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PTSD and Complex PTSD can seriously affect the default mode network in the brain and cause faulty neuronal connections that can lead to psychotic symptoms.  The failure to perceive this as an injury rather than a disease causes bio-psychiatrists to employ medications that cause further injury to this complex structure of inter brain communication, which consequently causes cognitive dysfunction and psychosis.  

Bob Johnson has focused on this and the concomitant decreases in oxygenated blood in the brain.  

Neuroleptics will not treat PTSD but merely depress the more florid symptoms of it.  The problem is that they also cause the disruption in the DMN to get worse.

Bob’s comments on the effects in Broca’s area of the brain is fascinating.  This is the centre for language processing and damage there might account for the word fixation that is seen in some patients incorrectly diagnosed as psychotic.  

“Dr Richard Ngomba and I are also looking into disruptions in the mesocortical pathways potentially caused by brain inflammation.”  Decreases in oxygenated blood may well cause the triggering of inflammation in the temporal horn.    We saw in Martin Harrow’s study that neuroleptics have caused a marked decrease in cognitive function in patients prescribed these drugs long term.   Precisely what you would expect in patients with damage to neural pathways (mesocortical pathways) 

Professor Roderick Orner, who is an international authority on complex PTSD is in our research group.  

Subject: What is complex PTSD? – Mind

https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd-and-complex-ptsd/complex-ptsd/


Disruption in the default mode network (DMN) has been implicated in numerous neuropsychiatric disorders, including posttraumatic stress disorder (PTSD).

My work has focussed on trauma recall.
This is blocked 100% in severe, untreated cases.
If the DMN is “autonomic’, then it is less significant clinically, than
voluntary, or insight driven cerebral
activity.

DMN abnormalities in patients with severe PTSD symptoms
are characterized by decreased overall inter connections.
Absolutely – but especially, as mentioned in Broca’s area, and the
frontal cortex. Decrease is an understatement – the blank look on the
faces is underpinned by Kolk’s PET scans when trauma tapes are played.

Those decreased interconnections are another potential reason why
patients incorrectly diagnosed with psychosis who are actually suffering
from PTSD are treatment refractive.
2 points –(1) beneath every psychotic symptom I have examined, there is a
fiercely blocked trauma. In one transcribed dialogue a 40 year old
verbalises the difficulty she has thinking. PTSD in spades.
(2) If the treatment envisaged is neuroleptics, then, as Harrow showed,
it makes things worse. In my view it does this by blocking even the
beginnings of reactivation of frontal cortical blockage, which is intimately
linked to Broca. Drug induced zombies cannot begin to pull themselves
together.

The decreased interactions will interfere with the uptake of psychopharmaceutical medications by creating an effective block in neurotransmitter receptors in the mesocortical pathways.
Is the assumption here that better uptake is clinically beneficial? Clinical
evidence does not support this, though bio-psychiatrists swear by it.
And, yes, the blockages noted by Kolk were arterial, oxygen supply related, I
imagine, which implies the whole frontal area shows decreased activity.
DR Bob Johnson Page 2 of 2 Your 6 points – 1MAY22

New Responsible Clinician Dr Shajahan Ismail

Responsible Clinician Dr H M Shahpasandy

Ward Manager Alison Bartlett

Carers Rep Zoe Blake

Dr Ismail has only recently taken over from Dr Shahpasandy and Ward Round is changed to Thursdays.

Last weekend’s visit followed everywhere by two members of staff all around the grounds.

CCTV installed outside Elizabeth’s room.

Still waiting to hear from MHA Office Manager regarding link to Tribunal as Elizabeth wants me to attend.

Have requested CCTV footage from FREEDOM Fire and Security regarding alleged assault in grounds whilst standing next to CCTV cameras on 3 April. FOI request also submitted to Trust Records. Still waiting to hear.

Turned to Adults safeguarding as most concerned regarding Elizabeth’s welfare re lack of exercise and fresh air and also now possible cancer on waiting list for Oncology when I could have provided the necessary tests privately.

Paid £38 for chiropodist to visit Ash Villa as Ash Villa cannot cater for this leaving patients in pain.

From: Blake, Zoe (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) <zoe.blake1@nhs.net>
Sent: Friday, April 8, 2022 4:49:43 PM
To: susan bevis <susanb255@outlook.com>
Subject: Sundays leave

Good afternoon Susan

It has been raised that you wish for 1 hour ground leave on Sunday

This will not be granted.

The Section 17 leave that is in place is for 30 Minutes twice a week.

30 minutes has been taken today the reminder can be taken on Sunday.

To be clear you have 30 Minutes ground leave booked in for Sunday at 14.00pm

Kind regards

Zoe Blake

Carer Champion

Ash Villa

Sleaford

NG34 8QA

Direct Line : 01522309776

Mobile: 07518294826

Email: zoe.blake1@nhs.net

Working hours Monday to Friday 09.00-17.00 pm

The Visits are barely worth coming to flanked by two members of staff. Vicious threats to arrest me for assault on a member of staff. My daughter’s complaints to CQC not dealt with.

An inspection urgently needs to take place at Ash Villa Lincolnshire Partnership Trust.

MY DAUGHTER IS BEING ABUSED BY THIS HOSPITAL AND HER LIFE IS PUT AT RISK. IT IS HEARTBREAKING THAT SUCH PROFESSIONALS WORKING WITHIN THE NHS CAN GET AWAY WITH SUCH CRUELTY AND NOTHING IS DONE ABOUT IT.

THIS IS PUNISHMENT NOT FIT FOR PRISON

Yesterday’s ward round took place and again my request for Section 17 leave refused. Elizabeth will neither be able to come home at Easter or spend any time with family unsupervised. Instead she will spend much of her time inside as I did not realise she had so little entitlement for fresh air and exercise. Whilst other patients are allowed out in the grounds alone Elizabeth is not and staff (someone called Helen) tucks her into bed during the day and she spends most of her time in her room, trying to keep warm. She has caught covid on the ward and nobody bothered to tell us as we are regarded as nothing in this institution. She wears pyjamas during day and night and now struggles to walk. I am concerned about the extra injections of prn which Elizabeth thinks are given in punishment for I/C. To give such injections straight afterwards sounds to me like she could be right. During my shortened visit which was only allowed outside due to covid, Elizabeth was cold and had to go back inside to get a coat. Elizabeth sat on a bench with me, witnessed by a ‘family friend’. I managed to sort out WhatsApp for her. Her phone was dead but I brought a charger with me. WhatsApp is where I send photos of her cat who she misses so much as well as home. No idea how much per week this unit costs but would not be surprised if it was over £5000 pw and not benefitting her at all. There seems to be staff shortages on the ward and sometimes only male nurses on duty. Elizabeth complained about her toe nails hurting which was pointed out to staff supervising but nothing done so I understand. Elizabeth was pleased to see me but the visit was cut short due to a CPA which apparently did not take place. I thought my visit was for one hour but I have only just found out just how restrictive a prison this facility actually is. I thought at least 30 minutes a day was allowed but I was wrong as the carer’s rep mentioned 30 minutes twice a week which is nothing. Elizabeth looked pale and overweight. The new coat I bought her for her Birthday did not fit around her stomach. Through lack of exercise and fresh air Elizabeth did not look at all well and complained she could hardly walk – not surprisingly. The only thing she looks forward to is my visit bringing her a few nice things – healthy treats and some money. Her breathing is not good at all and this was pointed out by the previous care coordinator in former area but nobody under this team has anything to say about this or the discharge note stating all physical health concerns and now possibly breast cancer. It has now been 6 months of imprisonment under Lincolnshire Partnership Trust (because of failure by the NHS to get the depot in place in the local area where we now live) and to be frank she would have been treated better in prison. I had visited the golf club nearby to buy something nice to eat for her and her friend to share. Elizabeth was ordered into the building by staff stating there was a CPA which she did not even attend or took place without her. Absolutely no consideration is given to carers who have to drive a fair distance to visit and now I do not even feel comfortable to visit alone after nurse (FB) accused me of assaulting a member of staff last week and they called Police again on me. This morning I wrote to Pals and added my concerns regarding the awful event last Sunday and I requested CCTV footage not just for this but for the in respect of the Ward Manager’s letter sent Special Delivery accusing me of threatening intimidating behaviour. All evidence would have surely been recorded one way or the other because you simply cannot go by a word staff say having read court papers and especially after last Sunday’s visit. I have nothing to hide so let’s see the evidence. All this is done to destroy your character and undermine you as an unfit parent/carer by NHS personnel who are desperately trying to protect themselves and they do this by discrediting you which amounts to bullying, all of them sticking together and protected by the carer’s rep so it would appear who is acting like a shield and defensive towards the staff not acting in your interest or speaking up for you as a parent and carer.

I am so concerned at the way my daughter is being treated that I recently raised a safeguarding and it was then I discovered that I was not under any safeguarding myself which I thought I might have been due to the restrictions towards me on visiting.

Staff at Ash Villa advised that such restrictions are in line with their Policy and that my daughter was on a different section that warranted such restriction but whilst I am still Nearest Relative, I should be entitled to know such information but no-one wishes to say a word. The MHA Office has failed to respond to my emails when I requested the link to the last tribunal which my daughter wanted me to attend.

There is no doubt Elizabeth’s physical health is declining under this dreadful institution, the worst we have ever come across.

As per the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Ash Villa is in breach of the following:

Ensuring the privacy of the service user;

Supporting the autonomy, independence and involvement in the community of the service user;

A health service body must act in an open and transparent way with relevant persons including NR’s in relation to care and treatment provided to service users in carrying on a regulated activity.

Severe harm, moderate harm or prolonged psychological harm to the service user.

ASH VILLA’S AGENDA

It was revealed by Dr S. that no Section 17 will be granted, no explanation given. The only entitlement is thirty minutes in the grounds twice a week supervised only so straight away this is not going in accordance with the Health and Social Care Act 2008 above in bold. This is punishment not care and even if there was dislike towards me there is no excuse to treat Elizabeth in this manner and deprive exercise and fresh air to her. I had not been writing a blog or publicising anything to do with care here. I had hoped it would be possible to make a fresh start.

It was revealed that Rehab was considered best option rather than discharge home so no note has been made of the previous CTR and the fact that Elizabeth had backing to come back home though nothing in the way of support was put in her independent flat. No respect for Elizabeth wanting to come back home or for her family.

We are so fed up with the NHS that we as a family will be prepared to provide everything privately including the depot so she could in fact come home as after 6 months of not benefitting by restrictive prison style facilities, surely something can be provided for her in the community and if they can’t then I will. The excuse they make seems to hinge upon Elizabeth’s return back to their facility after a successful stay with her family over Xmas. They say now their plans have changed as a result and this is all very wrong because on return to Ash Villa she was thrown into meetings and Tribunal which was overwhelming for her. They do not understand autism one bit and choose to ignore the fact that whilst Elizabeth’s screenings for autism have all come out positive, she does not have an official diagnosis.

Physical health appointments have had to be cancelled, she is placed on a waiting list as an urgent referral for cancer tests, MRI scan previously refused for Limbic System plus no blood test done, (though on this second occasion) she did refuse. The scan should come first in any case which was flatly refused previously.

Several doctors have left, replaced with new doctors.

The ward round was short, distressing and achieved nothing other than confirmation of their future plans for rehab which the RC said everyone agreed on. I do not think some members of staff are that happy about what is going on under Ash Villa but feel that this is a culture thereunder rife with bullying as I have been bullied myself by nursing staff and Management of Ash Villa to such an enormous extent where I have had to request CCTV evidence to support me.

I hope safeguarding done on Ash Villa will scrutinise thoroughly recent events and what goes on behind closed doors as I have nothing whatsoever to hide otherwise I would not be writing openly.

