Today myself and another family member visited Elizabeth on Suffolk Ward, Chase Farm Hospital Enfield for a meeting where we hoped to meet new RC Dr Matthew Liveras.

I have  concerns with Elizabeth being on this acute ward as she is not getting the right care for PTSD (SHOULD BE EMDR OR PSYCHOTHERAPY). When she was discharged none of the underlying issues were dealt with and it costs a lot to keep her on an acute ward when it is not helping her.  I wonder how much the scheme plus hospital is costing but I already know that acute wards on average cost at least £900 per night.

Suffolk Ward seems to have quietened down since last time but this is no place for Elizabeth to get well and Dr Joseph Anyaoh had to admit this himself it was not the right place for her.  To be cooped up on the ward when it is nice weather outside is not good at all.    It has been two weeks now and Elizabeth has not been allowed out and we hoped she would be in order that she could accompany us to the café in hospital grounds but this was not allowed as the new Responsible Clinician, Dr Matthew Liveras did not bother to come to the meeting.  Present at the meeting was new Psychiatrist Dr Joseph Anyaoha, Psychologist Dr Muckherjee and ward manager Kirk Hopwell.

I am not happy as tomorrow is the last date for appeal against Section 2.  I as Nearest Relative had specially informed Elizabeth about this that she had fourteen days to appeal.   Unknown to Elizabeth she has now been deprived of this chance of appeal as someone by the name of Mia from Suffolk Ward had telephoned Elizabeth’s solicitors (unknown to her or any of us) and now the solicitors are not coming as they had wrongly assumed after being told by Mia that Elizabeth no longer wanted to go ahead.  This is not true! The response I got from the ward  was “are they on our list?”.   So what if they are not –  it is even better in my opinion if these solicitors were not on the hospital’s list.   As Nearest Relative I wanted this section released and for Elizabeth to be allowed out to get plenty of fresh air. Even whilst at Edgware she was allowed out in the grounds but now she is  not being treated well in my opinion.   Elizabeth told me that she was visited by a psychiatrist on the ward recently who tried to persuade her to not go ahead with the appeal – this is all very wrong I am sure you will agree.

I could feel awkward response when I brought up the subject of the appeal as I expect they all knew that her appeal was prevented from going ahead.   Elizabeth had not cancelled the appointment herself- it was not her wish to do so.    If she had changed her mind in the presence of the solicitor then this would have been fair.   This is an example where the system is not fit for purpose as it is easy for professionals to interfere.  On other occasions, solicitors appointed by hospitals have done nothing and never bothered to visit her – “lack of representation” –  money from public funds at tribunal level is very profitable for solicitors as tribunals can be long and drawn out.   If you attend a higher court/Court of Protection there is no legal aid funding and if you as a carer need legal support then you have to pay privately for this.

Today on this lovely sunny day we hoped Elizabeth could accompany us to the café in the grounds but although those present at the meeting did not object to this,  other staff refused.  This reminded me of her imprisonment at the Bethlem (Bedlem).    Just because Dr Liveras  did not bother to come along to the meeting I was disappointed and saddened by what happened.

The only good thing was that Dr Muckherjee (Psychologist) did not do what most professionals have tried to do and that is not budge on the diagnosis of “paranoid Schizophrenia”  – suddenly “chronic treatment resistant” has been dropped but I doubt whether Elizabeth has been given her care plan even.  Dr Muckherjee did not deny that she had learning disability and complex PTSD.    It is crystal clear that Elizabeth has been misdiagnosed and for many years has had the wrong treatment – enormous amounts of mind altering drugs without thought for her physical health.   I have told them all that every test should be done on her physical health, including the latest research on antibodies by Professor Belinda Lennox that I previously requested.  It was agreed by most that the acute ward was the wrong place but I am extremely unhappy that Elizabeth has been deprived chance of appeal.   The discussion then turned to medication and to these doctors they all think this is the right course of action but according to NICE Guidelines “DO NOT USE ANTIPSYCHOTIC MEDICATION FOR THE MANAGEMENT OF CORE SYMPTOMS OF AUTISM IN ADULTS.”   IT ALSO SAYS “DISCONTINUE IF THERE IS NO INDICATION OF A CLINICALLY IMPORTANT RESPONSE AT SIX WEEKS” – so why on earth don’t doctors abide by the manufacturers instructions that quite often says no more than 12 weeks but this can go on for years and years and no help is given to come off the drugs.  In addition it does not say that for the condition of complex PTSD under NICE Guidelines that antipsychotics should be given.    When someone has suffered extensive abuse under care itself such as Elizabeth they are bound to suffer from trauma which requires specialised care like EMDR AND PSYCHOTHERAPY and I do not see this condition as “illness”.  This cannot be “cured” by any amount of drugs. Drugs cannot erase the suffering that a trauma victim has experienced.   No drugs were forced upon Elizabeth when professionals took her away for four months wonderful care. For once she had proper care.  I am therefore upset she is being treated like a prisoner in favour of sending her somewhere where they have beautiful grounds like the The Retreat in York so that they can properly help her with underlying issues during a one year programme.

A small scheme in the community would not have the  facility or expertise.   Elizabeth also has not benefitted from prison like institutions such as Cygnet and Cambian.  She came out suffering from agoraphobia.   The longer she is held at this acute ward the more difficult it will be to rehabilitate her but I continue to fight for decent care in the UK as there are few facilities where they really specialist in the condition of PTSD and this requires specialist funding.   Again you need consent –  it does not matter if you have power of attorney as far as healthcare is concerned this apparently counts for nothing yet I did a survey the other day and in the survey I was asked if I had experienced any difficulties in using the Power of Attorney so I responded “yes” in respect of healthcare.  but I got the impression that I would have the power to make appointments etc so all this getting consent is what is played upon to protect and not to benefit Elizabeth who has granted permission not just to me to help with certain things.  When Elizabeth came home from Australia she was making all her own appointments and dealing with everything herself.  It is wrong when vulnerable person does not have an advocate at appointments/meetings.   The safeguarding is the most disturbing thing of all as anything can be said and twisted behind your back whilst nine professionals sit around the table.

It would like everyone to hear what is mentioned under Safeguarding minutes as though coming from Elizabeth who is alleged to say “clozapine was found to be helpful“.   THIS IS NOT TRUE AT ALL – SO I WOULD LIKE TO KNOW WHO WROTE THOSE COMMENTS THEN TEAM? When I showed this to Elizabeth she denied saying those comments and I would like to confirm that …… ELIZABETH DOES NOT WANT TO GO BACK ON THAT TALC AND ASPARTAME CHEMICAL CALLED CLOZAPINE AS SHE HAD A SERIOUS REACTION ON THIS DRUG.   YOU MIGHT AS WELL ALSO KNOW THAT ELIZABETH DOES NOT WANT ECT EITHER AS THIS WILL DESTROY HER HAPPY MEMORIES OF THE DECENT CARE THAT WE PROVIDED. 

It is difficult to get the CQC or PHSO involved in investigations even if you have proof  someone’s life has been put at risk twice.  It seems like cost considerations play a huge part but when they do not take action this can lead to abuse and serious cover ups.  Someone could die as a result of lack of accountability.   What if the vulnerable person is put under pressure by team not to proceed.   This is all wrong in my opinion.    The system is rife with bullying.

At the end of the meeting we requested if Elizabeth could come out with us for just a short walk to the café but when staff noticed her coming out with us they stopped this and she was forced to remain on the ward on this beautiful sunny day.   We sent Elizabeth round the world to get well and to enjoy her freedom as the care system in the UK is completely rotten and rife with abuse.

Suffolk Ward may not be THE most restrictive MH ward it is disturbing what goes on – there are far worse, some of where you are not even allowed your possessions like Cygnet –   MH patients are treated like objects and stripped of their rights and I am very upset by the fact so many of have suffered extensive abuse themselves and then they get treated in an abusive manner under the system of care in the UK.     Their basic rights should be fairness under the MHA but this is being abused.

I explained to the meeting that Elizabeth does not need  any more drugs which she cant even metabolise.  At the most the odd lorazepam could be acceptable but not too many.  They do not understand about withdrawal neither are they experts in physical health problems which I have proven Elizabeth has such as endocrinal disorders and how this makes someone feel.  The drugs are not recommended for PTSD under NICE Guidelines to PTSD sufferers.   Elizabeth has given consent to her family to help in any way they can.   I could not care less if the team turned to anyone of those listed to help regarding consent as long as she is treated fairly.

It is important to challenge things like this when a vulnerable person is prevented under the MHA against the appeal of section and does not even know that the visit by her solicitor has been cancelled by Mia.

The complaints system should be changed so there is accountability.

It is hard to sit through these meetings and feel happy when you look back at so many past years of extreme over-drugging on the local wards by various psychiatrists (not one of those doctors questioning the diagnosis when there are several in the files)  they don’t seem to care what harm they are causing to the patient.    When you ask Elizabeth a question she now takes a long time now to respond and cannot process too much information. She has been injured by her treatment.   She needs a quiet and relaxing environment not one where another team in the community expect her to immediately  join in all activities and attend yet more meetings after the shocking experience of safeguarding.   If they were to provide the music therapy, the art therapy the aromatherapy that would be great as advertised in the brochure of the scheme.

The good parts of the scheme are location/nice house/nice support worker.   It is so essential that Elizabeth has familiar support workers but if they cannot understand her then they cannot deal with her distress positively which is no good.

If she is to be placed back there again then they need to leave her alone for quite some time without pressurising and alternative such as The Retreat applied for rather than returning back to Suffolk Ward like a revolving door case.

