Clare Blackwell
@clare_bwell
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Human | Gastro Doc 💩 back in training | Fiddle Player 🎻 | Disillusioned leftie ✊|| Ex bin resident and now #PTSD || My ❤ belongs in Cape MaClear 🇲🇼
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Trying desperately not to think about it but having been inadvertently given access to all of my GP notes on system one including psychiatric notes when I was only trying to access a copy of my summary care record is very unsettling. I had deliberately intended never to read 1/
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Posting with permission from a locked account. I am honestly baffled by this response from MH services to a patient who complained that their private twitter account has been accessed and written about in their clinical notes.
How can this possibly be justified? 1/
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This is a clear and inappropriate breach of boundaries. If I accessed a patient's social media account and wrote about their conversations in their physical health notes I would (rightly) expect to be disciplined.
Why is this happening?
2/
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@NHS_HealthEdEng
Would you like to celebrate by making training accessible for doctors with health conditions? 👀👀
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To attempt to conflate the two in anyway is wilfully disingenuous. Accessing patients' social media accounts seems to be done with the primary purpose of anticipating/preventing complaints or denying access to care.
It's disturbing and needs to end.
4/
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I can see there MAY be occasions when a MHP may see someone in person outside of a clinical setting that they are genuinely concerned about, who had missed appointments and may intervene.
That is not in any way the same as deliberately accessing a locked account.
3/
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Still reeling at the CMHT psychologist who was so defensive that she described the acts of violence I witnessed and experienced in hospital as "self-percieved traumas" or "care lapses".
I gave evidence to the police about an assault I witnessed and there were acts of self-harm..
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For anyone who isn't aware this is the reality of trying to sleep as a psychiatric inpatient.
Strip lights, noisy interminable hourly obs, torches shone in your eyes to make sure you're still breathing.
I wonder at the damage to our circadian rhythms and sense of..
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Am I too irritable or is engaging with MH services too irritating? 🤔
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Wild to me that I can have friends for decades, navigate the ups and downs that life can bring with them and with family with success yet MH services feel they can write things like "Clare cannot form positive relationships with those caring for her." when I'm wary of MHPs.
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Tentatively dipping my toe back into the world of work today.. wish me luck. 🤞🍀
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Full text of screenshot below as too long for ALT text:
Thank you for your email describing your concerns received on 25th October 2023. Your concern was regarding staff recording information within your clinical record which was gained from your social media account.
5/
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Just wondering if "complex" should be added to the banned list of words for health and social care.
Increasingly, it seems to be used by professionals working in constrained systems who don't know what to do.
Instead of admitting the discomfort of that, doing the best they..
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What an unhelpful narrative.. I don't remember being celebrated when I was on the psych ward. But I certainly saw bravery and resilience from the other patients. Far more so than anyone perpetuating the 'bootstraps' approach to MI.
We should stop celebrating mental health conditions as though they are a badge of honour, & start celebrating resilience, risk-taking, boldness, bravery & adventure.
Understanding of those who struggle is good, but the social contagion of diagnosed conditions is leading… 2/x
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This is the reality of trying to access support from MH services in England in 2024.
Trying desperately to stay well to be met with indifference and then when you inevitably deteriorate things get heavy handed or you're criticised for not seeking help earlier.
It's maddening.
Asked the CMHT to kindly re-refer me to the ED service 4 months ago. Phoned said services 57x to kindly ascertain the status of said referral. Was seen by ED services for the 1st time and have just been informed to - kindly - accept an inpatient admission. I’M KINDLY LOOSING IT.
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@AnorexiaMyths
I find it absolutely infuriating. "We've all got mental health" 🙈 It seems to be part of the ever increasing conflation of problems with mental wellbeing with actual mental illness and the unspoken truth that mental illness is still v stigmatised.
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@BettyBlue168
🙄 What the hell are
@BPSOfficial
doing endorsing her?!
These tips need to come with the disclaimer that she is an academic chartered psychologist with a PhD not a clinical psychologist or medical doctor.
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Can we stop doing this to patients please?
I have heard so many similar experiences since I spoke out about seeing some of my notes on the NHS app.
We need to do better. It is possible to write notes that are professional, curious and not judgemental. Let's start.
Just read my notes - via a SAR - and I fear I will never, ever - trust a MH professional again.
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Weird going back to work and hearing others doctors talk about complaints and how 'patients have so much power' when this current user of MH services couldn't feel more silenced and powerless.