Ash Villa seen to have adopted their own policy, code of conduct and rules where no human rights exist and no Dignity or Respect towards patients and carers as evidenced. They are most certainly in breach of the Health and Social Care Act 2008, MHA law and human rights law but how many more institutions such as this are failing vulnerable people like my daughter whilst focus is on Ukraine right now. Thought should never be ignored about the abuse going on towards the weak and vulnerable in care homes and institutions throughout the UK especially when the UK is offering to take in migrants from Ukraine who may be badly traumatised. God forbid if they end up under the UK’s failing mental health facilities.

Meanwhile builders are getting on very well with demolishing the old garage and we now have the comprehensive plans to provide/build a separate living accommodation but this team at Ash Villa do not want her to come home in accordance with her wishes and have no respect towards patients or carers alike in contradiction of their Charter.

As I feel so unrepresented and unsupported I have had to seek advocacy myself.

On this lovely sunny day I made the usual journey to visit my daughter at Ash Villa, Sleaford. I takes me over an hour. Elizabeth was excited and happy about me visiting as I always bring her some nice things. I give her money for the week also. She had made a list of things she wanted me to bring her.

Here are some of Elizbeth’s most recent messages:

“There is a man in Ash Villa and his comments were not nice to women”

Is that right what you told me that J injected you for incontinence “yes” pls report this.

“Can you bring a bike for me to ride around here”

“I’m still awake cant get comfy I wanna ride a bike through Sleaford Forest.”

“K one of the young girls who helped me on the shower said we’re nice here – duno what she means”

“K says you are lovely to be around when you are well”

“they are nasty and spiteful”

“The chaplain came see me he had a ??cat.”

“Can you bring me a picture of fluffy.”

“I’m so looking forward to seeing you ag”

I took the email below as permission to visit Ash Villa today at my usual time and assumed that if there was any problem I would have been advised by the Carers Champion, my only point of contact. I had written to her below following Ward Road but heard nothing and I would always ask permission and visit on a Sunday at 2.00 pm which is over an hour’s journey for me so I make a day of it.

From: Shahpesandy, Homayun (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST)
Sent: 01 April 2022 14:56
To: susan bevis; safeguarding@cqc.org.uk; Enquiries;

Subject: RE: Ward Round 01.04.2022

Dear Ms Bevis,

I have just left the meeting, and have another in 5 minutes.

I am happy to consider s17 for Sunday in hospital grounds.

I will respond to the rest of your questions next week. You could also liaise with Z as she is very well informed about the outcome of the meeting just finished.

Best wishes

Dr H Shahpesandy

From: susan bevis <susanb255@outlook.com>
Sent: 01 April 2022 14:38
To:ZB(LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) shahpesandy, Homayun (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) <homayun.shahpesandy@nhs.net>
Cc: PALS(LPT) (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST) <lpft.pals@nhs.net>; safeguarding@cqc.org.uk; Enquiries <Enquiries@cqc.org.uk>
Subject: Ward Round 01.04.2022

Dear Z/Dr Shahpasandy

Due technical problems on the part of Ash Villa and ward round commencing late and time being short I wanted to make the following points and confirm what was agreed.

First of all I am hoping to visit my daughter on Sunday 3 April and wish to book ground leave at 2.00 pm.  Please confirm?

It was discussed, following discovery of lump/s on Elizabeth’s breast that an urgent referral has been made to Oncology for an assessment,  appointment to take place within two weeks.   I had offered to pay privately for an immediate appointment but this you declined.

It was discussed about the MRI scan –  the scan, previously refused by you has now been agreed but I am unsure whether a referral has been made?

I could not hear what was being said about the blood test re Limbic System.   Elizabeth agreed to this when I explained what it was for so I would like your confirmation that this has been done.

I still have received no answers as to Section 26 – an explanation to me as NR why I am not allowed leave with Elizabeth other than supervised.

Safeguarding was mentioned at last ward round to be going on against me but as I am excluded from such meetings surely this is against natural justice?   There therefore needs to be a Section 42 meeting with Police/everyone present.  This could ruin career chances for me and my dbs.   I won the previous Ombudsman case when safeguarding went on secretly behind my back previously.  Please therefore ensure that a Section 42 meeting with entire family present is arranged

You confirmed the Manager’s hearing would be in April.   I am referring this to the CQC as I am still Nearest Relative and have been ignored by the MHA Office and feel like I am being bullied out of my role as NR by threats of legal action re displacement and not only that, in the case of our Power of Attorney.  I have been bullied and threatened so many times with legal action that if this is the route if I end up in court representing myself again the good thing is I did a very thorough job and this will bring about openness and transparency regarding everything Ash Villa or the  community MH resource centre or similar department is doing behind my back.

You said the plan had changed since Xmas in terms of release.  When I asked what the latest plan was you declined to answer.  Following successful leave at home without any problems, Elizabeth came back to your ward unsettled.  Well it was no wonder why.  She had started to settle down at home and was happy to be at home then had to come back to your ward and be faced with Tribunal and meetings which she absolutely hates.   Her presentation on her return back to your ward has been used as an excuse in terms of justification for her still being incarcerated after all this length of time, being held just like a prisoner.

Talking about punishment that is what we see you are doing by depriving any S17 leave and treating my daughter like a prisoner.  As I said at the ward round you are in breach of Art 8 and 3 of the Human Rights Act.  

I also feel as though there is discrimination against Elizabeth’s religious rights to go to church and to have a visit from Georgina Machell.  I have notified my concerns to Reverend Georgina Machell.  I am notifying the local churches how I feel my daughter is being deprived/discriminated against in this respect.

As regards delegation of my role as NR I have no intention of doing so until a Manager’s Hearing is called which you said would be end of April.  I have explained to Elizabeth who has had enough of being on your ward held a prisoner on such lengthy detention with such restrictive practice and this is not what she wants.  You have already said the matter of legal action against us as Attorneys is being dealt with separately.  Everything is being done to discredit us as parents and I want this thoroughly looked into.

After all this time, still nothing in place in the community so behind the scenes there are clearly other plans that you do not wish to disclose which is why I wanted that Manager’s hearing which comes under mental health law.  I as NR am entitled to call such Manager’s Hearing which request on my part is something that S.J in charge of the MHA office has avoided response to which I will get the CQC to look into as I feel that my daughter’s human rights are being abused under Ash Villa and she wishes to come home.  She has told you that on numerous occasions.

I am also concerned that B. the advocate from Voiceability should be allowed to see Elizabeth alone without any members of staff being present and this has not been the case at all from what Elizabeth has told me.  

Regards

Susan Bevis

I arrived early in Sleaford at St Andrews Church, Kelby. The history of this church is impressive, 12C parish church with 13th and 14th C additions nd tower/spire rebuilt in 1850. dating back to 1850. It is a Grade 1 Listed Building. It is a shame this church has been neglected in terms of condition. The service was very nice and I updated Reverend Georgina Machell on the latest re Elizabeth and said I would be visiting her later. I voiced my concern that the Carer’s Rep ZB had contacted me to say they had to refer Elizabeth for urgent Oncology tests due to a lump or lumps on her breast. I told her that restrictions were still placed against me visiting the ward and seeing my daughter other than supervised visits much like in prison and I voiced concerns that my daughter has told us the family that she is being abused.

After this I went swimming and then made my way to see Elizabeth.

When I arrived at Ash Villa, my usual time of 2.00 pm, I was confronted by two members of staff at the front door and I explained that I had permission to visit Elizabeth. The acute nurse FB said they knew nothing about my visit and that no visits were allowed because of yet another case of covid. It is not surprising that covid spreads easily in this facility because there are no ensuites and shared bath/shower rooms. Elizabeth has told me she has had to change rooms a few times. The member of staff accompanying FB was a HCA (VL). When I looked at her name back she tried to cover this up with her hand and I found their approach towards me as quite intimidating as all I wanted was to hand the things I have brought to Elizabeth as I wanted to make sure she had got them.

I knew I would not be allowed on the ward to visit so I then said what about her entitlement to come out in the grounds for 1 hour (Elizabeth had not been allowed out that day) I had driven for over an hour to visit. The answer was a firm no. No intention to allow me Elizabeth out in the grounds not even for 5 minutes. I noticed several other patients outside in the fresh air unescorted so I enquired why could Elizabeth not come out in the fresh air for her 1 hour break obviously keeping a distance away from me. I was again told no which was very upsetting. Elizabeth wanted me to visit today. I was then advised to come back again during the week but they just do not appreciate how expensive it is to drive all that way, not to be allowed even 5 minutes just to pass over the things I brought and be assured Elizabeth has them. I found staff to be intimidating and threatening towards me. They wanted proof so I had showed them the email as above from her doctor but this made no difference. I then asked if I could hand my daughter’s things to her. They had by this time led her to a room where the sash window was very slightly open and I was advised Police had been called. Sure enough several police cars turned up . I could just about see Elizabeth through the small opening in the window. FB accused me of assaulting a member of staff. This serious allegation made Elizabeth flare up and yell at staff to “get away from her” and she said “no my mother has not assaulted a member of staff”. I said in response to the slanderous accusations that there was CCTV all around. I later obtained a reference number from Police just in case matters got escalated. There was a male nurse present also in the small room busy writing some kind of report. I wanted to help Elizabeth with WhatsApp as she is unable to receive photos of her cat I had sent her but the phone battery was quite dead so before I left the premises I asked Police if they could ensure it was charging and I explained staff put the phone in her locker making it difficult for family to have contact. The situation at Ash Villa is becoming more disturbing and something is going on behind my back that is for sure.

I just feel alone and unsupported – I get to hear through Elizabeth her distress of several letters going missing.

I was asked by Police to remove my car which I did.

I then drove back home.

I was advised I should get an advocate to look into what was going on behind my back. It is not very nice at all when so many are against you and I cannot think of a better way to describe their actions as bullying.

When I first arrived FB (acute nurse) said she was sorry for the mis-communication as I had shown her the email. The same degrading thing happened at Ward Round which is virtual. I could not get into the meeting on the link already sent which did not work then received an email stating “can I please join the meeting” However, I waiting to be admitted and noone was allowing me in to this meeting. It narrowed the time down to virtually nothing. It was supposed to be 30 minutes but more like 10. Because I hardly got to say what I wanted I put everything in writing afterwards and the response is above.

It is a horrible when a whole team of “professionals” gang up against you, holding secret meeting and slag you off behind you back under safeguarding for which you are excluded. There was another member of staff hanging about outside and because I was so concerned they would all back one another alleging I had assaulted a member of staff I made a point of telephoning police when I arrived home and getting a reference number.

Lincs Police were professional in their dealing towards me. I was always looked upon sympathetically in the former area by Police who my daughter regarded as her friends. She would call police and ambulance because she was lonely as they never provided any care in her independent flat. This is why we moved hoping to be treated better in this new area but everything has been a disaster. I have had all this work done to my house just to benefit Elizabeth and am now beginning to commence the building works for Elizabeth’s separate living accommodation.

Elizabeth said she saw the Chaplain but he was not allowed to see Elizabeth alone. She told him that she was very unhappy at Ash Villa. She said he was going to visit her again.

It is the same with the advocate of Voiceability. I always thought it was unlawful for a member of staff to be present and listening to a private meeting with her advocate, correct me if I am wrong here. I thought the idea of an advocate was to see a patient on their own but not even the dignity of this is allowed by staff at Ash Villa.