Elizabeth gets very tired.  She cannot do too much right now as she is recovering from many years of being drugged to the hilt.  She needs plenty of rest and diet is very important too.

Whilst I would like to see her settle down in the community I believe that the underlying issues are best dealt with (not in a prison environment) but at The Retreat which has a unique way of dealing with care and specialised programme and no one is pushing mind altering drugs in that particular hospital like most places as the drugs do not work in Elizabeth’s case and this is why she has had so many adverse reactions ON the drugs and because she has PTSD reaction can be triggered by events and this needs specialised attention but not in a private “prison” style hospital.   I would also be happy if she was referred to the London Homeopathic Hospital as there they would pay special attention to diet and physical health.  This is the right environment in my opinion.

I’m so sorry I missed the opportunity to speak to you Tuesday but by writing I can go into much more depth than I could in just a short phone call.

I’ve received literature about Brexit.  I don’t see any mention therein of mental health but there is mention of:

Strong economy paying for a strong NHS;

safer streets with crime down by a third

welfare capped to reward work. 

You promise in your standard letter “strong leadership, economic security, more affordable housing and good school place for every child – strong economy for a strong NHS”

I will now tie in the above points mentioned in your campaign leaflet.

I would like to know what has actually happened to the NHS in the Health and Social Care Act?   All money seems to be up for grabs with no accountability.  I find this very disturbing. What are your views on this?

I am seeing the system to be one consisting of forms, roles, bureaucracy procedures, risk assessment geared to maximum profit in respect of inpatient care.  Do you think this should be changed with greater emphasis on care itself?

I see abuse towards those deemed “incapable” under MCA – how many vulnerable people are currently incarcerated in “prison-like” institutions costing as much as £12500 per week to the taxpayer?   Isn’t this wrong and abusive?  Isn’t this costing a fortune to the taxpayer whilst other services suffer?

What about the tribunal system –  this can be dragged out for years whilst private hospital institutions do everything to hang on to patients who deteriorate under their care as they are drugged highly.  There is widespread abuse going on. It is profitable for  private institutions and for solicitors when tribunals fail and under these institutions a vulnerable person can be prescribed ridiculous quantities of concomitantly prescribed mind altering drugs without any accountability.  The MCA is open to abuse particularly in a non-public hospital.  What do you think of this?   How can this situation be changed?

Community care programmes are all about making max profit – some are under the control of commercial bodies – a loaded system that eats billions to benefit not about care but profit.  What are your views on this?

As far as I see it the whole system needs change as in the case of those with so called “learning disabilities” this term should not be misrepresented and lowered to obtain MCA incapacity.  Unfortunately this is going on resulting in total control for life.

Residential care under Commissioner’s control – its all about compliance and drugging – don’t you think this is true?  Real care costs such as specialised therapy and this is what I am currently requesting as I have proven by providing “real” care myself that it works effectively.     For four months Elizabeth received the most wonderful care and if everyone was to receive a personal budget I would be inclined to keep this care ongoing as their approach was correct and worked out at a fraction of the price of say Cygnet or Cambian.   There needs to be a full investigation into this don’t you think?

I have observed that once you are declared “mentally ill” physical health problems are ignored.  This needs to be changed as the long term consequences can result in greater expense if physical health is ignored.   The very basics only are carried out under mental health –  weight/blood pressure.   How can this be improved?

The current system allows abuse and neglect and when things go wrong and professionals are unaccountable – as a result there is more than one Winterbourne.  The most weak and vulnerable people are put at risk by a system that allows unaccountability/protection but how can anyone learn from mistakes when there are no measures put in place to ensure accountability resulting in the same procedures allowed to be carried on instead of changes made?

In the COP there is no support for families unless you can afford to pay huge sums for it in terms of legal representation.     In our case the drug Clozapine was declined by my local area of Enfield but this case of “Deprival of Medication – Community Care” was replaced by attempts of certain professionals to Deprive Liberty, force return to care my daughter who had no food at the weekend at a care home in Northampton where a CTO was being arranged.   This is abuse and Professional bodies rally round to protect those involved but to deprive medication to force return is not only abusive but can be life threatening when I did offer to go and pick it up.    There is no accountability.

I know of others apart from Elizabeth who have suffered under care so badly they are traumatised and suffer from PTSD.    What can be done about all of this?   What about adopting a system of open dialogue available to all who want it?

A Trust/Council will investigate themselves and they all stick together to protect one another and I do not think this is right.

The CQC have limited powers.   This needs changing.

The PHSO want to speak directly to the person concerned and even when there is clear abuse and neglect by professionals they wish to hear from that person more than once in phone calls to ensure it is what they really want when really that investigation should go ahead.

We have been subject to safeguarding and a vulnerable person (my daughter) used by certain professionals under social care (who know nothing about my family) to encourage/put pressure on that vulnerable person to tick boxes alleging all kinds of abuse. Never are these professionals included in this abuse as they are above the law.  I had to report all of this to the Police myself.   I am assuming that this would have led to gagging if I had not obtained the minutes of the most shocking content and Elizabeth was put under pressure and up against 9 professionals without any advocate as they did not want to pay for Disability Action.   This in itself is abuse –  what can be done about this as all of this is a waste of time and public money as they should have been discussing what could be provided as Elizabeth had nothing to do – this could have gone on direct payments as we requested and in all the time Elizabeth was at home absolutely nothing was provided – no assistance whatsoever.

I believe that the system needs to be more open and transparent – after all this is taxpayer’s money.    You could do this by making Open Dialogue compulsory to all councils and Trusts.  This would save a lot of money as people like myself would have no complaints.

The public need to be able to view Council/Trust’s tenders for work and contracts as well as what the public accounts committee is doing.   The information needs to be easily accessible.

Mental Health Care:

A huge chunk of MH care has now been privatised but our experience of private sector care has been awful.   Elizabeth has come out worse and I believe this money should be spent on improving the NHS instead.  If someone has been abused under their “care” then they should provide the necessary treatment and facility for trauma immediately.  It only takes 10 days to get funding in place and in Elizabeth’s case there is no excuse to delay all of this.  I am sure there are many similar cases as with the right approach Elizabeth could be helped as I have proven.  So there should be more personal budgets readily available as I found good care abroad that worked and if their approach was evident in the UK’s mainstream care then the wards would not be overflowing like they are.   Correct approach could save a lot of money to the NHS which involves correct training and so could proper testing to see if someone can metabolise the drugs before drugs are prescribed.   Elizabeth will be writing more about her wonderful care shortly.

The NHS needs huge improvements to be made under mental health care with regard to facilities and care provided  so much money is being wasted.  The private sector care funded by the local area did not work.   A place like a prison is not the kind of environment to get well in is it?

There should be specialised facilities for PTSD and Police approach.

Police need to delegate questioning of someone who has been the victim of rape/abuse to other more specialised organisations who know how to go about things correctly and have better skills to deal with someone who for example has a learning disability or Aspergers.   They should not be quick to ignore or sweep things under the carpet.  Any suspected rape/abuse cases should instantly be referred to proper counselling and their a label such as “schizophrenia” for instance may be completely wrong which should be reviewed in the circumstances.   Specialist treatment such as EMDR and psychotherapy should be readily available.

Strong Economy paying for strong NHS –  vast sums of money are being wasted under current MH care and this needs urgent review and by such huge spending under private sector this is weakening the NHS.

safer streets with crime down by a third:

Enfield needs more Police Officers to tackle a spate of recent knife attacks.    However I would stress that placing people from MH hospitals from acute wards into the community without them having access to ongoing psychotherapy and treatments for PTSD is very wrong.     If less money was being spent amounting to over £12K per week on private sector wards then there would be more funding for the community care and treatment that is much needed.   Every area should have good facilities for treating PTSD and assessing patients properly.   No amount of psychiatric drugs can help someone who themselves have been  victim of terrible abuse and then there are patients who cannot metabolise these drugs and are labelled “treatment resistant”.  A waste of money to keep giving them drugs in the circumstances.   That does not stop a psychiatrist trying to prescribe another form of drugs such as “mood stabilisers” off label and this can itself trigger psychosis.    There needs to be greater monitoring of what is going on under psychiatry and what patients are being prescribed.  Tests like I had done for Elizabeth ie P450 liver enzyme should be given as a matter of course and if physical health was monitored properly by way of Endocrinology tests then this would also ensure the accurate treatment as the patient may have a physical health condition rather than mental health condition. Improvements need to be made urgently and care given on an individual basis as everyone’s needs differ.

welfare capped to reward work. 

Mental health conditions might mean that someone cannot work and this is not because they are lazy in any way – I have documented for instance the huge quantities of drugs Elizabeth has been prescribed under Enfield MH in the past.   Such huge levels of drugs are questionable as what are doctors doing prescribing such high levels? – they must surely know that this will cause injury, could harm the patient?   When someone like Elizabeth who cant metabolise the drugs and suffers from adverse reaction this is a dangerous situation and so how can that person work?   What is not understood is the long term effects of these drugs and I am pleased that East London NHS Trust are looking into this via the RADAR project.  This needs to be extended to all acute wards as there are terrible side effects from these drugs which are disabling to the extent that a person cannot function and there is not one single facility for a person to withdraw off the drugs safely when there is doubt about the diagnosis.  What can be done about this unsatisfactory matter?   Even when someone comes off these mind altering drugs it can take years to feel well again physically and Elizabeth has complained of physical pain and tiredness.  There is ignorance from doctors who thing that someone should recover after a few weeks –  it can take years.    For someone genuinely affected with MH conditions to have their welfare capped this can be quite devastating and make that person suffer more.  Many people have suffered injury as a result of their “treatment”.  There is no accountability for this is there?  It is not just a case of believing someone to be lazy as some people like Elizabeth can be very limited but when Elizabeth came back from Australia we saw a huge improvement.  If only the local area could have provided just a little then that support could have gone a long way.  I am sure Elizabeth has suffered as a result of her “treatment” of enormous quantities of mind altering drugs concomitantly prescribed by doctors who appear not to care less about the physical health of that person.   Well done to East London NHS Trust – Dr Joanna Moncrieff RADAR Programme.  It is good that the long term effects of these drugs are being looked into at last. If there is any doubt though in terms of diagnosis this should be investigated thoroughly and the facility provided to enable safe withdrawal especially in cases of adverse reactions.

