Arrested

So after a week-end of M being sometimes angry and very wound up and sometimes very happy and easy, me constantly trying to judge how to intervene, whether to intervene, what to say.  This was a three day week-end due to a bank holiday - so a long one.  I get out a bit on my bike, walk the dog for quiet time, sometimes she just needs time to calm down.  She is so angry with her lot but so confused in what she says and what she wants making it so hard to give her what she needs. She says she wants support but then rejects it when she gets it.

In rooms next door she rants and rehearses arguments with people who are not here, shouting at them, repeating mantras of how she needed them to be there for her and not leave her in mental hospital, how she will tell everyone the truth about how she has been abused, how her mother is a druggy etc etc. These regular bouts of aggression are hard to bear, but then at other times she is sweet and easy, we laugh sometimes when I say who are you shouting at on your imaginary phone?! Sometimes a comment like that goes well, other times it is the red rag to the bull, knowing which is very difficult.

By bedtime last night she was back to lovely (partly due to me pretending to be a dog and crawling around on all fours barking and pretending to wee), smiles and "I love you dad...you are the last one that I should fall out with".

Today the Social Worker came to see her to tell her that she is making connections for M so that she can actually go and see what 'supported living' is on offer.  No-one has ever shown her this before so it is great that the Cumbrian services are doing this so quickly.  But it can't happen this week as someone is away on holiday, so M rejects this and rants and storms off swearing.

I express how difficult the week-end has been.  M demonstrates the situation very well by ranting and screaming at me in front of the SW, calling me everything under the sun, how I am a terrible dad, how I never give her the support she needs etc.  It starts to get you frayed at the edges to constantly be given this abuse, to be shouted at so much. M also rants at the SW who actually has been helpful and quickly put in place a 're-ablement' service which is people who come to visit M three times a week to help her learn independence skills like cooking, laundry etc. This has been put in place and quickly delivered in response to M's stated desire to live independently.  I do privately express that M is a million miles from this sort of independence, but I am glad that something is there - it is an expression of M being taken seriously in her stated desires and I'm grateful for the support.  When the re-enablers come usually M doesn't want to do anything with them, though on the Bank Holiday Monday (yesterday) one of them got her to have a bath at least, first in a week.

I leave and apparently M calms down.  The SW arranges to come back later at 3pm when the CPN (Community Psychiatric Nurse) is also due to visit.

At 3pm the SW arrives.  M is already wound up. She shouts and screams at first the SW and then CPN when he arrives shortly afterwards.  This is all just ranty abuse about how none of you fucking people help me and a long list of historical examples of how she is always let down.  She leaves the room from time to time and we have brief snatches of conversation between ourselves about how to manage the situation, what each service might be able to offer, how I need support.  They see how difficult it is but we also agree that we need to keep her from an ultimately unhelpful outcome of a return to Psychiatric Ward, as the CPN says "it's a question of whether you can cope" as the Acute Psychiatric Ward is all that the NHS has. So I am caught between a rock and a hard place, I do need relief from the abusive behaviour and daily stress, but I don't want her back in the Psychiatric Ward.

M escalates. She gets to the level of throwing a chair at the SW and grabbing some scissors and behaving threateningly with them.  The CPN to his huge credit goes into the kitchen with her while she is waving the scissors in his face and helps her to calm down.  Later he talks to me about how she is always looking to see what effect her behaviour is having and how he knows that this is a signal of inner control rather than out of control behaviour. But at her heightened state accidents are very possible.

The support and engagement in Cumbria is human and real, especially in the light of the lack of it in Lewisham. It is a frustrating irony that M wants the support in Lewisham, but Cumbria NHS and Social Services do not see this as any reason to not engage with M, even though we all know she may 'up sticks' at any moment.  I do feel supported here, and that everything is being done in a truly engaged way for M, though the limitations on provision are a frustration to us all.  Having said that I receive texts and conversation from the services here, CPN SW and I have intelligent conversations about finding solutions, about recognising M's needs, these conversations and texts

SW and CPN decide to leave, and we talk about how I might leave too in order to allow her to calm down for a bit.  Adrenalin takes 90 minutes to leave the system I am told, which is helpful to know and does fit the leave her alone for a while scenario that I have come to adopt.

As they are leaving M plays her trump card which is to pack her bag and announce that she is leaving 'to go to London'.  We call her bluff. SW leaves, but CPN says he will watch in his car from a distance.  She stands at the end of the lane for half an hour.  I keep checking to see if she is still there, hopefully she will calm down.  Fortunately I live in a small town, where she would go is pretty easy to predict.

She disappears. I drive around and find her. She tells me to go away, that she doesn't need me, that 'she is going to London'.  She is so distressed, she is the child, but so full of her 'adulthood' that she will not comply with any pleading.

I can't let her wander around, and even less so can I let her get on a train to London and god knows where.

I go home and call the police and explain the situation.  They quickly find her, near the station. They call me.  By the time I get there, 10 minutes, they have arrested her due to her talking of suicide, they have the provision of a Section 136 detention to stop people from hurting themselves; this is not new to me.

She is taken to a hospital 30 miles away.  There she will be assessed.  I am sitting here waiting for my call to be returned from the new (to her) people that will be assessing her, they say that this may be as late as 2 o'clock in the morning.  I need to speak to them to help them to understand what is going on with her, and as the police say - to make sure that they don't just open the doors and tell her she is free to go...to where.  She is Learning Disabled, she has a low IQ, she is vulnerable.

The workers in the NHS, the police, the Social Services are not able to offer what they want to offer.