Friday, June 29, 2007

The drugs don't work

This post won't be the first time I'm motivated to write about mental health issues: try here or here for starters.
But once again recently I found myself reminded of the reality that is mental health care 'in the community'.
We got a call from the ambulance services. A young man- Spencer- lives with his relatives. He is supposed to take various medications, including anti-psychotics.

Spencer hasn't been taking his medication.

Spencer has smashed his room up.

Unsurprisingly the ambulance control take one look at their message screen and ping it straight across to us. One of my panda crews take the call.

I don't know why but I had alarm bells ringing with this one. The address was not known to our intel checks at all but it was one of those 'impending doom' moments. I'm the other side of town and start making my way over, blue lights and sirens going, harassing the school run traffic out of the way.

The panda crew are sage enough to wait for the ambulance crew before going in. That short delay saved them getting a pasting. As soon as Spencer sees the unfamiliar faces and uniforms he launches himself at the ambulance crew. The Pc's don't hesitate and jump in the way.

I had literally just parked up outside when the dreaded emergency activation button goes. All I can hear in the earpiece is a rage of shouts, screams, bangs and smashes. I don't actually hear whether its the crew I think it is or not but I don't wait for clarification. Myself and the other skipper (yes, there were two of us, for the first time that I can remember in a long time all supervisors were in across the district) barrel out of the car, forgetting to lock it, and sprint to the address.

There in the hallway are the two Pc's struggling on the floor with Spencer. One is desperately trying to get control of his legs and is getting several kicks for his efforts. The other is trying to get handcuffs on but Spencer is having none of it and is doing his best to bite her.

Its moments like this I am grateful I am 16 stone worth of ugly rugby forward.

With the four of us Spencer is quickly controlled- or at least, his limbs are. Go near his face and you get a faceful of spit (I later find out he has had TB. Hurrah.) Get too close and he'll do his damndest to take a chunk out of you.

I'm aware that I've got the whole of late turn running like a bat out of hell to get us. I eventually get in on the radio and cancel all but one more. To get Spencer out of the flat we will have to walk up stairs. Spencer is incapable of listening to us in his rage so I call for someone to bring down leg restraints.

I coordinate who's got what limb and we bring him out to the ambulance. 4 officers remain with him.

We are fortunate in Suburbiaville to have a hospital that is able to accomodate S136 patients, albeit only one at a time. The officers know, to their credit, that despite the assaults on them Spencer is not a well man and he is de-arrested and S136'd instead. (non-police readers, follow the link for S136 MHA explained).

I run to the hospital on blues to get there before the ambulance to forewarn them and make sure the room is free of anything that could be used as a weapon- a pen, a chair. The nurse in charge is not a happy man with the impending disorder.

4 hours later, Spencer is sectioned by the crisis team. We were lucky it is only just outside office hours and the relevant people required weren't too far away. It isn't uncommon to wait nearer 8 hours for this kind of decision.

The sedatives have finally worked, and Spencer is now in and out of sleep. The team that have been restraining him the last 4 hours are able to get up, stretch their aching ankles and knees and drink a gallon of water.

Politics and money now rear their ugly heads. Although Spencer was staying in our area, his home NHS trust is across a border. Suburbiaville NHS trust therefore won't accept him. His home NHS trust won't accept him because it happened in Suburbiaville.

Our job is now done though, and we stagger off in search of somewhere still open to have a rather late tea. I am forced to settle for a kebab. I leave the political wranglings of the NHS, and the psych doctor pulling his hair out at the bed administrators, behind for another day.