"crisis planning"

About: Tees, Esk And Wear Valleys NHS Foundation Trust

(as the patient),

After a crisis I wrote to TEWV asking for an updated crisis plan. Trusts are meant to provide crisis plans specific to the individual patient and to update them regularly under the care programme approach. For 16 months the only 'new' plan they provided merely stated that I should call my CMHT, call my GP and call the crisis team out of hours. This plan was written informally by a manager in an email to me. It was less detailed than the entirely generic crisis advice provided on the Rethink Mental Illness website. It could hardly be described as an 'individualised' crisis plan. TEWV failed in my view to follow the NICE guidelines for joint crisis planning. I sent my care team more detailed information that could be part of a crisis plan but no changes were made for 16 months and, as far as I'm aware, the crisis plan on my record was 2 years out-of-date before my care team finally updated it - a task that took them only half an hour.

If I had solely raised this matter with a care co-ordinator it might, perhaps, be understandable that no action was taken for so long but I even raised it with the then Director of Nursing and Governance. For 16 months my crisis plan was not updated despite me attending many appointments. I even offered alternative methods of contact like email and phone if the frequency of appointments was not leaving time to deal with issues I consider a priority such as a crisis plan, but my crisis plan remained generic and outdated. In my opinion, patients ought to be able to expect better crisis planning from a Mental Health Trust that claims to be committed to the Crisis Care Concordat.

An individualised crisis plan is really important to me. In the past I have been affected by lack of adequate crisis planning. On one occasion I missed 2 appointments and this was not seen as a warning sign. Even though it was unusual for me the mental health team simply planned to discharge me. Very soon afterwards I was an emergency admission under the Mental Health Act and hospitalised for 6 months. On another occasion I was acutely depressed. I contacted my care co-ordinator saying I had immediate suicide plans but no effective preventative action was taken. That night I was on life support and was in a coma for nearly a week then in hospital for a month. If it were not for my lack of medical knowledge at that time then I would have died.

TEWV's lack of crisis planning has left me feeling scared, at risk and increasingly hopeless about my future should I relapse. I am bewildered why Trusts don't learn lessons before tragedies rather than claiming they intend to learn them when it is already too late. I also feel angry that in one of the wealthiest countries in the world, and with all the knowledge and research there is about crisis prevention, ordinary service users are still not receiving adequate crisis planning from a Trust that the CQC rates as 'Good'

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