Don’t be fooled by the “local” issue. It’s never too small to mention when families are hurt.

Your kidneys become infected and stop working properly.  Your doctor insists that you’re admitted for emergency treatment, but when you get to the hospital, you discover that because more men than women need kidney treatment right now, they have closed the renal ward to women. 

You are put into an ambulance and taken to a hospital in a town you’ve never been to before, about an hour’s drive from where you live.  When you get there, your condition is assessed and they admit you for six month’s treatment. 

You suddenly feel very scared.  You have two small children and your husband works full time.  How will they be able to come and visit you?  You realise you’re going separated from your close family for months and that your friends, family and colleagues will struggle to come and see you too.  You feel very alone and very isolated.

When you demand to be treated closer to home, you’re told no; only male patients can get treatment locally in your area, but that it is perfectly acceptable as there are beds in other hospitals, that it’s only temporary and that some women can be treated at home, so they are all right.  The managers say they don’t know when your local ward will be open again, but a member of staff accidentally lets it slip that it’s a 6 month temporary closure.  That’s the whole of your treatment.

Six months away from your home, your friends, your family, all your support networks, the places you know and like, the town you live in.  Six months with only seeing your children perhaps once or twice a week, but the visits are fraught as they are tired after the journey and there’s nothing for them to do at the hospital.  Six months without the chance to go for a coffee during the day with a friend. Six months of hearing your children cry on the phone to you at night as they don’t understand why you can’t come home.  Six months and there is NOTHING you can do about it.

This sounds ridiculous doesn’t it?   A hospital wouldn’t close its doors to all women as there were more men who needed treatment.  No one would send you away for six months of treatment with no chance of being closer to home.

But if you’re a female mental health patient in North Lancashire that is exactly what is going on and exactly what would happen to you if you needed inpatient care right now. It is what would happen to me and to my children if I got seriously ill again.

At first glance Beds in the Orchard looks like a small local issue.  After all, what concern should be 6 female inpatient beds in one small psychiatric unit in a one small city be to people elsewhere in the country?

But don’t be fooled by the small, local appearance of Beds in the Orchard.  What has happened at The Orchard it is indicative of a much wider problem across the country with the chronic underfunding of Mental Health services impacting on the health and wellbeing of thousands of people and communities.  It is indicative of the hard price being paid by women and their families nationally; as they find that their local inpatient psychiatric care has disappeared, leading to them being separated from their support at the time when they need it most.

You need to take an interest because it may be the hospital in your town that stops admitting women next.  It may be your mother, your daughter your sister, or even you who finds yourself being sent miles away for care with no chance of being treated closer to home.  It could be your friend with severe PND or Puerperal Psychosis separated from her baby or young children for months on end.  It could be you if that niggling sense of unease you have turns into a severe depression. 

As time and again, the cuts to mental health care and the loss of psychiatric beds are not seen as newsworthy, and campaigns like ours are dismissed as being “too small” or “too local” for people take an interest; the wider picture of the loss of services is consistently missed and hidden.  Hidden, of course, right up until you need the service, only to find it’s not there. 

What makes it all even more difficult to get public interest is that the women it affects most are the ones who are often too ill, or too scared or too anxious to stand up for themselves, as is made clear in the piece about our campaign in the Huffington Post.  There is only strength and interest in numbers, which is why we need people who are strong enough to stand up for those who can’t.

Mental illness can happen to anyone.  It happened to me.  It could happen to you too.  Help us stand up for the women of North Lancashire by signing our petition or by getting involved using the information on elsewhere on this blog.  Help us let Lancashire Care NHS Foundation Trust know that this has to change,

Thank you.

S's Story - Moving female patients out of town is at best ludicrous, at worst, dangerous.

As our campaign gains wider attention, we are being contacted by more local service users who were not aware of the changes or the campaign to reverse the decision.  One of those service users "S" shares her fears and concerns about this change.

This is more first hand knowledge and experience of how the changes impact on service users and their families.

Dear Beds in the Orchard,

Hope this helps/makes sense as I struggle to write when unwell.

Suggestions that moving female inpatients out of town is not damaging to patients is, at best, ludicrous and at worst dangerous.

I personally know from my struggles with bipolar II, that I can rarely attend meetings with my CPN without the support of my partner and son. They are central to my recovery. If I was shipped out of town there is no way we would have time or means to keep up contact - potentially breaking bonds with my son, that I have fought so hard to rebuild since my PND, PTSD and psychotic episode on the postnatal ward after staff saw fit to (guess what) move me! All against the advice of the MH professionals...

