Involuntary Hospitalisation

[icu_baby]

Hi Everyone,

I am interested to know if anyone has been involuntarily admitted and if so did you think your admission helped you or made you worse? How long was your length of stay, why were you admitted and did you say in an acute/ sub acute ward? Were you coerced in any way or treated unfairly because you had BPD?

Here is my experience, I am against involuntary hospitalisation:

I was scheduled (or sectioned as they call it in the UK) for the first time due to a severe overdose. I awoke from my coma and my teating toxicologist told me that I was "a scheduled patient and if I try and leave the hospital the security guards will drag me back". The nurses were equally as horrible, they wanted to watch me on the toilet and when I said that they had to balance my dignity and privacy with their safety policy we got into a big fight. I was not told my rights and when I demanded information about my rights one nurse said to me "unfortunately because of what you did you don't have any rights". This infuriated me because as a law student everyone has rights - even if you do lose your freedom of movement under schedule. Secondly, it was a very insensitive comment to make. I got so frustrated that I walked out of my room and demanded to go home. One nurse threatened to "pull my pants down and stick a needle in my bum and be put in restraints". That was extremely demeaning; it made me sick. I was so terrified that I would be shipped to the psychiatric ward of the hospital that I said my overdose was an accident and promised not to kill myself in 24-48 hours. I got no follow up care whatsoever.

I had a relapse only 6 weeks later because of all what happened to me but this time I was admitted in another hospital and was forced to go to the acute psychiatric ward. Again the first night I freaked out and acted out and was put in seclusion where the nurse threatened to put me in there "stark naked". I was also forcibly held and given injections on 3 occasions. It was very humiliating. I protested and I was let out after 3 days. I found hospital to be a very boring and dulling environment.

I eventually complained to the Health Care Complaints Commission re my treatment at the first hospital and I was able to get a conditional apology from the Director of Mental Health Services. The acute care team also came to my house without letting me know one day and I told them to stay out of my life. They also refused to give me the anti-depressants that I wanted and wanted to supervise my medication. I declined and went to another GP and got the medication I wanted. Gaining control in the sense of what medicatio I thought might be appropirate for me and partially suceeding at the complaints commission helped me gain control over my treatment and although I am still suffering trauma of those experience it has helped me on the way to recovery.

icu_baby

[CharcoalKiss]

Hi Everyone,

I am interested to know if anyone has been involuntarily admitted and if so did you think your admission helped you or made you worse? How long was your length of stay, why were you admitted and did you say in an acute/ sub acute ward? Were you coerced in any way or treated unfairly because you had BPD?

Here is my experience, I am against involuntary hospitalisation:

I was scheduled (or sectioned as they call it in the UK) for the first time due to a severe overdose. I awoke from my coma and my teating toxicologist told me that I was "a scheduled patient and if I try and leave the hospital the security guards will drag me back". The nurses were equally as horrible, they wanted to watch me on the toilet and when I said that they had to balance my dignity and privacy with their safety policy we got into a big fight. I was not told my rights and when I demanded information about my rights one nurse said to me "unfortunately because of what you did you don't have any rights". This infuriated me because as a law student everyone has rights - even if you do lose your freedom of movement under schedule. Secondly, it was a very insensitive comment to make. I got so frustrated that I walked out of my room and demanded to go home. One nurse threatened to "pull my pants down and stick a needle in my bum and be put in restraints". That was extremely demeaning; it made me sick. I was so terrified that I would be shipped to the psychiatric ward of the hospital that I said my overdose was an accident and promised not to kill myself in 24-48 hours. I got no follow up care whatsoever.

I had a relapse only 6 weeks later because of all what happened to me but this time I was admitted in another hospital and was forced to go to the acute psychiatric ward. Again the first night I freaked out and acted out and was put in seclusion where the nurse threatened to put me in there "stark naked". I was also forcibly held and given injections on 3 occasions. It was very humiliating. I protested and I was let out after 3 days. I found hospital to be a very boring and dulling environment.

I eventually complained to the Health Care Complaints Commission re my treatment at the first hospital and I was able to get a conditional apology from the Director of Mental Health Services. The acute care team also came to my house without letting me know one day and I told them to stay out of my life. They also refused to give me the anti-depressants that I wanted and wanted to supervise my medication. I declined and went to another GP and got the medication I wanted. Gaining control in the sense of what medicatio I thought might be appropirate for me and partially suceeding at the complaints commission helped me gain control over my treatment and although I am still suffering trauma of those experience it has helped me on the way to recovery.

icu_baby

I've never been admitted involuntarily, but i am studying psychology (and am actually writing and essay now about whether there is a valid case for compulsory care for PD sufferers in the UK since the new Mental Health Act has altered the definition of mental disorder to incorporate PDs and has added Dangerous Severe PD to the list for compulsory indefinate detention for care. - not my choice of topic btw)

It seems, from what i've read, in the UK anyway, that there is a consensus that PDs are automatically dangerous as well as that PD is not a 'real' mental illness. Also, there are problems with treatment so some NHS centres seem to just, 'quieten' PD patients and keep them out of the way. I haven't read anything on particularly unpleasant treatment within the NHS... although i'm positive that it happens... the NHS is not geared up to deal with PDs... they can only just deal with 'mental illnesses' like depression and schizophrenia... and even then thats propably because they are treatable by drugs.

Your experiences do sound pretty awful. :-(

[horgz]

wtf!! i have never heard of anyone having that kind of experience! i mean i ahev seen it on tv and i know crap like that used to happen but i didnt realise that it still went on in this day and age! sorry to hear about it! i have been involuntary sectioned after an OD but my experience of it was rather pleasent! i had 3 meals a day and a free pool table! after 5 days of all smiles they let me go and they offered follow up care but me being an idiot said no to it!!

