BANK HOLIDAY MONDAY, 26TH MAY, 2025.

What follows is an account of a day in the life of my mentally ill daughter, Meg and me, her dad and carer. While the events that make up this account are, thankfully, not typical, they are, nevertheless, far too frequent.

Meg, is currently under ‘shared care’ at CMHT, The Bridge Centre, a recent decision made following my concerns at her fast deteriorating mental health.

A crisis had been developing over several days just prior to the May Bank Holiday.

Meg was sleeping when I received a telephone call from the ‘shared care’ team at 9.37 on the Monday morning. I related Meg’s current condition, which I felt was of immediate concern and agreed to call the Crisis team if things deteriorated further.

Meg woke shortly after 5pm but was already in distress. My attempts to calm her were initially successful but by around 9.30pm she was near hysterical. I called the Crisis team at 9.44 and left a message. The Crisis team called back 8 minutes later.

After a brief appraisal I was advised to call an ambulance.

I called 999 at 10.05pm and was transferred to a call assessor who asked me and then Meg a number of questions. According to what I remember, the call assessor alerted a ‘nurse’ who may or may not have been attached to the 111 service. That ‘nurse’ called at 3 mins past midnight and assessed Meg, speaking to her directly. The nurse then spoke to me advising that I call an ambulance. I explained the train of events, suggesting that I was now going around in circles. The nurse then advised that they would alert ambulance services but to expect a delay in a response.

An ambulance arrived at our home at around 3.30am on Tuesday morning. Paramedics assessed Meg and offered a ‘pathway’. They would take her to A&E in the hope that it would lead to a mental health assessment.

We arrived at Basingstoke A&E just before 4am and all seemed relatively quiet, an observation that was confirmed by the paramedics. They handed Meg over to Basingstoke A&E.

And then we waited in A&E until 8.20am.

I was tired but there wasn’t any opportunity to sleep. I had plenty of time to reflect, to question the long line of events that had led to this moment.

Meg was here because of the specific symptoms of chronic OCD. She had been suffering with this mental health condition for many, many years. OCD was the primary condition that had brought her to CAMHS, Bramblys Drive back in December, 2018. She had been placed on a waiting list for two years and two months before her mental health had been allowed to become a crisis and her case deemed to be an emergency. Meg should have been signposted to Adult Services as soon as she was seen, face to face, by a group of CAMHS professionals on the 5th February, 2021. She wasn’t. Her appointed CAMHS psychotherapist, Mark Birbeck, had many opportunities to signpost Meg to Adult Services, particularly at Meg's 17 and a half year birthday milestone on the 10th June, 2021. He didn’t. Instead, he and his clinical cohorts allowed a ‘culture of pessimism’ about Adult Services to influence decision making over transition from Child Services to Adult Services. In my own, well-informed opinion, Mark Birbeck fell upon his own overinflated professional ego and decided that he was sufficiently competent enough to contend with Meg’s severe OCD presentation. He absolutely wasn’t. Meg was denied valuable clinical treatment, maybe for up to a year, as a result of decisions taken or not taken by Mark Birbeck. He and his clinical cohorts failed, grossly, in their professional obligations to treat my daughter, ignoring internal policies and protocols and dismissing guidelines set out in the National Institute for Clinical Excellence document https://www.nice.org.uk/guidance/ng43 and the full document https://www.nice.org.uk/guidance/ng43/evidence/full-guideline-pdf-2360240173.

As did those working at CMHT, The Bridge Centre.

I have outlined Meg’s journey through CAMHS, Bramblys Drive, Basingstoke in earlier posts to my blog here at www.fourandtwentydeadcrows.com. I will be continuing her story through CMHT, The Bridge Centre in future posts to my blog.

As I sat there with Meg in A&E I thought about the failures by CMHT, The Bridge Centre to attend to my daughter’s severe mental health issues. She had waited until January, 2023 before being allocated just 8 sessions of ERP (Exposure and Response Prevention), a specialized form of cognitive behavioural therapy (CBT) that treats obsessive compulsion disorder. Meg was then deemed well enough to be moved onto ‘reablement’. Mental health reablement is a community service that provides short-term, intensive support to enable independence for those that have faced mental health challenges. The service usually offers help with coping techniques, social inclusion, confidence-building, and goal-setting. Support may also include assistance with housing, debt, self-esteem, isolation, or joining social groups and volunteer programs. Meg wasn’t well enough to engage with ‘reablement’. Her OCD was severe and required considerably more intervention than the 8 sessions of ERP that she had so far received. NICE guidelines suggest up to 30 sessions of ERP for those with severe OCD. There have actually been historic cases that have required up to 50 sessions of ERP!

