery and they both worked well together. They got me to the place where I am today, and I wouldn’t know where I would be without them.’ He explained that it felt like taking a photo ‘you’re concentrating in one moment, and in that present time just for a minute its headspace.’ Trevor’s pictures have been used by the Combat Stress charity and photography has been used as a therapy strategy for others struggling with their mental health. He is now very open about his story and experiences with mental health and shares them on social media to make others feel like they can be open to talking about their experiences too and not feel alone.
The service user was assisted in providing the story by Kirsty East, Patient Experience Facilitator.
Feedback from Seaview Ward:
The analogy of a swan springs to mind when thinking of the Seaview Team in action. To those on the outside, all appears calm as everything is taken in their stride. What often goes unseen is the intense work load and the mental stress of the job that we all go through. However, comments and appreciation like this from Trevor helps the team to stay focused on the positive impact we make in every individuals life.
We as a team will do our best to keep our standards high at all times.
We all feel that the game is on to be better every day.
Feedback from Wimborne & Purbeck CMHT
It’s really great to hear that Trevor has continued to use the skills and techniques he developed with support from the two teams he had most contact with. We endeavour to work with people to find their own strengths and resilience and it’s always very rewarding to hear from those who have been able to maintain their recovery and increase in their confidence to tackle new challenges.
Since Trevor left the service we have continued to work with other parts of the pathway and it is important in the months ahead that we maintain our relationships not only with other teams in the Trust , but also with services in our communities, so that we can offer as broad a range of opportunities as possible.
story started when she was 15 years of age, whilst studying for her
GCSE’S. She has learned that Pebble
Lodge staff never give up and now as a peer supporter she recognises it more
and more. She recognises that staff also have really difficult days seeing
children struggle. Now on the “other
side” of recovery she appreciates the fact that staff are human and try hard to
help everyone on the unit. Nikita sees staff
members come back every single day no matter what’s thrown at them and staff
continue to hope and see a future for their patients. Nikita continues to be amazed that, there is
a group of people willing to do that.
Three years ago Nikita began working with the Dorset Mental Health Forum. At the time she was still in recovery under the adult mental health team and was going through different therapies. Whilst working a as a peer she heard her line manager and different peers talk about personal recovery. This is the idea that service users hold the answers and solutions that will work for them. The approach encourages seeing the service as a tool to use, rather than the answer. Her recovery began with the concept of “I can do this” and has now developed further as she has something to offer back. Nikita feels she is an equal part of the team. I’m not Nikita, the ex-patient, I am Nikita, and she is a peer specialist.
Mr. S – An Ex-Serviceman’s Story
Mr. S is an 65 year old man who lives in Bournemouth, suffers from Post-Traumatic Stress Disorder (PTSD) and an has emotional unstable personality disorder. He explained that he routinely ended up in and out of hospital for mental health issues and between 2002 and 2018 he made 28 suicide attempts. These suicide attempts involved A&E attendance and inpatient mental health admission.
Mr S. had spent some time at Bethlem hospital in 2016 for a period of 18 weeks, where he began to see an improvement in his mental health. He was under the care of experts in PTSD and included 1.5 hours of therapy each day and medication that seemed to finally have some positive improvement in how he felt. He said that he had designed and made a coffee table during his time there. He felt these craft activities were more relevant to him than others he had undertaken when in Dorset. In addition he said that the unit allowed him and others to go out to town and to live a fairly normal life. He felt that this was a turning point in his treatment.
From his recollection, discharge planning began three or four weeks before the discharge date, preparing him and ensuring that arrangements were in place for his return to Bournemouth. He was referred to the Community Mental Health Team at Turbary Park. He was given details of the Crisis Service and discharged home.
Mr. S. said that his discharge happened at Christmas which was a particularly trying time. He was not in the habit of asking for help and always would feel that the Crisis team were there for people who “needed help more than me”. So he patiently waited for the CMHT to contact him whilst feeling that he was deteriorating. He eventually saw the CMHT on 18th January 2017.
