Tuesday, Chris was continuing to get more and more unwell, he had seen his social worker in the morning who hadn’t been overly helpful. It reached the afternoon and he rated his suicidal thoughts a 10, never has he scored himself so high before and he was looking for ways to harm himself. I suggested he ring his social worker and explain how bad things were. After a lot of persuasion he rang her and she asked if hospital would be a good idea, he agreed (that is huge for Chris) she said she would speak to the Gate keep of beds and if not would see about a referral to the Home Treatment Team. She said she would call back once she had made some phone calls.
After waiting for some time she rang back at about 2 o’clock and said both her and his other social worker would be out in half an hour to come and see him before they decide what to do. I had to go out at that time and collect my eldest daughter from school, upon our return home both of them were here and talking with Chris. I took the girls into the kitchen as I didn’t want them to hear the conversation that was taking place in the living room. Before they left they wanted to fill me in on ‘the plan’ you know the one that involves the carer but is never discussed with them? Yes? That one.
They said they didn’t feel the Home Treatment team would accept the referral, basically Chris is like this all the time and it just needs better management in the normal community team and that they wouldn’t look into hospital as he then didn’t really want to go and he said he would only as a last resort. I didn’t agree with their reasons for not involving the Home treatment team and could prove their point was invalid. They then left saying one of them would be out the following day, being Wednesday, someone would phone him on Thursday and then the other of them would be out on Friday. In the mean time, go to accident and emergency, ring the duty team or even phone an ambulance were the suggestions.( @diagnosisLOB would love to play taxi to us I am sure. )
Following their departure I sat and composed the following letter ready to hand to his social worker who was visiting the following day, it read…
To whom this may concern,
I am writing this letter in the hope you may better understand my thoughts around my partner Chris. I shall be busy with the children when you arrive to review him, as I feel it is important they are not around to hear the topic of conversation that will occur.
I have thought about what was discussed yesterday regarding the home treatment team and admission and would like to make you aware of my opinions regarding this.
Firstly you said that for Chris this is an ongoing problem that we all need to learn to manage. I don’t agree with this, his suicidal thoughts I agree are there most of the time which he more or less keeps in control of, with scoring his suicidal thought severity of 4’s and 5’s out of a possible 10 being worst, we accept that is an ongoing part of having ‘Emotionally Unstable Personality Disorder’. We also agree that occasionally he will have the odd bad day where he will struggle to control those thoughts with a possibility of hitting 6’s 7’s and even the odd 8 out of a possible 10 for his thoughts. However at the moment Chris has remained suicidal for several days with his scores getting progressively worse, this has been triggered by an unexpected meeting of his Uncle who caused him trauma to as a young child. As you can respect this has been a massive emotional trigger for Chris.
While I respect that his EUPD is an ongoing problem, his current presentation is extremely different and has significantly changed. Since seeing his Uncle there have been a number of changes including flashbacks which he hasn’t had problems with for a long time, he has been having recurrent nightmares about his uncle following him and waking up terrified. He has started using alcohol before going to bed, drinking as much as two large bottles of WKD a night, or a bottle of Malibu straight, to name a few. He has started to skip medication not only because he was drinking but because he didn’t feel it was helping him anyway so didn’t see he needed to bother taking it.
Therefore I don’t feel you can regard this as an ongoing problem, again things are significantly different now than normal. I would regard this at the moment as a period of crisis.
Secondly at the moment Chris is having periods of severe agitation, struggling to sit still preferring to be moving, even pacing. I have not seen him as bad as this, this year, not even before his last overdose. He has on more than one occasion actively tried to get into the safe to take all his medication and become emotionally distressed when he couldn’t. He disappeared at the weekend without a word after telling me he was suicidal and struggling, he didn’t tell me he was going let alone where he had gone, thankfully he returned just before I was about to report him missing and at risk to the Police. This isn’t rapid shifts in his mood this is currently low mood, suicidal thoughts, agitation and anxiety with no look at the moment that anything is improving.
As you can respect it is taking an awful lot out of me dealing with everything alone. I felt it important you understand exactly where I am coming from which can sometimes be difficult to explain at the time when I’m caught up with varying emotions.
I hope you will take some of what I have said into consideration, you are welcome to contact me anytime if you want to discuss anything further.
I then copied his GP onto the bottom of it and sent the letter to her as well, so she could follow what has been going on and my opinion around what they were choosing to do about it. I fully expected to hand it to his social worker the following day to give my thoughts and opinions clearly to them in black and white so no one could argue they didn’t know the full situation or how I was feeling about things.
Stay tuned… more to follows on ‘Crisis Care? What is that? Part Two’