On this beautiful sunny day Elizabeth is back on Suffolk Ward. I am going to visit her over the weekend.   She is not allowed out but drug free after 95 days. A couple of weeks ago she was discharged into the community following 13 weeks of being on various acute wards.   Elizabeth was getting so distressed at being on wards that are volatile and noisy, witnessing the “treatment” of others who are being forcibly injected, drugged and some given ECT.   This has only served to increase the trauma suffered.   It saddens me as not long ago we sent her away to a lovely peaceful and natural environment which gave Elizabeth the strength to tell the entire family/close friends about what happened to her at the Moti Villa Scheme and other things not previously revealed.  This care involved psychotherapy and the professionals were getting somewhere in helping Elizabeth for the first time.    When Elizabeth came back home she deteriorated as there was no ongoing therapy and the area triggered reaction as this is an area where there are not good memories.  She ended up in hospital when she refused to take the small portion of Abilify and has been allowed to withdraw although professionals have tried so hard to get her back on the drugs again.  Each time Elizabeth has refused their attempts.

So the team placed her into a supported living scheme.   The scheme was new but part of a network of similar schemes in a nice location.   I felt happy that finally after all that time of being on acute wards she was being released and felt that anything would be better than being stuck on acute wards.      I begged for Elizabeth to go somewhere first to a more peaceful place in order to prepare for her release into the community but this was ignored.

The house/scheme had a support worker and newly graduated psychologist and according to their brochure offered music/art therapy and aromatherapy.    Despite my reservations I was hopeful that eventually Elizabeth could settle down and I hoped that she would be understood by staff working there just like the private MH professionals understood her.    The longer you keep someone incarcerated the harder it is to rehabilitate them.    When Elizabeth moved in there was no water and no toilets working and this was not up and running until the next day (Sunday) some time after midday.   I think Elizabeth was moved very quickly in haste without much thought to health and safety/risk factors.  Unfortunately Elizabeth became very stressed out in this new environment as too much was expected of her –   it was too much too soon and through lack of understanding.

If Elizabeth has the condition Aspergers and PTSD then this needs to be fully understood in itself  but she has been denied proper assessment and it is no wonder therefore that past care has failed her.  MH professionals are not necessarily trained to understand such conditions as autism/aspergers which is essential.

I decided not to come round to see her immediately at the scheme but to allow her to settle down.   She moved in on Saturday (last Bank Holiday).   On Sunday I received a call from her asking me to visit.   I brought round some of her possessions including her guitar as I hoped she would be having the music therapy whilst there.  I felt happy in reuniting her with some of her things I could not give her whilst she in hospital.  I met for the first time her keyworker who I really liked.   I liked the house and area.   I came away feeling positive.   During the week I got a call from Elizabeth worried about her physical health.   She had been complaining of backache, headaches and stomach cramps for some time before being discharged from hospital and kept trying to get help from doctors (psychiatrists) but on a psychiatric ward physical health seems to be ignored.    All she was given was paracetamol but there were no intensive physical checks on her health apart from maybe blood pressure and weighing.  So the support worker was woken up by Elizabeth and waited with her around 5.00am in A&E.  Elizabeth had blood test/various other tests done which appeared OK but what she really needed was ultrasound or further endocrinology tests.  I pointed out to doctors that there were specific problems mentioned in private tests I had done but this was not looked into.   Elizabeth was very tired and sounded unhappy during her call to me and I felt very sad about the situation.  The dedicated support worker must have been exhausted, waiting for hours to be seen in A&E but I am most impressed with this particular support worker.

The following Saturday Elizabeth still at the scheme but again sounded unhappy when I took the call.  She had problem in accessing money and complained there was no food and I had to reassure her that the next day I would try and help her but there was a new support worker on duty this time.    I have noticed that Elizabeth finds hard to adapt immediately to any changes and now there was a new person on duty.   Elizabeth said there was no food but when I spoke to the support worker I was assured that this was not the case.   I did not wish to come round that day as she sounded quite distressed and I did not want to make matters worse.  On Sunday I called round to the scheme with a close family friend and Elizabeth was lying on her bed around midday not feeling at all well complaining still of physical pain. There was a lot of noise as workmen were making part of the living room into a medicine room.   I think all of this contributed to upsetting Elizabeth too.  How can any amount of medicine help someone who has suffered the most appalling abuse under care that has never been dealt with properly.    Anyway I took her out in my car for a nice drive and we went right out in the countryside and Elizabeth started to feel happy again and was very happy when she returned back to the scheme.

Whilst out Elizabeth started to talk about her daily life at the scheme.  I was concerned to hear that she had overheard private conversation to the effect that “…………….(Manager) of the scheme does not feel she is doing very well”  Elizabeth felt relaxed to tell us more and complained about being put under pressure.    She was upset by a visit from her care coordinator in the first week suggesting meetings at another location.   This care  coordinator was involved in recent safeguarding and I could understand Elizabeth’s reaction as this was triggering for her.    She told me that she had reacted in distress following the care coordinator’s visit but the very nice support worker was on duty and knew how to handle the situation whereas others wished to immediately call police.     This was a far cry from the private care we provided where professionals were able to talk things through and deal with situations effectively  but when I read through the brochure of the scheme it says they specialise in mental health and learning disability but I could see that they have a “no tolerance” threshold.   Elizabeth complained that everyone was talking at once on occasion/s – another time that she felt she was being ignored and a new lady had moved in so there was yet another thing for her to get used to.  I feel Elizabeth was very much misunderstood by the majority.

From what I heard only one support worker was bonding with my daughter and  understood her.   There was a new resident just moved in and I found the new resident to be nice but in order to adjust to new situations what they should have done is just leave her alone to settle in for a couple of months at least.    Elizabeth feels constantly tired having come off powerful drugs but there seems to be no understanding of this whatsoever.

The Psychologist who is newly qualified and attached to the house where Elizabeth resided did not seem to understand her.   I don’t know what to think –  sending Elizabeth away for four months with MH professionals/peer support/music and art therapy clearly worked wonders so I know it is possible to work with her but here, at this scheme, things were falling apart but this is reality – this is community living but is still restrictive when you are expected to attend this meeting or take part in activities immediately and what if that person does not feel well and does not wish to join in all the time.  All the time the resident is being monitored as to how you get on and knowing that you are on a month’s trial adds to stress.  This is in stark contrast to when Elizabeth stayed in the family home of MH professionals who allowed her time to adjust and settle in without pressure and demands put upon her.    Elizabeth could have coped better if she had been sent somewhere first to adjust in a quieter environment having been on violent/noisy acute wards for 13 weeks.  You cant just take someone from acute wards after all that time and expect them to immediately take part in everything.

I have written to the owner of the scheme and told him what worked for Elizabeth – ie psychotherapy, art therapy, music therapy.   I complained that I was not notified of Elizabeth’s transfer to hospital by anyone at the scheme. I told the owner I liked the house and  area but questioned the ability of staff to bond with Elizabeth and said it was not about qualifications but life experience and that only one person had a way with her.   I mentioned I knew someone else who could maybe help but that it was not a good situation when only one member of staff understood Elizabeth and knew when to  stand back allowing her time and space.    I spoke to the Manager of the scheme who understood that Elizabeth could not process too much information all at once and could cope with too much talking.  After all, take a look at the amount of drugs Elizabeth has previously been prescribed:

800mg Quetiapine Nocte

Clonazepam 1mg Bd

lorazepam 1-2MG po OR 1/m PRN (4MG MAX/24 HRS)

Haloperidol 5-10mg PO (30mg max/24 hrs

She was also given zopicol.

The Manager said the scheme was still open to Elizabeth but I pointed out it was extremely damaging if staff called police every time Elizabeth showed signs of distress and that if they stepped back and just left her alone she would calm down.  Also they should allow her to slowly/gradually adjust to her new environment instead of pressuring her to participate and attend meetings immediately.  She had after all been on acute wards 13 weeks.

Now on Suffolk Ward it has only been one week since her arrival.  There is a new Acting RC called Dr Liveras.   The Psychiatrist who has seen Elizabeth twice so I believe is called Dr Abraham.  Elizabeth is in a shared room right now and I have visited her twice in the week bringing possessions and food.

I have to take yet another day off to attend a meeting next week on Tuesday next week and hope Elizabeth’s sister can also attend with me.    It is so horrible to think that Elizabeth is cooped up on a ward not allowed to go out in the fresh air.  This is what caused Agoraphobia whilst at Cambian.  It is a step backwards as there was never any problem in her going out and walking outside of the ward was quite therapeutic for her. I hope this situation will not drag on and also it is a very costly situation.

