How Speaking Out Can Lead to Positive Change in Caring for People With Mental Illness

Sitting in a board room full of heads of nursing and other patients and their representatives, I felt scared. In fact, I felt very scared. I don't know where my courage came from but I felt I had to speak about what mattered to me. So, I spoke up. It was time to talk.

Sitting in a board room full of heads of nursing and other patients and their representatives, I felt scared. In fact, I felt very scared. I don't know where my courage came from but I felt I had to speak about what mattered to me.

So, I spoke up. It was time to talk.

I wanted to speak out about the inequalities in the treatment that people with mental health problems receive in general hospitals when admitted for physical illnesses. The reason I was so scared was because I was going to be talking about my own experiences. I was preparing to stand up and address the room of strangers using my own mental health problems as an example. This meant publicly admitting, in front of my old colleagues, that I have experienced mental health problems.

Sweaty palms and a stuttered start lead on to 30 minutes of uninterrupted speaking.

I spoke about how I had been initially dismissed as being physically unwell because I had an eating disorder and any tummy pains were 'all in my head'. I felt I had not been taken seriously because of a mental health diagnosis.

I pointed out that all that was written in my nursing assessment under 'psychological and emotional wellbeing' was 'depression' and 'self harm'. There was no reference made to my other mental health diagnoses or current treatment, even though there were boxes for this to be written in. I felt that my other diagnoses were being ignored. I had a copy of my mental health care plan which I had given to the staff but it was just filed away in with my notes, seemingly ignored again.

I spoke about how my parents had had to advocate for me because my anxiety and lack of self worth prevented me pressing a buzzer to ask for help. I talked about how being in general hospital had increased urges to self-harm and take my own life. Because of these urges I was not safe to manage my own psychiatric medication and my parents had to come in and manage it for me. The risk, and the fact that I could not safely self-medicate, were not acknowledged by staff.

I went on to talk about how I had felt as though I was being treated as a second class citizen because of my mental health diagnoses, while at the same time I felt nothing was being done to manage my mental health problems.

Following the forum, the other patients and their representatives hugged me saying I was inspirational. I was gobsmacked that they'd stayed to listen to me. More important was the reaction of the head of nursing who stayed to meet with me in person and ask what I would want to change if I could. I was struck that I was being taken seriously. I was struck that someone wanted to hear my opinion even though I had mental health problems. I was struck because I hadn't been listened to in the past so why listen now? I struggled for words but I was able to talk about the need for general nurses to be educated in caring for patients who have concurrent mental health care needs alongside the physical illness that had brought them into hospital.

A few months down the line and the head of nursing emailed back. They had listened to me. They had invited the local mental health team to come in and speak to the heads of nursing about caring for patients who experience mental illness in a general hospital setting.

There is still a long way to go in achieving equality of care for patients with mental health problems and although it was terrifying speaking about my experiences, my words had an effect and led to a positive change.

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