If I could’ve picked a worse time to have a mental health crisis, it would have been during the school summer holidays. If I could’ve picked a worse time to be discharged it would also be during the summer holidays.

But then there’s no good time really. There’s better times, but being discharged, whilst a relief, is also hard to manage.

Due to bank holidays and staffing issues with the Crisis Team, I was discharged without my knowledge, back into community care. I knew I was heading towards being discharged as my twice daily visits had been reduced to once daily then, once every few days to then hearing nothing (I suspect as it was bank holiday, I got lost in the hand-over notes).

I was told: “We’ll be in touch to sort out your medication and a jopint meeting with your community care co-ordinator,” and I genuinely thought they would be in touch.

But luckily for me, when my mental health co-ordinator returned from holiday, she informed me that the crisis team had discharged me.

Now I wasn’t expecting balloons and a cake but it did feel quite abrupt, going from such great intensive care to once a week.

 

But surely being discharged from mental health care should be a cause for celebration?

 

Whilst it maybe a cause for celebration for some, as it can be a sign you’re improving (or at least that’s what the mental health team believe), discharge needs to be done like a dream break-up:

 

  • A phased approach
  • Good Communication
  • Honesty
  • Putting other support in place
  • With care
  • With a plan

 

This is the same, in my opinion, for a course of counselling sessions. As often funding only allows six sessions, in my experience, unless you apply for me. But without the right ‘ending’ or ‘discharge,’ I think the care can have a detrimental impact as you’re left feeling exposed and alone, after such individual care you feel like you’re spat out and just a number.

But with the right discharge, this can be avoided.

I’ve always struggled with saying goodbye to someone I have trusted with everything. I am still traumatised from my discharge from an in-patient unit (before I had kids).

My mental health nurse had fought for me to get a bed on an eating disorder unit because I was “the worst bulimic” she’d ever come across. And whilst I was extremely poorly and on death’s door, my weight and BMI were too high for me to be accepted as an in-patient. I am sure you can imagine the stress that puts onto someone with an eating disorder already. I didn’t have it in me to fight but luckily that nurse did. She knew I could die anyday, she knew that my weight had always been “high” even when I was skeletal. She knew I needed intensive treatment but the funders didn’t know.

Thankfully, she ended up getting me a place on an in-patient unit, I thought that was where I would be saved and I could begin to recover.

But I was wrong, it was like walking into hell. I felt so huge compared to everyone else and I felt like a total failure. I’d failed as an anorexic. My bulimia became more secretive and I started to copy the behaviour of others on the unit. I dreamed of being as skeletal as them.

And I started to lose weight as meals were controlled and I refused to finish off most of my food, but then I wasn’t able to binge and purge either.

But within a few weeks I was given a warning. I had to go home and think about whether I would obide by the rules of the unit or I would have to leave.

I felt rejected. If I had been at a low weight in those circumstances I would probably have been sectioned. But because I was still medically a “healthy weight,” I was deemed to be Ok physically (although bulimia can also kill you too, especially if your potassium levels drop).

Not only did I feel like an outcast, I felt I had been thrown out and there was no way my bulimic voice would let me go back in there.

So that was the end of my in-patient journey and my bulimia and self-harm became worse than ever.

On paper, I had discharged myself. But in reality, my bulimia was too bad for me to make a rational decision.  

But not all discharges have been bad (yes I am a pro at being a mental health service user!) 

I have been on a couple of self-help courses, one run by the Well Women Centre in Wakefield and the other by HomeStart.

Yes there were set sessions for a series of time but the ending of the course was also planned as part of the journey. It’s easier to accept that way. And to do activities which build on what you’ve done on the course and how to adapt them to real-life.

It’s still sad when something ends, but it can be done well so that you learn self-help practical skills to cope and/or your sign-posted to other courses of treatment. For me, I love having complementary therapies when I can, as I struggle with childcare and the intensity one-to-one counselling.

It’s vital that all treatment is person-centred, honest and consistent.

How would you like to see discharges happen? What’s your experience? 

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