Yesterday I got a call from Elizabeth that concerned me.    A doctor (wont mention his name) suggested to Elizabeth that she should think about going back on on medication.  He was not suggesting anti-psychotics which Elizabeth cannot metabolise but suggested  mood stabilisers.    I had heard that they are good by someone I know who has Bi Polar but nevertheless as I do not know anything about these drugs I decided to look into matters further by contacting an expert on the drugs that  I know and I was informed “mood stabilisers can trigger psychosis themselves and no mood stabilisers are indicated for the condition of PTSD” and I was told that “this is a dangerous “fashion” in psychiatry.”   I had also looked up the mood stabilisers such as Carbamazepine or Mirtazepine which are said to have disastrous consequences re PTSD.  I looked up Topiramate which is for seizures and only approved to treat seizures but sometimes is used for other conditions yet not been approved by the FDA to be safe and effective.  Therefore I decided to ring the psychiatrist concerned yesterday afternoon quite late in the day.  I told him I was aware of the fact he had suggested mood stabilisers to my daughter to which he replied that he “had not”.   There is no way that Elizabeth would have spoken so openly using the word “mood stabilisers” had she not been spoken to.   He started to get agitated when I insisted that Elizabeth had been spoken to and tried to make out this was a lie.  I said no way was this a lie and he went on to say that the call was “being recorded” so I told him likewise as there were people around me witnessing this.  Suddenly the line went dead.  The phone had clearly been put down on me.  I then contacted Elizabeth to tell her what more than one leading expert had told me about the safety of mood stabilisers.  I said “whatever you do…. do not take them as they could cause psychosis in themselves”.  More harm than good.

Elizabeth also told me that she had a visit from Clinical Psychologist Dr Mukherjee who claimed to be able to help her.   I don’t know what she means by that as from what I understand this Psychologist is shared by lots of different wards and I cannot see that a once a week visit can help at all whereas if Elizabeth was sent somewhere where they specialise in rape/abuse/PTSD/anger management on a long term programme such as the Retreat offer then Elizabeth will eventually get better.    Under a small Assisted Living Scheme you cannot deal matters of anger management and certainly this is something out of depth for someone newly qualified in psychology.   It requires much more specialised treatment and there are special treatments available that are effective such as EMDR.  It is only natural that I should ask for this to be provided.

I cant believe that the team ignored health and safety risk factors by placing Elizabeth straight away into the community without providing the specialised psychotherapy/counselling/EMDR etc.   Releasing her into a scheme that was not ready and had no water/toilet facilities up and running.

As Inspector Brown said in his blog “what the hell is going on”.

I am going to write next a letter to the Rt Hon Theresa May open dialogue style –  I am very concerned that there is the wrong care being provided and not available to so many, not just Elizabeth and that there seems to be no accountability so if there is no accountability how can anything ever improve.    Also the general public should be questioning where public money is being spent just as I am.

There are two alternatives:

Either change procedures at the scheme to be more accommodating towards Elizabeth, employing only staff that can work with her and not enforcing her to attend  straight away meetings and ease back on monitoring her progress when all she wants to do is just have time and space to settle down initially.    The support should be in the background as and when she needs but not forced upon her as it she will ask for it but she is not alone but she should be surrounded by only those who understand her and not put pressure on her.   It is this view that should be taken and staff briefed on how best to deal with Elizabeth so Police are not called constantly if she becomes distressed.  I have proven that MH professionals can work with Elizabeth to the extent she travelled far and wide with them so how comes all is failing in the community and only 1 support worker really understands her and knows best how to deal with situations.

The other alternative is to provide funding for Elizabeth to go away on a specialist long term programme for a year to The Retreat, set in beautiful grounds where she can relax and take part in the correct kind of therapy relevant in dealing with the trauma resulting from the abuse she suffered whilst under care through Enfield.   I think seeing as she has been abused under care itself  it is only fair that this is provided and Elizabeth gave me permission to deal with the Commissioners in this respect.  I was told that I should be hearing next week in this respect and the person responsible for the funding under MH is called Peppa Aubyn.   The Retreat whilst not local could benefit her making a return to the local area successful in due course and if she is to remain on a section then certainly this rather than an acute ward should be provided as an acute ward cannot provide the right kind of therapy.  An acute ward is not the right place for Elizabeth to be.

A scheme open, coupled acute ward is costing a money and I don’t want this situation to drag on for weeks and weeks on end but on the other hand measures must be put in place to ensure that reoccurrence does not happen when Elizabeth is constantly sent back to the wards.  The Rt Hon Theresa May would like to see people living in the community and not incarcerated long term but first of all you need staff that are highly trained to deal with situations like those under “working to recovery”.

 

 

If anyone has been subjected to severe stress over a long period of time they could be suffering from such a condition which would explain one reason why the drugs do not work.  Liver enzymes such as the P450 group might be comprised by an undiagnosed condition such as Selyes and if so the patient’s ability to metabolise the drugs might be similarly compromised which is why all of the drugs Elizabeth has been prescribed do not work.

Many soldiers returning from Afghanistan are drug refractive and many are suffering from PTSD –  this could coincidental but clearly needs examining”.

PTSD originally was believed to have been caused by a single shocking event such as disaster or being attacked.  It is now widely recognised that sustained stressors can be even more damaging and disorder of extreme stress is the long term version of the one-off event causing PTSD”.

Elizabeth has been misdiagnosed and consequently had been caught in a revolving door style trap.  The situation she has been in has caused the stress.  it is incredibly important that she is reassessed and that her endocrinal function is checked out. (Yes I’ve done this).  The metformin prescriptions are because medics have identified a dysfunction and have misinterpreted both its causes and its effects.”  I have proven this to be correct.

I have had the P450 liver enzyme tests done by the world leading experts in Rotterdam.  In addition I have spent over £1000 on endocrinology tests which prove my point.

Both Endocrinology tests and P450 liver enzyme tests should be given to everyone first.   All these years Elizabeth has had the wrong treatment and the wrong diagnosis and up until now no one would budge on it.  The treatment has caused Elizabeth to suffer from a lot of pain.

She is now out from hospital after 13 weeks of being on acute wards drug free after 80 days but some doctors think you just get over a withdrawal after just a few weeks and this is not the case.  I did not agree with the decision to just place her straight into the community without providing proper intensive trauma therapy that Dr Johnson  mentions in his accurate report.

Elizabeth has been placed in a new scheme in the community and still appears to be under the same team whose Responsible Clinician is DR Bassit Hussain based at Silver Street Enfield.    All of them were involved with the safeguarding so I am not too happy as I thought she would have a new team.

It has only been a week in the scheme but Elizabeth is finding things hard to adjust after the noisy volatile atmosphere of the wards.  The scheme has 24 hr care with support workers but I must say I am pleased with one –  I’ve only met the one support worker.  This is Katherine and she is a mother herself.   I really like her approach with Elizabeth.

It is a nice house, in a slightly different area but nice area not too far away.  I think the team rushed to get Elizabeth out from hospital as I was complaining it had been 13 weeks on acute wards – far too long and she was going downhill. but I had been asking for somewhere like Khiron House where they offer the correct therapy.

It is too early for me to comment on the scheme yet but I am not getting the distressed calls from Elizabeth every night and during the day like before.  She has contacted me a couple of times.   Elizabeth needs to get on with her life but it is difficult to adjust and the team need to be patient.   I get the feeling from listening to Elizabeth that some team members are rushing her – no one can make a judgement too early.

I took a friend over to visit on Sunday and we took her out for a drive into the countryside.   I do not like microwave ovens so I took over a steamer, a nutribullit, garden chairs and some cooking utensils and plates.    I took Elizabeth shopping but she felt very tired and had to go and sit in the car.  I bought some healthy food and hope she can live more healthily and not live off takeaways.   I have had extensive tests done at the Bio Lab that show some mineral/vitamin deficiencies.    Elizabeth is now registered with a GP but is worried about her physical health.  I have warned her that some of these GPs like to prescribe anti-depressants for physical health conditions and to be very watchful.    The surgery needs to be aware that Elizabeth cannot metabolise these drugs – they could produce an adverse reaction as we have seen on Prozac and practically all of these drugs – none of which have done her any good.   Elizabeth is complaining of cramps, headache, backache –  I am keen for her to be included in the RADAR Research as she has been allowed her to come off the drugs in accordance with her wishes.  It is a waste of money to give drugs that do not work and especially wrong if there is the slightest hint that the diagnosis may be wrong or there may be some physical health problems.

I agree that physical health problems can be caused as a result of stress caused by trauma.

It is early days and I hope that after my email to the team today they will not put pressure on Elizabeth especially to go to yet more meetings.   At the last scheme Elizabeth was dragged unrepresented to four safeguarding meetings.  It is no wonder she does not want to go to any more meetings and I am far from happy about this.  At home we had no support.  Those meetings were not about care and instead of what 9 professionals could do to improve things instead they centred the meetings on me.  Luckily I got hold of copies of these minutes and reported them to the Police.

It would be better if Elizabeth could be referred to another team such as Dialogue First –  we were deprived joining Dialogue First and I bet this did not cost a great deal and could have benefitted everyone.

So I think the Dialogue First should be available to everyone especially those cut off from their families in hospitals.

Sometimes professionals do not act in the best interests and this is why it is important that more funding can be given to this wonderful programme nationwide.

I am looking forward on Friday going to the event at Kingsley Hall where Dr Moncrieff is speaking.

I am hoping things will go smoothly at this new placement and that eventually once Elizabeth has settled in she will want to do things with her life but she will need a mentor and ongoing support for some time- just hope she can settle down and it says in the brochure that they provide music therapy, art therapy and aromatherapy.  This sounds fantastic.   I think Elizabeth will like this very much provided these things are given as per the brochure.  These are the kind of things that were given to Elizabeth when she went away for four months having private care with excellent MH professionals and I have taken the wonderful pictures Elizabeth did using the technique of “threading”  to be framed.

