I was in a specialist self harm clinic. To my knowledge it's the only national one, so it's probably the one she is looking into. It's called the
Crisis Recovery Unit and is based at the Bethlem Royal Hospital.
You stay there for a fixed period of six months. You are inpatient from Monday-Friday and you go home for the weekends. All patients are voluntary (ie, no sectioned patients). They take a maximum of six patients, mixed, but the majority are female.
You are allowed to self harm whilst you are there, but you have provisos set. You are not allowed to self harm in communal areas. If you self harm, you MUST report it to the nursing staff using a blue form within two hours, and you have to accept any treatment they deem necessary. If you need to go to A&E, they will call you a taxi and you go to A&E on your own. You will have other provisos set according to your individual needs. If you break a proviso you will be sent home for one week's leave.
There is a huge emphasis on groups. You receive a timetable of groups which run from 9am to 8pm daily. You are not forced to attend, but it is strongly encouraged.
The CRU does not like prescribing benzodiazepines (eg diazepam, lorazepam) as a general rule, anyone admitted currently on them will be taken off of them slowly.
At the CRU there is a team of nursing staff, you will be allocated three which make up your team. Twice a day there are "negotiations" which is basically a 1:1 with you and your allocated nurse. You talk about any issues you are having, your feelings, your self harm, how you feel about the other patients, anything you want. Also at the CRU is a psychiatrist, two doctors, and an occupational therapist. You can see a dietician also.
You have ward rounds roughly once a month where you have a meeting with the psychiatrist (Dr Paul Moran), the nursing manager, your primary nurse, the occupational therapist, one of the doctors and your CMHT and your family if you wish. Here you talk about your progress, your meds, stuff like that.
Once a week the whole team meet up for management round where they also discuss the patients, so the psych is around every week for more urgent matters.
The groups you have are- Community Group (every morning) where all of the residents and most of the nursing staff on duty meet in the group room. The residents lead the discussion, and they can pretty much talk about any topic they want to.
There is art therapy, creative writing, movement (a dance therapist runs this), cooking, HOTUSH (helping others to understand self harm), coping skills (DBT) and evening activity (every night, everyone plays a game together). Also, meals are eaten together in the dining room (including nurses). And evening evaluation at the end of each day, you just evaluate every group you went to and how you felt and what issues you had.
Each resident has their own bedroom. You can stick stuff on the walls and have your own bedding. A cleaner comes in to clean the room. You can't lock the doors though, and there is a window with a curtain on the outside so that the nurses can check on you at night. None of the other residents tend to come in your room though, cos your room is your own space and people respect that.
There is a huge emphasis on boundaries. For example, you cannot turn up to a group more than five minutes late. If you are any later, you cannot attend that group. You have a period of about half an hour in the mornings where you have to ask to "negotiate" later in the day, and if you dont ask during that time then you will not have a negotiation that day. Medication times are strict. You will not be called for medication, you have to remember to go to the meds hatch. If you forget, you will not be given your medication. You cannot discuss self harm with the other residents outside of the groups. If you have self harmed, you cannot go into communal areas or talk to the other residents until you have been treated. You cannot say to the other residents if you feel like self harming, or declare you have just self harmed. If you feel unsafe you can request to see a member of staff to "safety plan" but you cannot ask for a particular person, they will allocate someone.
You cannot drink alcohol or use drugs in the unit. If you drink alcohol or use drugs on weekend leave, you have to put it on a blue form the same as you do if you self harm at the weekend.
I've probably forgotten loads, so feel free to ask questions.