[sundries]

Yes I have had similar expereince.

in my opinion a lot of nurses are uneducated ignorant thugs.

i think sometiems hospital can do a lot mroe harm than good.

[Barebones]

i was a voluntary patient at first as i was adviced to go in by my pdoc. when i was there for couple of weeks things got worse and came to ahead and i tried to hang myself, it was then when i said next day i wanted out they put me on emergency section and after that because i was still in same state they sectioned me to 6 months which i could of appealed if i was stable enough which i wasnt who is when in hospital. i used to play up and run away when i could. it was alocked ward but i managed to run away a few times but was brung back, but they didnt hurt me or treat me badly. when i was there they took aboard my behaviour and tried a couple of times to give me meds to help what i was going through but i wouldnt take it as i was paranoid. so all in all i never had bad treatment even when i finaly made them take of section and put me home becasue of my behaviour as they saw that hospital wasnt doing me good.

since then ive been in vountary again even they was worried that it would spark me off but i behaved myself and took the meds and it did help for awhile. it kept me safe.

im sry icu that you had such treatment, its not the first time ive heard of this as some other have had bad treatment aswell.

[rebeccaborderline]

Hi,

Ive had many voluntary hosp admissions, and in addition was detained under Mental Health Act, Sectioned first for 28 days but just before that ended they reassesed me and extended it to 6 months. It was an acute ward. After a while I was alllowed some freedom eg go to hosp shop under escort but was always absconding (to go to the pub!) so freedoms were withheld, allowed again, withheld etc etc. I S/Hed heavily on the ward, getting other patients to buy me razors (which Im not proud of); I also used nooses and other S/H behaviours. I was often watched 24 hours a day with the nurse no more than 3 feet away, including when in the toilet, as this was the prime place for S/H. I am not an aggressive person but must have driven the nurses nuts as they tried to stop me injuring myself or escaping. I saw some people get forcibly sedated or restrained but in all cases I saw it was because of aggression to others, sometimes through mania, sometimes through aggressive intent (or so it seemed) .

In general I cant complain about my care, I got to talk to my very good key nurse for 30 mins every day which made me feel that they were listening; my psychiatrist once a week for an hour, and my psychiatrists SHO was around most days if there were problems. I was very unstable and barely functioning really, it was just a case of trying to protect me whilst meds got me on track again. I was there 4 1/2 months in total.

Most nurses were OK, some were really good, some just read magazines and tried to avoid any contact with patients for the whole shift; one was rather heavy-handed when restraining people, it was noticable people acted up less if he was on shift!

The worst thing was the mind-numbing boredom. Was OK at first as too nuts to care but day after day it was relentless. Very little therapy available as was acute ward with high turnover; some occupational therapy.

I wouldnt want to repeat the experience, and have learnt to avoid psych wards; but at times, like on Section, they have been invaluable for my own safetly, I was determinedly suicidal

rebeccaborderline

[Nightvision]

Hi Everyone,

I am interested to know if anyone has been involuntarily admitted and if so did you think your admission helped you or made you worse? How long was your length of stay, why were you admitted and did you say in an acute/ sub acute ward? Were you coerced in any way or treated unfairly because you had BPD?

Here is my experience, I am against involuntary hospitalisation:

I was scheduled (or sectioned as they call it in the UK) for the first time due to a severe overdose. I awoke from my coma and my teating toxicologist told me that I was "a scheduled patient and if I try and leave the hospital the security guards will drag me back". The nurses were equally as horrible, they wanted to watch me on the toilet and when I said that they had to balance my dignity and privacy with their safety policy we got into a big fight. I was not told my rights and when I demanded information about my rights one nurse said to me "unfortunately because of what you did you don't have any rights". This infuriated me because as a law student everyone has rights - even if you do lose your freedom of movement under schedule. Secondly, it was a very insensitive comment to make. I got so frustrated that I walked out of my room and demanded to go home. One nurse threatened to "pull my pants down and stick a needle in my bum and be put in restraints". That was extremely demeaning; it made me sick. I was so terrified that I would be shipped to the psychiatric ward of the hospital that I said my overdose was an accident and promised not to kill myself in 24-48 hours. I got no follow up care whatsoever.

I had a relapse only 6 weeks later because of all what happened to me but this time I was admitted in another hospital and was forced to go to the acute psychiatric ward. Again the first night I freaked out and acted out and was put in seclusion where the nurse threatened to put me in there "stark naked". I was also forcibly held and given injections on 3 occasions. It was very humiliating. I protested and I was let out after 3 days. I found hospital to be a very boring and dulling environment.

I eventually complained to the Health Care Complaints Commission re my treatment at the first hospital and I was able to get a conditional apology from the Director of Mental Health Services. The acute care team also came to my house without letting me know one day and I told them to stay out of my life. They also refused to give me the anti-depressants that I wanted and wanted to supervise my medication. I declined and went to another GP and got the medication I wanted. Gaining control in the sense of what medicatio I thought might be appropirate for me and partially suceeding at the complaints commission helped me gain control over my treatment and although I am still suffering trauma of those experience it has helped me on the way to recovery.

icu_baby

I'm so sad to hear that this was your experience.