So I’m happy with the area, the house is nice, a nice support worker but I will not be happy if Enfield do not provide the music therapy, art therapy and aromatherapy and proper counselling –  now that I have seen that my local area what huge funds they have to spend it needs to be spent properly.  It should not be a case of dumping someone into a house in the community without any activities once again and I will soon find out and I will keep you all informed how I get on as once these things have been provided I will feel much better knowing that the correct treatment is in place and NOT these mind altering chemicals that Elizabeth cannot metabolise.  Besides, these psychiatric drugs are not for the condition of Selyes Generalised Adaptational Syndrome – the correct diagnosis in my opinion.

Last of all I am looking forward to doing a course on PTSD  in June at the Recovery College.

 

Message to the Chief Executive and Deputy Leader of Quality.

Message to the Rt. Hon Joan Ryan MP

It has been over nine weeks and Elizabeth is still on an acute ward at Enfield Chase Farm Hospital – Suffolk Ward.  The RC left all of a sudden and replaced by another on a temporary basis.  The care coordinator and Manager are also based along with the acting RC at 58 – 60 Silver Street Enfield –  Enfield East Recovery Team.

COMPLEX PTSD

I believe my daughter Elizabeth has the diagnosis of complex PTSD.  She is so traumatised that she has disassociated herself from certain events too painful to deal with and needs professional help of a specialist nature before being placed straight into the community without enough support.

YESTERDAY

I received a phone call from Elizabeth distressed.  I can tell by the tone of her voice.  She had been taken to see a scheme called Emerald House Care Home.  Elizabeth does not like the area –  It is situated on the corner of a busy road junction.  When I visited her in Edgware she was struggling to cross small roads.  Elizabeth was transferred to Edgware from Suffolk Ward as she was being attacked by another patient and hit around the head.  Elizabeth was upset by the assessment which concluded she had to take medication to live there.    She has been medication free now for 60 days and starting to recover.

PRIVATE CARE WE PROVIDED

I provided the most wonderful care in desperation as I could see Elizabeth going downhill in the local community.  What we spent was a fraction of what care must be costing right now on an acute ward which is the wrong environment.  Elizabeth stayed in the family home of MH professionals.  She was taken on holiday with them to France and Spain and saw some wonderful places, ending up at the World Hearing Voices Congress in Paris and was taken out to dinner by some French MH professionals who made were fascinated by her story.  To everyone’s astonishment Elizabeth got on a plane and went to Australia to stay in various recovery houses, working with international MH professionals who were appalled and fed up with the mainstream system of care.  They did a wonderful job in making Elizabeth well again – when she came home she was unrecognisable and we were so happy but we had no support in the local area and something triggered her returning to the family home and local area which was not the plan as we had hoped she would make a fresh start elsewhere.   When she came home she revealed to everyone that the most terrible things had happened to her under a local scheme in the community called Moti Villa based along the Ridgeway Enfield.  This is recorded in files and Police were involved but she was on 800mg of Quetiapine (Seroquel) and Police did not investigate properly so I have contacted them and they are currently looking into information I have supplied and I am waiting to hear further. To this date no appropriate counselling has been provided.

MOTI VILLA, THE RIDGEWAY ENFIELD -2010

I wont reveal all details but have kept extensive records on what happened to my daughter back in 2010.  When Elizabeth came back home from Australia and even prior this, she was reliving her nightmares and untreated trauma resulted in her behaviour through incidents which would suggest she is suffering from complex PTSD.   I am not  a Doctor to come to this conclusion but not one doctor is willing to look into matters further and recommend the appropriate help.   Elizabeth complained of seeing faces from the past, hearing knocking at her window.  She is traumatised by her experience which was displayed in her behaviour.  I have proven that with kindness and humane care provided by an organisation called http://www.working-to-recovery who have a unique response that she can be helped and if she can be helped then so can so many others.  Going back to Moti Villa, Elizabeth was full of fear to return there and  she was not given the opportunity to move elsewhere.   She was too unstable on the 800mg to have home at the time.   She was a revolving door case and each time she was prescribed even more drugs such as Chlorpromazine, Haloperidol, Zopical and Lorazepam.  All these drugs resulted in tremendous suffering caused by local Doctors instead of dealing with the trauma by way of therapy.  A leading Professor said “how on earth can anyone function on as much as 800 mg of Quetiapine.  Good Question.

POLICE INVESTIGATION AND NEGLECT

Police failed to interview anyone in connection with the incident at Moti Villa which Elizabeth has openly spoken about to family and close friends and even in front of staff at Cygnet Beckton.  (it is no use ENFIELD MH trying to deny what happened as I have extensive files)   These files are with Police right now as no one could  be bothered to come round to see me.  It was only when I complained they finally got in touch as I had threatened to send the files right to the very top of the Police Force and may still do so.  It may well be an incident that occurred quite some time ago but at the very least , the case should remain “open” and not be closed  –  I have evidence that says the complete opposite of their conclusion.

If there was any hint of abuse that occurred back in 2010 Moti Villa then appropriate counselling should have been given rather than enormous quantities of drugs.  Having seen that Elizabeth can be helped by proper care and therapy it is only natural that I feel in the circumstances that this should be offered to her now she is drug free after eleven years and starting to feel a bit better but still suffering from the pain of withdrawal.

When I look back at the file records I see nothing but incompetence as obviously something is wrong when someone is so desperate they keep ending up time and time again a revolving door case and each time the answer was yet more and more drugs.

I see nasty comments written behind our backs by people who know nothing about the family.

AUSTRALIA UP UNTIL NOW:

Since returning home from Australia Elizabeth had hugely improved.   The private MH had worked with her extensively on underlying issues.   They recognised she could possibly have a learning disability and we as a family feel that she has complex PTSD as she is clearly a trauma victim.  I have a psychiatric report for court purposes that states this fact.  When Elizabeth came home she tried to do everything herself and making a huge effort.  She even wanted a job.  She was just left to go downhill.   No-one helped her and we applied for the new initiative called Dialogue First run by North East London MH Trust, as we thought that this would be of benefit to work in an open transparent manner with other professionals from outside of my local area of ENFIELD as all Elizabeth wants is for her family to be together not pulled apart by professionals who do not like me as a mother.   We met the criteria as Elizabeth was discharged from local MH services and wanted nothing more to do with them. She was under her GP based at Willow House Surgery, Willow Road Enfield and we both requested this but for some reason he never referred Elizabeth to this wonderful initiative. I am left wondering why to this day we never received this referral from the GP

Without any support whatsoever Elizabeth went downhill and PTSD can be triggered by an event that occurs.  Getting away from this area into a different more peaceful environment did her the world of good.  Feeling safe in the company of professionals who truly helped did her the world of good.  Treating her like a human being instead of an object also worked brilliantly too.   Being surrounded by kindness, animals, healthy environment –  I’m sure if you took any of those patients from the acute wards and gave them this opportunity they could come back quite well.  However without any backup in the local community someone can easily go downhill.  She needed just a little bit of ongoing therapy and support in the community which would have cost a fraction compared to Cygnet.

As Elizabeth felt so well on her return she no longer wanted to take the tiny portion of Abilify at 2.5 mg.   This drug has caused many problems with adverse reactions twice at home.   Now sadly she has ended up back in the mainstream system. However they have respected her wishes in hospital to remain drug free and she has been off all psychiatric drugs for about 60 days now.

Elizabeth has so far been sent to three different hospitals:

Cygnet Beckton:  costing £12500 per week –  put her back on the drug Abilify despite knowing she had more than one bad reaction on it.   They also introduced Chlorpromazine.  After I posted how much my local area were spending on Twitter she was released in one afternoon and taken to Suffolk Ward Chase Farm Hospital.

Suffolk Ward Chase Farm Hospital:  Acute ward but better than Cygnet in terms of the fact at least she could have her possessions and not be overshadowed during family visits.  RC  Dr Choudhuary has since all of a sudden left – he told her at a meeting I did not attend that if she did not choose her father as next of kin she would be thrown out on the street.  This prompted me to obtain the Discharge Policy of the hospital.

Withdrawing from the drug Abilify at 2.5 mg in a volatile environment is not easy.  It is a very powerful drug and Elizabeth has complained of chronic pain.  Peace and quiet is needed and staff are busy on acute wards so the environment is not right for Elizabeth to recover.  Elizabeth was beaten up by another patient on this ward and this is why she  was transferred to Trent Ward Edgware.

Trent Ward Edgware:

Some distance away from where we live and I could only visit at weekends.  She was eventually allowed out of this ward unescorted for a short time each day and was able to find her way around the local area which was unfamiliar with.  Elizabeth was starting to get distressed by the environment on this mixed ward and was intimidated by some male patients.  I attended a meeting with RC Dr Rashid who mentioned about a recovery house shared with twelve others was all he could offer.  Elizabeth who was quite traumatised has described her experience as alarm bells sounding every five minutes,  difficult to sleep as not peaceful and upset by seeing the way other patients were forcibly injected/drugged and I was receiving daily calls from her quite distressed.  She said “do something, Mum – please do something about the system of MH care in the UK.”  I said I would do my best and the only way was to speak openly about what was going on.