During this time he visited his GP to get a repeat prescription of his medication prescribed by the professor at the Bethlem. Mr. S was prescribed two separate blood pressure medications to manage his PTSD. However his GP said he could not prescribe the drugs as they were not licenced for this use. Eventually he managed to get back in touch with the professor at the Bethlem and they then agreed to send prescriptions to his GP. However he had not been takin his medication for some time before the issue was resolved. Due to the lack of medication and a delay in his CMHT support his “pack of cards” collapsed and he attempted suicide again.
Mr. S was taken to Bournemouth Hospital and was admitted to Melstock House at Forston Clinic on 1 July 2017. He had become homeless and therefore remained as an inpatient on Melstock House for five months. Mr. S said it was a very difficult time as he felt he really was not in the best place for his particular needs. He said it was extremely challenging living on a ward with many older people with dementia and the activities such as jewellery making and colouring-in seemed irrelevant to him. “I was stuck there just waiting for housing to be sorted out for me” he said “and I could see it could take many more months.”
Mr. S was still under the care of the CMHT at Turbary Park. The team of psychiatrists advised him that his medication should be changed as it was not appropriate. He explained that this had been initiated by a specialist in PTSD and he did not want it to be changed. As his medication is not well known or recognised he says it is a constant battle to remain on the prescription he believes finally has managed his condition.
The CMHT put him in touch with the Armed Forces Community Health and Wellbeing Team (AFCT), based at Hahnemann House. He said that they were amazing. “They realised I was not in the right place and that Melstock House, although a lovely ward, was not right for an ex-serviceman suffering from PTSD. Firstly I met Andy Gritt however Jason Wilkinson became my regular contact and he worked night and day to find me somewhere to go. Initially he got me back to Bournemouth living at the YMCA.” He said he had little in common with anyone else at the YMCA as many were ex-prisoners or were ex-drug users however Jason was his constant contact and he managed to keep on an even keel.
Mr. S could only stay for one year at the YMCA and the deadline to leave began to loom which added to his anxiety. Jason had been working to secure Mr S a place in the War Memorials Homes in Bournemouth, a specialist housing association for ex-servicemen. Mr. S said that during this time Jason would call him or see him and tell him where he was on the waiting list which gave him hope. Through Jason’s sheer determination and a very helpful manager at the home he moved into a flat in September 2018. He now feels secure in his own home for the rest of his life.
Mr. S said that he has not had any further suicide attempts since June 2017 and puts this down to his medication being continued despite the problems he has encountered with repeat prescriptions. In addition the support he has received from the AFCT has been pivotal. “They understand my thoughts” he said. “Squaddies are different and we do better when we are dealing with other squaddies. They know what tone to take with me, when I need pushing and when I need to be given an order! They understand why I may not call the Crisis team.”
His life is definitely better, he now is a trainee at Crumbs, a catering project whose workforce is made up of vulnerable adults, and he loves it. Mr. S says he has good times and bad times and Firework night is real trial but Jennifer from the CMHT will ring him on that day and help him through.
Mr. S wanted to make the following points to the Board:
· Why was there a delay in CMHT support when a referral had come from a specialist unit in what he believes is a reasonable timeframe?
· Dorset has a huge number of ex-forces residents and many suffer from PTSD. He feels that the condition is not the same as other mental health illnesses and does need different expertise and support.
· Without the input of the AFCT he believes he would have stayed on Melstock House for a significantly longer period.
· Can access to medication be improved, despite the treatment not being recognised, when experts in the field have prescribed? He now helps other ex-servicemen friends who are going through similar issues with their medication. Mr. S believes he is not an isolated case.
· His multiple suicide attempts have ceased due to his medication, settled home life and support from the CMHT and the AFCT.
Feedback from Armed Forces Community Health & Wellbeing Team
I have known Mr S since November 2017 where I first met him at Melstock ward at Forston clinic; he had been admitted there in July 2017 due to a suicide attempt. The first contact he had from this team was from the service lead who was trying to resolve his housing issue which was having an impact on his mental health with other issues also.