I have been sent an article “Importance of ‘I’ in IMHA by Catherine Pease Consultant Solicitor of Peter Edwards law about the independence of advocates and how mental health professionals view and treat IMHAs. One advocate said “I have been asked on numerous occasions what my view is in relation to someone’s treatment or asked to attend professionals meeting without the service user present. I am staggered at the lack of understanding by some professionals as to my role as an independent advocate and their surprise that I do not hold a clinical view on their required treatment.” Apparently a social worker/care coordinator had asked this advocate to contribute towards a social circumstances report for Tribunal who was very surprised when the advocate declined wanting information to strengthen an argument in favour of the patient’s ongoing detention. This shows how awful professionals behave and another advocate said she was asked to attend meetings in the absence of the patient and not to tell them about forthcoming ward rounds or inform them about their care and treatment plans in case they get upset and cause trouble on the ward.

I will have to feature more on this topic on another blog together with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, the contents of which are very interesting. “Service users must be treated with dignity and respect.” Dignity and Respect – None whatsoever exists at Ash Villa. Elizabeth has not even got her care plan and cannot find any of her letters she said were from her solicitors. I can only assume these were on her detention continuing. Perhaps the tribunal went on behind her back but she was in fact given the excuse the care coordinator could not attend for some reason and the tribunal was adjourned. I have since asked for a Manager’s Hearing as I am still the Nearest Relative and Elizabeth agrees with what I have done.

The other interesting article I have seen is https://www.medscape.com/viewarticle/971481?src=

Medscape is the leading source of clinical news, health information and point-of-care tools for healthcare professionals. Medscape offers specialists, primary care doctors and other health professionals the most robust and integrated medical information and educational tools.

Medscape Education (medscape.org) is the leading destination for continuous professional development, consisting of more than 30 speciality-focused destinations offering thousands of free C.M.E AND C.E courses and other educational programs for doctors, nurses and other healthcare professionals.

Very interesting article featured:

“United Lincolnshire Hospitals NHS Trust ordered to pay £111,204 in fines and legal costs after pleading guilty to failing to provide safe care and treatment to an elderly patient, causing them avoidable harm, following a sentencing hearing on Friday 25 March at Boston Magistrates Court.”

The case was taken by the Care Quality Commission (CQC) under regulations 12 and 22 of the Health & Social Care Act 2008 (Regulated Activities) Regulations 2014.

I do not feel my daughter is safe under Ash Villa with covid case after covid case and having to wait for an appointment that we as a family would have provided immediately for an urgent oncology assessment in light of the lump on her breast. She was expecting a visit from Junior Dr RM about the blood test on Friday morning but Elizabeth said she did not turn up as expected. I have been told by a leading expert in any case that the scan should come first and this is what has been consistently denied to Elizabeth by her Doctor who says a scan is unjustified, yet it is HIS research and study into the Limbic System that is being denied to Elizabeth which is surprising.

I think that Section 3 has been renewed and at ward round it was discussed about the Manager’s Hearing being end of April.

I will finish this blog with Elizabeth’s most recent comments “I am desperately waiting to come out of this dreadful hospital”.

Today’s ward round took place this morning delayed by technical problems meaning whereby I could not join the meeting despite having the calendar link and had to re-join using another link.

I heard yesterday that it has been discovered Elizabeth had a lump/lumps on her breast and my first thought was about long waiting lists for such assessments due to covid. I therefore offered to pay privately but this was dismissed as being unnecessary and they tried to reassure me that her appointment would be within a couple of weeks. I do not feel reassured as I have no idea how long the lump/s on her breasts have been evident but was told this was only recently discovered. I then enquired regarding the MRI scan previously refused by Dr Afolafi when I offered to take her back to London. Dr Shahpasendy also had refused a blood test for his own Limbic research but hopefully this can now go ahead too. This was the reason why Elizabeth was admitted to hospital in the first instance under S136 when she called into her GP surgery in the former area demanding an MRI scan. No she did not smash up the surgery or jump over the desk as documented. There is a pack of lies documented in file notes regarding this incident. It is hard to trust a single thing that the NHS does in light of this and when you ask for corrections to be made this is ignored.

Section 17 leave was discussed and once again refused by Dr Shahpasandy and team so Elizabeth continues to be held in the most restrictive manner like a prisoner without even the most basic human rights. How degrading is it to drive for over an hour for a meeting just for half an hour, the to call Elizabeth in for five minutes to accommodate the other half an hour allowed. I was advised that the entire Disciplinary Team were in agreement with this to make it look like it was everyone concerned but I doubt this is true and have seen evidence this is not the case but there is clearly a culture of bullying under Lincolnshire Partnership Trust.

I only saw a few present at today’s meeting but here is an example of how many “professionals” you are up against who are invited as a matter of course.

There are 4 other doctors, some of which are trainees.

Afolabi Temitope

Auty Charlotte

Middleton Rachel

Patel Ashishkumar

I dont know who half these are but they are perhaps on video link:

FB

SG

GJ

MJ

SM

SM

JP

CS

G J S

KS

JT

JH

JF

LOUTH CMHT

ZB

KB

AB

There is just myself invited from family but excluded from the main part of the meeting which is conducted in secret as they do not want to reveal their true agenda, secret meetings held by a multi disciplinary team to discuss their plans against us as a family. Safeguarding would appear to be continuing behind my back. It is all about protecting one another, plans to get rid of me as a Mother, carer and Nearest Relative who they use bullying tactics against – I can’t think of a worse punishment than restricting contact in the way they are doing.

When I tried to discuss Section 17 leave Dr Shahpasandy said that there would be no change – supervised escorted grounds visits only. I told him that this was in breach of Art 8 and 3 but he responded that everyone was in agreement because of their collective concerns against me but I sense this is not true. He refused to discuss S26 MHA when you as nearest relative are entitled to explanation as to why such restrictions are in place. We see it as punishment.

To deprive someone of their religious needs and going to church is discrimination and then when Reverend Machell tried to contact confidentiality was being played upon and it is impossible to get through sometimes on the phone.

CODE OF PRACTICE

Treat people in places that are safe and help them get well  – “I will never get well in here” Elizabeth stays in her room most of the day according to male nurse called Fred.    She has not been in any trouble. She lies in bed a lot to avoid noise and seems to be up late night as this is when I get her calls.  Elizabeth has also phoned to say she was freezing but Dr Shahpasendy denies this. She says the bed in uncomfortable and her back hurts. I brought blankets for her to the ward but was told these are not allowed from outside the ward. I had to advise staff as Elizabeth finds it difficult to ask for things. She often tells me that “the doctor/or staff are putting words in her head”. If you dont ask you do not get in that facility.

Think about patient’s physical health as well as their mental health.   Elizabeth has been refused various physical health appointments – one most recently in London by Dr Afolafi which was a Neurologist appointment in London recommended to attend by the new GP.    (“it is a doctor’s absolute duty to investigate abnormal findings on a scan as mentioned on Discharge note from previous hospital.

The scan was consistently refused by her doctor who has only just reconsidered this now that I have pointed out re his research into the Limbic System.

Work together to give you good safe mental health services and the right support when you leave hospital.   No this is the not the case at all. Quite the opposite as you are up against so very many all backing you. This facility is very distressing to Elizabeth which is probably why she spends much of her time in her room.  She cannot stand noise and has sensory issues.  Their plans have changed since Xmas as Elizabeth returned to the ward distressed. The leave was a tremendous success but she was distressed at going back and being thrown into meetings and tribunal now everything has changed and the restrictive visiting rights are most probably just the tip of the iceberg and I assume leading to even more restrictions and banning of contact. This has been done to me before. I thought doctors were meant to do no harm. In fact it puts you off ever seeing a doctor again as there is no thought, no compassion towards you as a carer or towards a family who are trying to provide a decent living accommodation that is safe and comfortable and all they can think of is to get rid of you. After all these months nothing has been provided by the community MH team whose agenda is to gang up against you and take you to court to get rid of you. They are situated in Stamford and Lincoln from what I can see.

Patients’ Rights The Code says patients should have a say in their care and be treated with dignity and respect  –  Voiceability are supposed to the advocates but are never there to support Elizabeth at meetings. Even when her advocate did telephone a member of staff, namely Katy remained present at all times so even advocates are only allowed supervised contact at Ash Villa by the sound of it. Elizabeth finds meetings stressful especially where she is constantly questioned. She is refusing to attend such meetings and when she has done, she has stormed out because staff fire question after question at her – same questions all the time about where she wants to live.  Constantly she says she wants to come home.  What dont they understand but perhaps this is not their agenda and they know nothing about the family. There is no dignity and no say at all. Only a CTR in the former area provided Elizabeth with a chance to say what she wanted and be listened to but not under Lincolnshire Partnership Trust where it is like going backwards.

Work together to keep patients in hospital for as short a time as possible  This is definitely not the case. All this length of time, going back to September and still nothing provided in the community. Elizabeth has been detained in facilities totally wrong for her due to noise, extreme restrictive practices and deprived not only of her liberty but fresh air and exercise with physical health appointments dismissed and ignored that should have been dealt with from the very start of detention. In addition, she has been deprived of having quality time with her family except for just a few days at Xmas which was a great success but on her immediate return to Ash Villa she had a tribunal and meetings which greatly affected her to which she reacted.  This put back her discharge back as it was originally planned for her to come home but now there seems to be other secret plans going on behind our backs and care homes have been mentioned more than once. There is currently an attempt to get rid of myself and Mr Bevis as Power of Attorney and we are being investigated right now.  I am being accused of stopping/encouraging to stop treatment which is not true and I can prove it. They are also slating my character detrimentally in other ways and in general trying to discredit me in particular. They are also trying to get rid of me as NR, stating Elizabeth does not want me as such and denying me having a Manager’s Hearing and displacing me with my younger daughter. What kind of a system is this!  

Services must stick to laws about treating people equally and fairly.   There is no fair treatment under Ash Villa because not only are visiting rights totally restrictive, she is not allowed out for fresh air whilst during my visit. It is so degrading to have two members of staff stand over you in the same room listening to every word of conversation treating you like a criminal and it is not a nice experience for Elizabeth either.

§  The Code says patients should have a say in their care and be treated with dignity and respect.   There is no dignity as per the above Code and with such restrictive practices akin to Dols there is no respect either for carers or patients alike. Their Charter looks good on the surface but you are not treated accordingly so why even bother to display this on the wall.    You are treated in a condescending, patronising and degrading manner, made out to be someone who is rude and aggressive by some staff members. You cannot always get through on the phone, a patient is denied religious rights to go to church which is discriminative. Elizabeth has been denied fresh air and exercise also.   With the excuse of covid, the little dog that brought much joy to Elizabeth is now no longer allowed in the visitor’s room.   All my daughter has is the window of her bedroom to look out at the outside world and the birds outside where she spends most of her time indoors like a prisoner.  She has named all the birds. She has asked to go swimming and asked me to get a costume just in case but this is denied and even going out around the grounds has been denied on my visits as mother and carer at times.  It takes me over an hour to drive for just 1 hour’s visit and the visits are very upsetting because my daughter has said “I will never get better in this place”.  

If you are treated under the Mental Health Act and do not have capacity, your Attorney or Deputy can make some decisions for you. HOWEVER ELIZABETH DOES HAVE CAPACITY AND HAS PUT A PRAYER ON LINCOLN CATHEDRAL’S WEBSITE BEGGING GOD TO ALLOW HER TO COME HOME.   With such restrictive measures in place I believe they are either trying to go down the DoLs/ MCA route because Elizabeth does not like the depot as she has a fear of needles unsurprisingly, having been dragged from one end of a former ward to another by four male nurses and forcibly injected and has had needles broken in her by rough treatment under Elysium.  They are trying to blame us as attorney’s for encouraging her to stop taking the depot or from stopping it. It could also be safeguarding to make me, her father look out to be unfit parents and they want to put my younger daughter in place of me as NR and are threatening all kinds of court action which is bullying. With regard to compliance they fail to note Elizabeth did not refuse their treatment in the community in London previously and there was never a problem and she was not on a CTO either.  She was being slowly and gradually reduced off the Clopixol by the former area of Enfield who produced a letter detailing this as well as a discharge note pointing only to physical health conditions.