Sometimes I really wonder how I can balance the different bits of myself. 🤔🤷🏻♀️
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You did not give consent for them to access your account. You also state that record keeping also falls below information governance standards and contained subjective information.
Social media is a public domain. If you want to restrict people from accessing the information
6/
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"unreasonable" and "hysterical". (I had really hoped we had moved beyond defining women's distress by our reproductive organs in 2023.. 🙄)
Perhaps most disturbing is "claiming to be a hospital doctor to seek preferential treatment". "Appears to be pretending to be manic in 8/
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Therapy is not harm free no more than medication is.
Important this is spoken about, it can be so damaging.
An interesting and unsettling piece about when therapy goes wrong.
“James had made things weird and now I would have to spend my money discussing his weirdness.”
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I think I showed myself some self-compassion today by disengaging from the Recovery College webinar about self-compassion.
There was just something too maddening about being told that we must treat ourselves with compassion to build our resilience when services have just been..
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I find it horrifying to think that anyone could think that this would be helpful to anyone unwell enough to need IP psychiatric care.
To think that is anyway appropriate is baffling to me.
I have never seen anything like this on any of the physical wards I've worked in.
Why?🤔
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One of the things I hate the most about being a MH patient is the constant questioning of my integrity..
The CMHT recently altered the doses of one of my medications. The letter hasn't reached the GP yet.
Pharmacist asks me to chase up CMHT.. Why would I have any power in..
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@thefatdoctoruk
Please don't imply that people who are hateful trolls are mentally ill. It harms those of us who genuinely struggle with MI. Being ill doesn't make you a dick. Most people with MI aren't hateful.
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you post then you need to change the filters within your account to reflect your preference. You state that staff would not seek you out and follow you in a public street to write about you in your clinical notes. It is possible that staff may observe you in a public place
7/
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that the majority of us witnessed which required emergency surgery.
How can someone who has worked in the MH system for years be so oblivious to the power dynamics on MH wards.
There was no acknowledgement that it may have been difficult to bear witness to such suffering..
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addressed in previous concerns you have raised. Audits are regularly undertaken to monitor standards.
I appreciate this letter will be disappointing for you, but we are unable to accept this complaint for the reasons described.
Yours sincerely,
ENDS//
#MHTwitter
#MadTwitter
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You know that feeling when you have been asked for your feedback and you've hesitated as you know that having been mentally unwell your feedback has been used to discredit you in the past. The person with the power has assured you they are "a person who will listen and act." 1/
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@shuntedmdphd
Very sorry to read that your Neurology programme were unable to accommodate you. 😔 We are losing so many valuable people as a profession due to a failure to make adjustments to training programmes.
Wishing you every success with your new field of rehabilitation medicine.
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Not working today and stayed up too late last night thinking about awful things old psychologist wrote about me following our attempt at EMDR last year and how hard that's made it for me with new CMHT.
God there are ex's mums who would give me a better character reference! 🙃😂.
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blood to eat our evening meal.
Does denying that was traumatic help people? Is that a therapeutic technique to support people with
#ptsd
?
#psychology
#psychtwitter
#therapy
#MHtwitter
#MadTwitter
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and this could be recorded in your clinical records if it was felt to be beneficial to your care and treatment. Neither requires consent. If you are unhappy with this explanation, then please raise with the People and Culture Department (previously known as HR). The PALS and
8/
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complaints team are only able to investigate concerns about care and treatment. Any concerns about the professionalism and conduct of staff need to be considered by the People and Culture Department.
Your concerns about documentation standards and subjectivity have been
9/
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@Mirandarrgh
Errr.. there are v many legitimate reasons that people are fearful of those with the power that psychiatrists/police and social workers have.. this is a ridiculous take 🙄
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Psychiatric wards are not well set up to deal with physical health emergencies. It was chaotic and most of the initial first aid was delivered by fellow patients.
We were shepherded out and then back in to the dining room that had been freshly mopped but was still smeared with..
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reliable and useful pair of hands when I'm well. I know that I have provided effective, safe and compassionate care to patients and hope to continue to do so when I'm better.
It is hard to describe how upsetting it is to see myself described as "demanding", "irritable", 7/
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@LucyGoBag
I think my head is about to explode reading that headline 🤯🤯🤯
And yet we still wonder why so many people don't report DV. 😪
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..so utterly devoid of compassion to me lately.
It's just a headfuck really.
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I don't know what else I can do. Thanks to all those of you who've reached out in response to my recent tweets. It means a lot.
