DiMH 2021 CONFERENCE KEYNOTE


physical environment right, we are absolutely not the only people to have focused on this. We and many other sector bodies talk about how a noisy and poorly designed mental healthcare setting can impact on sick people, and how the resulting distress and agitation may then lead to them being segregated and secluded. Psychiatrist and epidemiologist, Professor Sir Simon Wessely, in his foreword to the independent Mental Health Act review, however, points out that the environment we look after people detained under the Act in is often anything but therapeutic. NHS Providers, meanwhile, has said that the under-prioritisation of investment in the mental health estate is ‘having a huge impact on patients, and placing them at increased risk’, adding that greater investment would 'make a huge difference to people’s recovery, as well as to staff morale’.”


Department of Health & Social Care had emphasised – this would not only improve the individual care given to patients, but would also enhance patient safety, notably through better infection control, and a reduction in risk incidents involving patients and staff. She added: “This is a shared vision for all in the sector.”


Jane Ray exhorted those keen to discover more about what the CQC is ‘thinking and doing’ to look online at the various opportunities to engage and get involved with the organisation, ‘via everything from Twitter, to podcasts and blogs’.


Funds to eradicate dormitory accommodation


More positively, Jane Ray said the CQC had been delighted that some of its recent work had let to the announcement of funding to eradicate dormitory accommodation, because – as the


Here she put up a slide showing the CQC’s current latest ratings for mental health services in the NHS and the independent sector across England. Services highlighted in red were those rated as ‘inadequate’, the ones in orange those ‘requiring improvement’, and those in green the ones rated ‘outstanding’. She said: “You can see quite clearly that there are two services with a particularly high level of ‘inadequate’ and ‘requires improvement’ ratings – wards for people with a learning disability and autism, and acute wards for adults of working age and psychiatric


Expert-by-experience tells her story


Talking to be me by phone following the DiMH 2021 conference, Kenita Watson shed a little more light on her own mental health struggles, which she explained had led to a number of admissions – both voluntary, and under the Mental Health Act – in her 20s and early 30s. She explained: “While in the final year of a Business degree at Liverpool John Moores University in 2009 I was pregnant with my daughter, and was told by doctors after a 12-week scan that she had a chromosome disorder. The foetal consultant suggested there and then that I terminate the pregnancy. Doctors subsequently told me the baby had a heart defect, although scans showed a normal heartbeat, and it was again strongly suggested that I end the pregnancy, which I was extremely reluctant to do.”


Mentally scarred by pregnancy experience Her daughter was born healthy, but – mentally scarred by what had happened – Kenita soon began experiencing doubts about her ability and adequacy as a mother, as well as envisaging problems with her daughter’s health and her ability to look after her in the future. Diagnosed with post-partum psychosis, she was admitted to a psychiatric ward in Leigh, Lancashire, near her home, and, over the next five years, a series of further admissions – both voluntary and ‘under section’ – followed, some lasting up to a fortnight. Over time, her relationship with her partner deteriorated, and her job as an assistant manager at a local large toy store was


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put in jeopardy She said: “At times I was working 70-hour weeks, and definitely took my job worries home with me, which impacted my home life, the stress and anxiety also exacerbating my concerns over my mothering skills.” Eventually, her relationship with her partner broke down, leading to custody hearings in the courts. Today, her daughter, now 13, lives with her former partner and his new female partner, and Kenita sees her mainly at weekends, on birthdays, and on other ‘special’ days, plus at other pre-arranged times. Although they have regular contact and are close, she would like to see more of her.


In and out of psychiatric units She said: “In the five-year period after my daughter was born, I was in and out of psychiatric inpatient units, absconding a number of times, as I found the atmosphere and surroundings impossible to cope with. While many of the staff did their best, the regime, and the conditions and atmosphere on the ward, were often oppressive, extremely restrictive, and highly institutional – thus entirely unconducive to recovery for someone in my state of mind. Who, for example – when treating somebody with post-partum psychosis – would feel it appropriate to put them in a six-bed dormitory in a bed next to a schizophrenic patient? Yet this happened.


Doubts about her diagnosis “I also questioned my diagnosis; in fact doctors later changed it to borderline personality disorder, but the upshot – so unpleasant and uncomfortable did I find the ward environment –was repeated inpatient stays and several subsequent


absconcsions. On occasions, I spent a short period initially while really unwell in a single en-suite room, but I was generally soon back on a ward. At least dormitory accommodation is now being addressed.” Of her various ‘escapes’ from inpatient wards, she said: “I would gather a change of clothes, get out through the fire exit at the bottom of the ward when I or another service-user set off the fire alarm before staff could catch me, and then head to the nearest large supermarket, having withdrawn the maximum allowable amount from a nearby ATM so that I could pay for everything in cash. Once changed into other clothes, I’d call a taxi from the supermarket’s public phone, and then take 2-3 further separate taxi rides so it was much harder for the Police to find me. On one occasion I was so desperate that I got onto a plane to Cyprus, where my parents lived, at Manchester Airport, and was then hauled off by the Police after the plane had begun taxi-ing towards the runway. On many of the occasions, however, I ended up in some grotty bedsit until I felt able to return to my inpatient facility.


Some blame for ‘escaping’ “When I absconded, the unit staff either just rolled their eyes when I got back, or appeared to blame me, since my ‘escaping’ reflected badly on them. My care was not all bad, however; there were some excellent nurses and clinicians, and today I am supported by a great mental health team, but often staff were hidebound by rules and regulations seemingly designed to remove all privacy, dignity, and personal choice, from the inpatient.” In 2014 – due to marry her former partner six weeks later – she experienced


OCTOBER 2021 | THE NETWORK


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