There are some times where hospital managers may restrict visitors, refuse to let them in or ask them to leave. Managers should have a policy (plan) for the times when they can limit visits to patients.   Covid being the excuse.   I am restricted with no answers given as to why but they are trying to make out I am threatening and aggressive.   There seems to be a culture of bullying under Ash Villa.  I did hang around on her birthday, not expecting to visit the ward due to covid but since Elizabeth was out of isolation I just wanted to hand her the Birthday presents. She did not know I was there and now states she was upset at being kept a prisoner.  Unfortunately they called Police and I was not even parked in their car park at the time. Nobody could get through to Elizabeth several days later.  I had dropped her cake in and dropped the presents in that were just dumped in a store room and Elizabeth says now that she did not know I had waited outside just to hand her the presents.   She was apparently not feeling well enough to go out anywhere as she was recovering from covid and felt weakened.   I was not pressurising her to go out but not even a phone call –  no one else could get through to her for several days and she did not know about the presents and card I dropped in.

I have asked for the reason for my restrictive visiting rights under S26 MHA but no-one will give a reason.   When Police were called I asked if Police could do a welfare check on my daughter as she seemed to be really upset and was looking forward to my visit the day before and she was acting out of character but Police said they were not allowed on the ward.

I have also been refused information as to whom the Hospital Managers are. I have received a letter from AMHP Andrew Morrans about getting rid of me as NR and displacing me with my younger daughter but I want a Manager’s hearing first and so does Elizabeth as I have explained this to her.

Policy:   This should be clearly displayed on the ward so staff and patients can read it.  All there is displayed on the wall is a Charter and unfortunately Ash Villa do not act in accordance with their own Charter.  

They have to write down why they stopped the visitor coming and show there is a good reason for this.   Hospital managers must check when staff are stopping visitors. They should have a policy on when visits are not allowed.  This is not done. However I have had the phone put down on me and been treated with rudeness myself.  I have not always been able to get through as her phone is charging or switched off.  I have then called the ward to see if her phone is charging and the Policy is to put the phone down as I should only have 1 point of contact. They will say they ” i will see if she wants to speak t or not.”   I have had the phone put down on me more than once but I am never threatening or swearing towards staff but they are trying to make me out to be this way.  It is because I am asking for information and they have been told not to give it.  The Carers Champion firmly states she is my only means of contact and I get a 15 minute slot only but in that 15 minute slot the only answer I got was “no” to the Neurologist appointment in London and that it was not necessary.

The hospital manager must make sure the patient and their family can be involved and understand what is happening

This is not being done.

Services have to think about these safeguards if they give you any care or treatment that deprives (takes away) a person’s liberty. This means where you are not free to leave and where you may be watched or controlled all the time.

This is what I think they are doing as she is not even allowed outside of the grounds and is watched and controlled at all times and it is so utterly degrading.

They must tell the local authority (council) and the Care Quality Commission (CQC) if they use the Deprivation of Liberty Safeguards so they can check what they are doing. Sometimes people have to decide whether to keep a person in hospital under the Mental Health Act or the Deprivation of Liberty Safeguards. Both cannot be used at the same time. It is as though this is being done at the same time although denied when I asked.

Elizabeth has called the CQC more than once herself stating she is being abused and has been unable to contact her advocate and they have not been helpful in this respect as the number would not work when she tried.  She was asleep on one occasion when the Advocate wanted to see her and on another a member of staff sat in and listened to the video linked meeting. There does not seem to be any contact with her and her advocate now as she is completely outnumbered in meetings and increasing of numbers of staff invited which is intimidating for both of us.

I think they are using both MHA and DoLs at the same time against Code of Practice though DoLs has been denied however they are in fact depriving her liberty and it should be the least restrictive care.    They are trying to get rid of her Attorneys (myself/her father) by saying they are not fit for purpose under Health & Welfare and depriving or encouraging deprival of her depot injection with a view to displacement and Guardianship under no doubt an AMHP.

The NHS should try to place patients as close as is reasonably possible to their home. If it is difficult for the patient’s carer or family to visit a patient because of the distance they need to travel, then the NHS should think about what support they can provide.

Elizabeth has in the past been sent all over the country even Wales but this journey is over an hour for just an hour’s visit and the visit is absolutely degrading and restrictive against human rights.   It is so upsetting that my daughter is being punished when she has been so badly abused and as someone who reviews MH services/carers rep myself, I have never come across anything as bad as Ash Villa.

People with learning disabilities or autism. A person cannot be detained and treated under the Mental Health Act just because they have a learning disability or autism.  Whilst said to be border-line LD – all screenings have come out positive re: autism but they do not want her to have an autism diagnosis.  There was enough evidence for NAS to get involved in the provision of a CTR that took place whilst back in London where the Independent Chair of that meeting commented “the whole thing stinks”.

People with autism can find changes difficult or upsetting. Being kept in hospital can be difficult for them so they need support from staff who understand autism. The staff should listen to carers and other people who know the person well and can say if they understand the decision.

“I am desperately waiting to come out of this dreadful hospital”

Firstly the former area of Enfield declined to admit Elizabeth was a multiple rape victim and they refused a CTR and autism diagnosis – nothing was done fairly and we moved in the hope there would be fairer treatment here.   Staff do not listen to carers and the information sent by myself does not appear to have been read or else dismissed such as the Discharge Notice indicating only physical health concerns along with the letter from former area detailing the reduction plan off medication.  Doctors are ignoring physical health and will not acknowledge the fact my daughter’s breathing is very bad –  will not give any answers but in past files she is noted to be of high risk of mortality and choking.   They have not once listened to me as a mother and carer and even got the dosage of the drugs wrong to begin with virtually calling me a liar when I said she was due a reduction down to 250mg.   My daughter finds it very distressing to be in that hospital. 

§  Doctors should think about the patient’s wishes when they plan their treatment and care.   They are not listening at all so thank goodness Access Charity are involved.  She says “the doctor keeps putting words in my head re care homes”.

§  In certain cases the Court of Protection may have a power to order that doctors must not give the treatment.   The CoP treated us both fairly in 2014 when Elizabeth was being forced back to a care home where she had no food at the weekend and where a CTO and DoLs was planned plus severance of contact.

care for patients in safe places that are not noisy or upsetting    Elizabeth says she cannot stand the noise on the ward at Ash Villa. She is clearly unhappy there so why isnt an entire team of “professionals” listening.

Think about physical healthcare and not just mental health.  Not allowed to take her to appointments or assessments re physical health and she has missed all her appointments which the new local GP recommended she attend. Now has possible breast cancer only just been discovered, an urgent referral has just been made.

Local authorities and clinical commissioning groups must make sure patients get the right care in the community after they have been kept in hospital for treatment. This is called after-care and the Mental Health Act says what this means.   Absolutely nothing is being done otherwise Elizabeth would not still be incarcerated suffering no end to the point where she has said she cannot stand any more of her life and that no one understands her.   She is missing fresh air and exercise.  She is missing her cat and her family.  She is becoming weakened physically.  She is in pyjamas all day long and sleeps during the day and all night awake judging by her messages. 

Guardianship:   The rules should not mean you are watched and controlled all the time. They should not stop you leaving the place where you live.   AMHPS from this area of Lincolnshire have already tried to put her under Guardianship and displace me as NR and even appoint the Official Solicitor over the head of her solicitors Ringrose Law and Dr Shapasandy said measures are being put in place to a get rid of me as NR and admitted safeguarding on concerns (by whom exactly?) – total breach of confidentiality has gone on to discuss my displacement behind my back which has got back to me.

If you lack capacity to make some or all decisions about your treatment and care, your doctor should think about whether to use the Mental Capacity Act instead.   Elizabeth clearly has capacity about where she wants to live and has said time and time again “home”.     Their agenda is into a care home or supported living and housing where no doubt her liberty would be deprived and so would contact with her family as has been done in the past.  Elizabeth has also suffered the most terrible abuse under past schemes which is why we as a family moved to provide a separate living accommodation for her so she can be independent and this has been architecturally designed and the environment of the surrounding area is perfect as it is quiet and peaceful and overlooks the sea.

Hospital managers’ discharge powers The hospital manager is the person or organisation in charge of the hospital. They can arrange for a panel (or group of people) to carry out their powers.   Have asked who the Hospital Managers are but have been refused that information. Have now called a Manager’s Hearing and explained this to Elizabeth who is in agreement but the Manager of the MHA has not got back to me and Pals are taking along the lines of code of conduct and my delegation of my role of NR.

§  Hospital managers should tell patients about their decision and the reason for them.   They are not giving information and playing on confidentiality and putting Elizabeth under pressure to sign papers but she is sharing information with her family. 

§  Attorney If you find it difficult to make some decisions for yourself, an attorney or deputy can help you. A Lasting Power of attorney is someone who you have said can make certain decisions for you in the future when you do not have capacity to make that decision. You must follow the rules in the Mental Capacity Act 2005 to create a lasting power of attorney. The person you choose is called an attorney.   As Deputies who they want to get rid of,  we are trying to provide everything so that Elizabeth is supported and looked after including a home of her very own.  We are not stopping contact with MH professionals and have not interfered with current treatment but have a letter stating that she was being taken off the drug in the former area and this is not being continued here in Lincolnshire as this has all been disregarded by professionals.

§  Deprivation of Liberty Safeguards (DOLs) Safeguards in the Mental Capacity Act for people who lack capacity are deprived of their liberty. Services have to think about these safeguards if they give you any care or treatment that takes away your freedom.    They tried to put me under safeguarding – I have had to inform my employers and called for a Section 42 meeting that was not granted.    The safeguarding is brought about through “concerns” by nursing staff who are maliciously accusing me of encouraging or stopping treatment which in this case is a depot and in fact all the time I have evidence to the contrary that I did everything to get this continued and in place. I have nothing against safeguarding but this should not be done behind your back as I believe is the case under Lincolnshire Partnership Trust. 

Anyway I did not get a chance to say all I wanted to say as this meeting was disrupted by technical problems.

I am now going to write to my one point of contact in this respect right now.

From: susan bevis
Sent: 31 March 2022 11:58
To: PALS(LPT) (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Jackson, Sophie (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); Twist, Sarah (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST); safeguarding@cqc.org.uk; Enquiries
Subject: FW: HOSPITAL MANAGERS Ward Round Today Please can Elizabeth have her phone back if charging fao ALISON WHITING

Dear Ann

I have requested the Manager’s Hearing and I am still the Nearest Relative.  Whether or not the MHA Team assume I am delegating my role I have not done so yet and will not do so until I have that Manager’s Hearing.

I am not going to be bullied by anyone within the Trust.  

Please advise the date of the Manager’s Hearing just like I requested.

And as for Code of Practice pleased advise why human rights are being breached with regard to Art 8 and Art 3 HRA and Section 26 of the MHA.

I have plenty of concerns I wish to discuss at the Manager’s Hearing and perhaps an inspector from the CQC can be present to witness this.  

 I would therefore like a copy of Lincolnshire Partnership Trust’s Code of Conduct for my records.

Thank you.

Regards

Susan

Sent from Mail for Windows

From: PALS(LPT) (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST)
Sent: 31 March 2022 10:57
To: Susan Bevis
Subject: RE: HOSPITAL MANAGERS Ward Round Today Please can Elizabeth have her phone back if charging fao ALISON WHITING

Hi Mrs bevis

I have checked with the MHA team. They are aware that you are delegating your nearest relative responsibility . Please be assured that the hospital managers hearing is being scheduled in accordance with the code of practice and relevant people will be informed in due course

kind regards

Ann Munro

Patient Experience Lead

Quality and Safety Team email

Lincolnshire Partnership NHS Foundation Trust

Unit 9

The Point

Lion’s Way

East Road

Sleaford

Lincs. NG34 8GG

www.lpft.nhs.uk

facebook/LPFTNHS

Twitter: @LPFTNHS

Dear Dr Shahpasendy

Do you agree that ‘upregulation’ and ‘downregulation’ of dopamine might affect presentation of psychotic symptoms?”  