I understand that you are in Australia so I don't know too much about the health system there but I guess certain factors are common to all national health services. There are so many different factors involved in the kind of care you get and I really wish Governments would address this, namely

- The treatment you get depends on the funding where you live - postcode lotteries exist within the NHS in the UK

- Not all people who enter the mental health profession do so in order to help people who are suffering

- Rural hospitals may not see as great a variety of people as city practices and have less experience dealing with some conditions, conversely, city practices may just not have the time to give everyone the care they need

[jen91]

I have done the involuntary admission (more than once) and the experience varied. The fist time I was so scared I ran - not a good call -, because the whole hopsital was on a hunt for me. It was humililating. And when I got back to the hospital no one explained what was going on and everyone (nurses, janitors) were all talking about my flight, it was the most excitment they had had in ages). What can I say, I don't go without a fight:)

And there was NOOO confidentiality, everyone knew everything about my situation. I understand why the docs did it but it didn't help.

Another time it made me even worse because they had someone stay with me - a creepy man - who stayed in my room with me and stared at me. I have been sexually assualted so this triggered me immensely and I fell apart. I tried to complain to the nurses and they just tried to medicate me. It was as if my cocern was not valid because I was in a psych ward, they completely dismissed me. The man was very offended that I was afraid of him and so he just dug in his heels and tried to stare me down. It was awful, I didn't sleep, relived many horrible memories and it still upsets me to type this.

So for me while the hopsital kept me safe it certainly didn't help me get better.

[icu_baby]

[icu_baby]

I have done the involuntary admission (more than once) and the experience varied. The fist time I was so scared I ran - not a good call -, because the whole hopsital was on a hunt for me. It was humililating. And when I got back to the hospital no one explained what was going on and everyone (nurses, janitors) were all talking about my flight, it was the most excitment they had had in ages). What can I say, I don't go without a fight:)

And there was NOOO confidentiality, everyone knew everything about my situation. I understand why the docs did it but it didn't help.

Another time it made me even worse because they had someone stay with me - a creepy man - who stayed in my room with me and stared at me. I have been sexually assualted so this triggered me immensely and I fell apart. I tried to complain to the nurses and they just tried to medicate me. It was as if my cocern was not valid because I was in a psych ward, they completely dismissed me. The man was very offended that I was afraid of him and so he just dug in his heels and tried to stare me down. It was awful, I didn't sleep, relived many horrible memories and it still upsets me to type this.

So for me while the hopsital kept me safe it certainly didn't help me get better.

Jen91, that is completely terrible and insensitve in having you monitored by a man. This is a classic example of how sometimes hospitalisation can be more harmful then helpful. They should have gotten a lady nurse for you. When I was in a general ward after my overdose I had to have a 1:1 nursing special where the nurses just sat outside my room on a table and chair and observed me 24 hours a day. Some of the nurses where male but they were outside my room, its not like they were sitting on a chair next to my bed.

When you say you ran out of hospital, did you actually leave the grounds and who brought you back? I tried to leave the ICU before they had a chance to transfer me to the psych ward and the security guards just grabbed me by the arms and put me back in my bed. It was also quite humiliating. That happened twice.

[icu_baby]

Hi,

Ive had many voluntary hosp admissions, and in addition was detained under Mental Health Act, Sectioned first for 28 days but just before that ended they reassesed me and extended it to 6 months. It was an acute ward. After a while I was alllowed some freedom eg go to hosp shop under escort but was always absconding (to go to the pub!) so freedoms were withheld, allowed again, withheld etc etc. I S/Hed heavily on the ward, getting other patients to buy me razors (which Im not proud of); I also used nooses and other S/H behaviours. I was often watched 24 hours a day with the nurse no more than 3 feet away, including when in the toilet, as this was the prime place for S/H. I am not an aggressive person but must have driven the nurses nuts as they tried to stop me injuring myself or escaping. I saw some people get forcibly sedated or restrained but in all cases I saw it was because of aggression to others, sometimes through mania, sometimes through aggressive intent (or so it seemed) .

In general I cant complain about my care, I got to talk to my very good key nurse for 30 mins every day which made me feel that they were listening; my psychiatrist once a week for an hour, and my psychiatrists SHO was around most days if there were problems. I was very unstable and barely functioning really, it was just a case of trying to protect me whilst meds got me on track again. I was there 4 1/2 months in total.

Most nurses were OK, some were really good, some just read magazines and tried to avoid any contact with patients for the whole shift; one was rather heavy-handed when restraining people, it was noticable people acted up less if he was on shift!

The worst thing was the mind-numbing boredom. Was OK at first as too nuts to care but day after day it was relentless. Very little therapy available as was acute ward with high turnover; some occupational therapy.

I wouldnt want to repeat the experience, and have learnt to avoid psych wards; but at times, like on Section, they have been invaluable for my own safetly, I was determinedly suicidal

rebeccaborderline

Dear Rebeca, its good to hear that your experience was better then mine. Obviously your nurses were well trained and understood that your behaviour was caused because of the fact that your were sick. The nurses responded with care and compassion to your agitation rather then reactive in a negative and destructive way towards you.

I am just curious, you said that when they finally stopped you from self harm as soon as the nurses stopped trying to stop you from injuring yourself and escaping. This is why in Australia people with Borderline disorder are usually only hospitalised briefly (to manage an a crises) as long periods of hospitalisation can lead to regression.

6 months seems like an awfully long time - being in an acute ward is like Jail - the environment is so dulling, there is nothing to do but get your family to bring you books and magazines and watch tv. I almost went nuts after three days and hence pushed hard for my realise. If you had alot of contact with the nurses I think that is good thing. I felt that hospitalisation was really a holding environment and nothing else. You wait long periods of time before you get a chance to talk to a psych doctor.

Did you regret your 6 month hold or did you think you need to be there for that long?

[bibiddi]

ICU, I know you are studying psychology at uni.Can I ask, are you asking these questions for your course?

[icu_baby]

[icu_baby]

ICU, I know you are studying psychology at uni.Can I ask, are you asking these questions for your course?