At first when I met Mr S he would not engage with me at first as he just saw me as another “Civvie” who did not understand, until I explained I was a Combat Veteran. He then warmed up to me a little more as we discussed certain combat zones we had served in. We discussed many issues he had such as having no accommodation to go to, hence the reason why he had been on the Melstock ward for such a long period.
Over the next few days after meeting MR S I had managed to secure him temporary accommodation at the YMCA on Westover Road in Bournemouth with the help of the Service Lead. Mr S moved into the YMCA a few weeks after however it was a struggle at first as the majority of patrons are ex-offenders which was hard for him as he had nothing in common with them and he kept himself to himself. I knew it was important to keep regular contact with him to ensure he knew he had the help and to keep him on the straight and narrow and to significantly lower the risk of attempting suicide again.
Mr S could only stay at the YMCA for a year so I had to look at different options of accommodation once the year was up. I had secured him a place on the waiting list at the War memorial Homes in Bournemouth, accommodation for Ex-servicemen and woman. I would meet with Mr S Once a week with updates on where he was placed on the list which he appreciated. In September 2018 he moved into a one bed flat at the homes where he feels secure and a lot happier.
Before Meeting Mr S he was in the process of joining The Crumbs Catering Project for vulnerable adults as a trainee which had to be delayed due to his admission to Melstock Ward. This was something I was encouraging him to re-engage with as I believe it would help with his Mental State. I had spoken to the Training Manager to arrange a taster day for him which he excelled at and he has now been working there as a trainee for nearly a year now.
Since the time I have engaged with Mr S I have seen a vast improvement on all aspects of his life including his mental health, he now has no thoughts of suicide and this is down to all Departments within the Trust who have supported him. We now still have regular contact at least once a fortnight which helps him know he has the support when he needs it.
Feedback from Melstock House
In response to the patient story provided by Mr S, it is great to hear the positive feedback about Melstock and Mr S feeling the ward is a lovely environment. In response to the occupational activities on offer at Melstock House, we endeavour to provide activities tailored to individual needs. The feedback gained from the MDT that provided care to Mr S was he was supported with his occupational interests and this enabled him, in terms or recovery and ‘moving forward’ to obtain employment on discharge from the ward, working as a chef.
Whilst staying as inpatient, Mr S was able to practice his culinary skills, providing meals for other patients. Interest checklists are completed and OT and nursing staff encourage participation, within the limitations of what can be offered over the whole site at Forston Clinic. We have an exercise facilitator, and individuals are encouraged to remain as independent as possible from a hospital setting, such as going to town on the village bus. This is important, especially when people’s discharge is delayed due to external factors, such as housing needs, which of course we know has a strong correlation between poor mental health. Unfortunately this is a something people experience too frequently and is not something that can be greatly influenced due to the national housing crisis.
Melstock is a functional mental health unit for people over the age of 65 years old. Due to structural organisational changes within West Dorset, having had two Organic units close over the past 5 years, this has had an impact upon the service user groups who access Melstock, so sometimes there can be greater numbers of people on the ward with a primary cognitive impairment diagnosis.
Community Mental Health Team – Bournemouth West
Mr S was referred to the team on Friday 23/12/16. The duty worker spoke to him on the same day and arranged an appointment at Turbary Park Centre on 28th December which was the first day following the Christmas break. It was agreed that the duty worker would email Mr S with the Turbary Park clinic address. Unfortunately the email address used was incorrect and therefore the email did not arrive. Mr S rang the team on 29th to say he had not received the email and so had not attended his appointment on 28th.
The team should have double checked that the email had been received and or sent a letter in the post confirming the appointment details and for this we apologise.
Mrs Sanderson - A Patient’s Story
86 year old Mrs Sanderson was delighted to be able to share her experiences as a mental health patient since the age of 18. Mrs Sanderson’s story highlights how much Mental Health Services have changed, developed and improved over the 60 years. It also describes the life of someone living with a mental health illness.