And thank you to all those of you still working in the
#NHS
who can hold some hope and kindness for any of us who find ourselves in a MH crisis. 14/
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Just seen this response from the wonderful
@TraumaPhDandMe
to a thread a couple of years ago from
@PerinatalBirder
and my heart is heavy.
I miss her.
❤️💜💛💙💚
@PerinatalBirder
@roryreckons
Do you have the reference for this paper?
I'd like to take it to my psychologist. I am in permanent burnout and overwhelm. So much of what you have written here describes me, but when I have previously tried to talk to my psychologist about it she thinks I'm trying to avoid 1/
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Wild to me how many psychologists I see on this bird app asserting that they have no power compared to the psychiatrists..
Your words and 'formulations' that you write 'about me without me' are just as harmful as some of the drugs I've been prescribed. Probably more so..
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@Robyn_Medhurst
I'm so sorry Robyn for all you have endured and cannot imagine how you must have felt coming across that social media post.
There are real problems with the way some HCPs use SM. Some things should be kept in the staff room not blasted across the Internet.
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..your own narratives. Psychological assessments and interventions are as powerful as psychotropic drugs when you're on the receiving end of them. Cultivate the humility and self-reflection to know that you might not always get it right.
#MadTwitter
#MHTwitter
#PsychologyTwitter
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I keep seeing absolutely heart-rending threads from
@StopSIMMH
MH activists and those with lived and living experience who engaged with
@NHSEngland
in good faith and have seen months of hard graft be reduced to a letter.
This is not how meaningful
#coproduction
should work.
Have now been told "the letter is the final position" after asking if joint policy w/ StopSIM will be published
@NHSEngland
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@SurvivorsNotPD
It's a bit disturbing that a MH nurse can't conceive that a psychiatrist might not be good at their job so the patient must be lying.
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.. reminded me what is possible. What I can get back to doing. Meeting people where they are. Being real and authentic and trying to support them to move forward.
Feeling inspired. Thanks for your support twitter. 💕💕
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Brilliant weekend in London Town.. climbing, badminton, the theatre, all the food at Borough Market. Good Times.
#culturevultures
😂😂
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You have provided some bright spots in a very tough few weeks. 🎆
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Aripiprazole rather than Quetiapine for recurrent severe depression because it doesn't make you sleep 10 hours a day.. Sleeping that much isn't that compatible with life. I like life.
I'd just like to be supported to get through this cycle of
#PTSD
symptoms so I can get 12/
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OH appointment tomorrow having been back at work for.. *checks notes*.. 3 months.
Letter says please be in a private space with a landline.. 😂 who has a landline or a private office in the NHS?!
Look forward to being told exercise releases endorphins on my mobile in my car.
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It is entirely understandable and I think normal for someone who has had x2 psychiatric admissions, been sectioned and has ptsd as a result to be wary of MHPs.
How can this be pathologised?.. it's such a headfuck.
Anyway am off to visit some friends for the weekend. ❤️
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..speeding up their admin as a patient.
Why not pick up the phone? Why introduce a third party into the equation? Why not believe what the patient is telling you 🤔. I'm really not sure anyone is going to that effort for 50mg Quetiapine. 😉
This nonsense is TIRING.
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Like any of us who come to need MH services in our lifetime I am more than my
#ICD
10 diagnosis, "relapse signature" or care plan approach. I know that I am generally a modest, self-deprecating, calm person who is more than happy to take the piss out of myself as much as 4/
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Having a moment where I feel so fucking lucky that I didn't get unwell/hospitalised til my early 30s and had been able to build a bit of a safety net. Also how lucky I have been with my current employer.. not hyperbole to say I could have been unemployed/homeless with another..
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Need to rescind my driving licence for a one year medical review one. Not clear why or what purpose this serves and not what the psychiatrist told me was going to happen.
Just quietly raging at their power and the blanket application of pointless policy.
Drowning in bureaucracy
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@LuckyErica3
This sentence was particularly disturbing to me.. "If he had stopped and thought rationally, as a mature and sensible man".
This shows a fundamental absence of understanding of
#ptsd
, suicidality and the effects of alcohol intoxication.
Is this person fit to be a judge? 🤔
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This is horrifying but not surprising to anyone that's been an inpatient on a psychiatric ward.
We must believe people when they say that this is happening if are to do anything to stop it.
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..purpose. I didn't develop severe MI because I needed to be taught a lesson. It happened.
Does this resonate with anyone? Are there equivalent courses for people with significant physical illness or disability? How are they run?
