Mental health cruelty is not a historical issue

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Over the past week or so, there’s been an impassioned Twitter discussion where mental health patients have shared their experiences of judgemental, disrespectful and downright cruel treatment from health professionals, specifically in the context of self-harm.

It was triggered by a series of tweets from the Government’s advisor on suicide prevention, who posited the opinion that this sort of treatment is ‘unusual’ nowadays.

Instantly, a huge number of people replied giving recent examples – some truly shocking – of how they’ve been subjected to borderline inhumane treatment at the hands of HCPs, particularly in A&E.

Still, though, the prof defended his position, implying that these scenarios were ‘common a few years ago.’

 

I’m one of the many, many people who can testify that prejudicial and downright cruel responses to HCPs towards those of us who have self-harmed or are suicidal are still hugely prevalent – and causing untold damage to patients who have hit crisis point.

Here are just a few examples.

In Minor Injuries, being treated for self-harm, the nurse said to me, ‘I’ve never known anyone do this and still be in a relationship. You’re lucky your husband hasn’t left you.’

On a medical ward after a suicide attempt, and with new self-harm injuries visible, an HCA told me, ‘You look like you’ve been attacked by a cat.’

On the same medical ward, being treated for an overdose, I was too distressed and nauseated to eat. The nurse in charge said, ‘If you don’t eat something, we’ll put a tube down your nose.’

Related to this, on a psych ward and unable to eat (my appetite disappears when I’m severely depressed: not an uncommon symptom), an HCA came into my room and said, ‘Oh, we’re on hunger strike now, are we?’

Also on the psych ward, I was found cutting in my room. The nurse sighed and called for colleagues, saying in a world-weary tone, ‘She’s self-harming.’ She then ordered, ‘Give me that [blade]’ and told me to clean myself up with a wet wipe, even though the cuts were deep and needed medical treatment. Not once did she or any of the other staff show any concern for my mental state, or even ask why I’d felt the need to hurt myself.

In a busy A&E, while being put on a drip to counteract the effects of a large overdose, I asked whether it was possible to stay on the trolley rather than moving back to the seating area where I’d been sitting, despite being violently sick. The response? ‘Not a chance.’

I know the department was full of other people in need of beds, and in the end, I did get to stay on the trolley, but I was made to feel utterly worthless, and as if I was being punished.

Other forms of cruelty are implicit rather than overt, but still harmful.

I’ve had cuts that needed stitching hastily and dismissively repaired with steri-strips, which were inadequate and have left me with severe scarring.

I’ve had stitches without sufficient pain relief.

I’ve had a massive panic attack in A&E awaiting a mental health bed; my husband summoned a nurse to tell her I wasn’t well, and she pretty much shrugged and walked off.

I’ve been told, in a specialist psychiatric hospital, that no one would remove stitches for me, and I would have to get my husband to take me to Minor Injuries (I ended up taking them out myself).

I’ve passed out, mid-panic attack, at the feet of a mental health nurse, been asked, ‘What are you doing?’ and told to, ‘Get up.’

I could go on. And on and on. And others on Twitter can list just as many examples of casual cruelty – many of them far worse than I’ve ever encountered.

Of course, not every HCP is so judgemental or unkind. I’ll never forget the kindness of a young A&E doctor, who simply laid his hand on my back while I was wracked with vomiting. Or the A&E nurse who held my hand and said, ‘I’ve been where you are. You’ll get through it.’ Or the same nurse who, while making the mandatory call to social services (it’s an automatic referral in this area if you have kids and present at A&E with self-harm injuries or having attempted suicide), told them, ‘She’s a lovely lady. I have no concerns.’ Or the lovely doctor who let me suck on gas and air while he was doing my stitches.

Such small gestures, but such kindness.

These kindnesses will stay with me forever, but so will the harsh words, the dismissive treatment, the way I’ve been made to feel like a time-waster, an attention-seeker, a drain on services.

There’s a term for the damage that this compassionless, mean-spirited treatment can cause: iatrogenic harm. It refers to physical or mental harm caused by the process of treatment, including the actions of HCPs. And if you take a look at Twitter, you’ll see hundreds of people who’ve been mentally scarred in this way.

How I wish that Prof Appleby was right in saying that such cruelty is a thing of the past, or at least vanishingly rare.

But what I wish most is for HCPs to show a little humanity to those of us who are at the lowest possible ebb, and who have reached out a desperate hand for help.

I wish they’d remember why they went into medicine, before they became hardened to their patients’ suffering.

I wish they’d realise that NOT ONE of us would have chosen this life for ourselves.

And I wish they’d realise how much their words and actions hurt.

What can be done about it? I don’t know. If we report such cruelty, it’s our word against theirs, and because we’re written off as mental, crazy, hysterical – and often labelled with BPD – our word counts for nothing.

Something has to be done, though, Prof Appleby.

Because the scars are deep. They’re real. They can cause untold psychological damage, and even be fatal.

And they could all be avoided with a simple drop of human kindness.

 

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