Participant 3
Interviewed by Molly Wilson
Biography
This is a clip from an interview with a service user who has been a patient at the Warneford several times over the past 5 years. The interview was conducted by Molly Wilson. In this clip, the service user describes their experience of being put on a Section 136 (a police-enacted section). She a detailed account of being taken to the 136 Suite at the Warneford. The service user’s wider interview talks about ward life in the hospital, and compares the experience of her admissions to both Wintle and Allen ward, two of the women’s acute wards in the hospital. If you would like to access the full interview, it will be available at the Oxfordshire Health Archives.
Transcript of audio excerpt
00:01:11 Interviewer
Can you tell me more about the first time you were admitted?
00:01:14 Interviewee
The first time I was admitted, I’m trying to think who the first, because I’d been put in 136 suites before. The Vaughan Thomas Ward has a 136 suite, and I had been in there before I was admitted to the Warneford as a patient in one of the female wards. So if we’re talking about the very first time I went to the Warneford, it was the Vaughan Thomas 136 suite, and I was taken there by police, which I think is a pretty standard procedure for them. And I stayed in there for about 12 hours, had a Mental Health Act assessment and went home. But the first time I was admitted to the Warneford as a patient, I went to Allen Ward after having a Mental Health Act assessment in a general hospital. And then they sent me to Allen Ward from there after that. It wasn’t straight after the assessment. I had to wait for a bed to become available. And they took me, I think it was around 2.30 in the morning, by secure ambulance over there. And I had a little tour around the place at 3am by the head nurse. And yeah, that was my first admission.
00:02:24 Interviewer
Could you tell me a bit more about that kind of being moved at 2.30 in the morning?
00:02:28 Interviewee
So I was having medical treatment. I had taken an overdose, and so I was being treated for that in the general hospital. I’d been brought in there under 136 by the police a few days before. And I stayed in there for, I think it was around a day and a half before the Mental Health Act assessment came. The psychiatrist came to interview me. And that assessment, usually, I’ve had quite a few of them, so usually they would take anywhere from about 20 minutes to an hour. This one only took about 5 minutes because they decided quite quickly, you know, they didn’t really ask me many questions. They just saw my presentation and put me on a Section 2 quite quickly. And so then I had the rest of my medical treatment there treated for the overdose. And after I was treated for the overdose, I had to stay in there until the bed became available in Warneford or elsewhere due to the ongoing bed crisis. It’s quite a long wait a lot of the time. And they found a bed at 2.30 in the morning and woke me up and said, we’re going to the Warneford. And yep.
00:03:31 Interviewer
That doesn’t sound like fun.
00:03:35 Interviewee
For Wintle Ward, Wintle Ward was different because I’ve been there as well. The first time I was sent to Wintle Ward, I had, again, I had liver failure and I survived liver failure, took about two weeks in the hospital. And during that time, they were trying to find a bed at one of the hospitals nearby in Oxford, but there was no beds available. So they were thinking of sending me to a private one in London. Thankfully, they didn’t. They found a bed on Wintle Ward. But because I’d been in the general hospital for so long, having treatment that I consented to after the first few days, they decided that they’d let me go there as an informal patient. So I went to Wintle informally, first off, which meant I had a lot more freedoms, which was nice. But then the second time, around two years later, I went there sectioned under a Section 2. So I have both those experiences and the ways that they differ. There’s quite drastic changes depending on if you’re sectioned or informal.
00:04:36 Interviewer
Can you tell me about those changes in those differences?