In spite of the rise of stay at home dads and many families successfully co-parenting; my personal experience suggests that in the majority, women run their homes, make decisions regarding children and are better placed to arrange their child's day to day activities - even those women with difficult mental health issues.

For many patients gaining control in a positive way helps their recovery - taking away this option will greatly hinder recovery, increase stress and in turn extend stays in hospital.

This should be about what is best for the patient. If I were to be moved out of town because the help and care I would recieve would be greater then of course I would consider it short term, when I'm at my very worst BUT that isn't happening here and even in the above hypothetical situation I still would need to be moved closer to home as my mental state improved in order to become stable.

For people who struggle with change and need consistency this cruel decision needs looking at again.

Clare's Story - A near miss, distressed children and a fear for the future.

 In April 2014, I was assessed in A&E under the Mental Health Act.  I’d been depressed for a long time, but the descent was long and slow, until it reached the point where making plans seemed like a perfectly rational thing to do.  Fortunately I had a good friend who knew it was absolutely not a rational thing to do, so she took me A&E with me protesting all the time that no one would believe it and it was a waste of time.

After being assessed by the MH liaison nurse, I was asked if I would go into hospital, but the only bed available was at The Priory in Manchester, a private hospital well over an hour’s drive from where I lived.  I refused as I didn’t want to be so far away from home with no possessions and no means of my husband getting there, as he had our two small children to look after.  In the end they decided not to detain me, but pass me over to the care of the local Crisis Team.

Like Crisis Teams all over the country, they are massively overstretched and a decision was taken to leave me in the care of the community team as I was seeing my psychiatrist the following afternoon.  By mid-morning the following day, I was waiting on the platform of the station for the London express train, however, the same good friend as the day before had sent her husband speculatively to see if I was there. That was the near miss.  If a local bed had been available the day before then I would’ve been in hospital, safe.

Thankfully this time there was a bed in Ridge Lea hospital in Lancaster and I was admitted and stayed there as an inpatient before the hospital was closed and all of the patients transferred to The Orchard, the new unit in Lancaster.  I was in hospital for around 3 months.

The impact of my admission on my family was enormous.  My son has autism and was extremely disrupted by my being away as it changed his routines.  His autism meant that couldn't express how he felt easily, so he got cross every day.  His home to school diary was filled with examples of him being upset by my absence and struggling in school.  My young daughter didn’t remember the last time I’d been admitted as she’d been too young, but this time she was very aware and her behaviour became very difficult as she struggled to come to terms with my being in hospital.  She became clingy to everyone else in the family and anxious that I would never come back.

The only thing that made it better for them was that I was still close by.  My husband bought them up nearly every day after school and nursery and we got to spend time together, even though at the time it took monumental effort for me to be ‘normal’ with them.  As I got better and had leave, I was able to go home to dinner, or do bedtime with them or all the small things that a parent does for a child.  Sometimes this was more for their benefit than for mine as mental illness takes away some of the person you are, but to them it meant everything.

If I had been at a hospital miles away, none of that would have been possible.  My children’s struggles would have been even harder.  The visits would be more sporadic with long journeys to get to see me and the impact of my absence would have been amplified many times over.  At the beginning, my only motivation to get through the day was the obligation I felt to see them.  As I got better, that changed to wanting to see them as I missed them, till eventually I was discharged.

Even when they are unwell; mothers need to be near their children and children need to have regular contact with their mothers.  Isolating me from my children would have caused distress on both sides, but now this is what would happen if I was admitted again. 

Getting ill again already scares me as it has had a huge and lasting impact on my life emotionally and financially and has shaken my whole world.  Now I have the additional fear that if I get ill, I will be taken away from my family, my friends and everyone who means anything to me.  I will be ill, alone and isolated from the very people I need to support me to get well.

Closing The Orchard to women like me, may mean more near misses like mine as they are too scared to take help knowing they will be sent away.  Speaking to other women in the community, I know I am not alone.  Fear when you already have a mental illness is not good.  Not good at all.

The full article published today on Everyday Victim Blaming

For those of you who haven't seen the article published today on Everyday Victim Blaming, I'm sharing it below, in full.

Lancashire Care NHS Trust delivers a stark example of Victim Blaming and delivers changes that maximise the distress of vulnerable women in its care.