Please can I have some Section 17 leave so I can take Elizabeth to Kelby Church on Sunday morning.   Please can you increase the 30 x minute twice daily as she would like to see the ducks on the canal.  She might also like to come swimming.  I bought her a new swimming costume by the way.

Please note that as I feel her religious needs are not being met on your ward I have had to notify Georgina Machell, the Reverend in charge of all the churches in the vicinity of Ash Villa and she is more than happy to come and visit.   In fact she has already tried to make contact with Elizabeth but could not get through on the telephone.  Please ensure that the phone is with Elizabeth in her handbag and not in a locker.

I hope you have reconsidered the tests on the Limbic System re your brilliant research as I am sure you will agree this is extremely important and relevant and as a carer’s rep I feel it my duty to tell everyone about your brilliant research so that everyone can benefit.   The whole ward could benefit. 

It is not as if I am against treatment but it is wrong to prevent a proper examination and I am willing to pay whatever for any tests that are needed especially as someone from Lincolnshire Partnership Trust has reported me to the Public Guardianship Office and I am being investigated as an unfit Attorney on Health and Welfare plus as an unfit nearest relative you all want to get rid of when I have no problems with my daughter having the correct treatment.

I am also not happy that the bed is not comfortable, the room is cold and no blankets from outside are allowed, no visiting dogs are allowed –  you have to think that this is not a prison but a hospital and therefore patients should have nice things such as outings like in Lincoln Hospital “The Out and About Club” .   Ms Connery please can you intervene in making sure that the CCG provides everything that is recommended for Ash Villa in terms of funding and what is the point of having empty grounds, a netball court not being used and gardening facility abandoned.

I look forward to your confirmation Ms Connery that you are going to deal with the above as a matter of urgency and also I await your comments, Dr Shahpasandy and to hear about the S17 increased leave entitlement and exactly what stage are you at with the safeguarding against me as I will need to inform my employers.  

Look forward to hearing from you.

Regards

Susan Bevis

One last thing where is all the underwear I bought for Elizabeth?   Has this gone missing?  Does she need to be referred to an i/c nurse?  And where is the third blue blanket?    

MESOCORTICAL PATHWAY

“Elizabeth will feel worse because there is some evidence that she is a poor or non-metaboliser of Clopixol. A few years ago Susan Bevis paid for tests on some the common liver antigens (P450s) responsible for metabolising psychiatric drugs.  You might want to ask her about this.  

If I recall she was deficient in the two main enzymes mentioned below.  This can and often does lead to toxicity and or treatment failure.  So in a nutshell the drug will not treat the psychotic symptoms but can cause poisoning because the patient cannot evacuate the metabolites fast enough.  Dr Shahpesandy definitely knows the pharmacodynamics and pharmacokinetics here.  See page 47 of the attached slides.

In vitro studies suggest zuclopenthixol is metabolised primarily by CYP2D6 and CYP3A4. The clinical study supports this, demonstrating the impact of co-prescribed inhibitors or inducers. Guidelines should incorporate these interactions noting the potential for zuclopenthixol-related toxicity or treatment failure.

“I’ve read reports where there manufacturers tests these drugs on existing patients and ask them if it makes them feel better or worse.

Elizabeth says it makes her feel worse but Dr Shahpesandy isn’t listening.”

On Wed, 30 Mar 2022 at 19:30,

“The mesolimbic pathway is implicated in schizophrenia.  In paranoid schizophrenia fear and anger are magnified and distorted and might cause disruptions in the mesocortical pathways to the frontal lobe causing psychosis.  

Zuclopenthixol Decanoate (Clopixol) is a mesolimbic antagonist* on D2 receptors in the mesolimbic pathway.  Those with poorly expressed CYP2D6 (poor or non-metabolisers) experience significantly attenuated elimination of Clopixol leaving the drug active in the mesocortical pathways for longer an potentiating increased risk of adverse effect .   

*meaning it depresses the activity of dopamine receptors in the mesocortical pathway between the limbic system and the prefrontal cortex.  This is why it is important to know if there is any sign of inflammation or any lesion in those areas of the brain.  An MRI scan will give the first clue and a search for specific antibodies will conform whether there are any lesions or inflammation.  

It is also why it is necessary to determine if a patient is a poor metaboliser of Clopixol. 

Subject: Limbic Inflammation

“Here is a scan showing limbic related inflammation in the temporal region of the brain.

As you can the pale area on the left temporal area of this patient’s skull that part of the brain is inflamed.  That is the part of the brain where the mesolimbic pathways are found.  That inflammation might stop dopamine D2 signalling and affect thought process, especially anger and fear.

Clopixol is a D2 antagonist on that pathway too.  If a patient had an inflammatory condition it will likely affect neurotransmission and the metabolism of this drug.

Dr Shahpesandy is, from what I can see from his research well aware of P450 metabolism and the effect of inflammation and lesions on neurotransmission.  

Do the MRI and follow up with looking for inflammatory markers.  “simples” as Meerkats say.

B”

>
Sent: Thu, 31 Mar 2022 0:06
Subject: On a final note re; Mesocortical pathways

“That’s why the Martin Harrow study is so important.

That’s why patients on long term anti-psychotics have adverse effects on cognition and not improvements.”

Subject: Brain scan indicating inflammation.

 Further to the earlier comments.  The left temporal lobe of this patients brain is inflamed.  Note that the brain crenelations are closed up and the brain tissue is pale on the scan just before the eyes.  

Above this the mesocortical pathways extend to the pre-frontal cortex where our higher and abstract thoughts occur.   Interruptions in neurotransmission can be caused by this inflammation and interestingly some anti-psychotic medications also interfere with D2 (dopamine) receptors in the mesocortical pathway.  

Ask the doctor if he would agree that ‘upregulation’ and ‘downregulation’ of dopamine might affect presentation of psychotic symptoms.  I would be fascinated by the reply. 

If you look at the diagram of the mesocortical pathway from the limbic system to the pre-frontal cortex pathways (in red on attached diagram) you will see them moving forward of the temporal zones.  

Anti-psychotic medications down regulate those neurotransmitters, that is indeed what they are designed to do. 

B”

The court case that did not go ahead as although I did object to S2 I knew how hopeless it is to even comment but without comment or signature on documentation it was wrongfully assumed that I as NR objected to S3. My following comments show why there is a great need for reform under the MHA.

MB AMHP (Claimant) and E Bevis (Defendant) (By her Litigation friend, not yet appointed) In Lincoln County Court in the Matter of the MHA 1983

The litigation Friends were completely and utterly ignored in this matter.

No sooner had we arrived in Lincolnshire my efforts in trying to get a continuation of treatment in the community were failed by the NHS and instead of helping AMHP’s from Gervas House Long Leys Road Lincoln sectioned Elizabeth instead of assisting in getting treatment in the community ongoing for which I am being accused by various professionals of stopping/encouraging her to stop so the emphasis needs to be on what the role of such professionals should be in my opinion instead of bullying and threatening court action against you. As everything I had tried came to nothing, all that was needed was for the treatment to be ongoing – continuation of care and not sectioning lasting months on end and bullying by way of displacement.

The legal documents included a report AMHP by RM (a senior AMHP), First Tier Tribunal Decisions (I was not included in this Tribunal) a clinical assessment and risk framework plus Medical recommendation by Dr Ismail and Dr Turabee and AMHP Margaret Biddles.

This cost £332 to produce the paperwork issued on 20 October 2021.

Does your claim include any issues under the Human Rights Act 1998 and the box ticked in yes – lol! What Human Rights Act are evident under MH? That is a joke as they most certainly do not exist under MH and Lincolnshire Partnership Trust is a good example.

On document A1 there are lies and accusations that I avoided the AHMP with an assumption I disagreed with S3 because I had not agreed to Section 2 which went ahead anyway regardless. We had just moved and all I wanted was for the treatment to be continued in the new area. I had a letter from the former area and discharge note pointing to all physical health conditions. The Clopixol Depot was being reduced slowly and gradually by the former area and all I wanted was for this to be put in place. Paperwork was dated 20 October 2021, Section 2 ended 21 October 2021. Due to pressing time restriction the Claimant files this application to displace the Nearest Relative under Section 29 (3) (c) urgently. By filing the Application under S29 (4) the Act deems the current S3 detention will be automatically extended until such time that this application is finally disposed of by the Court. Statement of Truth is signed by Kyla Bailey Legal Representative of Lincolnshire Legal Services.

We had only just moved, had poor internet connection, we could not move into the house straight away as services not up and running. Despite this all I made every effort to get treatment in place and if this had been done there would have been no need for sectioning.

They turned up at the house unannounced so I was told but I in the shower, was already late and had to rush out to college. I did not know they were coming. They assumed I was avoiding them and that I disagreed with Section 3 and so immediately instructed their legal team to take action at a cost of £332 (court fee deducted from their PBA Account) Instead of sending the S3 papers by email or post, Had I have received them miscommunication and false assumptions would have been avoided. Their behaviour amounted to harrassment even hanging around and watching the house and noting a car had left. I had to be in college by a certain time and their visit was unnanounced. Instead of taking such heavy handed approach surely their role should be one of caring but sadly it is not. I cannot see any compassion in these people from shocking past experience of a previous area but so hoped that in the new area things would be better.

CHARLESWORTH WARD LINCOLN HOSPITAL SAFEGUARDING CONCERNS TOWARDS MOTHER SUSAN BEVIS Dr Ismail RC

After waiting in A&E Lough virtually all night to see a Doctor who failed to arrive eventually an ambulance came. I was told I could not accompany Elizabeth – they just took her away and sectioned her without any regard to the efforts I had made in just trying to get necessary treatment up and running in the community like before. Our move had turned into a disaster. I was advised by an expert to call 111 who advised A&E but instead of necessary help so that Elizabeth could have returned home immediately she was sectioned and it was obviously too complicated for the NHS to provide continuity of care in the new area. It was devastating, they just took her away, refused me accompanying her and then made her subject to yet more torture on locked acute wards but if they had read the notes properly they would have seen the discharge note and letter from former area detailing the reduction plan off the clopixol depot by the CMHRT RC.

Elizabeth sectioned to Charlesworth Ward Lincoln whose nursing staff accused me of all kinds of things ranging from neglect, incapabilities and psychologically controlling/abusing my daughter. As a carers rep who has a DBS I had to notify certain others that I was under safeguarding and they offered me support. I called for a S42 but this was never forthcoming then was told that the safeguarding had been dropped as I complained about this. The court bundle amounted to many pages but I am only going to feature some of it to reveal what is going on that I feel needs to be changed in the current system not fit for purpose.

On C1 of the court papers several errors: My daughter’s name spelt wrongly and GP Surgery completely wrong. It is bad for such errors to appear in court papers which should be accurate. More mistakes on P2 of 10 C2, name spelt wrongly and false reporting that she tried to commit suicide two days prior to sectioning which would have been whilst staying with me at a local guest house for which we had no end of witnesses. Even more errors appear on C3 3 of 10 “In Enfield she was supported by a range of services and lived in supported accommodation. That is not true in the slightest bit. There was not a scrap of care in place in Enfield apart from the fortnightly depot which was being reduced and she was not living in supported accommodation but an independent flat. I have been labelled as someone coercive and controlling towards my daughter and that I repeatedly phoned MH Liaison to find out the situation which is far from true. If this Hannah mentioned is the duty worker from former area of ECRHT who recommended the MHA assessment she is well known to us as a family and in the files reported in the most nasty and shocking manner then ENFIELD COMMUNITY REHAB TEAM tried to force return Elizabeth to Phoenix House Care Home by depriving her with drugs in our local area for four days. I kept an accurate diary of everything and took Elizabeth to Harley Street. Hannah would have been one of the AMHPs who came to the family home reporting nastily for the purposes of CoP.

