A Narrow Escape

Before I start on today's post, I just have to say a big thank you to the voters at This Week in Mentalists who gave me an award for Best Carers Blog.  I am very flattered: I follow many of the winners and runners-up in the other categories and I know how remarkable their own blogs are. In particular, knowing what I know now through the eyes of my daughter, I appreciate the rawness, the courage and the sheer eloquence of the many first-person mental health blogs represented there.

Gratitude seems to be the word of the day, because I am going to start by thanking the (unfamiliar) psychiatrist who assessed Julie earlier this evening and kept her out of hospital.  After a pretty gentle canter through Christmas and New Year, the last few days suddenly picked up the pace a little here.  The school term starts tomorrow, and as it drew nearer, Julie became quieter and quieter: ominously quiet, with hindsight.  We had to ask what she planned to do - did she plan to go to school, and did she want to attend classes?  It is difficult to ask this sort of question without appearing to put pressure on a child, but of course the practical considerations of arranging transport, keeping staff at the school informed, or planning our work routines, meant that we could not completely avoid the subject.  Each time we asked, there was a deafening silence.  A day or two would pass, and we would be obliged to ask again, and the silence became heavier.  As the start of term approached, the silence slowly extended, until all conversations were slowly blotted out.  I knew there was something wrong.

Yesterday Julie finally broke the silence in the only way she knows: by cutting.  By now accident and emergency no longer seems either strange or threatening: we glide through the waiting hours with the slick polish of professionals.  I have my bag full of books and games; I do not use the words 'self-harm' until we are sitting down privately with the triage nurse and have time to explain the situation (this avoids having 'DSH' written across the top of the notes); I choose my moment to go and stock up on snacks from the hospital shop; I make sure we drink plenty of fluids; I have the receptionist stamp my car parking ticket so that I can get an outpatient discount; we remember to ask them to call the on-call psych as we arrive, not after the stitches are done.  The waiting room is full to overflowing because it is a Bank Holiday and the GPs are not working.  Everywhere I look there are desperate parents clutching small children with broken fingers or feverish cheeks, fretting about where to park, the cost of parking, where to find a toilet, how long they will have to wait.  Julie and I sit quietly in our corner, reading our books, not bothering about the time passing.

Having said this, Julie was visibly shaken by her lapse.  She asked to speak to the on-call psych, which she rarely bothers with.  A youngish man finally arrived and talked to her for half an hour.  He seemed dismayed at what he saw.  Was the olanzapine working?  Shouldn't she be in hospital?  I filled in some of the back story; we have been at the same point often before and worse.  I could not see the point of hospital, which is disruptive and from which she might well emerge in precisely the same situation.  We were nowhere near breaking point at home.  He agreed, sent in his report, and said encouraging things to Julie.

Julie had an appointment to see her regular therapist this afternoon.  Martha was not happy with the look of her at all.  Julie was getting desperate and talking about suicide.  It was just the sort of thing that Martha gets anxious about.  Yet another on-call psych was called, but it took a couple of hours for them to reach the clinic through the rush-hour traffic.  In the meantime, Joe, who was stuck in the clinic waiting room, sent me text messages to let me know what was happening, and Martha phoned me to apologise.  It looked for a while as if readmission to hospital was inevitable: a provisional bed had been found and spoken for, and the hospital alerted.

So I am grateful for the psychiatrist who finally arrived, long after their shift should have ended, and took the time and trouble to talk to my daughter at some length.  Admission to hospital would have been so easy - in the short term there would be less risk, and it would be somebody else's responsibility to deal with her in hospital and work out how to get her back out again.  But the psychiatrist took the trouble to look at the picture, look at the previous admission, look at the context of this latest incident, and take the risk of sending her home.  The psychiatrist's rules are:

1. Julie is never to be left alone.
2. She is to take Zopiclone so she can sleep at nights.
3. She should try to talk to me.
4. She is not to go to school except if she expressly wants to.
5. She has permission to cry.

I was never so relieved as when Julie came home later that evening with Joe, and asked for her dinner.