I do have a shiny certificate though...
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@_emilylovesrhcp
Absolutely.. clearly it was the patient's fault that staff accessed their twitter account inappropriately 🙄
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the moment why would anyone want to pretend to be a doctor?! People aren't clapping 👏 us anymore. Even more strange to think a person would pretend to be a Gastroenterologist.. we mainly ask people nosy qs about their 💩, tell them to stop boozing and stick cameras in 10/
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This. I had many many advantages growing up but I'm a 1st gen doctor. I was astonished when I went to medical school how many were from medical families. There are so many hidden advantages that perpetuates inequality in the profession.
We desperately need a workforce that is 1/
I'm a 4th gen doctor. This meant I went to good schools, socialised with other doctor's kids- many of whom also wanted to become doctors and shared tips and resources about medical school entry- and already knew many lecturers when I got in. It's *not* a level playing field.
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order to access sedating medication". I have close friends with
#bipolar
disorder. I consider it grossly insulting to them and all the suffering they have endured to even suggest a person would do such a thing. With all the terrible news about the
#NHSCrisis
and
#NHSStrikes
at 9/
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In an unfortunate bit of scheduling I have a CMHT appointment and a smear test tomorrow..
What a DELIGHT of a Wednesday to look forward to. 😂😂
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..an opportunity to rebuild ourselves better and stronger.'
As a very much lapsed Catholic I'm a bit allergic to the 'transcendence through suffering' narrative. Sometimes suffering is just that. It needs to be acknowledged and we need space to grieve. Not everything has a...
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@DrJessTaylor
I've seen many psychiatrists and none of them have given me a questionnaire to complete.. it's the psychologists who love the questionnaires.
New appointments with hospital specialists are often 30mins.
GPs regularly diagnose diabetes in a ten minute appointment.
Misleading.
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Came home to three letters from the CMHT: one from new psychiatrist, one from old psychiatrist and one from old psychologist.
So glad that I came back from a job where I was literally welcomed back with open arms and then chased away by my lovely boss with a reminder to...
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Claire (whoever she is) has completed recovery. 🥳👏💪
I hope she's enjoying it. 🙃🌳🏞🏔✅️
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Went to a
#Recovery
college course this morning with decent facilitators who treated us as adults and generated some thoughtful, respectful discussion.
Another participant had also unexpectedly come across their
#psychiatric
notes on the
@nhsapp
. It hadn't been a positive..
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If you don't know the reality of trying to access MH care such as it is in the UK at present please read this.
If you've ever said "it's ok not to be ok", "just reach out", "it's just like a broken leg" please read it.
This deserves to shared far and wide and read by those 1/
I've been risk assessed a lot recently. It's not been much fun. I wrote this blog post about "risk aversion" in mental health services, to consider whose risk is actually being assessed and avoided - patients' or professionals'?
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unmentionable places.
I do not think I have bipolar disorder. I have had severe depression in the past and now I have
#PTSD
. I hate taking sedating medication if I can help it. I couldn't wait to see the back of
#mirtazapine
.. and was delighted to be offered low dose 11/
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nonsense that can be written about us by "services". The three letters I received today describe three different women. One I vaguely recognise; the other two are strangers. It must be awful to be so defensive and contemptuous of patients. To be so afraid of admitting that MH..
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This is completely unrealistic and unworkable in the current climate.
Making eye contact with everyone in the corridors of ED would mean nothing else would get down that shift.
It's terrible and many of us hate it but we have to be realistic about where we are.
"It would take little effort for each person in the NHS to cultivate a routine of looking directly at every patient we pass and at least nodding politely to acknowledge their existence, if not actually saying hello."
#sayhellotopatients
says
@johnlauner
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I'm so disturbed and angry by what happened to Dan and Kim Harrison and their family.
The rhetoric of behaviourism and 'responsibility taking' and dismissal of patients is so ingrained that people with known psychosis are ignored.
The negative symptoms
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guidance now that clinic letters are sent to patients but I previously opted out of receiving them. It always felt so strange to read about myself in such a clinical way. I began to dread the brown envelopes with the off white NHS paper that came through the letterbox. 3/
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.. clinic today with my boss and met more than one patient that I'd met over the last few years. They were pleased to see me. My boss connected with them where they were and treated them with compassion and respect. It was world's away from my recent experiences but it...
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Like the model mental that I am I went to a Recovery Course at my local recovery college this morning. It's good that some of these are running face to face again and it's nice to connect with others who have had similar experiences to me.