Elizabeth was 6 days without the depot in the new area when I desperately sought help as I did not want her to go downhill but instead we got bullied again.

Documented in these court papers Elizabeth had explained she was Autistic and needed someone to talk to like a psychologist but all they thought about was medication but having said that, only a continuation of treatment as before was needed which was being reduced down anyway by our former area. The letter detailing that was given to the GP and MH services. Elizabeth stated she was not mentally ill and that her problems were physical – she is correct. Elizabeth also said she had been misdiagnosed in the past.

I am accused under C7 that I am “unable to see the inconsistency of requiring a depot if she believes Elizabeth has no MH problems.” I would comment that I tried to get the drugs up and running but her discharge note pointed to abnormalities on a scan twice and CNS Central Nervous System. No mention of mental illness so wanted this to be looked into.

The Report was written by Senior practitioner Robert Mansfield of Adult Emergency Duty Team and concludes that there was no viable alternative to an admission to restart her medication – well if this was so then now what excuse is there to this day then that still nothing in the community provided to continue this treatment as in the former area???

EXTRACTS FROM THE FIRST TIER TRIBUNAL REPORT “The patient shall not be discharged from liability to be detained. Featuring evidence from Dr Ismail RC, Nurse A Skelton and Ms Awosanya.

I was accused of weaning Elizabeth off Aripiprazole and this is not correct. This is a blatent lie.

They cut and past reports from previous area full of inaccuracy and lies. the subject of a family complaint where nothing had been done to make relevant corrections.

Most disturbing is the allegation that Elizabeth tried to take her life which would have been whilst in my company two days prior to admission. That is an absolute lie. It then goes on to say there were witnesses but they were not able to tell us what that attempt involved. Why put such blatent lies in court papers?

We were booked in a lovely little guest house just around the corner where Elizabeth was fascinated by the birds and animals therein. Elizabeth was happy and looking forward to a fresh start as I was after years of bullying under Enfield. We can soon verify such lies.

The report continues stating she was expressing ideas of suicide when Elizabeth was truly happy to have moved and to be starting afresh. The report says she wants to return living with her mother that she has the physical condition of PCOS and neurological condition of autism and has balance problems. She agreed to accept visits by a new MH team in the community but preferred tablet form to depot

One nurse who failed to comment in the same negative mannerism, Ms Awosanya, refused to express agreement about the need for detention. Well maybe Ms Awosanya observed things in the correct manner unlike everyone else but was criticised for her differing views.

The tribunal decision concluded the patient has a mental disorder and that the RC’s evidence was not contradicted by any other evidence – pity as if I had been invited I would have provided abundance of such evidence by way of file paperwork/reports. They then state Elizabeth lacked insight labelling her condition to be a disorder and blaming – “mother’s attitude to be cause of exacerbation of her disorder”. Also mentioned was a severe physical health condition (IC) that Elizabeth was noticed to have at this acute dormitory-style ward.

Nurse Skelton’s evidence:

Nurse Skelton commented on diet and that on her shift there was an occasion where Elizabeth had several takeaways in addition to hospital food for which I was blamed. I telephoned Nurse Skelton who denied writing any of this and she blamed admin staff for notes under her name. Nurse Skelton had stated “on one occasion several takeaways turned up” however none of them came from me but this shows Elizabeth has capacity to order what she wants as I had refused to buy a takeaway stating only one a week was allowed on that ward. Elizabeth managed to get the takeaways through others. As usual I was blamed. Nurse Skelton assumed wrongly that her dietary concerns towards me would continue with risk to Elizabeth’s physical health if allowed in my company (IF SHE WERE NOT DETAINED) and in the community. Well this shows lack of insight and wrong assumptions on her part. When I phoned she completely denied writing such comments so who did in that case? They are done to discredit you and portray you in a detrimental light to the court in other words making out you are unfit as a mother which is really nasty. Who would think I would be reading these defamatory comments against me in the tribunal papers prepared by “professionals” for a tribunal I was not even included in. Also, because of Elizabeth’s physical health condition associated as a side effect of the current prescribed drugs (IC) that by releasing her from section this condition warranted nursing care and support. Well that doesn’t bother me as I did this all for my father with Alzheimers previously and he lived in the community for many years but died as a result of care meant for respite. Even more false allegations about the attempted suicide which would have been in my company prior to admission – what a pack of lies! Another reason or rather excuse for non-release was safety concerns and inadequacy of mother in addressing anything mentioned above whether it be diet, IC, my whole personality slated by strangers including this nurse that Elizabeth would be risk to family and healthcare workers. If Nurse Skelton or whoever wrote these notes bothered to look into matters properly they would have seen that Elizabeth was released into the community without being on any section and was compliant with medication and living in independent flat in the community without a scrap of support apart from that given by her mother who used to visit every single day on her own. They simply haven’t got a clue and just write assuming things and if only there was something good in this area like Open Dialogue, none of these assumptions, allegations and false reporting would be evident in court papers. It makes me sick the constant mention of lack of insight towards Elizabeth and myself when it is the professionals themselves who lack insight and have no understanding into LD or autism or in communication

They wanted to carry out DASH assessments when I have no concerns. Obviously I sought help in getting treatment continued and realise that someone can go downhill if a steep reduction which is nothing to do with a relapse of mental illness but withdrawal syndrome. It states she was happy in the dormitory accommodation but only with a couple of people sharing. However they had to move her from one end of the dormitory accommodation to the other and then put her in a side room so that was not the case. She could not stand the noise and has sensory issues. She then expressed her wish to come home to Dr Ismail.

Then the report goes on to say “unkempt, hair unwashed, clothes unwashed and dirty, poor insight, fixated stare – answered questions with one word – quiet and reserved and presented as agitated and frustrated with questions being asked.

I am saddened at reading what these so called professionals have presented before a court by copying and pasting reports and alleged incidents from former area going as far back as 2008, all of this done to discredit both patient and relative and ensure that someone is detained in hospital for a long time and punished in this way.

It says in 2008 she broke a window with a chair – pack of lies.

Numerous criticism of inappropriate behaviour going back to 2008

They report she was charged with GBH – another pack of lies. No she wasn’t.

Caused extensive damage to a caravan – ANOTHER PACK OF LIES LINCOLNSHIRE PARTNERSHIP TRUST.

Offence of rape – I am finding it hard not to use inappropriate language on this blog as this is getting worse. What a lie!

Jumped over a desk at her GP Surgery. Oh no she did not – she pulled the phones out of their sockets and did not cause extensive damage as when I called to offer to pay I was told there was no damage. Elizabeth wanted an MRI scan in an open scanner and it was the height of lockdown. I was trying to sort this out privately for her myself at the time.

They have dug out every bit of dirt to discredit myself/my daughter to make us out to be bad and inadequate, none of the alleged events documented correctly – many either did not occur or are blown out of all proportion to justify longer detention and make someone look like some inhumane monster when those who are in such profession should be kind, caring and compassionate are clearly not so from what I have just read.

Under Lincoln Hospital’s facility we had little contact with Elizabeth except for a couple of visits supervised, only 2 x 30 minutes escorted leave given to Elizabeth in noisy unsuitable environment.

Oh my God they have not finished yet – the report goes on to describe other very nasty things and she has never been suicidal except felt that way whilst under the so called “care” of an inpatient setting where it was so unbearably noisy Elizabeth said she was so distressed she tried to gouge her eyes out.

The facility at Lincoln Hospital is not fit for purpose for someone who has sensory issues. They had to move her to a side ward.

They say she has a previous diagnosis of schizophrenia.

The meaning of the word “Abuse” to my daughter is the refusal of a takeaway or it could be a simple disagreement but professionals blow things out of all proportion leading to safeguarding which I personally would welcome. I believe safeguarding to be in progress at Ash Villa going on behind my back as this would explain the very restrictive current visiting rights and that is why it is important to investigate holding a Section 42 meeting which I have requested many times. What is so bad is the safeguarding is going on in secret behind my back so I believe. I too have safeguarding issues myself so all such issues should be discussed at a S42 meeting. Throughout the report Elizabeth states she wanted to come home but this has just not been listened to and we have witnessed the worst restrictive treatment and breach in human rights ever encountered under Lincolnshire Partnership Trust.

Nurse Skelton’s Referral Details

Hostage taking and stalking – what a pack of lies!

Under Section 2 she was forcibly restrained and administered with depot. “Doctor thought this was best”.

Copying and pasting of reports going back to 2003???? drowning in the sink ????? Oh come on now!

Incidents completely wrongly reported and discrepancies in line with dates – just copying and pasting erroneous records from former area’s notes without checking for accuracy.

On page C34 last para completely wrongly reported and was not charged – please get things right before presenting absolute rubbish before the court.

More rubbish on Page C35.

She did call emergency services and thought the Police were her friends and the ambulance drivers and crew. She used to sing and play her guitar to the Police and ambulance drivers who I would thoroughly commend for their kindness, understanding and compassion unlike brutal MH professionals. She kept phoning them as she was lonely and had nothing to do in the community – nothing was provided.

The relationship between us is not volatile but there wereproblems when Elizabeth stopped the drugs “cold turkey” and so I would agree that a slow gradual reduction plan is therefore necessary but the problem is the NHS have never helped with such reduction plan prior to most recently in the former local area.

Having read nasty vile comments from various professionals who do not know us I want to say in defence of my daughter she loves animals, she is fascinated by pigeons in particular. She has received the most apalling treatment under the NHS and been sent to some absolutely dreadful places. It is no wonder she has complex PTSD and traumatised. She has suffered extensive abuse but none of this appears in any of these court papers other than intent to cowardly portraying us both in the most nasty manner you can imagine. We moved to try to provide the right environment but instead of help to get treatment ongoing we were faced with bullying yet again. I wish now I had sought private help instead of turn to the brutal NHS.

Charlesworth Ward had Safeguarding concerns regarding me as Mother.

Seems like Ash Villa also have Safeguarding Concerns.

Well I too have safeguarding concerns about my daughter and I have reported these to Adult Social Services yesterday.

I never even commented regarding S3 but they assumed objection and went for me by displacement of nearest relative and my blog documents the rubbish and lies produced before a court when such professionals think it best interest to get rid of the nearest relative without even obtaining proof of objection officially in writing. They assumed that I would object so just went for displacement. The abuse allegations were no doubt because I refused to buy a takeaway yet this is what I am being accused of by Nurse Skelton or whoever wrote those comments. Elizabeth said she would be reporting me for the refusal but showed full capacity in managing to get three takeaways in one day for which I was blamed.

Included in all this paperwork amounting to about 50 pages is a copy of the MHA 1983 “Compulsory Admission to Hospital and Guardianship Procedure for Hospital admission”. Sadly the law is supposed to protect vulnerable people like my daughter but it is not protecting them at all and with Corona Virus human rights have vanished and there is even more abuse going on behind closed doors.

I have received a letter amongst this paperwork from Legal Services Lincolnshire County Offices Newland Lincoln LN1 1YS. It says “as NR you had the ability to sign the papers for that second detention which would be under S3 of the MHA and would allow her to remain in hospital for up to 6 months”. Well actually I didn’t because the papers were not left or put through my letter box or sent by email or post.

