Putting your arm in the mangle, 999 what is your emergency

When helping can feel like you’re being pulled in too fast and with no escape. This program which is sadly only available today on 4oDlooks at 999 calls related to mental health in Blackpool and when it was first aired caused quite a stir.

I was prepared for an emotional onslaught as I find watching people in various states of degenerating mental health distressing and sadly I found much to be distressed about particularly the unprofessional comments that many of the police, ambulance and 999 call centre staff uttered. My overall impression was that the people dealing with those in distress was of overwhelming responsibility, yet total agreement that it was not there responsibility. They seemed to feel that they had to act and not only that but in a timely fashion, and by timely I mean swiftly yet my own experience suggest that actually rushing those with problems may have made the situations worse rather than better and also that they had no idea what to do. I can’t imagine anything more stressful and therefore don’t find it surprising that they made some of the comments that I found distressing.

 I’m not well versed in the law and how it relates to such situations but I would draw your attention to this blog that is written by a police inspector about this program and other things relating to mental health and the law. It’s very professional and I am struck by the lack of emotion within it, mainly because I doubt very much that when you are faced with these situations that people actually do leave their emotions behind. We’re all human and feeling is a natural part of who we are and affects what we do. Maybe I’m doing him a disservice and he has a good grip on them when he’s working however I doubt that is so for many and maybe it should be.

He makes some excellent points and sadly shows that despite training not everyone reacts in a manner that is befitting. I am however inclined to think that some of them relate more to an editing policy in making watchable television than to any need to provide the total picture.

 And sticking to the law and not getting pulled in is all very well except that often the services he feels people should be earmarked for are often unobtainable or more importantly unknown about. I draw your attention to the community mental health survey

and under Crisis care Question 34 it states that of the people surveyed 13486 for 2012 only 60% of them had a number for the out of hours service for their local NHS. And let me remind you that the response rate was 32% so extrapolate if you will to how many people that could mean did not get given the number. The next important step to consider is that of the 37% who called the number (8124) 80% either got the help they want to some extent or yes definitely, but interestingly 3% replied that they could not get through to anyone.

I might add that I am a loss as to why we have a separate number for crisis care from 999. Why exactly does the crisis team not get linked through to this number so that everyone gets the people they need. Seems a bit daft to me.

999 for emergencies but you still have to remember a separate number for mental health crisis care....!

And maybe this why throughout the program people were under the impression that it wasn’t their bag to deal with mental health issues, just a thought but maybe it would be easier on everyone if they integrated the system a bit more and put mental health crisis on a par with physical health crisis and let us all use the same 999 number.

You might say that actually we do that already?..But do we?

Because I don’t think we do, I think most people take it to heart that actually we should be calling this number we’re given and when we can’t find it we get by because we can’t face A&E, we can’t face the police that as this program put it are routinely called in such circumstances.

 I think the people who ring 999 are the people who are not mentally ill and have no clue about the crisis number we as patients are given and they call it because they have no idea what to do but feel they have to do something. In fact many of the reasons in the program for the interference were because of a duty of care or the feeling that they had a duty of care but without any real idea of what was the possible or appropriate and my take home from it was that they had no real idea what to do, that they had not been trained and they were never going to make a difference to this problem. They were overwhelmed and felt were expected to act regardless, which is what they did however badly.

In fact over the last few months I’ve looked at plenty of data on the issue of care and in most instances people have stated that they don’t’ feel they know enough to help, that they don’t feel confident in being able to help so do nothing and these are GP’s and practice nurses and even the paramedics and police on this programme. They do not feel confident about what they ought to be doing.

Leading on from this, it was notable that everyone agreed that police custody was not the place for those with mental health problems but sometimes was necessary yet it seems that more and more people are ending up there but I’m not sure that A&E is the place either. I for one would rather not go there if I can avoid it. The whole rush and tear and numbers of people going through would drive me nuts, I’d be out the door in no time. So why if detention is needed is there not a A&E for mental health a place of safety that could detain those not fit to be assessed in safety, with trained staff, and less agressively obvious police should they be needed.