I can't help feel weary though...
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Why are some HCPs so terrible at asking patients about sex?.
Nurse at smear yesterday: "are you sexually active?"
Me, thinking well I'm not 15 but "yes"
N: "So you're in a relationship"
M, what are you my mum? but: "No"
N: "oh... so you have a casual boyfriend then?"
M: 🤦♀️
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@drjanaway
This is a terrible example and displays an unpleasant attitude toward patients.
Anyone who has been on the sharp end of MH services or social services knows it's not that easy to "get a house".
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can for the person concerned and advocating for change it's easier to just write them off as "complex".
Seems to be a handwringing excuse in every Inquest I've read. "Well we did our best but they were just SO COMPLEX".
#MedTwitter
#PyschTwitter
#MadTwitter
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Met my manager and agreed to take a step back from covering IP work for a bit again.
Feels crap but probably for the best. Everything still feels so raw.
Sometimes I wonder if I'll ever make it back. I feel a bit broken by MH services right now.
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..services can be traumatising that you have to contort yourself into such uncomfortable shapes and write letters that make so little sense. To take such little care that you spell my 5 letter name incorrectly and the 3 letter name of my NOK is unrecognisable. 😳
I sat in..
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Week 3 of the phased return done. Only managed 2 days instead of the 3 that I had planned.
Temptation to rush back to prove the people who've implied that I'm workshy in my notes is high.
Grateful to have colleagues who can remind me that I'm conscientious and dedicated and..
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..to sit in a room with others who've endured tough times and psychiatric admissions, sometimes with enforced treatment and be told that we 'need to take control of our own recovery'. We need to develop our 'skills and resilience' for 'the journey ahead'. 'A breakdown can be...
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psychological safety that ensue from these practices.
Whenever I've reported vivid dreams of lighthouses or nightmares of being watched whilst I try to sleep to MH services since leaving the Bin I told endlessly to engage in basic sleep hygiene techniques or download apps..
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The replies to this are part of the reason why so many of us completely broke before asking for any kind of adjustments/why it is so hard to stay in medicine if you have been unwell.
🙄🙄
It is F*CKING crazy that residency programs would rather LET GO of a trainee rather than exempt them from doing night shifts. Like is it easier to replace 12 months of a human than it is four weeks of nights??
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back to enjoying it. Being this restless and agitated and sleepless all the time is not fun. There is only so much I can do to help myself. I have been living like a nun off the booze and caffeine and trying to CBT-I myself with
@Sleepio
for weeks now. It's not working. 13/
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@RITB_
Physical containment when risks are high.
I really wish they would focus on creating a sense of psychological safety though.
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Doesn't work very well though.
Is it just me?
Or are there some things that can't be cured by self-help.
Are there practices in IP psychiatric units that aren't serving patients well in the long-term?
😴💤🛏🌚🌙
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@rosieICM
Cool. How much is your house in Stroud worth Philip? 🤔
Are any of your neighbours junior docs? 🤨
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These victim impact statements from the Whorlton Hall case make harrowing reading.
So important that this is reported and a light is shone on how people with learning disabilities are treated in this country.
Whorlton Hall Sentencing Hearing: Context and victim impact statements
[Pleas in mitigation and judge's sentencing comments to come in later blog posts]
#WhorltonHall
#Autism
#LearningDisability
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fond memories of the people I met and worked with here.
I work as a
#SAS
doctor in Gastroenterology because the demands of the training programme that I worked hard to gain a place in were too much alongside managing treatment for
#mentalillness
. My colleagues consider me a 6/
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@hurkle_durkler
@Shrink_at_Large
I know it's not much as a doctor working in physical health but I refuse to recognise it as a valid diagnosis and write it in the notes/in clinic letters.
A small boycott but make me feel slightly less powerless against the waves of injustice that label causes.
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For anyone who doesn't think that class divides are entrenched in modern Britain and life paths set far too early...
Overheard in a coffee shop in my home town this morning..
"I knew from an early age I was going to come to Oxford to study Maths."
😳😳😳
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@NHSEngland
Hello
@NHSEngland
👋
Would you like to hear about my recent experience of trying to access urgent MH care and why I find this advert offensive and inaccurate?
Yours,
A doctor who's worked for the NHS for > a decade and who's previously been sectioned for severe MI.
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@Redpumpkinbunny
Good analogy. I found that aspect particularly bad, blaming the patient for the staff accessing their twitter. 🙄
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