“You have reasons to object to the continued detention of Elizabeth as you do not believe she has a mental health illness. I understand you have expressed your objection to Section 3 and have exercised your right as NR to make that objection.” No again because I did not receive any paperwork to object to S3 in order that I could either way make a decision as NR so do NOT make any assumptions therefore. The mental health illness my daughter has is trauma (complex PTSD) from years of abuse not by myself or her family but by professionals and others and she was a rape victim under care said to be consensual. This has only just been recognised because I obtained the files from Elysium. Yes you are right there are substantial underlying physical health problems that are not a figment of my imagination but fact and again I have the files to prove this as I had private tests done by doctors.

“As a result the legal position is that the approved mental health practitioner decided to instruct the legal team at the Lincolnshire Council Council (me) to file an application to the local Court asking for you to be displaced as the Nearest Relative for Elizabeth and to name the local authority (Lincolnshire County Council) as the nearest relative in place of yourself. ” So why did you not look into matters properly and see that in 2017 there was a case at Royal Courts of Justice where I represented myself. It was decided that it was a CONFLICT OF INTEREST FOR THE LOCAL AUTHORITY TO BE THE NEAREST RELATIVE. I was complimented by the Judge by the vast amount of evidence I gave to show how the Local Authority nominated NR who had tried to say that the rape and abuse of my daughter under Moti Villa was consensual WOULD NOT MAKE A GOOD NEAREST RELATIVE and when I saw who it was and had read all her nasty comments about me I decided to write corrections to everything and represent myself in court. There was so many mistakes in the court papers I had to re-do the reports to the County Court from the AMHP from scratch, correct everything before I even got started on my own reports. I did a good job of it to the point that Solicitors representing them could not tell the reports apart from their own due to me even copying their logo. The first Hearing took place without me, as I was given the wrong court details but I had the best experience of all meeting Lady Justice Roberts who went out of her way to help me as nothing was listed and I was not given the information correctly so a second hearing took place. The Judge quite rightly said he would like to meet Elizabeth to hear her views. It is a pity that AMHPS do not listen and treat vulnerable people, their carers and family with respect. instead they act in an intimidating threatening manner. An independent capacity assessment followed by a wonderful psychiatrist who confirmed Elizabeth had capacity. I only backed out when threatened with £5000 by Enfield’s Legal Services for their costs. However I enjoyed the experience of representing myself in court and exposing inaccuracies and lies in the reports. As you can see it is very wrong of you to replace me with someone from the Local Authority due to conflict of interest.

By doing this and filing the application papers at the Court which we have done on 20 October 2021 this then gave the hospital legal powers to continue to treat Elizabeth under S2 MHA and keep her safe

Safe???? What safety – to put someone on a dormitory not fit for purpose ward who has sensory issues is FAR FROM SAFE isn’t it!

I am not going to feature this all but the letter addressed to me is from Kyla Bailey (Lawyer) For Legal Services Lincolnshire. My daughter – first defendant, myself noted as second defendant. This is not the first time I have had to read such painful comments amounting to bullying and the reason staff play on confidentiality is to conceal what they write about you behind your back all geared to failing court hearings. This is just one example.

I have previously said I did not want a battle against professionals in the new area and hoped we could start again afresh but this has not been possible. To begin with I was impressed with the carers network. I liked the people here in my area which still stands but I was hoping that we would be looked upon afresh and not judged by file notes originating from the former area.

In the former area they were just starting to take her physical health seriously and there were no end of physical health appointments arranged.

Unfortunately now stuck on a MH ward physical health is disregarded even when you discover the most wonderful research done by none other than the doctor in charge this is denied. Physical health under MH in Lincolnshire Partnership Trust is denied in terms of a patient having appointments and not being allowed to attend.

Only observations are relied upon not scans which are considered irrelevant even when it is stated “abnormal findings on a scan” twice. I have even offered to pay for such scans.

As for the AHMP department I am totally disappointed. I am not even asking for anything provided except for the very basics and that is for her “treatment” of the depot to be continued as it was in the former area taking note that it was being reduced. What is so unreasonable in that and why spend hundreds and thousands of pounds of public money on taking people like me to court and slagging them off behind their backs treating them like criminals.

Lincolnshire County Council “Working for a better future”

A better future can only be obtained if there is honesty and transparency along with compassion – Open Dialogue is first and foremost the only answer towards working for a better future.

12th February2022  –  My Account of Events

“It is evil to keep her from seeing her Mother on her Birthday”

I drove for over an hour to visit my daughter on her Birthday.  Two hours leave had been granted by RC  HMS just to go into Sleaford but then I received calls from ZB (Carer’s Champion) advising me not to come but the day before my visit I had numerous text messages from Elizabeth instructing me on what Birthday cake she would like.   I had this made specially so I felt I ought to go even though I was told due to Covid I could not visit on the ward and this I did not challenge or act aggressively when advised.  I did feel as though it was never really the intention to allow her out and spend time with me with me alone for any length of time and I was correct.    I arrived at Ash Villa and rang the front doorbell.  I handed the cake to staff and I was told Elizabeth could not come out even for five minutes to see me and most disturbingly she did not want to speak to me.  I was very concerned as this is out of character and it was as though something had upset her.

I spent the day in Sleaford and decided to call back to the ward later on   I was met with dismissive behaviour by ZB stating that nothing had changed – Elizabth still did not want to speak to me or see me on her Birthday which was really strange as she was excited about my visit the day before but most concerning of all was that no one (either family or friends) could get through to Elizabeth.  She either did not have her phone with her or else the phone battery was dead.  Whatis more no-one could get through from the family/friends for several days thereafter which was really distressing especially as there was supposed to be covid on the ward.    I went back to the car as all I wanted to do was to hand her the presents for just 2 minutes which I did not just want to leave with staff.    Not even two minutes was she allowed to come out.

I then went back to the front door and rang the bell and said I would wait in the car park as I wanted to hand the presents and then leave –  when I did this I was threatened with Police and said they had called Police on me who were on their way.  When the Police arrived at the ward  I had moved my car elsewhere.  I could not believe their actions to waste Police time in this manner.     I was not constantly knocking on the ward door, swearing, or threatening staff – far from it.  Obviously I was upset but not acting in an intimidating manner apart from saying I would stay in my car all night and then just hand the presents when she felt better.   I had moved my car.

I then called the Police as I was worried about my daughter’s welfare and asked them to do a welfare check on her but they were not allowed in –  there was supposed to be covid on the ward, the excuse for a ban on visits.

What was so concerning was that it was at least four days later that anyone from the family could get through to Elizabeth who claimed she was not feeling very well on her Birthday but still all of this was out of character not to hear from her for around four days and everyone was so concerned and all we got was excuses that she did not want to speak to anyone.   When finally I got to speak to Elizabeth she did not even know I had brought her a card and presents.  They had just been dumped in a locker room like rubbish.     I then complained about this to Sabrina, deputy ward manager, who told me that Elizabeth never asked for the presents but how could she when she would not have known about them.  It was very upsetting and I got the phone slammed down on me which has not been the first time.  

It is justified under Ash Villa (Lincolnshire Partnership Trust) that staff should put the phone down when they see fit and that there is only one point of contact under Ash Villa but you cannot even get through on the ward phone at times which points to staff shortages.

Further to the above:

Elizabeth was advised by a nurse that the tests had already been done on the Limbic System but this is clearly not true. No tests have been carried out and yet Elizabeth must have asked regarding such tests. They are obviously being denied to her so I have written to all her advocates. This points to discrimination and denial of a vulnerable patient’s wishes. Elizabeth told me she had asked re the tests. This hospital Ash Villa could not care less and the examples below are all related to how a parent/carer is treated and if this is how a parent/carer is treated if they dare to challenge in any tiny way what is going on which is clearly in breach of human rights and MHA law then this is clearly a safeguarding issue and I have requested this to be looked into by Adults Social Services. I am only too happy for safeguarding to be done on me but in this case I think there needs to be a Section 42 meeting as there is clearly breach of the law on their part.

From ZB
Sent: 29 March 2022 11:06
To: susan bevis
Subject: RE: THE BOLITHO CASE

Good morning Susan

Thank you for your emails.

Whilst I understand your frustration having been advised we could do the tests unfortunately Elizabeth has not given the doctors consent to the bloods to be taken.
I’m sure you can appreciate that the doctors need the consent from Elizabeth directly.

As for Dr Shahpesandy study this is something you can discuss with him further on Friday when you have your meeting.

As far as I am aware No section 17 will be granted for leave to see the ducks and swimming, again this is something you can speak with Dr Shahpesandy about on Friday.

I will ask Elizabeth about her underwear and if she has enough and feed back to you.

Kind regards

Z B
Carer Champion
Ash Villa
Sleaford
NG34 8QA

From: susan bevis

Sent: 29 March 2022 10:34
To: ZB
Subject: THE BOLITHO CASE

Dear Zoe

If it is not possible for Elizabeth to take part in the study on Limbic system please can you enquire via Dr Shahpesandy as to how he managed to do the study on the 51 year old admitted with acute psychosis who turned out to have inflammation in the temporal zones caused by some problem in the Limbic system.

I am just querying this as it has come to my attention he too had been put on Clopixol for his psychotic symptoms that were in fact as a result of the inflammation of the brain – please note the Bolitho Case.

I would like to confirm with you as to whether S17 leave can be granted to show Lynsey the canal with all the ducks and birds or maybe to come swimming. If not please supply the reason for his concerns regarding me under S26 MHA.

I bought Elizabeth some more underwear. Elizabeth says staff have taken the this away and I am wondering if this has been thrown away or has this been handed back to her. I am entitled to know because I bought the underwear and would need to know so that I can supply more.

Also I have not heard anything from sophie and Sarah from the MHA Office regarding the Manager’s Hearing. Please advise when this is. I am having to copy in others as this is most relevant and they need to be informed about the Manager’s Hearing.

Regards

Susan Bevis
Mother, Nearest Relative, POA and McKenzie friend

From ZB

Sent: Thursday, March 24, 2022 11:24:15 AM
To: susan bevis <
Subject: RE: Elizabeth’s PHONE

Hi Susan

I have just spoken to the doctor and he has advised that No section 17 leave off hospital grounds will be granted at this time.

Kind regards

ZB

Carer Champion

Ash Villa

Sleaford

NG34 8QA

From: susan bevis
Sent: 24 March 2022 10:34
To: ZB
Subject: Re: ELIZABETH’S PHONE

Dear Z

Phone cut out reception not good here.

My main question is can Elizabeth have some leave?

Regards

Susan Bevis

Get Outlook for iOS

From: ZB

Sent: Tuesday, March 22, 2022 11:46:19 AM
To: susan bevis <
Subject: RE: Elizabeth’s PHONE

Hi Susan

As advised I have spoken to Elizabeth and her wishes was for the phone to stay in the locker.

If at any time Elizabeth changes her mind staff will facilitate.

Kind regards

ZB

Carer Champion

Ash Villa

Sleaford

NG34 8QA

From: susan bevis <

 Sent: 22 March 2022 11:40
To: ZB

Subject: RE:  Elizabeth’s PHONE

Hi Z

Please pass the phone to my daughter and say that her family wish to speak to her to wish her good luck for today.

Thank you.

Regards

Susan Bevis

Sent from Mail for Windows

From: ZB

To: susan bevis
Subject: RE: Elizabeth’s PHONE

Good morning susan

I have been down to see Elizabeth and her phone is in her locker.

I have been to Elizabeth and asked if she would like it and she asked that I Leave it in the locker.

If you need anything else don’t hesitate to let me know.

Carer Champion

Ash Villa

Sleaford

NG34 8QA

From: susan bevis < Sent: 22 March 2022 09:40
To: ZB

Subject: Elizabeth’s PHONE

Dear Z

I cannot get through to Elizabeth on the phone and wondered if  Elizabeth had her phone with her or if it is in the office.    She may well be asleep.  I wanted to wish her good luck for the Tribunal.   Whilst there have been times that Elizabeth has wished for my attendance this has not been allowed but nonetheless if I am excluded from the Tribunal I would like to wish her all the best for this afternoon.