Mrs Sanderson was brought up in a country town in Surrey and recalls a fairly happy childhood with her mother, father and three sisters. She did well at school and went onto study at university in London. It was during a vacation back home that she found her mind went blank; she found it impossible to study and had ‘forgotten how to learn.’ In those days no one knew about mental health and you were classed as either ‘mad or sane’. Mrs Sanderson felt that she had become mad because of the inability to learn or remember and she felt that she was useless and unworthy to the man she had fallen in love with therefore she thought that it would be best to die and took an overdose of Aspirin. Mrs Sanderson was admitted to a mental health hospital but it was more like a ‘cottage’ than the nearby asylum. University was put on hold but she continued to enjoy reading the Observer. Mrs Sanderson was admitted to various mental health hospitals over the years and recalls the old style asylums and described the various treatments that she endured. She particularly remembers that there was often a chapel, ‘a place it seemed of sanctuary and solace, whatever your religion.’
During the time that Mrs Sanderson was well she was able to return to university to finish her degree, continue onto a Masters and take up a scholarship in Italy. She went onto to study in Rome and Finland and then to teach English as a foreign language. She then ventured to Australia to become a lecturer at the University of Adelaide. Mrs Sanderson continued to take medication for her mental health illness ‘in the background’.
Whilst on vacation back in the UK, Mrs Sanderson became pregnant. Her daughter was born and she subsequently suffered from post-natal depression (as an inpatient) therefore her daughter was fostered by a lovely lady for six months. Once well enough Mrs Sanderson was able to care for her daughter and later met a man and got married. Her husband was a good father to her daughter but it was a very unhappy marriage. During her 35 years of marriage Mrs Sanderson suffered from breakdowns now and then, received various treatments including ECT and was once an inpatient at St Anne’s Hospital. It was a frightening time and place. However, during the times of being well she worked and was an English teacher to foreign students. Teaching was her salvation. Her family continued to be a support to her and she would often visit them. She has found it particularly difficult to talk to her friends about her illness as it is seen as a taboo subject but she has relied on the Samaritans and in particular two friends that have supported her through the Samaritans.
In more recent years Mrs Sanderson has remained as an outpatient and attends regular appointments at Kings Park and she also receives regular visits from her Community Mental Health Nurse. She feels that General Practitioners have a general lack of understanding of mental health illnesses but is pleased that she has been able to easily access mental health service provided by Dorset Healthcare and describes the staff and service as always making it as ‘personal as possible’.
Mrs Sanderson is delighted to feel well and said that it is a joy to feel better and be aware of the beauty of everyday life. She believes that ‘work and poetry saved me.’
Mrs Sanderson has written three poems to emphasise how the joy of recovery has impacted on her.
The Joy of Recovery
Welcome as a water in the desert –
Unvalued, ordinary – precious
To think my own thoughts quietly –
No struggle, no division
Not to hear voices;
Not to want to die;
Not to hate every day, and see ugliness;
But feels compassion, and to value –
To look once more outside myself –
Someone has cleaned my window,
And the sky outside is blue
I had forgotten.
Beautiful to have a brain – written in Spring 1984
After long years of lethargy, deadened by drugs
To note the sweet gradation of the seasons
The opening of each bud, the markings of each bird
To trawl the treasures of memory;
To send the questing beam of the mind into the future;
To weigh probabilities –
To delight in design, match colours,
To classify, identify, know names –
To a neighbour, Mr McKile
Too drugged to understand anything –
I understand flowers,
And you gave me flowers
Amelia (not her real name) is a 67 year old, retired teacher who lives in Sherborne. In 2017, Amelia experienced two sudden bereavements (her mother and her five year old dog, which leapt over a ledge on to a road) and, additionally, a 27 year relationship breakdown. These events took place over a three month period, leaving her feeling alone, empty and bereft.