Hi Bidddi, I am studying law. I am doing a question on involuntary detention and treatment under the Mental Health Act as part of my Health and Medical Law. Its a topic that I am extremely passionate about because I experienced involuntary detention twice! My lectuere seems against any form of involuntary detention. I have very mixed feelings about it. After being put in an acute ward I got a chance to talk to some people and most seem complacent about being there. My concern is more the treatment you can receive against your will. I was held down on 3 occassions and sedated because I didn't want to be there. If I was not a scheduled patient (in the UK you guys call it sectioned) I would not have received that treatment...so I am very bitter and don't agree with involuntary detention yet at the same time some people may benefit, for example people later acknowledge that it kept them safe or in the case of a manic phase, people are kept from giving away large amounts of money.

[bibiddi]

I hear what you are saying, ICU.

However, I am concerned about the ethics side of this discussion.

You appear to be carrying out research here for your University question without obtaining informed consent from any of us.

Has Josh been asked if you can use us in such a way?

Perhaps deception too, not in a evil malicious way, but in a way where your personal feelings,mix with the need to have evidence to back your theory.

I havent gotten involved in the discussion because I'm feeling like a lab rat.

Have you discussed what you are doing, and how you are going about it with your lecturer?

[icu_baby]

I hear what you are saying, ICU.

However, I am concerned about the ethics side of this discussion.

You appear to be carrying out research here for your University question without obtaining informed consent from any of us.

Has Josh been asked if you can use us in such a way?

Perhaps deception too, not in a evil malicious way, but in a way where your personal feelings,mix with the need to have evidence to back your theory.

I havent gotten involved in the discussion because I'm feeling like a lab rat.

Have you discussed what you are doing, and how you are going about it with your lecturer?

Dear Bididdi,

There is nothing unethical about my discussion and I am a bit perplexed by your comment .

I opened the thread because of my genuine distress and trauma I suffered as a result of my experiences as an involuntary patient. I explained my personal story in quite some detail. I am sorry you feel like you are a lab rat but no one is forcing you to contribute to the discussion.

I have not been able to talk about my feelings which have been burning inside of me for months. My involuntary hospitalisation is not something that I generally go around telling people (I am not ashamed of it but it is extremely private) and I thought that being able to use this forum to share my experiences with other people who have had similar experiences might be therapeutic especially because there are not many people that will UNDERSTAND what I went through unless they have been through it themselves.

When I mentioned that I have an assignment concerning involuntary hospitalisationI was responding to Charcol's post because she is studyig psychology and is doing an assignment on borderline personality disorder and the mental health act. I was simply making a joke thats all - we both have a head start against our classmates because Charcol's assignment is on BPD and she suffers from it and my assignment is on involuntary commitment and I have been subjected to it. Yes I veered off the topic a little bit in relation to the Mental Health Act, I am a law student I find it interesting to compare the law in other common law countries.

In any case, my assignment is quite technical and involves interpreting the act, critiquing the framework and wording of the Act, how it should be read, the purpose of the Act. Furthermore the Act that governs a very specific area - NSW, Australia. Furthermore, there is no primary researched involved, I have to use academic journals. There is plently of good quality academic matieral out there; I don't need to come on this forum to research. I came on this forum simply to be able to tell my story with the benefit of anonymity and feel consoled in any sense when people respond to my experience. I still suffer from constant flashbacks.

I chose to study Medical and Health Law as an elective shortly after my experiences because I became passionate about the rights of patients esp people with BPD because of how the stigma assoicated with the disorder affects how mental health professionasl and other practitioners tolerate actions, throughts and emotional reactions to people like us - the very people who are supposed to help us. I had nothing to hide when I mentioned my assignment, if I was going to use any of this information I wouldn't have mentioned it. I am proud of the fact that when I graduate I want to use my skills I learnt at law school to help people who were in my postion.

So in short, I am not using any part of what is discussed here for my research assignment - it was never my intention in the first place and find it quite disturbing that you would suggest that I was though I can see the coincidence which might have wrongly lead you to make a conclusion that somehow I was trying to obtain information by "being deceptive".

If I was trying to somehow gain information there is no need to do it deceptively, I would just be frank and honest and say "I am doing an assignment on involuntary hospitalisation and would be greatful if people could give me there opinions, all confidentality would be upheld...." I have no doubt that if I was doing an assignment and need primary research that many people would be more than happy and willing to help and answer my questions.

[seafree]

Hiya, i've never been hospitalised apart from after suicide attempts when i've been recovering on the ward. But never sectioned or anything. I'm at university and they sent me for private help rather than referring me over to the NHS, this is because the psych ward is described to be like 'the fiery depths of hell' lol. It's not got good feedback. I have been an outpatient there though, and it's disgusting. Under-staffed for starters, no room and the CPN's are malicious!!

Jess x

[icu_baby]

More information:

Magnetic Resonance Imaging Volumes of the Hippocampus and the Amygdala in Women With Borderline Personality Disorder and Early Traumatization

Martin Driessen, MD, PhD; Jörg Herrmann, MS; Kerstin Stahl, MS; Martin Zwaan, MD, PhD; Szilvia Meier, MD; Andreas Hill, MD; Marita Osterheider, MD; Dirk Petersen, MD, PhD

Arch Gen Psychiatry. 2000;57:1115-1122.

Background Based on findings of stress-induced neural disturbances in animals and smaller hippocampal volumes in humans with posttraumatic stress disorder), we hypothesized that patients with borderline personality disorders (BPD), who often are victims of early traumatization, have smaller volumes of the hippocampus and the amygdala. We assumed that volumes of these brain regions are negatively correlated with traumatic experiences and with neuropsychological deficits.

