This former asylum is punctuated by cigarette butts underfoot everywhere and are there to welcome you at the gate. Smoking is encouraged and a way of passing the time. Staff can be seen partaking, in stolen moments at hidden, and not so hidden, places. It gets you through the days and nights of keeping patients quiet or locked away, in rooms without toilets or wards without joy. You can tell the nurses by their uniforms, the patients by their demeanor, the visitors by their leaving.
If you're lucky the hospital shop will be open, where you can stock up on smokes, drinks and confectionery. It's now run by a voluntary sector organisation and has a (bulletproof?) screen at the counter. To protect the shop staff and volunteers from flying missiles, so I'm informed. Visiting the shop allows time to engage with the left behind customers, the people that time forgot, for whom the institution is home and a very familiar place. Nurses have told me these patients wouldn't manage in the community. I wondered if it could be more about keeping themselves in a job.
A decision has been made for around 45 of these left behind patients to be discharged from hospital. From a total bed number of 90. (has someone told the nurses?) I suspect it will mean more institutionalised living but at less cost. These rehab patients will have been given the mantra of lifelong mental illness and lifelong psychiatric drugs with a bit of psychology on the side, for maintenance. The recovery agenda has passed them by although they may have seen recovery posters on the ward walls. Merging in. Visible when lining up for pills.
In Scotland we have a new national mental health strategy imminent. The consultation highlighted suicide prevention and crisis support as priorities. In anticipation of the focus on people in mental distress I approached our local partnership coalition of statutory organisations around wellbeing, asking what funds would be available for this, and was told that there is around £1million to spend in 2012/3. However it had all been allocated up until 2015. After some further digging for information I found out there were funds for new initiatives. And an FOI (Freedom of Information) request revealed even more detail.
Yesterday BBC News Scotland put out an article with a great strapline 'Banged up for being suicidal' and a TV programme Scotland's Silent Deaths. Describing the many times that people who are suicidal end up being arrested and put in police cells overnight. "The police do not want to arrest them. But sometimes they are left with no choice because there can be nowhere else for them to go." SAMH (Scottish Association for Mental Health) Suicide Prevention National Programme Manager Kirsty Keay says that police cells can't be the best place for people "at the darkest point of their lives", and that there needs to be a different way of thinking about suicide. A need to consider the large numbers of suicide attempts and those who slip through the net.
The Edinburgh Crisis Centre is a place where people can go if suicidal. The only one of its kind in Scotland, the centre "is open 24 hours a day 365 days of the year and provides community based, emotional and practical support at times of crisis". Carers can also access all the services. Visitors have the opportunity of staying overnight and the centre has 4 rooms where people can stay for up to 7 nights at a time.
I want to see a crisis service like this where I live. A service that people can access themselves if suicidal or in mental distress. Staffed by people who know how to listen and have time to listen. A place of respite and refuge. Is this too much to ask for?