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by Ann Hughes


When you require in-patient treatment you are assessed and treated depending on what symptoms and behaviour you present with. This appears on the outside as perfectly logical and acceptable; in reality, however, it is very different.

The behaviours we display and present with are very often not representative of our true distress and are therefore misinterpreted which affects treatments and outcomes.

There is a lack of professional engagement from staff as they mainly rely on medication and their own observations and interpretations, which ultimately influence our treatment and length of in-patient stay.

We need to be fully engaged to gain the insight into the cause of the distress before anyone can treat the effect accurately. We are mainly authors of our own misadventure (not knowingly but through ignorance and lack of self awareness); we are multi-faceted personalities with multi-faceted dimensions to our own unique set of circumstances, not one size fits all or shoved in a appropriate box to define our treatment.

The key word for patients who access in-patient services is ‘loss’; we might have lost our homes, our relationships, our job/career, a loved one, our way and ultimately our minds and our liberty. The treatment as an in-patient feels more like a punishment than a helping hand back to our former glory.

We present with behaviours that are alien to ourselves. Those working with us need to see beyond the displayed behaviour and focus on the cause; through sensitive communication and positive dialogue, insight and clear effective care pathways can be achieved.

I have misrepresented myself on a few occasions, being diagnosed with hypomania, being perceived as euphoric, over active, erratic, inflated self-esteem the list goes on. My reality was very different. A rabbit caught in headlights comes to mind, unimaginable fear, total loss of control, desperation, anxiety, listless with suicidal thoughts as my life was in bits. I masked my true thoughts with over the top behaviour, playing to my audience with jocular outlandish pranks, regularly absconding to try and escape my unbearable reality

As my behaviour and symptoms were characteristic, I was perceived and treated accordingly. I was not encouraged or engaged to discuss the root cause of my distress.

We don't need glorified baby sitters, we need staff who will empathize with our doubts and fears without judgement. Any in-patient treatment should be based on communication with positive empowering dialogue from staff, with nursing staff taking a positive roll rather than hiding behind paper work or in the office.

Having very recently chatted with my peers, all felt that with better communication, from both doctors and nursing staff, their in-patient stay would have been substantially reduced.

Ann Hughes

Published at Perceptions Forum in the What We Think section.