Methods We studied 21 female patients with BPD and a similar group of healthy controls. We performed clinical assessments, a modified version of the Childhood Trauma Questionnaire, and magnetic resonance imaging volumetric measurements of the hippocampus, amygdala, temporal lobes, and prosencephalon. Neuropsychological testing included scales on which disturbances in BPD were previously reported.

Results The patients with BPD had nearly 16% smaller volumes of the hippocampus (P<.001) and 8% smaller volumes of the amygdala (P<.05) than the healthy controls. The results for both hemispheres were nearly identical and were controlled for the volume of the prosencephalon and for head tilts. The volumes of the hippocampus were negatively correlated with the extent and the duration of self-reported early traumatization only when BPD and control subjects were considered together. Levels of neuropsychological functioning were associated with the severity of depression but not with the volumes of the hippocampus.

Conclusion In female patients with BPD, we found reduction of the volumes of the hippocampus (and perhaps of the amygdala), but the association of volume reduction and traumatic experiences remains unclear.

From the Department of Psychiatry (Drs Driessen, Meier, and Hill, and Mr Herrmann, and Ms Stahl) and Institute of Radiology (Drs Osterheider and Petersen), Luebeck School of Medicine, Luebeck, Germany; Department of Psychiatry, Gilead Hospital, Bethel, Bielefeld, Germany (Dr Driessen); and Institute of Diagnostic and Interventional Radiology, Ammerland-Clinic, Westerstede, Germany (Dr Zwaan).

woops wrong post - this was supposed to go under the labelling section

[bibiddi]

Hi Everyone,

I am interested to know if anyone has been involuntarily admitted and if so did you think your admission helped you or made you worse? How long was your length of stay, why were you admitted and did you say in an acute/ sub acute ward? Were you coerced in any way or treated unfairly because you had BPD?

Here is my experience, I am against involuntary hospitalisation:

icu_baby

Im glad you havent got dodgy motives, and explained things!

I felt very uncomfortable with the questions you primarily asked, prior to you disclosing your experience.

You experience is your own, others may have similar or different experiences. But why do you want to know whether it was an acute or sub acute ward? or length of stay?Well infact all of the questions.To me, the questions you asked, felt like they were information gathering.

I'm all for sharing experiences, I feel it helps us get on the road to recovery.

[icu_baby]

Hi Everyone,

I am interested to know if anyone has been involuntarily admitted and if so did you think your admission helped you or made you worse? How long was your length of stay, why were you admitted and did you say in an acute/ sub acute ward? Were you coerced in any way or treated unfairly because you had BPD?

Here is my experience, I am against involuntary hospitalisation:

icu_baby

Im glad you havent got dodgy motives, and explained things!

I felt very uncomfortable with the questions you primarily asked, prior to you disclosing your experience.

You experience is your own, others may have similar or different experiences. But why do you want to know whether it was an acute or sub acute ward? or length of stay?Well infact all of the questions.To me, the questions you asked, felt like they were information gathering.

I'm all for sharing experiences, I feel it helps us get on the road to recovery.

Hi Bibiddi, thats ok, no dodgy motives, lol. Those questions are just questions I am personally interested in given my experience and they are just a kind of prompt for people if they want to write something but don't know what.

I was put in the acute ward myself and was allowed to go into the sub acute section for a while. The acute section was horrible in terms of design. There was a TV in the corner of the living room covered by glass (to protect it incase anyone became aggressive". There was an outside area that was very desolute with a patchy grass area that was not cut. At 11.00 a huge security wall that completely sectioned off the living room and the nurses station with the corridor which contained the individual bedrooms and this was not opened until 9.00am in the morning. So as you can imagine from 11.00pm to 9.00am you are stuck in your room. The nurses did a couple of rounds in which they shined a torch in your face. You could not basically go anywhere except up and down the corridor and you were blocked off from the nurses station so it was hard to get there attention though they could see you via camera - you are not free to get a drink or a snack (unless you have a food in your room), use the phone, watch tv etc.

I felt very isolated, locked in my "cell", I felt that I was in jail but I was not a criminal.

Me and another "inmate" started pacing the hallway up and down at 3.00am in the morning and just talking. He helped me get through the boredom and restriction of my freedom of movement which started to take a toll on me.

This is why I had my "hissy fit" when I arrived at the ward at 10.00pm from ICU which lead to all that drama. When I checked my records the seclusion sheet said that I was debriefed as to why I was put in seclusion - I was never debriefed or comforted and this made me so angry. By contrast the subacute section was much better - they could use the phone whenever they wanted, had a ping-pong table and a big tV that was not covered in glass and a nice backyard.

I just don't think the facilities in the acute ward are very theraphetic especially if you stay there for long periods of time. I was just curious/wondering if maybe it was the hospital I was in or maybe the country I live in or if its like that all over the world, thats all.

I think the length of stay contributes to whether you view your hospitalisation as a positive or negative experience. I find it extremely fasinating actually that someone could last 3 months or 6 months in that environment. I think I would have really crumbled. Where I was there was no activities at all to do during the day - I practically begged and said anything so they could let me out early that is how desparate I was. There was one girl with me who was there for 6 weeks already when I came in and she told me she had given up trying to get out and I thought that that was very sad. Maybe its because people who are there for 6 months either believe they need to be there or don't appeal there cases or don't make a loud enough fuss to be let out.

Maybe I am just being a "cry baby" and being over emotional about the whole thing. I should just get over it but I can't about the seclusion and sedation bit.

[CharcoalKiss]

Hi Charcol, I was meaning to get back to this topic. I find it extremely interesting that the Mental Health Act in the UK has incorporated PD's as indefinite detention and care.

Does this include Borderline Personality Disorder if it is severe. I find this extremely fasinating actually. I am not studying psychology but law and I just finished Health and Medical Law in summmer school in which we covered the Mental Health Act 2007 (NSW).