Elizabeth told me on Sunday that she was prepared to take the drug Clopixol and engage with the MH team so hopefully this will go well.   There were no problems previously in the former area and she was discharged without CTO and took the depot without problems but this time instead of a noisy flat where murders occurred in the immediate vicinity I am providing the right environment.

As you can appreciate we pay for a contract on her phone and we need to know she has her phone with her and to hear from her personally that she is well not third party.

I look forward to hearing from you prior to the Tribunal today with the link or explanation why I have been excluded which would be against Elizabeth’s wishes as per my visit on Sunday.

Regards

Susan Bevis  

SPECIAL DELIVERY

LETTER FROM ALISON BARTLE

WARD MANAGER

Adult Inpatient   Ash Villa

Willoughby Road   Greylees

SLEAFORD    Lincs

NG34 8QA

AIP/AB/LJCA

10 March 2022

Dear Mrs Bevis

I am aware there has been some challenges with visits and contact with your daughter and following consultation with the multi disciplinary team I am writing to you to outline our concerns and expectations.  I am referring specifically to your rudeness on the phones and the rudeness and intimidation whilst on site at AshVilla.

This Trust is firmly of the view that anyone working in or being treated on our wards does not have to be subject to or witness to rude or intimidating behaviour.  You may be aware that on three separate occasions staff have considered your behaviour to be so rude or intimidating.  This has resulted in Police having been notified.  Whilst I understand having a family member in a health care setting is stressful to act in the manner you have is unacceptable therefore I must ask you to stop any rudeness or intimidating behaviour in the future.

In addition to this request my staff have been instructed to terminate any calls they receive when the caller is rude or abusive and to call the Police if they consider there is a breech of the peace or other such behaviours in the grounds of Ash Villa.

I would also like to advise you that any planned outings with your daughter will have to be pre-approved and agreed prior to the outing taking place.  This would require section 17 leave to be approved by the Responsible Clinician.

Visits to the ward can be planned and limited to one hour due to Covid visiting restrictions, these should be booked in advance, staff will be present outside of the visiting room and if your behaviour is rude or intimidating you will be asked to leave.

I understand it must be difficult to receive this letter, but I do hope you acknowledge it and manage your behaviours better in the future.  If you think our services or responses fall short of your expectations you can of course complain to the Trust using the following address:

Patient Experience Team

Lincolnshire Partnership NHSD Foundation Trust

Unit 9   The Point

Lions Way

Sleaford  Lincs   NG34 8GG

Chair:  Paul Devlin

Chief Executive Brendan Hayes

http://www.lpft.nhs.uk

A WITNESS TO MY CALLS ALLEGED TO BE ABUSIVE

From: Gh < @gmail.com>
Date: 14 March 2022 at 11:27:58 GMT
To: alison.bartle1@nhs.net
Cc: lpft.patientexperience@nhs.net
Subject: Letter from Alison Bartle to Susan Bevis

I have read the letter from yourself to Susan Bevis and would totally refute the allegations of rudeness or threatening behaviour by Susan Bevis.
I myself have witnessed such calls as I have been in the same room as Susan makes the calls.   I am also aware of the awful occasion on Elizabeth’s birthday and having spoken to her direct how she was looking forward to receiving her birthday cake.

Several friends and family in addition to myself spoke to Elizabeth prior to her birthday and were given the same impression. It seems to have been out of character for her to not want contact.

I am witness to Elizabeth’s care over many years and have to say this has been the most restrictive to date.

In every ward round interview Elizabeth has been asked where she wants to live. She constantly says she wants to come home. We are working on providing her own safe self contained and peaceful accommodation. No way should she still be kept at Ash Villa but staff should be working towards providing care in the community.
I wish this email to be included in any complaints procedures as I would back Susan Bevis in stating that no threats have been made against members of staff, and that current restrictions are wrong, unhelpful and a backward step in Elizabeth’s care. Indeed I would say that both myself and family members have stated that it has been staff that have been rude and dismissive. Have staff been told not to give information, perhaps they are bullied by senior staff.

When we initially moved to Lincolnshire, Susan did all in her power to put medication injections in place for her care to continue. This included notifying the new GP and a trip to A&E even contacting a pharmaceutical professor at Lincoln university to see if he could help.

The ward round recently appeared to be a deliberate attempt to stop us attending.
A reply to this email is not required but please ensure it is included in any complaints procedure.

GH


Subject: Re: Limbic system update

“Elizabeth does have capacity to consent to those tests.  I am a senior lecturer in medical ethics and law and since this study is to determine possible treatments for Elizabeth it is perfectly OK to carry them out.

I would have hoped that medical practitioners would have known that.”

—–Original Message—–
From: susan bevis

To: ZB  (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST)
Sent: Mon, 28 Mar 2022 19:05
Subject: Limbic system update

Hi Z

Are you trying to say that my daughter has no capacity?

Where is the study being done and who do I contact to get the necessary forms?

Elizabeth has agreed, witnessed by more than one family member.

I look forward to receiving the necessary forms.  The tests are very important I am sure you will agree and this has already been agreed by Dr HMS in any case.  His important research needs to be widely publicised and I have proof she has already agreed.  The more people who know about his research the better as this could widely benefit more than my daughter.

The entire family are witnesses to this consent in any case.  

Regards

Susan Bevis

NEAREST RELATIVE, POA, MCKENZIE FRIEND AND MOTHER

Sent from Mail for Windows

From: ZB (LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST)
Sent: 28 March 2022 17:35
To: susan bevis
Subject: Limbic system update

Afternoon susan

I have spoken with Dr HMS and the bloods that need to be taken for the Limbic system are not able to be Done as it’s as part of a study, and the study requirements stipulate that the patient must have capacity to consent to have those particular bloods taken.

Kind regards

Z B

Carer Champion

Ash Villa

Sleaford

NG34 8QA


From: b

Sent: 20 March 2022 15:44
To: susanb

Subject: The Limbic System

All the doctor has to do is repeat the tests he did on the other patient.  It was his research for god’s sake he should not need it explaining!

If it was not possible for a psychiatric patient to take part in a ‘study’ you might want to ask Z how Dr Shahpesandy managed to do the study on the 51 year old admitted with acute psychosis who turned out to have inflammation in the temporal zones cause by some problem in the Limbic system.

Upon admission he too had been put on Clopixol for his psychotic symptoms that were in fact a result of the inflammation in the brain.  

It is hardly ‘responsible’ to ignore a possible cause or diagnosis.  If physical symptoms are being ignored he needs to be reminded of clinical negligence and the case of Bolitho.  

Subject: Anti-voltage-gated potassium channel complex antibody–mediated limbic encephalitis: a case report of a 53-year-old man admitted to intensive care psychiatric unit with psychotic mania

  1. Homayun Shahpesandy1
  2. Rosemary Mohammed-Ali1
  3. Ahmed Oladosu2
  4. Tarik Al-Kubaisy3
  5. Moses Anene4 and 
  6. Umesh Sira Ramaiah5
  7. Correspondence to Dr Homayun Shahpesandy; homayun.shahpesandy@nhs.net

 zuclopenthixol deaconate (600 mg/weekly)

On further assessment, cognitive decline and severe short-term memory were noted; Addenbrooke’s Cognitive 55/100. CT, EEG and lumbar puncture were normal; however, MRI on 29 November 2017 demonstrated bilateral high signal around the temporal horn and diffusion abnormality, suggestive of encephalitis. Consequently, the patient was transferred to medical ward and zuclopenthixol decanoate was stopped.

https://gpsych.bmj.com/content/33/4/e100196

I have been reading follow ups to Dr HMS’s interesting observations on damage to the limbic system.  It is very strange that he acknowledges that inflammation or lesions in this part of the brain can and do cause psychiatric disorders but does not want to investigate this in Elizabeth’s case.

Since the psychotic episodes experienced by Elizabeth are characterised by anger and fear and clearly from the photographs there are comorbid endocrinal problems associated with her illness, damage to limbic structures could be responsible for both.  It is of course possible that the endocrinal problems are caused by ADR’s to the drugs she is medicated with.    

The limbic system is the part of the brain where emotions are controlled (or not as the case might be in psychosis)   Emotional responses to stimuli are triggered in the Limbic Structures such as the hippocampus and the amygdala.  Lesions or inflammation here would be likely to cause a marked and even severe display of exaggerated anger fear or both.  Dr HMS commented on this in his joint paper on neuropsychiatry so it is not as though he is unaware of the research.  An MRI scan would indicate this an it could be backed up by a serum antibody test for any type of antibody affecting inflammation or lesion healing in brain tissue. 

In the severest form of PTSD or disorder of extreme stress, known as Selyes Generalised Adaptational Syndrome serious endocrinal and neurological symptoms are observed and the syndrome can cause permanent damage.   

Researchers are examining the possibility of treatments directed at the limbic system for the treatment of acute anxiety disorders.  The fact that new neurons are made in the limbic system indicates that stimulating such growth might offer a possible treatment for number of psychiatric disorders.  

I am now going to suggest this as a research topic at my pharmacy school for the next academic years research students starting in October.  

From:  b

Dr HMS had an interesting case in 2017 when a man was admitted to the psychiatric intensive care unit.  The patient presented, following almost a 2-month deterioration of his mental health with physically aggressive behaviour, elevated mood, paranoid-persecutory and grandiose delusions. Prior to his admission, he assaulted one of his neighbours. He presented with pressured speech and flights of ideas. He believed he had contact with politicians, including heads of states and powerful individuals. No cognitive deficit, no neurological symptoms.

After tests which included an MRI scan it was determined that the man did not have an underlying  psychiatric disorder and that his psychosis was induced by encephalitis around the temporal horn.  Further examination indicated the presence of anti-VGKC antibodies in the serum.  

He had been treated with zuclopenthixol decanoate for the psychosis and on detection of the inflammatory condition in the temporal lobe area of the brain it was terminated.  Inflammation in the temporal horn can cause disruption to the limbic system which can result in presentation of psychotic symptoms.  Here are Dr HMS’ and his colleagues actual words used in the paper.

“Disruption of limbic structures has huge clinical implications and is presented with a variety of neuropsychiatric disorders including epilepsy, dementia, anxiety and mood disorders, schizophrenia as well as attention deficit and hyperactivity disorder”

I have encountered this before.  A few years ago a woman presented with acute psychosis.  The psychiatrist did not read he complete medical notes and proceeded to administer a range of neuroleptic medications. Had she read the notes she would have seen that the patient had undergone surgery on her thyroid and it was clear that damage to the parathyroid had occurred during this intervention.  

Damage to the parathyroid is commonly associated with psychosis.  

Dr HMS’ patient made a full recovery after the Clopixol was stopped and anti-inflammatory and anti-seizure medication was used to treat the encephalopathy and temporal lobe seizures.

The patient in the second case also fully recovered from the psychosis after the psychiatric medication was stopped and appropriate treatment for the endocrine (thyroid) disorder was prescribed    

It always pays to investigate whether the psychosis is induced by lesions or infections especially of an inflammatory variety.  Dr HMS went to great lengths to investigate his patients psychosis including EEG, CT and MRI scans as well as lumbar fluid.  

Dr HMS has written research papers on neuropsychology that indicate he is positive about carrying out brain scans to detect lesions and or neurological causes of psychotic disorders.  I just read one where he discovered that the patient had a limbic encephalitis and that it was that physical brain disorder that was causing the psychosis. 

Therefore it seems odd that he would block Elizabeth from getting a scan since his research indicates he is in favour of carrying them out.  

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