In October 2014, The Orchard Psychiatric unit in Lancaster was closed to women.  This change was made without consultation with service users or the wider community and the result is that any woman in Lancaster and its surrounding towns and villages will no longer be able to access local inpatient psychiatric care. 

The closest psychiatric hospital with female beds is in Blackpool, a 50 minute drive from Lancaster.  Women will also be sent to Blackburn, Burnley, Chorley and as far as Manchester and beyond.  The shortage of psychiatric beds in the Lancashire Care NHS Trust has always meant that patients could be sent to hospitals out of their area, but moved back into the area once a bed became available.  Now there are no female inpatient beds in Lancaster, seriously ill women from that area will be separated from their families, friends and support networks at a time when they are most in need of that support.

While information about why the closure was made is sparse, due to the lack of a consultation process, there have been two reasons given by the trust for this decision.  Firstly, it is to help protect vulnerable women and secondly, because there is a greater demand for male beds.  The first of these reasons falls under Victim Blaming and the second is gender discrimination as the trust prioritises the needs of men over women. 

Need for Beds?

Before this move, the Lancashire Care NHS Trust already held more male than female beds across the trust.  Information about numbers can be found on their website - http://www.lancashirecare.nhs.uk/Services/Adult-Mental-Health/Inpatient-Care.php. 

The Orchard had 10 Male and 8 Female beds.  Occupation rates in the Female area ran at 100%, with beds being filled the same day, and in some cases just hours after a patient was discharged.  There were frequent occasions where a female bed would be used temporarily for another woman, while the patient it belonged to was on home leave or at the general hospital in order to cope with demand. 

There is a definite need for female beds in the area, so why is the demand for male beds more important than local psychiatric care for women?

If lack of male beds is an issue then that should be addressed by the trust by looking to increase the number of male beds without denying access to a whole group of people under their care.  Women should not be denied local access to inpatient psychiatric care due to a lack of male beds.  The needs of women with mental illness are not less important than the needs of men.  The need of women to be close to their families, children and support networks is not less important than male beds. 

Victim Blaming and Maximising distress

The suggestion that the move to make The Orchard a single sex ward is to protect vulnerable women seems to be a clear case of Victim Blaming as instead of addressing the problem of male aggression, it is blaming women for their vulnerability.  It says to women "You may be vulnerable, so to protect you, we are going to deny you access to local inpatient care."

Before the closure there were 10 male beds and 8 female beds in the unit.  The male and female areas were separate and could only be entered via key-card access, so the men and women could only access their own bed areas.  Individual rooms in the unit were also locked via key-card, providing extra security.  A single sex lounge was available in both the male and female areas of the ward.  In addition to these areas, there were communal areas, including a dining room, games room, lounge and inner courtyard.  In the other hospitals of the trust, Chorley operates a similar system with single sex and communal areas and Ormskirk has a fully mixed ward.  This would suggest that there are reasons other than vulnerability for denying women access to The Orchard.

Rather than protecting vulnerable women, removing local inpatient care will increase their vulnerability and significantly increase their distress.  Sending women 30-70 miles away from their home for treatment means that they won't have access to their families, friends or support networks.  Research on isolating women from their support networks is well documented as having negative effects.  Women are also still overwhelmingly the primary care givers to children and carers for older adults.  Treating women 30+ miles from their home means less opportunities for contact with their children and people they care for, causing distress on both sides.

If there has been a problem with male to female aggression in the communal areas, then the trust should address how that is managed.  There are single sex units available for men who are seriously ill, and therefore at risk of harming others and otherwise aggressive males.  A better solution would be for staff to ensure that known aggressors or those shown to be aggressive are moved to male wards, able to deal with those problems, rather than place the blame on women's vulnerability and deny them access to the local services that they need.

Removing access to local care is likely to discourage women from seeking help and accepting voluntary admission, and will discourage their families from seeking help for their relatives, knowing they will be sent miles away from home.  This can lead to increased detentions under the Mental Health act, with women not willing to accept voluntary admission, or by deteriorating to the point where a section is inevitable.

This closure leaves the women of Lancaster and the surrounding areas with stark choices.  Should they accept treatment for their mental illness isolated away from home, or stay with the support of their families and friends, knowing that they may be detained against their will anyway?

Either way, the decision of the trust to close the female beds at The Orchard is likely to have significant negative consequences for the women and their families.