Because I am studying law, we probably learnt about involuntary admission in the context of a persons right to Autonomy v's Beneficence (the state can invoke involuntary care for your benefit).

The criteria for involuntary admission, detention and treatment in and out of facilities are if you are a mentally ill person or metnally disordered person:

14 Mentally ill persons

(cf 1990 Act, s 9)

(1) A person is a mentally ill person if the person is suffering from mental illness and, owing to that illness, there are reasonable grounds for believing that care, treatment or control of the person is necessary:

(a) for the person’s own protection from serious harm, or

( for the protection of others from serious harm.

(2) In considering whether a person is a mentally ill person, the continuing condition of the person, including any likely deterioration in the person’s condition and the likely effects of any such deterioration, are to be taken into account.

15 Mentally disordered persons

(cf 1990 Act, s 10)

A person (whether or not the person is suffering from mental illness) is a mentally disordered person if the person’s behaviour for the time being is so irrational as to justify a conclusion on reasonable grounds that temporary care, treatment or control of the person is necessary:

(a) for the person’s own protection from serious physical harm, or

( for the protection of others from serious physical harm.

My lecturer can't understand why people who have mental illness are subjected to forced treatment and those who do not can refuse life saving treatment. In reality though, from my experience anyway, you have to be at emminent risk of harm (eg 24-48 hours) or have attempted suicide to be admittted. Even after a serious attempt (I was in a coma and almost died) I was not admitted, partly because I was so terrified of going to a psych ward and I said it was an accident, and partly because I had a supportive family - if there was no other care of a less restrictive kind then I would have been admitted.

Oddly enough I have a 2000 word assignment where I have to analyse the assumptions underscoring the law and make recommendations for legal reform for three Acts; needless to say I am doing the first topic which is Involuntary detention and treatment under the Mental health Act.

I have mixed feelings about involuntary detention. I know that when I was in a locked ward, some people, although they were involuntary did not mind being there and were either complacent or thought that it was a "good ride". Other people are later thankful for there involuntary detention once they get better and feel a relief once they are there because they are forced to get help when they are not good at asking for help.

[icu_baby]

Hi Charcol Kiss

Wow, thats great. I agree, research suggests that people with mental illness are not more likely then other people in the population to be a danger to other people. I think that is just discrimination against people with mental illness.

Why was there uproar when the bill came in?

I would like to read the relavent sections of your assignment. I think it would provide useful information for people who have BPD in terms of their rights not to be detained. The good news however, is that the government, your governemtn anyway, is starting to recognise that PD are treatable and this is a good thing!

Thanks so much for sharing your information with us.

[CharcoalKiss]

Hi Charcol Kiss

Wow, thats great. I agree, research suggests that people with mental illness are not more likely then other people in the population to be a danger to other people. I think that is just discrimination against people with mental illness.

Why was there uproar when the bill came in?

I would like to read the relavent sections of your assignment. I think it would provide useful information for people who have BPD in terms of their rights not to be detained. The good news however, is that the government, your governemtn anyway, is starting to recognise that PD are treatable and this is a good thing!

Thanks so much for sharing your information with us.

VERY LONG POST!!! I MEAN REALLY LONG. READ ONLY IF YOU'RE FEELING IN THE MOOD FOR A LONG READ ON INFORMATION GATHERED FOR THE PURPOSE OF A UNIVERISTY PSYCHOLOGY ESSAY. THERE IS A LOT TO READ!

It is discrimination. If you say to a 'normal' person that you're mentally ill, or live with a PD they immediately start thinking horrible things in most cases. The media only ever portrays the bad side... the murders and violent crimes in the news... the figures for the number of people with mental issues in the prison service... and even films have an effect... the 'psycho' killers... people start to notice similarity between the killer in a horror they just watched and the perfectly harmless guy with Sz living down the street... and they petition to have him removed when he's done nothing wrong. It sickens me.

There was uproar because the Mental Health Alliance and the other mental health organisations and psychiatrists thought that the government was being unfair. (nb the mental health alliance was formed from 79 organisations within various sections of various health services specifically to petition this bill - as far as i understand anyway.)

Ok... the assignment. These are snippets of the info i've found. I won't bore you with my analysis and conclusion. lol.

'Since 1996 when Michael Stone murdered a mother and her child after having previously been diagnosed with Anti-Social Personality Disorder (ASPD) and released from hospital on the grounds that personality disorders are not treatable, there has been call in Britain to tighten the policies on compulsory mental health care of those individuals deemed to be ‘potentially dangerous’ to themselves or to others.'

'In the field of psychology it is thought that each person has a unique personality which is part of what makes us who we are and determines how we interact with others. For the majority of mental health problems, psychological tests give criteria for diagnosis but there is no test for personality disorders. The difficulty in describing any personality clearly leads to problems with diagnoses. '

“You can’t ‘treat’ someone’s personality... so people with personality disorders, as opposed to mental illnesses are not deemed treatable by psychiatrists”

(Steele, L; 2001)

'The Royal College of Psychiatrists released the figure in 2006 that 1 in 20 people in Britain have a personality disorder. These personality disorders can be divided into three ‘clusters’ depending on the symptoms associated with the disorder. Cluster A: eccentric personality covers diagnoses of Paranoid, Schizoid or Schizotypal disorders with symptoms associated with paranoid behaviours. Cluster B: dramatic personality includes diagnoses of Anti-Social, Borderline, Histrionic and Narcissistic disorders with symptoms such as dramatic and erratic behaviours and mood changes. Cluster C: anxious personality includes diagnoses of Avoidant, Dependent and Obsessive-Compulsive disorders with symptoms including inhibited and dependant behaviours. In addition to these there is an extreme form of ADPD which has been termed ‘Dangerous Severe Personality Disorder’ (DSPD), a disorder similar to psychopathy. However, the term DSPD is not a diagnostic category, it is a term adopted by the government as a description of the type of personality disorder contained within the Mental Health Act 2007 for which sufferers should be put into compulsory mental health care.'

