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Old 29-07-2014, 01:41 AM   #1
Ballerina123
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crisis team /HTT saying distract yourself. opinions?

A lot of people on here complain that if they see or speak on the phone to the crisis team they say "distract yourself".

I just wanted options, since it's such a regular complaint, what would you prefer them to say?

Please don't be vague and say "I want them to help". What I'm trying to get at is what specifically would help?
What is your expectation when you tell them your struggling? Is your expectation realistic?

Do you think the crisis team can offer anymore than listening and suggestions of distraction techniques? Baring in mind they are mh nurses and HCA not therapist or doctors who can prescribe drugs.


I ask mainly because I find crisis team helpful when im ill and when they suggest distraction techniques I do them and they help so I can't see why it such an issue for other people. But I'd like to understand others prospective.



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Old 29-07-2014, 02:04 AM   #2
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I think it's a difficult one. Personally, I have only been under the crisis team once, and they never told me to distract myself I don't think so don't really have personal experience! But I can imagine that it would be quite frustrating to be told to distract yourself when you're feeling really distressed. I admit that I find it quite frustrating / patronising if members here tell me to distract myself because it is quite a basic thing and I find it odd that people would assume I hadn't already tried that.

I think if you're after someone who'll listen to you for an indefinite amount of time and give you the space to properly talk things through you're probably better off with a helpline such as the Samaritans. Crisis teams probably don't have the time / resources for that.

The cynical side of me says that frequently what people want is a more dramatic intervention (e.g. hospital) and to be told that they're so ill they couldn't possibly keep themselves safe. But hey, I could be wrong.



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Old 29-07-2014, 08:31 AM   #3
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The 'distract yourself' thing annoys me because I find it patronising. I don't call the crisis team often and when I do, it's after hours of trying to distract myself and deal with it myself, so them telling me to distract myself after I've been doing that for hours and finally built up the courage to call them is really frustrating.

I called them the other night expecting to hear 'distract yourself', but instead they said to come to the hospital and get prn and that was helpful.

Sometimes they can come up with some good advice. Like once when I was so paranoid and I couldn't sleep and was panicking, she gave me some good advice to get through it other than distract yourself. I can't exactly remember what it was but she basically got me to think it through logically and that helped.



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Old 29-07-2014, 10:27 AM   #4
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I've been under the crisis team about 4 times I think.

It takes A LOT for me to call them because I know they are very busy. So often when I feel distressed I do all my distractions and coping skills first and only when I've exhausted every option and STILL feel at risk of suicide/harm then I ring them. And to then be told "distract yourself" after hours of doing exactly that is the last thing I want to hear. It feels like they cant be bothered to help, they only suggest distraction and then they want to end the call. A couple times I've said "I've been distracting myself, it hasn't helped, I really feel unsafe" and in response I got a very patronising/condescending "So are you telling me you WANT to be in hospital right now? Because that is what will happen and we're REALLY short staffed right now" and then I've kind of mumbled and hung up, still feeling intensely distressed but now also guilty for taking their time.

Personally I've found that because I (apparently) come across as an intelligent, independent person who is always coherent with full insight they assume that I will be fine. I always comply with everything, I'm not a patient who needs constant monitoring or depots. So when I actually have to say "er, I feel like I want to kill myself" their response is always "why does an intelligent young woman want to do this? Think about your family! Your future! You are so young you have everything to live for. Just go for a walk, you'll be fine" and that's basically it.

It's frustrating that I often don't get 'believed' because I look nothing like a stereotypical psychiatric patient. And so when I do come to ask for help in a time of crisis it's always assumed that I can cope by myself, despite the fact I've attempted suicide before and been on a section.

In an ideal world when I ring the crisis team I'd like someone to come and visit me and talk to me. Help me think about reasons to live, help to calm me rather than just TELLING me to distract. But that will never happen due to budget cuts and lack of staff.



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Old 29-07-2014, 02:32 PM   #5
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Yes I've seen one or two nurses from the crisis team who've been kind of rude and abrupt with me. I told them I was suicidal and they basically told me I was being selfish and hurting those around me.

That being said there were a few absolutely wonderful nurses who saw me and talked to me in my bedroom and really gave me hope.



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Old 29-07-2014, 02:57 PM   #6
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We have a 24 hour support line open to us where I live this is in addition to the crisis team.

I haven't used them but a few people I know have. One of the things I've seen is they actually talk to you and don't offer distraction techniques I've heard of them calling ambulances or getting in touch with the crisis team and to me that seems a much better solution as a lot of people have been distracting themselves prior to phoning and to be able to get some support of the phone would be fantastic but realistically crisis teams don't tend to have the time.