Suffolk House Palmers Green Recovery House:

Barnet Home Treatment Team discharged her there.  At the weekend prior to this move I could tell Elizabeth was not happy and distressed.  Elizabeth had asked me to bring some possessions up for her but when I arrived in the evening she was quite distressed and so  I promptly left and she had thrown the bags of belongings back at me.  She was upset that I had missed her calls as I was driving.  I got a call from the Recovery House that she was being discharged onto the street and I was distraught as I was so far away and could not help –  I made numerous phone calls but I could not get through to care coordinator or anyone in that department.

Back at Suffolk Ward Chase Farm:

Back to square 1 –  Back on a noisy acute ward.  Elizabeth has only just started seeing a  Psychologist who was just about to refer her to some trauma therapy for relaxation/ anger management.  However whilst this therapy is beneficial the environment is wrong and unless someone is in a peaceful environment how can such therapy benefit them.

The various NHS wards have respected Elizabeth’s wishes not to take medication. She is not on section and is voluntary.  Elizabeth can go out unescorted into the grounds and beyond.  Going out into the fresh air makes Elizabeth happy.  For those patients stuck on the wards under section, it must be awful even though they are taken out for regular fresh air.   Elizabeth has been distressed at seeing how other patients are being treated.  Last Sunday when I dropped Elizabeth back to the ward after seeing the R D Laing film there were about 4-5 patients involved in fighting on the ward,  trouble started in the lounge and spread to the corridors right next to me. We quickly retreated into her room and locked the door to stay away from the escalating violence.   This kind of environment is wrong for Elizabeth and I heard costs as much as £900 per night, yet what is sad is that she can get better in the right environment at a fraction of the cost being spent.  It has been over nine weeks and Elizabeth has not had the therapy she needs which is only now due to commence and now care coordinator based at 58 – 60 Silver Street – namely Enfield East Recovery Team wish to discharge Elizabeth into the community before the therapy even commences

Yesterday whilst at work I got a call from Elizabeth which was upsetting.  Elizabeth was talking about placements and that she had been taken to see one of them.

PLACEMENTS AND TREATMENT.

Care coordinator, her Manager and Acting RC Dr Hussain are based under Enfield East Recovery Team, 58 – 60 Silver Street Enfield and they have identified placements for Elizabeth to view locally.   I feel she should have the counselling first before she is just placed straight into the community as she has gone through further trauma by being on acute wards

Elizabeth has been further traumatised by being on three acute wards where she has witnessed and experienced violence and drugging/injection of other patients.   She was also subject to the enforced injection herself whilst under Section 2 where her brand new slippers broke, when dragged to the seclusion room for throwing out another patient’s bags from her shared room.   Acting Responsible Clinician DR BASSIT HUSSAIN  agreed this was not acceptable.

No appropriate therapy for PTSD has even taken place yet on the ward and Elizabeth has only just started seeing a Psychologist who has suggested medication rather than therapy but for PTSD it is not recommended psychiatric drugs under NICE Guidelines.  Therapy is the answer for a trauma victim and this works as I have proven.  Elizabeth needs to be referred for therapy not put under pressure to take drugs.

Emerald House is a care home based in Enfield and Elizabeth was told at the end of the assessment she would have to take medication or have injections to live there. Elizabeth has refused the placement.

There are two more placements to be seen – one in a different area but do they have the same stance on medication I wonder?

I have been told the following regarding medication in the community :

quite a few people recently in the UK say they are being told that they have to take “medication” because of a CTO (community treatment order). You may have been told this is the case but it isn’t really how CTOs work. They are meant to be an agreement between the patient and professionals and according to the Code Of Practice they should only be used if you are prepared to agree with the treatment plan. They are not meant to be used to blackmail you into taking the “medication” with the threat of hospitalisation. There is no legal power that allows forced medication to be given in the community – in reality being on a CTO really makes little difference (you can be sectioned with or without one). If you are on a CTO and disagree with the treatment plan, you should make it clear that you will NEVER accept the proposed treatment. They can drag you back into hospital if they think you are at risk of “relapse” and then give you “medication” without your consent, but they will need your consent to give it in the community and it would not make sense for them to use a CTO if you are not in agreement with the plan. I had one client who refused to accept the depot in community and was told she would not be allowed out of hospital. She said “fine, I like it here” and they discharged her without the depot. Remember that nobody can force you to take the “medication” in the community, and don’t let them tell you that they can.”

Well said!

QUESTIONS TO BE ASKED

Do the two remaining schemes have the same stance on medication?

Why should Elizabeth be forced to go back on drugs after 60 days off them when:

  • she cannot metabolise them as proven in P450 liver enzyme tests
  • her trauma back in 2010 relates to abuse suffered under local scheme Moti Villa, the Ridgeway, Enfield – no appropriate counselling offered

Why was Elizabeth not offered appropriate counselling going back to 2010 when professionals knew something had happened to her?

Why didn’t Police do a proper investigation?

Why was she placed in the community on as much as 800mg of Quetiapine?

Why wasn’t Elizabeth moved from this placement?

Why was a social worker trying to push Clozapine at Elizabeth despite knowing it was against her wishes.

Why cant she have the therapy for complex PTSD provided now first BEFORE placement into the community – why cant this therapy be somewhere else that specialise in it as the environment should be peaceful and not a noisy acute ward.

Why is no-one taking any of this into account just ignoring my emails?

What support will be given to Elizabeth in the community for complex PTSD apart from just a support worker on release from hospital?

Why is so much money being spent on Cygnet that could benefit the local hospital and its wards providing better facilities.

Why isn’t there a nice rehab facility where patients can go to recover from their ordeals from being long term under an acute ward.

 

WHAT HAS BEEN TRIED AND FAILED:

Moti Villa – multiply abused

Phoenix House – Northampton –  no food at the weekend -could not manage on £30 pw. This care home costing £70000 per year refused to give the clozapine when I offered to collect resulting in two cases “Deprival of Medication Community Care” and  Dols Ct of Protection 2014.

Mays Cottage – assured shorthold tenancy – serious health and safety shortfall costing £277 pw  for accommodation only run by Inclusion Housing.  Constantly locked out of her room due to faulty key/lock – told to sleep on settee – care provided by Craegmoor (part of Priory Group).  No supervision at night leading to drugs supplied.  Facing eviction due to another resident constantly staying over from another scheme.

Bethlem Royal Hospital Nat Psychosis Unit – max levels of drugs – Clozapine (against wishes) mixed with Metformine – contra indicated.   Face covered in bruises, advanced declaration ignored, tachycardia developed on Clozapine.

Cambian – Wales –  displacing me with father as NR a priority,  supervised phone calls until challenged by solicitor – long drawn out tribunal – deprival of Xmas leave allowing c2 hrs home visit flanked by two nurses who would not leave her side.   Rest of family treated differently and allowed unsupervised home visits according to the files.

Cygnet – Stevenage and Becton – £12500pw

Stevenage – introduced Abilify raising it to 20mg just prior to release making her unstable.

Beckton – just put her back on the Abilify despite adverse reaction and introduced Chlorpromazine

Both Cygnet hospitals failed to do assessments on other diagnoses

Various Wards under Enfield MH – (Trent and Suffolk)  –  volatile environment where forced drugging/injections and ECT are taking place.  Noisy environment with alarms going off frequently- every 5 minutes so Elizabeth said on Trent Ward.  Fighting/ violence on the wards. Disturbed patients being locked away in the exclusion room.  Costing c£900 per night or thereabouts.

Elizabeth has had her phone stolen on one ward, £100 of calls racked up,  been forcibly injected and dragged into the seclusion room breaking her brand new slippers (because she threw some bags out of her room when a man entered bringing another patient to share).

Elizabeth is not on section any more and can go out which is some relief but she has been transferred between Suffolk and Trent Ward Edgware as she was been beaten up by another patient and hit around her head on Suffolk Ward.

Elizabeth was also told to choose her father as next of kin otherwise she would be thrown out on the street by Dr Choudhury who was RC (Suffolk Ward) all of a sudden he has left and Dr Bassit Hussain has now overall responsibility as Acting RC.   Dr Hussain is based at Enfield East Recovery Team 58 – 60 Silver Street Enfield where her care coordinator and manager are likewise based.

Acute wards are not the right environment for Elizabeth but neither should she just be dumped into the community by her care coordinator without adequate support and therapy being in place and I don’t just mean a support worker but ongoing therapy as Elizabeth who is a trauma/complex PTSD sufferer has not received any appropriate therapy in the nine weeks on acute wards and that applies to the past years in total going back to the beginning apart from four months of wonderful private care we provided.

Elizabeth is recovering from withdrawal from the powerful drug Abilify which caused more than one serious adverse reaction and apparently causes increased agitation and anxiety according to Dr Joanna Moncrieff.  She should therefore be sent somewhere peaceful to aid that recovery before just being dumped into the community.

SOLUTIONS:

I have identified at least three places (not local) where they specialise in programmes for PTSD sufferers that last several months – one year.  I strongly feel Elizabeth should not be immediately placed into the community. I strongly feel she should have the trauma therapy first.   If she is placed straight into the community then I feel she needs extensive therapy and support to begin with instead of being forced to take drugs within a supportive housing scheme.   Drugs are not recommended for PTSD but for Schizophrenia and Bi Polar but this is the problem despite huge evidence that Elizabeth suffers from PTSD certain Doctors (psychiatrists) refuse to budge on diagnosis.

I have supplied a list of placements to her care coordinator and written to various people in the CCG.  I have not  had one single reply to my emails.  I have written to the Deputy Leader of Quality who has likewise ignored my emails.  I have written to the Rt Hon Joan Ryan MP.  I have written to many people but no one can be bothered to respond.  Every time you try to phone the team are in meetings or on holiday/out of the office and do not bother to get back to you.