'The behaviour patterns associated with personality disorders are usually long-lasting and entrenched within the individual’s mental state; their personality. Recent research suggests that personality disorders can be treated. There is some evidence that Borderline Personality Disorder (BPD) can be helped through dialectical behaviour therapy (Linehan et al 1991) and that the irritability and aggression in some personality disorders can be reduced through the use of fluoxetine.'

'A systematic review of the accuracy of the ‘dangerousness’ assessment by Buchanan and Leese (2001) found that in order to prevent one person suffering from a personality disorder from acting violently six ‘Dangerous with Severe Personality Disorder” (DSPD) people would have to be detained in compulsory treatment. Therefore, the proposal under the mental health act 2007 to detain those people with ‘mental disorders’ deemed ‘dangerous’ could lead to a marginalisation of an already scrutinised section of society as the public opinion would become that all people suffering from personality disorders are violent and therefore dangerous.'

'Under the Mental Health Act 1983 sufferers of mental illness could only be detained against their will if their mental disorder was treatable. The separation in this act of diagnosis of mental illness and personality disorder, as well as the opinion throughout psychiatry that it is not possible to ‘treat’ someone’s personality led to a loophole in the law where those people diagnosed with a personality disorder could not be given compulsory mental health care due to the ‘untreatability’ of personality disorders.

However The Mental Health Act 2007, which amends The Mental Health Act 1983, The Mental Capacity Act 2005 and The Domestic Violence, Crime and Victims Act 2004, was passed on 19th July 2007, and will be implemented by October 2008, and has altered the definition, under the law, of those individuals diagnosed with a personality disorder. Under this new legislation, a ‘mental disorder’ is considered to be ‘any disorder or disability of the mind’ (Mental Health Act, 2007: Part 1, Chapter 1.). This definition closes the loophole in the original mental health laws and, according to a BBC news report in June 2002 ‘ensures better treatment for dangerous mentally disordered patients and better protection for the public’. Under this act the government has specified that the purpose of treatment must be to “alleviate, or prevent a worsening of the disorder or two or more of its symptoms or effects”.'

'However, The European Convention on Human Rights incorporated in the Human Rights Act (1998) prohibits the detention of anyone who has not been convicted of a crime unless they are “of unsound mind”. therefore, although the compulsory care of individuals with personality disorders can be seen as a breach of civil liberties because the individuals are being detained without conviction it is not, in fact, a breach of human rights law as under the new mental health act (2007) personality disorders have been categorised under the umbrella term ‘mental disorders’ and therefore constitute the diagnosis of being not of sound mind.'

'misdiagnosis possibility is supported by a further case of a person suffering with a personality disorder committing a violent crime. Alex Crowley who was originally diagnosed with severe Anti-Social Personality Disorder was not detained under the legislation at the time (2001). Following the murder of Diego Piniero-Villar, a 12 year old boy with whom Mr Crowley had developed an obsessive relationship, another psychiatrist diagnosed him as Paranoid Schizophrenic, a mental illness for which Mr Crowley could have been detained prior to the murder.'

'the government emphasis on public protection while ignoring the need to improve the services for mentally ill individuals the homicide rate in Britain is low and less than 5% of these are attributed to mental illnesses, not specifically personality disorders.'

The term ‘psychopathic’ was coined by the German psychiatrist Koch in 1891, and he said firmly that ‘even in the bad cases the irregularities do not amount to mental disorder’ (Lewis, 1974). What Koch meant by mental disorder, however, was largely restricted to insanity and idiocy, and his concept of ‘psychopathic inferiorities’ embraced most non-psychotic mental illness as well as what we now call personality disorder or psychopathy. Even so, Kurt Schneider subsequently argued that personality disorders are simply ‘abnormal varieties of sane psychic life’ (Schneider, 1950), and therefore of little concern to psychiatrists, a view that is still influential in Germany today.

Many — perhaps most — contemporary British psychiatrists seem not to regard personality disorders as illnesses. Certainly, it is commonplace for a diagnosis of personality disorder to be used to justify a decision not to admit someone to a psychiatric ward, or even to accept them for treatment — a practice that understandably puzzles and irritates the staff of accident and emergency departments, general practitioners and probation officers, who find themselves left to cope as best they can with extremely difficult, frustrating people without any psychiatric assistance. The reasons for this attitude were explored by Lewis & Appleby (1988). Using ratings of case vignettes by 240 experienced psychiatrists, they showed that suicide attempts and other behaviours by patients previously diagnosed as having personality disorders were commonly regarded as manipulative and under voluntary control rather than the result of illness, and that the patients themselves were generally regarded as irritating, attention-seeking, difficult to manage and unlikely to comply with advice or treatment.