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Old 29-07-2014, 03:46 PM   #7
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The support line are just as bad as crisis team in my experience. I got told to 'stop having flashbacks' when I was very distressed.



I'm fine! Totally fine. I don't know why it's coming out all loud and squeaky, 'cause really, I'm fine!


Who else is fine?!?!?


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Old 29-07-2014, 05:20 PM   #8
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I'd be tempted to be really sarcastic :p

Oh, sorry for the inconvenience of having flashbacks! I had no idea I could simply stop them on demand. Now why did I not think of that before? FLASHBACKS- BE GONE!



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Old 29-07-2014, 05:55 PM   #9
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I can can definitely empathise with you all there. I get the same thing over and over and it's like your in crisis right, you can't distract as your mind/body is in the fight flight response, so physically it's impossible. For me, telling me to watch tv, read a book, listen to music is a bit like saying to someone with appendicitis/giving birth to take a pain killer and it will be gone in five minutes. When i am in a low state/anxious crisis mode, I am not in the rght frame of mind to give a damn about a book etc, I can't concentrate and my body is shaking.



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Old 29-07-2014, 06:59 PM   #10
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Quote:
Originally Posted by sherlock holmes View Post
I'd be tempted to be really sarcastic :p

Oh, sorry for the inconvenience of having flashbacks! I had no idea I could simply stop them on demand. Now why did I not think of that before? FLASHBACKS- BE GONE!
I would have if I wasn't in such a state! I think I said something along those lines when I was explaining it to the crisis team a few days later!



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Old 29-07-2014, 07:31 PM   #11
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Hi

I have only had one episode of contact with them but it was over a few days I had to ring to 'check in' etc so had about 8 contacts with them.

I found the 'distract yourself' 'go for a walk' 'have a bath' talk very very very frustrating and it made me behave worse as I felt they wearing taking me seriously so I thought they think I'm making it up so thing escalated for me.

Having struggled for a long time I am very used to distractions, but when I was at that point I could no longer keep myself safe and in reality I probably needed an admission or at the very least some medication. That's why getting told to have a bath was patronising and unhelpful. I reacted really very badly to it.

I find it patronising
When we ring it's because were out of options!!



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Old 29-07-2014, 09:27 PM   #12
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Thanks guys.

A lot of you have said that the crisis team giving you medication or admitting you to hospital helps.
But technically the crisis team is meant to prevent a hospital admission and why could your cmht not have given you prn to cope with your crisis rather than referring you to crisis team?

A new question: if hospital, prn meds and the suggestion of distraction techniques were not an option, what options are left? What can they actually do/say that's helpful?


I am asking for a reason, which I forgot to put in the original post sorry, I'm part of a mental health panel that help the mental health team make positive changes in care. I'm asking because this problem comes up at panel a lot and no one actually ever comes up for a good reason to continue the use of crisis teams.
What works?
What's positive?
Is there a use for them other than giving out prn and admitting people (which is not the reason they were set up)?



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Old 29-07-2014, 09:44 PM   #13
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All I can really think of is that if the crisis team wasn't there, then the options would literally just be home or hospital.

I know in my case, they say hospital doesn't help but they'd probably get into trouble if they didn't put something in place. So then I get the crisis team.

Sometimes it helps to talk, but in my area at least, the crisis team (only 2 staff on at night) work over 3 hospitals that are quite a distance apart. So they don't have time to chat and calm you down and they're stressed so you end up with the usual response of distract yourself and call back if you need.



I'm fine! Totally fine. I don't know why it's coming out all loud and squeaky, 'cause really, I'm fine!


Who else is fine?!?!?


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Old 29-07-2014, 10:06 PM   #14
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Crisis teams work well for the nhs - they prevent a lot of unnecessary admissions/I see them as a gatekeeper. They see if you really do need to be admitted or not. I think were people are upset with them is because it's often the person will feel their at the point if needing admission but crisis don't always agree. For example I was in A&E and the doctor wanted me admitted basically crisis refused to see me because I was 'known' to cmht.

In some cases cmht won't put people on a prn because they don't use it appropriately - when I was in crisis I was given diazepam and it helped whereas they can't give me that at the moment but if I had it a as sure as hell I would take it cos it helps so much. So ideally if they could prescribe something that would be good.