I have spoken to Dr Rashid from Trent Ward who said all they could provide was recovery house and this did not work out.  It is like banging your head against a brick wall.  The Home Treatment Team in Barnet discharged her to the recovery house and this did not work out and this prompted me to write to all the commissioners again in desperation.

I have written to:

MP – The Rt Hon Joan Ryan

Chief Executive of Barnet Enfield & Haringey MH Trust is  Maria Kane

Deputy Leader of Quality Margaret Southcote-Want

Director of Psychosis – Leigh Saunders

Acting RC – Dr Bassit Hussain

Manager – Enfield East Recovery Team – George Benyure

Care Coordinator Bola Quadri

I am saddened by the treatment of my daughter who came back from Australia well.  She has gone downhill because of neglect in the local area and desperately needs some intensive trauma therapy.   Here are the names of the CCG professionals I have desperately written to for help:

Piesse, John – Primary Care Development Manager John.Piesse@enfieldccg.nhs.uk]
Cc: Aubyn, Peppa – Head of Mental Health Commissioning <Peppa.Aubyn@enfieldccg.nhs.uk>; MacDougall, Graham – Director of Strategy and Partnerships <Graham.MacDougall@enfieldccg.nhs.uk>; Mazarelo, Jenny – Primary Care Strategy Programme Manager <Jenny.Mazarelo@enfieldccg.nhs.uk>; Sharp, Kim – Enfield Referral Service Manager <Kim.Sharp@enfieldccg.nhs.uk>

Only Mr Piesse has been helpful in responding to my email asking for help.  He has cared to write back.

The Deputy Leader of Quality (Margaret Southcote-Want) has said she is not responding to any further emails from me as they have to think of resourcing.

Maria Kane has not responded to my letter going back to 2015 when I complained about our shocking treatment when drug Clozapine was deprived and we were taken to Court of Protection.

TO THE COURT OF PROTECTION – I would praise you highly for your help that you have given me in the case of my father with Alzheimers and my daughter back in 2014.  If she had been forced to return back to the care home she would now be on a CTO – they would have made contact with family awkward, deprived home visits and continued with a drugging regime that left her barely able to walk or go out.  She had no food at the weekend and was expected to manage on just £30 pw.  They deprived the drug Clozapine when I had offered to go and collect it hundreds of miles away.  The deprival of Clozapine by my local area put her life at risk when not one professional was prepared to prescribe it locally despite the fact that the time limit for restarting the drug had not reached the deadline of 48 hours.  It was 25 hours and I made every attempt to get it locally.   We then had to endure visits for court purposes by nursing professionals infiltrated by the Home Treatment Team infiltrated by staff from Enfield Rehab and Recovery Team who were ordered to go in twos and report every word that mother said.   Not one single apology for this degrading treatment of a vulnerable patient.  I feel like naming the entire team and their nasty notes written behind our backs.   Whoever would have thought that I would have obtained the files for my records.

Under the private sector there is to a large degree honesty and accountability but not when it comes to Trusts and Councils, some of whom employ people who earn more than the Prime Minister herself.  How can this be right when you receive appalling treatment, some of which I have mentioned above.  They feel they can get away with writing what they like in the most nasty way, trying to label you as being mentally ill yourself and a vexatious complainant when all you are trying to do is get the right kind of help instead of having to say “I told you so”.    There is also a lot of bullying going on within these tax payer funded organisations.

I got a call one day from my younger daughter who said they were hiding in a cupboard terrified when the consultant psychiatrist Dr Imelda Duignan turned up with social worker probably to do an assessment.

I was so happy I sent my daughter away from this country where abuse is rife to experience proper care of a humane nature. I was overjoyed to get text messages from her to say she was in Dubai, she was in Australia etc.  I’m so glad she at least has some happy memories to fall back on.

When care is at fault and abuse has taken place in the community under a local scheme then the necessary therapy should automatically be provided.  I have proven that therapy works.   It is negligent of her team to ignore this fact.

It is negligent of the hospital to discharge her into the community without adequate support or threaten a vulnerable person with eviction as has been done.

It is negligent to ignore what is needed in terms of therapeutic care.

I have been accused of interfering by the care coordinator in respect of placements by “confusing” Elizabeth with other options.   To begin with – Elizabeth was given one option only – Emerald House – a scheme where there is high security and CCTV in the office on ground floor.  A scheme where no therapy is provided whatsoever.  Twelve other residents.

I feel Elizabeth should have choices and she has said so herself so there are two other potential placements yet to be seen locally which I cannot as yet comment on.

Thought should be given to the correct type of placement, bearing in mind Elizabeth may benefit for a while being away from the local area where there are bad memories provided she was to receive the correct treatment but certainly not in prison-like Cygnet or any other similar horrific institutions under the private sector costing a fortune of taxpayers money.

I identified Care Farms as she loves animals and wanted to do gardening as a job on her return from Australia.  One care farm is situated close to rest of family.  This is the kind of environment she benefitted from whilst away but I doubt this has been looked into.

I also identified Camphill Village Community Trust – various schemes, some situated close to rest of family – there are some not too far away from home and even if no on-site accommodation this could be sought and a live in support worker provided by way of direct payments.

All of these places above are suitable in that Elizabeth would not become isolated and would be supported and encouraged to participate in a natural therapeutic healthy environment where they produce organic food and learn new skills this is the right environment.  Bearing in mind Elizabeth suffers from chronic pain coming off the drug Abilify no way should she be forced to do too much just being in a therapeutic environment could lead to her health improving physically.

There are also recovery houses and hospitals that specialist specifically with abuse and PTSD/dissociation, details of which have been passed on to the hospital/care coordinator.    If just dumped into the community without the correct treatment this could lead to substantial problems and is neglectful.

When you complain and fight for the right type of care all you get is bullying from a team of professionals who stick together like glue and do not budge.  If mistakes are made no one is accountable. No-one wishes to take overall responsibility but the overall responsibility is with the Responsible Clinician Dr Bassit Hussain.  He is the person who responsible in every way and tried to say it was a team decision.  He is the one with sole responsibility.

I am not sure how commissioning works but I have written to the commissioners above as this requires specialist funding but it is a waste of money sending someone somewhere where they are not getting the correct treatment and whilst I agree that the acute ward is not the right place I feel that much thought should be given to where Elizabeth is placed in the community and I feel she should be given the opportunity to try out the Care Farms, Camphill community trust and see how that works out.  Even if there is no accommodation on site, a shared cottage with support worker could be provided so that she can participate in activities on the care farm.  The right environment is essential before being placed back into the local community which is far from peaceful being London and thought should be given to her becoming isolated and also bear in mind that she is suffering from symptoms of chronic pain through withdrawal so cannot do too much to start with.  A year away from the local area given the right support would avoid return to acute wards.

At the very least if Elizabeth is found accommodation within the local area funding should be put in place so she does not end up either on a local ward  or prison like private hospital such as Cygnet/Cambian but at one of the suggested placements that really do specialist with therapy for PTSD/trauma.

Over the Easter holiday I will be taking Elizabeth to church.  I will be helping her as much as possible get out from the ward and get her some nice food.

I would love to see her settled and getting on with her life. In desperation I am writing this blog which many people can identify with as I know of many cases where parents really do care and fight to get the right treatment.

Elizabeth said  “please do something – please change the system”  The only way things will ever be changed is if people speak out about it and if there is accountability and measures put in place to ensure that the weak and vulnerable are being heard.  In places like Cygnet you can become lost in the system as if someone is highly drugged then they cannot call for a solicitor for instance.  You as a relative cannot just appoint solicitors and as a result patients can be kept for years in these institutions.

One member of staff appointed to investigate my complaint said “I have no doubt institutional care is the right thing for Elizabeth” – this complete stranger went and passed the complaint to the department to whom the complaint was all about as she did not know the family well enough.

There would not be one single complaint from me if there was an open honest system of care such as open dialogue in my local area of Enfield.

I would not have any complaints if Elizabeth was given the trauma therapy treatment first and ongoing support for this.

I would not be complaining if there was recognition that things had gone wrong in the past but now this is the plan to put matters right.

MESSAGE TO DR HUSSAIN:

I do not agree with you Dr Hussain when you say “lets start afresh”.  In order to deal with the trauma you need to look back and see what happened and I have saved you time and effort by doing a SUMMARY OF CARE.  I hope you as RC with overall responsibility have read the summary of care.

MESSAGE TO THE TEAM

You may well wish Elizabeth to move off the ward but first of all she needs to be given the chance to try out the various schemes and other things like care farms.  I do not want to hear any more threats from anyone or comments like “you should not be here”.   Instead you should be asking the care coordinator and her manager and Dr Hussain “what the hell is going on” – just like Inspector Brown and my favourite blog of his.  Please do tell me what is going on in all aspects as communication is very important as I am sure you will agree.

I will end by saying HAPPY EASTER to those who celebrate it and I hope everyone enjoys the Easter Break.

 

 

 

 

 

 

On Thursday I attended a meeting at the ward with Elizabeth’s sister expecting to see RC – Dr Choudhury but we were told he had all of a sudden left Suffolk ward.  I was surprised by this as we were not informed prior to the meeting.    I asked if I could go in separately as there were private medical test results I wanted to discuss.  I emphasised I wanted them to check out her physical health as a result as she had been complaining of physical chronic pain.  I am hoping she will get the right support not just accommodation in the community as she is a trauma victim but unlike at Trent Ward when we met with Dr Rashid, we were not given much time at all to discuss.  I was told “you have only 5 minutes”.    I had taken the day off on holiday for just 5 minutes but luckily prior to the meeting I had copied lots of information that I would otherwise not have had time to discuss.  My first question was “who is the new RC”.   I was told that Dr Hussain from  Enfield East Recovery Team is now Acting RC.  It was a long time since I had seen him last at my house and I did not recognise him after all that time.  Present also was the care coordinator who was once coming into my home during the titration of Clozapine in 2014.  There was a new nurse, a student nurse and minute taker and the ward manager was not present.

