Not ready to go out alone

Staff in psychiatric hospitals do not always know the importance of
properly monitoring and reviewing patients’ conditions. As a
patient who was brought to hospital in a disturbed mental state, I
think staff ought to have made the effort to find out I had a
history of psychiatric illness before they granted my request for
overnight leave – just two days after I was admitted.

Ward staff allowed me to leave at 8.15pm on a Friday evening
without money or shoes and with little clothing. They had no idea
where I would be staying or whether I had made any travel
arrangements.

If a patient is not known to the clinical and nursing staff, then
surely a detailed mental state examination and risk assessment
should always be sought from a consultant psychiatrist? Surely
discussions with the patient’s next of kin are routine?

Sadly, this isn’t always the case. Too often staff prefer not to
waste time on an assessment or consultation with a consultant, and
ignore the appearance and behaviour of a patient, including those
with cuts to both wrists.

And if the patient decides not to return to hospital to continue
with their treatment, that’s fine, too. Staff may not know when the
patient is supposed to return, and may not try to make contact. It
is up to the patient to monitor their illness and pick up the
pieces when things go wrong.

Although the police had picked me up in the street in the first
instance and had taken me to a place of safety – the hospital –
they were there again with Swat (special weapons and tactics) teams
five days later. Three days following my readmission, they were
called yet again to return me to hospital. I can only presume that
the police asked the trust why they were being called upon to
provide a very expensive taxi service.

As a result of this experience, I suffered moderately severe
post-traumatic stress disorder – damage that I believe was a
predictable consequence of the decision to grant me home leave.
Ward staff should think much more carefully about the nature of an
individual’s illness before they grant leave to a disturbed
patient.

Caroline Meaker has been diagnosed with bipolar
disorder