Having a link to GP and cmht helps as they keep everyone informed is useful



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Old 29-07-2014, 10:07 PM   #15
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I think they should see everyone who's self harmed in a&e



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Old 30-07-2014, 02:13 AM   #16
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I think maybe where the crisis team are really useful isn't just that you can call them, but that they are able to provide more intensive support for a short period of time, which the CMHT wouldn't be able to do. I know in some areas crisis team and HTT are separate, but where I was it was the same team. They came out to see me or called me every day for several weeks, and they didn't just tell me to distract but made a real effort to listen and encourage me to talk things through. I ended up being admitted in the end anyway, but I can see how it may help to prevent admissions. And when I was discharged, I was actually fine and only saw them a couple of times, but the offer was there that they could come out to see me up to twice a day, which I think is great as it means you wouldn't be going from having support available all the time in hospital to very little, which I'm sure could make the transition easier.



"I know you're sad, so I won't tell you to have a good day. Instead, I advise you to simply have a day.
Stay alive, feed yourself well, wear comfortable clothes, and don't give up on yourself just yet.
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Old 30-07-2014, 09:54 PM   #17
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I like practical advice. So if I'm having severe anxiety, I want to be taken through relaxation (my support worker did this a few times before and it helped). If it is an acute exacerbation of psychosis, then that is harder, but I can at times respond to logical steps, it depends on how acutely ill I am.

I haven't called the crisis line for years now as I was in supported housing so I could ask people for help (even though it wasn't the greatest help), and now I have the NAS supporting me who are also available in the evenings / early nights.



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Old 31-07-2014, 09:34 AM   #18
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My psychiatrist told me at the beginning of the year that our crisis team would be changing so that anyone could self-refer to them, and they would have a drop in centre at the hospital so that if you felt unsafe and needed to talk and have a drink you could drop in and speak to someone.

As far as I know it's not happened, it may never happen now due to budget cuts, but something like that would really help.

Last time I was in crisis I rang the crisis team number and told them what was going on and literally all they said was "We can't help you because you've not been referred to us." and ignored the fact I said I was extremely suicidal and unsafe. Fortunately for me I was able to tell my mum and she rang the CMHT and got things sorted, but if I'd been alone or had it been someone else then it could have ended very differently.

And I also think they need more night staff on. At my crisis team there is only one person who works overnight, and they actually go to bed with the phone next to them. So every evening before the late shift sign off I get told "you can ring at night if it's AN EMERGENCY because the person working will be asleep and YOU WILL WAKE THEM UP IF YOU RING so make sure it's an ABSOLUTE EMERGENCY" so then I feel so guilt tripped that nothing would make me ring in case if wasn't urgent enough even if I'm sitting on my bed with things laid out in front of me ready to take my life.

So I think also that people working for the crisis team need to consider more how what they say comes across and can be very guilt-tripping for us patients.



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you once called your brain a hard drive, well say hello to the virus.


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Old 31-07-2014, 07:05 PM   #19
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I used to really struggle with the HTT when I was in the earlier stage of my illness, I think because I wanted/needed more than they could provide (ie admission to hospital).

In recent years I've been able to work with them differently and find them really, really helpful. I would be gutted if they got rid of the crisis team because I really need to stay out of hospital now and without them, I would have either no extra support during illness, or I would be admitted to hospital which would be really unhelpful for me.

I find they treat me as an individual and recognise the unique situation that I (that we all are) in. I like that they can assess me for improvement/deterioration and take the necessary action, that they are on the end of the phone if I just need a quick chat and some reassurance, I like that I am reviewed by their team psychiatrist weekly when under them so can make any medication changes necessary quickly. I like that their support workers can take me out for a little while if I am struggling to leave the house, to have a break from talking about my difficulties.

I don't mind distraction suggestions because sometimes they are helpful for me. I just prefer it if there is a small opportunity to outline what is going on for me before I am told to distract.

During my last three crises I have avoided hospital admission altogether and got better without harm - something I wouldn't have been able to do if I was left in the community alone. They have also, in the past, allowed me to be discharged from hospital before I was well but with their support.

The one issue I really struggled with last year was meeting a psychiatrist on their team who I hadn't seen before (or in a long long time) who treated me as though I was in the same place as I had been when he'd 'known' me many years earlier. Things had actually changed a lot since then and I felt very undermined at that point in recovery. It was enough that I decided to discharge myself from the team. I had another experience with the same psychiatrist a few months later under their care and it was absolutely fine.

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Old 31-07-2014, 08:08 PM   #20
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I think crisis are a subjective thing from a patient's point of view. If I feel suicidal then it's me who has to say "I feel suicidal!" so for that reason I believe we should self refer to the crisis team.

It doesn't make any sense to me to have to go through a referral process when you feel extremely unwell and even asking for that referral can be too much. It would so much simpler to pick up the phone knowing someone would come and see you in a few hours.



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you once called your brain a hard drive, well say hello to the virus.


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