"Poor Response to Self Harm from A&E"

About: Princess Royal University Hospital / Accident and emergency Royal Surrey County Hospital / Accident and emergency

(as the patient),

I started suffering from Mental Health issues at the age of nine, which was also the age at which I began self harming. By the age of fifteen I was having to be taken to Royal Surrey's A+E at least once or twice a week for stitches. I, as someone whose injuries were caused by themselves, did not expect special attention or to be a priority or, indeed, much sympathy.

I became accustomed to waits of six or seven hours to be seen for stitches, if this had simply been down to long queues or even having two or three more high priority cases pushed in front of me I would not have minded, but, I believe I regularly saw basically anyone that came into A+E, whatever their condition put ahead of me.

On 90% of the occasions that I went to check the queue of folders by the nursing station I saw that mine would be the only one that stated next to the injury how it occured. Whilst others would simply have "twisted knee", "head wound", "headaches and chills" etc, mine would state "arm injury (self harm)".

The reasons for putting this I do not know but I do believed it discouraged the doctors from dealing with me and placing me behind other patients, this is baring in mind that I had never been insolent, abusive, arrogant or demanding in their service, in fact I was often extremely polite and apologetic to the triage nurses (which were, without exception, fantastic) and any other nurses or doctors that would deal with me. It should also be taken into account that I rarely had wounds that would require less than 20 stitches.

I do not expect everyone to understand self harm and I certainly do not expect everyone to sympathise with it either, but when I begin to feel open hostility towards me, it has crossed over, in my view, into bad care.

It is my belief that I was regularly either not given local anaesthetic (because, apparently "if you can do this to yourself then you don't need pain relief") or it was injected all at once in one area rather than around the wound, seeming to me like they deliberately wasted it to make me "pay". I was, on many occasions, sent away without dressings, being openly told on a couple of occasions that it would be "a waste".By the age of twenty I just assumed that this was how every hospital dealt with self harmers.

I spent several months at a specialist psychiatric ward in Kent, away from the wards I had previously spent time on in Surrey and whilst there, whenever I or another patient self-harmed we were sent alone to the Princess Royal Hospital where there was no pushing us down the list, we were actually asked questions about why we had done this and what care we were currently receiving with genuine constructive comments of caring for our wounds.

I was actually shocked to find that in the six months I was being sent there for stitches I never once was denied anaesthetic or bandages and in fact, was often given spare bandages even though I was returning to a psychiatric ward where they were in full stock! This it appears to me was the sad and sickening confirmation that my treatment at the Royal Surrey was, in any comparison, vastly substandard and, some may say, cruel.

I had to also been to the Royal Surrey previously on suicide attempts - mostly taken in by my parents. More often than not, in my opinion, they were seen to be attentive when my parents were present but, literally, as soon as my parents left they would disappear and leave me and not check on me at all and often stand within hearing distance of my bed giving cruel observations to each other about me and making jokes about me as if I was not even there. It is my memory that I was often left, even when vomiting and weak, when I could not move and on two occasions ended up wetting myself. I was laughed at for soiling myself.

Whilst in hospital I often had bouts of psychosis or paranoia related to the illness I suffered, triggered by anxiety or confusion. In none of these bouts had I ever been violent to anyone, but I was denied the medication that I had been prescribed by my psychiatrist for several months.

It was vital that I take my medication regularly or when needed, but I was told "because we don't have confirmation that you are on those medications" despite copies of prescription and a letter from my psychiatrist that I carried with me to the hospital for these instances. I do recall often being told to "shut up" or "stop crying" and one nurse even mimicked me when I was hearing voices.

Once my father had driven me there after discovering I had taken an overdose of over fifty paracetamol tablets. In my view whilst we were taken to the Major Injuries unit I was just left with no examination and my father was not questioned for fifteen minutes. As my father watched nurses gossiping with each other and laughing before he got up and complained and stated that he had taken me in having taken over fifty paracetamol tablets and no one had seen to me. I was barely conscious so was not aware of this going on my father was so shaken by their complete lack of concern that he refused to leave me for the following days until my discharge.

The crunch came for me last year, by this point I had made a large improvement in myself and my state of mind but still struggled with self harm. I went, on an unrelated issue, to A+E one night (suffering pains in my chest) and met a doctor who noticed the marks and scars that are obvious on my arms and legs and started telling me about how he dealt with Self Harmers.

He said he just refused to treat them and sent them away and was certain that, because they never returned, he had stopped it because, he said, its all for attention anyway. He said it matter-of-factly because it was not the issue that was being dealt with but I left feeling incredibly upset because I knew that the people that were not returning to get stitches anymore very probably hadn't stopped but carried on without getting help.

Since, for most, self-harm includes an element of self-loathing, refusing to treat that person will simply increase that self loathing and make their behaviours more secretive and make them much, much more unlikely to seek any kind of help, as their afflictions, whether self harm alone or part of a disorder, get more severe.

Then I myself had the utter misfortune, the next time I self harmed (and by this point the time between self harm episodes had lengthened considerably to several months) of being treated by this same doctor who, after I had waited seven hours in A+E, did not even look at the wound, just said to send me away for the same reasons that they had sent away the patients they had previously told me about and then left the cubicle.

I was so shaken and disturbed, I felt deeply humiliated, I cried in front of the nurse who also appeared horrified at the Doctor's words and told me that if it was up to her and she was qualified then would have certainly stitched a wound that was five inches long and three inches wide, she dressed it and calmed me and I was grateful for her because at that point I felt like such an awful person that, despite my progress, I would have happily gone out immediately and done something impulsively horrific to myself if she had not taken her own time to calm me and reassure me that I was not being stupid in my reaction to this "doctors" insensitivity.

I did end up writing a long letter to the CEO about my experiences, attaching photos and times and dates. I did recieve a reply that, in my view simply stated that the last doctor had denied the acts I accused them of and insinuated that, because I was ill, I could just have been imagining it.

Over a year later I have not returned to Royal Surrey. Do I still self harm? Yes. I have taught myself to stitch my own wounds and even though this could very possibly lead to greater issues I rather do this than face any more of what I believe to be their ongoing callous and horrendous treatment of me and many other mentally ill patients in the area. In fact, I have been so affected by the six years I have been mistreated by the Royal Surrey that I no longer go to any form of therapy because I am sceptical and afraid of any organisation linked with the Surrey NHS, especially in regard to Mental Illness.

My partner and I have also been having serious discussion about moving from the area so maybe I might feel more free to make advances in myself but, more importantly, should I need medical care or help I will never, ever in my view be as continuously mistreated and discriminated against as I have been here.

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