It’s now been 9 weeks on various acute wards during – apart from at Cygnet Beckton where they put her back on Abilify,  Elizabeth has been withdrawing from this drug which has caused no end of problems.  She is drug free after 11 years but has been suffering withdrawal symptoms, stomach cramps, headaches, backache etc.   Trent Ward tried to discharge her into a recovery house for two weeks pending transfer to accommodation but Elizabeth was not at all happy about this and things did not work out so she is back on Suffolk Ward but she is at least allowed out alone.

On every ward staff have tried to persuade her to take drugs and each and every time she has refused.  There was the incident I was far from happy about where her slippers broke and brought these along to the meeting.  Forcibly injected when she threw bags out of her room,  Elizabeth was staring into space looking traumatised when I arrived in the evening.  I criticised this course of action as over a four month period away staying with MH professionals in their home, travelling abroad with lots of changes how comes they coped without forcibly injecting or drugging her.

There was an incident where Elizabeth was attacked leading to her transfer to Edgware Trent Ward.  Elizabeth has phoned me several times in distress as it is not always peaceful.  She said of the other ward that every five minutes the alarms were going off and it was difficult to sleep.   Whilst I feel she is in the wrong environment she has needed to stabilise coming off a powerful anti-psychotic drug that did not agree with her and I feel she cannot just be dumped into the community without ongoing trauma therapy.   It is recommended in a report for court purposes that she should have intensive trauma therapy but this has never been provided and surely the best place this can only be done is in a hospital environment but somewhere where they have nice grounds and where patients are not treated like prisoners.

They seem to be going down the route of placement in the community and Elizabeth has been to see just one placement but did not like the area.  There is another one lined up for her to view.

I was accused of confusing Elizabeth by identifying several other placements or hospitals where they offer intensive therapy but surely she should have that choice. It is for her to decide and she certainly has a mind of her own. I would ideally like to see her get the right support and therapy which could be a year programme but I do not want to see her in a prison-like setting like some of these private hospitals.    No-one commented on these suggestions which I had previously brought to a meeting there.

It must be costing a fortune if a locked ward is £900 per day and on an acute ward how can anyone get better when they are around others who are also disturbed.  I’m pleased now the weather has improved Elizabeth is allowed out.   Elizabeth said tonight she needs therapy, not drugs which I would fully agree.

Elizabeth has told me she has now got an advocate which is good news.

After my 5 minutes at the meeting, Elizabeth was called in on her own for some length of time.  Elizabeth had been complaining of stomach pains and I asked that she be thoroughly examined in terms of physical health.   Elizabeth’s sister and I were then called in for the remainder of the meeting.   I have advised Elizabeth to go and look at the placements but was accused by the CC of confusing her by providing details of other placements but I felt that choices should be given and not all my suggestions were local but some provided specialist therapy.  The final decision is of course Elizabeth’s but it is wrong for only one scheme to be offered for consideration and Elizabeth was not sure about the area it was situated in.

After the meeting we all went to the café on the hospital grounds for lunch. It was a beautiful day and Elizabeth was very happy to see her sister who has now moved away from the local area.  I then took Elizabeth to town for  shopping and then dropped her back to the ward.

Today I have spoken to Elizabeth and she sounded happy.  She has been out alone for a walk and went back to the café.

Tomorrow I will take Elizabeth out somewhere.

Sunday if she feels OK I have tickets for the R D Laing film “Mad to be Normal”.

Elizabeth told me they drug tested her today.  Elizabeth had only been to the café and to one shop.   I suppose they have to do such things occasionally but Elizabeth was not impressed.  I doubt she would ever take illicit drugs now she is drug free – she is quite specific in her views about drugs.

Mention of drugs was made by Dr Hussain but what drugs exactly – no doubt anti-psychotics but none have worked as Elizabeth is “treatment resistant”.  With diagnosis in doubt and police investigation, Elizabeth has said in her own words “I need therapy not drugs” .  I would quite agree.  We have seen how well therapy worked over the past four months when she stayed with professionals through “working to recovery” and there was no need to drug her during her stay.   Coming off these powerful chemicals that contain ingredients such as poisonous dyes and aspartame can take time for the body to adjust but I know a lot of people who make a full recovery but this can take at least 1 – 2 years.    There really does need to be more help for people like Elizabeth not just forced drugging for the rest of their life.   There needs to be better facilities provided for this purpose in the UK.  I understand from Elizabeth her psychologist has mentioned about her taking drugs and Elizabeth was not happy with this suggestion quite rightly.

 

 

Elizabeth has been on various wards as you know for just over six weeks.  An acute ward is not a good place to withdraw from psychiatric drugs but neither is the family home. There needs to be facilities for this provided.  It is not peaceful on an acute ward.  However having said that, when someone is a trauma victim, there needs to be ongoing therapy and when I checked out what was on offer in a couple of future possible placements I was not too happy.  These specialist facilities are not in the local area.  Anyway, I telephoned the recovery house to tell them that Elizabeth is withdrawing from Abilify.  I was astonished that the Responsible Clinician thought that she should be recovered after a short space of time so I had to point out to him that it took much longer to recover and can take a year or so.  When someone is coming off drugs such as this they should automatically have the counselling/psychotherapy.

Yesterday I got the news that Elizabeth was being discharged but I did not agree with the decision as much as I wanted her off the acute ward, I felt that first of all Elizabeth should be sent somewhere where they specialise in PTSD (not Cygnet!) but somewhere where they offer proper care like I provided for four months in Scotland and in Australia.

As a former colleague of Dr R D Laing told me, he never used drugs on patients and it is lazy to use that approach in my opinion.  If psychotherapy was used together with other therapies then as I have seen through the wonderful care provided by http://www.working-to-recovery, it is possible to get well again –  I must emphasise the term “well” – Elizabeth feels unwell physically because she is withdrawing from a powerful drug and not because she has any psychiatric labels.

Getting back to the discharge of Elizabeth from Trent Ward, I had already contacted the recovery house – at such recovery houses people are all on prescribed drugs and there are as many as 12 others there short term.   I got that feeling Elizabeth was feeling anxious about such a move and had identified a smaller ward for neurological rehab on the site of Edgware Hospital but when I mentioned about this we were told a referral was necessary and the consultant psychiatrist brushed Elizabeth’s wishes aside.   Anyway for six weeks Elizabeth has refused every drug on offer locally and at Edgware which was not the correct environment either when going through drug withdrawal.  No-one warns you of how difficult it is to withdraw off these drugs or the fact there are no facilities for psychiatric drug withdrawal.   I am proud of the fact Elizabeth has said no.  Coming off these drugs has enabled her to speak up for herself much better.  Anyway, the recovery house was situated not so far away from where I live and much easier to travel to than Edgware.  I had a call from Elizabeth when she arrived there to  bring her some things but I had not noticed she had tried to contact me as I was busy driving and finding where to park.   She was in a foul mood on arrival.    I had previously warned the recovery house that Elizabeth suffered from PTSD.  I therefore did not stay long but today arranged for a friend to visit instead, bringing her mobile phone and other possessions.   When this friend got there it was obvious that Elizabeth was still distressed.    Then I got a call  from the recovery house to say they were not letting her back in.  I was a long distance away from home at the time and it was awful to get this news as I could not help in any way.  I made several phone calls to the team but you can never get through as they are always out at meetings and then they do not ring you back or write.  Elizabeth is now back again in the local area and on a local ward (Suffolk).  The kind of place I would like to see her recover from these drugs is somewhere peaceful as at times I get calls from Elizabeth who is distressed and I think that environment is extremely important and especially as I have proven this works – going away to a peaceful natural environment most people could get well.  The kind of environment I am talking about is Scotland and then Australia through “Working-to-Recovery”.   This costs a fraction of what some private sector wards are charging.   Elizabeth stayed at recovery houses in Australia and all the time she was getting better that is until she returned to my local area which is not what I would have wished.   We don’t seem to have any recovery houses of this nature in the UK.

I think going away from the local area to somewhere quiet and peaceful was the answer and receiving the correct therapy.  Staying at recovery houses, working with international MH professionals and peer supporters was the best solution in an environment where no one pushed psychiatric drugs.  We need more of this type of recovery house as there is nothing like this in the UK.  The care provided worked and the UK needs to take an very different approach to that currently adopted under mainstream care as this approach has worked for Elizabeth who came back well from Australia but such care needs to be continued for at least a year in the cases of abuse victims.

I have identified several specialist centres that deal with trauma/PTSD and who offer therapy but why are there not more?  these are not local but it is crucial that counselling/psychotherapy is provided and not just accommodation in the community.  I have emailed everyone about this today as something needs to be done urgently especially as a locked ward is costing a lot of money.  I would prefer Elizabeth to stay in a nice hotel or health spa where there is a gym and swimming pool and nice facilities quite frankly.

I do not want Elizabeth to remain on that acute ward much longer but I want her 100% well before being discharged into the community and I am going to discuss all this with the Consultant Psychiatrist  RC – Dr K Choudhury on Thursday this week.

 

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