In past times when I have been very ill a bed has been found at my local unit – and quickly. I think one was sourced within the day the first time around, and the following day at the start of my second admission.
Today marks day five of waiting for a bed. During this period only one other bed has come come up within my Trust, and that was over an hour away by car and two hours by train. I was worried about feeling lonely, but with hindsight I wish I’d just taken it. The only other beds on offer have been ECRs (basically, private hospital beds paid for by the NHS to take patients on a temporary basis) which haven’t been guaranteed and have been further away than that.
Yesterday there were no beds in my Trust at all. Not one. I looked at the Wikipedia page for each borough my Trust serves and came up with a population of about about 1.5 million people under the Trust’s remit (I suppose this isn’t that surprising given that like a number of London Trusts, it covers some areas out of the capital and let’s face it, there are 8.6 million Londoners to start with).
Anyway. There you have it. This is the bed crisis in real terms.
Every day Home Treatment Team push for a bed for me on my usual unit. Every day they are so sweetly apologetic about the fact that no, there still isn’t one, even though we all know it’s hardly their fault. Every day we talk about what to do.
I met the consultant today. Essentially my options are:
- Carry on in the community with Tom watching me 24/7 as I become increasingly distressed and exhausted in the ongoing hope of a local bed
- Ask for an ECR bed with the risk that I could be moved back to any Trust inpatient unit when one opens up – both could be far away
- Choose to take up any other bed that opens up within the Trust, wherever it is, and stick it out
- Choose to take up any other bed in the Trust with the agreement that I come back to my usual unit as soon as there is a bed.
None of the options feel good. I don’t know what I want.
And unfortunately not knowing what I want, or think, or feel, is the whole problem. In the grip of mixed mood again I fluctuate from mildly hypomanic to sharply low within the day. I shift from thinking that I am fine, that I don’t need to be in hospital, that Tom should just go back to work, to sobbing that I am totally overwhelmed and can’t manage in the community a moment longer.
In the moment, I mean it. I believe it. I believe that I am fixed, that in fact there was probably nothing ever wrong with me, that I am a fraud even. I announce happily that I have never felt less like killing myself in my life, then get irritated when others are sceptical, when they gently point out that just that morning I was saying I couldn’t shake the thought of buying lots of pills on the internet, for the specific purpose of an OD. And wasn’t I just saying that it was not viable for me to be in the community, wasn’t I just crying out, literally, for a bed?
Conversely, in great distress, I feel I can never be happy again. It’s this that’s behind the pills thing. I am not prepared, no, cannot do, another round of bipolar depression. I have explained this. If the only way to avoid it is to take myself out of the equation, so be it. Unless Tom will take me to a euthanasia clinic that deals with mental health issues, and I think we have clearly established that he will not.
I cannot trust myself. I don’t know if what I feel at any given moment is true or right or reasonable. It churns and churns away, and the bed issue is contributing hugely to the rumination. What should I do? How far away can I cope with going? What if it’s awful? Whatever I never get to come back to my own unit? I have never felt so confused. I described it to my dad earlier as being a mental washing machine; a pink sock rises to the top, but with the next spin a green one takes its place.
My biggest fear is that I take a bed and end up somewhere awful. Previous admissions have taught me that informal admission is very Hotel California – when you arrive you sign a piece of paper stating that you can check out any time you like. Then just try to leave. How can I make this decision, when I don’t even understand what or how I think at the moment? Maybe I need somebody to make it for me, but apparently nobody can.
Part of me wants to go in to give Tom a break. He says it’s not, but it must be so boring and stressful hearing me go through these loops again and again, all day every day. I worry about him.
He and HTT suggest taking it a day at a time. The goal is to distract, distract, distract, so I am colouring in, taking loads of baths, doing a complicated jigsaw puzzle. Blogging. If things get markedly worse, then a private bed might be the only option. Or by an immense stroke of luck, a local bed may come up. Maybe there is someone waiting to go home as I wait to go in. Maybe.