Personality disorders are described in the International Classification of Mental and Behavioural Disorders (ICD-10) as ‘deeply ingrained and enduring behaviour patterns, manifesting themselves as inflexible responses to a broad range of personal and social situations’; they represent ‘either extreme or significant deviations from the way the average individual in a given culture perceives, thinks, feels, and particularly relates to others’ and are ‘developmental conditions, which appear in childhood or adolescence and continue into adulthood’ (World Health Organization, 1992a). They are distinguished from mental illness by their enduring, potentially lifelong nature and by the assumption that they represent extremes of normal variation rather than a morbid process of some kind. Whether or not these assumptions are justified, there is broad agreement that personality disorders are important to psychiatrists because they impinge on clinical practice in so many different ways. People with personality disorders are at increased risk of several different mental disorders, including depressions and anxiety disorders, suicide and parasuicide, and misuse of and dependence on alcohol and other drugs. In addition, people with schizotypal personalities are at increased risk of schizophrenia and those with anancastic personalities are at increased risk of obsessive—compulsive disorders. The presence of a personality disorder also complicates the treatment of most other mental disorders, most obviously because the individuals concerned do not easily form stable relationships with their therapists or take prescribed medication regularly. Indeed, in group settings they often disrupt the treatment of other patients as well. Finally, with or without treatment, the prognosis of most mental disorders is worsened by coexistent personality disorder. Because of these important, complex relationships, it is taken for granted that psychiatrists need to be alert to the presence of personality disorder, even if, as is often the case, the disorder does not correspond to any of the distinct types described in textbooks and listed in glossaries. The contentious issues are whether personality disorders are amenable to treatment, and whether people displaying these habitual abnormalities of behaviour deserve to be accorded the privileges of the ‘invalid role’.

It is much harder to establish that personality disorder involves dysfunction, in the sense of ‘failure of a mental mechanism to perform a natural function for which it was designed by evolution’ (Wakefield, 1992). Indeed, it has been argued that several of the characteristic features of antisocial personality disorder, such as manipulation, aggression and deception, were originally successful predatory strategies that evolved in a prehistoric social environment (Lilienfeld & Marino, 1995). Fundamentally, there are two sources of difficulty. The behaviours and attitudes that define personality disorders are probably graded traits present to a lesser degree in many other people, and also quite different in different types of personality disorder; and as yet little is known of the underlying mechanisms of which they are a manifestation. It could be argued, for example, that the impulsiveness and liability to become dependent on drugs or alcohol — which are such prominent, and frequently lethal, features of antisocial disorders — are prima facie evidence of an underlying dysfunction, but in the absence of any understanding of the cerebral mechanisms involved the argument remains inconclusive.

Personality disorders are a particularly troublesome diagnosis anyway. They’re not technically mental disorders as they don’t appear in Axis I of the DSM, the bible of mental illness. Whilst there is still argument about the extent to which mental illness is socially constructed, clearly something like hearing voices is abnormal. Personality disorders, on the other hand, are really just extremes along the continuum of “normal” behaviour. Where you draw the line between normal and personality disordered is really quite arbitrary, and it is certainly arguable that there isn’t actually anything wrong with those exhibiting personality disorders.

Quote from Mental Health Alliance: "The committee has also clearly understood the stigma that surrounds mental illness and the important role the Mental Health Act should play in improving services and tackling popular prejudices."

SORRY THIS POST IS SO LONG... IT WAS A LONG ESSAY! LOL.

I HOPE YOU FIND THE INFORMATION INTERESTING EVEN IF IT ISN'T USEFUL... AND AGAIN, SORRY ITS SUCH A LONG POST.

OH, AND PLEASE REMEMBER THAT I HAD TO TRY TO BE OBJECTIVE IN THE ESSAY... SO I DON'T NECESSARILY AGREE WITH WHAT'S WRITTEN, I JUST HAD TO TRY TO SEE IT FROM BOTH SIDES.

NB/ THE ESSAY TITLE WAS 'IS THERE A VALID CASE FOR THE COMPULSORY CARE OF PEOPLE SUFFERING FROM PDS IN BRITAIN TODAY?'

IF YOUVE TAKEN THE TIME TO READ THIS. THANKS.

[rebeccaborderline]

I give it an "A" lol

thanks for that; makes it pretty clear why a lot of us have such problems getting adequate treatment. Doesnt explain the enormous variation of attitude/treatment to BPD across the UK

rebeccaborderline

[jen91]

Jen91, that is completely terrible and insensitve in having you monitored by a man. This is a classic example of how sometimes hospitalisation can be more harmful then helpful. They should have gotten a lady nurse for you. When I was in a general ward after my overdose I had to have a 1:1 nursing special where the nurses just sat outside my room on a table and chair and observed me 24 hours a day. Some of the nurses where male but they were outside my room, its not like they were sitting on a chair next to my bed.

When you say you ran out of hospital, did you actually leave the grounds and who brought you back? I tried to leave the ICU before they had a chance to transfer me to the psych ward and the security guards just grabbed me by the arms and put me back in my bed. It was also quite humiliating. That happened twice.

Hey ICU

A classic example of a hospital not helping, no kidding, but it sounds like your experience was pretty bad too. They said no women were available, it was all very innapropriate with the implication basically being that I was a mental patietn and thus had lost my rights - or at least that's how I felt. I really wanted to write a letter to the administration when I got out, but I didn't want to put my situation in the spotlight. It just doesn't encourage a trusting relationship, so when hosptialized I put on a smile and my best behaviour and I am out within a few days, albeit with no help.

As for running out of the hospital, yes I actually left the grounds. I outran my doc and his staff. He called security but I was long gone by the time they arrived. But they chased me, I got pretty far from the hosptial before they caught up. They basically gave me a choice - I walk back or I go back in handcuffs. Since we were on a busy street where I could have seen someone who knew me I chose to walk back with him. The hospital staff called me "legs" during that stay. The whole experience was like a joke to them, meanwhile I was scared to death as no one explained what was happening. The ironic thing is at the time I was in a day hospital program that was suppose to be helping me. I was having a bad day and the doc got worried and so he sectioned me. I just think there could have been a better way.

But I am still glad I ran (as bizarre as that sounds), before I got sick I was a fighter and that always reminds me that the real me is still in there somewhere.

Good luck with your studies, I hope your work can make a difference.

jen