I objected to this decision and spent the rest of the year advocating, robustly, for further psychotherapy for Meg. Further psychotherapy was denied. In December of that year I resolved to protest against CMHT, The Bridge Centre by way of hunger strike. In the meantime, Meg had lost the opportunity for continuous and valuable clinical treatment for at least several more months.

My hunger strike seemed inevitable until Gemma Stubbington intervened. Gemma, at that time, was the newly appointed ‘services manager’ at CMHT, The Bridge Centre. Her arrival marked a change in clinical attitudes. In my mind I refer to my experiences with CMHT, The Bridge Centre as either pre-Gemma or post-Gemma, the former being regarded as bad, the latter, good.

It was Gemma who sought and secured appropriate funding for Meg’s continued psychotherapeutic treatment. Meg was allocated to psychotherapist, Stan Roman throughout much of 2024. Psychotherapeutic responsibility was then transferred to psychotherapist, Matt Sopp, mid-February this year.

By my reckoning, there have been

2 YEARS AND TWO MONTHS LOST while Meg was on a CAMHS waiting list.

1 YEAR AND 2 MONTHS LOST in between CAMHS ‘emergency’ meeting in Feb 2021 and the eventual referral to Adult Services in Mar 2022.

7 MONTHS LOST while waiting initially waiting for psychotherapy at CMHT, The Bridge Centre between Mar 2022 and Jan 2023.

Another 7 MONTHS LOST between being inappropriately scheduled for ‘reablemment’ and commencing psychotherapy with Stan Roman.

That’s an accumulated FOUR AND A HALF YEARS where my daughter Meg has been left unattended, abandoned due to incompetence and indifference! And I haven’t even mentioned the historic failures by our former GP, infant school, secondary school, Social Services and our first encounter with the blundering CAMHS, Bramblys Drive back in 2011.

As we sat and waited in A&E, I ruminated upon all of the events outlined above and had plenty of time to reflect upon and to question the long line of events that had led to this moment.

Here was Meg, overwhelmed and defeated, wishing that she could be ‘dead’. Her face was bloodied, a consequence of her OCD rituals, the repeated aggressive rubbing at her head resulting in friction burns and cuts, old wounds and new ones partially healed. Her hair that hasn’t been washed since 2021, hacked at with scissors so that she looks more like a concentration camp internee than the brilliant, beautiful girl that she really is and suffering from poor hygiene because she cant wash properly, attired haphazardly because she can’t dress properly. And so terribly tired because she can't even rest her head on a pillow without ritualizing, without going through a convoluted process that means she can make as many as 30 repeated aborted attempts to rest her head. God help her if whenever something ‘goes wrong’ with her hair at any time of the day and she is overcome by compulsions.

And there was so, so much more that I could have ruminated on.

I am her dad. I have to watch her suffer. Meg hasn’t got a life. She is denied the simple things that most people take for granted. She spends most of her time at home, with me, isolated and horribly diminished.  

And I think of those whose job it is to care, the clinicians and leadership staff charged with responsibility for healthcare. I think of those who are responsible for negligence, often willful, gross and unfathomably irresponsible negligence.

It makes me fucking incandescent with rage. I am like a steam engine under so much rivet-busting pressure, or like a nuclear reactor in meltdown, leaking phosphorus-bright radiation through bursting seams.

And I become hellishly focused on holding those same clinicians and leadership staff to account, like a forest fire about to raze an entire continent, a Mount Everest-sized asteroid on collision course with the Earth.

At around 5.30am Meg was becoming highly stressed, again.

By the time it got to 8am on that Tuesday morning in A&E, Meg felt desperate and needed to get out.  We were, apparently 3rd in a queue to be seen for assessment. I told duty staff that I was taking Meg out of A&E but was informed that she would need to sign discharge papers. A doctor told me that someone from the mental health would arrive within 1 to 2 hours but that would have made it 10.30am. And what then? More delays? Further procrastination? She needed urgent attention, probably a prescription for a more powerful sedative. I chose what was likely a swifter ‘pathway’, her scheduled psychotherapy appointment at CMHT The Bridge Centre at 11am that morning.

I advised Meg to sign discharge papers and get into a waiting taxi.

Meg attended her therapy session.

She was proscribed Lorazepam, a benzodiazepine medication.

At the time of writing this entry she has just taken her second 500mcg tab and reports to be feeling weird, kind of numb and sleepy . I‘m guessing the effects of Lorazepam are fairly rapid.

We live to fight another day although Meg’s days look to be largely confined to bed. The future continues to look uncertain.