i hate to say this but the experiences you describe are not unique to mental illness if that helps at all. i work in an ER and one night i got a 911 call from the waiting room. i hate the ER and my entire team knows that i will not go in for any reason if i am still conscious. if you are not dying, the wait will be 6-8 hours on a good night. you will run into those who get angry that you are there seeking care when so many people who are "really hurt" need help. you will run into rude receptionists who often are not very well trained and ancillary staff (hey i love my nurses but still they can be so inappropriate at times) who need more training.
i find it best when going to ER or A&E over there to be very upfront and direct about why i am there. how can you expect to get good treatment if you act like you are ashamed or be very indirect about why you are there? talking softly is a no go because it is a very loud place to begin with. it is so hard but i find that people often see how i would react to why i was there and treat me accordingly.
if i cut myself, i present and say " I cut myself and I need to be treated." Be ready for the inevitable questions. how long ago? with what? it may seem like the person is being nosey but those are important questions. time frame is very important in whether or not you get stitches. how you cut yourself is very important in knowing whether or not you need a tetanus vaccine. i often find the broken record technique works well. if i run into someone who keeps asking questions that are not relevant (to him or her)like why would you do that? i just keep repeating i cut myself. ask for what you need too. it never hurts to ask. if the waiting room is overflowing and too noisy, ask if there is a quieter place you can wait. there may not be but it never hurts to ask.
If i overdosed, i tell them i took too many of x-medications. if i am there because i am not feeling safe, i say that also but for most of the staff you will have to blunt. i am suicidal. if i am at home, i am going to hurt myself so i am here and i need help. i find that "i'm not feeling safe" just does not work because it is confusing. from yourself? from someone else?
the lack of follow up and care out there is appalling and unfortunately a fact of healthcare on both sides of the pond. do not agree to something that is not going to work. if going home to talk to the crisis team tomorrow is not going to work for you, say that. if you know what you need, say that. most doctors in the A&E or ER often do not know how to help plus at any given time we are waiting for 3 or 4 people to return calls, labs to come back, scans, etc. and i often have 8 on a slow night to up to 25 patients at a time on a busy night. personally i appreciate the patient who comes in and says I am suicidal. I need to be admitted or I am x and this is what i need.
don't know if this helps at all but feel free to ask questions. it is in all of our bests interests as docs and patients to work together to get needs met.
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