One evening in October 2017, Amelia drove to The New Forest, with her new puppy. She drank half a bottle of gin and waded into the river, with the intention of drowning herself that night. Thoughts of her daughter and family prevented her from further self-harm that evening and somehow 48 hours later, she managed to drive to Worthing to stay with her family.
Amelia stayed with her daughter and family for the next three weeks. She suffered from severe panic attacks and dissociation; she couldn’t talk, eat or sleep. Her daughter started to become severely concerned by Amelia’s behaviour and mental state, and contacted the West Sussex Mental Health Team and local GP Practice. Within days, Amelia saw a Psychologist from the local Community Mental Health Team; she also saw the GP Practice’s Counsellor many times over the 3 weeks.
Following her meetings with the Counsellor and the Psychologist, they made contact with the Sherborne Older Persons Community Mental Health Team (OP-CMHT), as Amelia wanted to move back home. At first, she was reluctant to meet with the team, as she didn’t want to expose herself, following her teaching roles in local schools. However, following conversations with her daughter, Amelia agreed to meet with the team, and her daughter made the initial appointments with Dr Sue McCowan, Associate Specialist, and Katie Higgs, Community Mental Health Nurse.
Dr McCowan visited Amelia at her home regularly, and would discuss various things with her and review her medication when Amelia felt it was needed.
During the first few months with the service, whilst Amelia still had suicidal thoughts, she was seen twice a week by Katie. When Katie couldn’t attend, she would be notified and someone else would visit. Amelia felt that Katie understood her creative nature; she got her to do things and would make something of their conversations, mirroring Amelia’s comments back to her. Amelia describes the visits as ‘helping me to understand that tiny improvements were very good, Katie became a sort of touchstone to help me ground myself through the darkest of days.’
Amelia felt that both Dr McCowan and Katie were absolutely incredible, supportive and diligent about her needs. They knew the ideal time to say things to Amelia and trial certain techniques and methods with her. Specifically, they found the optimum time for Amelia to begin psychological intervention with Psychologist, Dr Theo Roberts. Amelia commented how this was seamless and perfectly timed
In early 2018, Amelia started her appointments with Dr Roberts. She originally found it hard to meet with him at Stewart Lodge, but, in time, realised that the space was less important and the time she spent with him was more valuable. For her, this was an indirect form of healing. Amelia found Dr Roberts’ sessions practical and compassion-focussed. Dr Roberts was able to accommodate Amelia’s antipathy for diagrams and used a slightly different approach.
Amelia had in excess of eight sessions with Dr Roberts; some had long periods of time between appointments, owing to room demands, whilst others were regular weekly sessions. However, she found the larger gaps gave her time to reflect on what they had discussed and allowed for her to go camping and “live”. Amelia describes her sessions with Dr Roberts as him “lighting the wick, and she would let it burn.”
She had her last session with Dr Roberts on 12th November 2018 and had her last appointment with Dr McCowan on 7th November 2018. She now believes that she is in a more positive place and has a far better and clearer sense of understanding herself, and a more contented outlook on her life than before her mental health deterioration.
When reflecting on her initial journey with Sherborne OP-CMHT, Amelia described it as ‘being in a frightening and intimidating jungle, where everything was going to hurt me.’ She described the sensation that each person she worked with was carrying her above their heads, supporting her and thinking for her; whilst not disabling her in the journey, but more enabling her to take responsibility for her recovery. Amelia also felt that the team had such a cohesive way of working with her, where each member of staff involved fed into her care and ensured it was joined up – everyone knew what was happening and when.
Amelia cannot fault the care, compassion and treatment she received from everyone at Sherborne.
The OPCMHT was delighted to receive such positive feedback regarding the journey this lady experienced with our service.
The response will be shared with the wider team, across both sites and also with teams within the North Dorset Locality through the Team Leaders Meeting, in order to highlight good practice.
It is recognised that it is fundamentally important to ensure there is a good liaison and continuing discussion between all teams within the wider Older Peoples Service, in order to promote the person using the service feeling empowered, supported and enabled in their recovery, as occurred in this case.