00:04:40 Interviewee
So if you’re sectioned, you do go to ward rounds. You have a ward round once a week, typically, with the doctors and the multidisciplinary teams. You do go to them and you’re allowed to speak in them, of course, but most of your care is out of your hands. You don’t really get to, you can sort of recommend what you want, like, ‘Oh, I’d like a bit more leave’, or ‘I’d like to do XYZ’, but it’s ultimately up to them whether you do do those things, based on what they see as your risk, which can be, of course, useful, in a lot of cases, especially if the patient doesn’t have capacity. But in my case, I did have capacity, but I was still under section. So it was quite frustrating to, I wanted to go and leave more and things that I thought I was able to do those things. But because the doctor disagreed, I wasn’t allowed to. Whereas when I was informal and not under section, I was allowed to leave freely from 9am to 9pm every day, as long as I told them where I was going, who I was with. Typically it was with my mum, just going out to shops or whatever it was. They’d let you go out 12 hours a day. You have to still give them information such as like, when you leave, you have to write what you’re wearing and like what hair colour is, eye colour, in case you do abscond and they need to call the police, they can describe you and that sort of thing. That’s still the same whether you’re sectioned or not, but the freedoms you get as an informal patient are very different. It’s less structured, whereas being sectioned is very structured. You have a lot of rules and a lot of, you can’t go out as much. A lot of the times you’ll be on a one-to-one nursing, which is quite intrusive, but it’s used for patients who need it. You know, it’s better to be intrusive than to allow the patient to be dangerous towards themselves. But yeah.
00:06:39 Interviewer
That sounds like a lot. Are you happy to tell me a bit more about one-to-one?
00:06:42 Interviewee
Yeah, so one-to-one nursing, it is the highest, or no, not the highest one. As far as I know, the levels of observation, one of the highest is one-to-one nursing, which means a nurse is with you 24 hours a day and doesn’t leave your side. I believe that there is 2-to-one nursing and there’s also 2-to-one arm’s length, where of course the patient stays with an arm’s length of two people. I’ve never witnessed anyone on that personally, but I’ve seen a lot of people on one-to-ones and things. And depending on your risk, you might get toilet privacy or you might not. A lot of the times you don’t, which is awkward. Someone has to watch you use the bathroom, which seems pretty barbaric, but in this environment, a lot of people are at really high risk of terrible things. So it has to be done. Same with showering and things, you get watched in the shower. If they’re nice enough, they might turn their head away, just let it slide, not tell anyone they didn’t look. But a lot of the times they are instructed to stare at you the whole time, which can be quite confronting. It’s the same in general hospitals. When you’re in a general hospital being treated, if you’re on a one-to-one nursing, they have to watch you in the shower and things as well. Same with a 136 actually. The majority of the time on the 136, I think they watch you use the bathroom and things. I got watched by the police, but I don’t know if that’s standard all round. But yeah, one-to-one nursing, someone just sits with you and you have, the good thing about it is constant support, because obviously if they’re sat right next to you, easy to support the person. It means that no matter the staffing of the day, like staff shortages and things, you’ve always got that one person for support that rotates every few hours or so, which can be really good for some patients.
00:08:29 Interviewer
I can imagine. Could we kind of circle back to the 136? You’ve kind of, you’ve talked about it as being a police section. Can you tell me a bit more about it and your experiences with it?
00:08:45 Interviewee
So my understanding is a 136 can be implemented when the person is in the public, so outside of their house, or they can’t be in the house when a 136 is, I don’t know the word, implemented on them. If the person was in their house when the police were called to detain them, that would be called a 135, I believe, which is where they have to get a warrant first in order to enter the person’s house and detain them. But a 136, like the ones that I was on… Anyway, so a 136, like the ones that I was on, would be that you’re in a public place. So for me, I was sectioned, it wasn’t on a bridge, it was near a bridge. It was like a public footpath. I’d been declared a missing person by my dad, and had the police called and they came and searched and things and they found me there. And what they do is they, firstly, they try and talk to you like a normal person and they say, ‘you seem distressed, we think you’d benefit from coming to a safe…’. They have a list of safe locations and that can be a 136 suite or a general hospital if the person needs treatment. I know it’s not allowed to be a custody suite. They’re not allowed to be taken to the police station and put in there. It has to be a hospital or another safe location of that sort of description. Sometimes I remember I’d been 136’d and they would also bring a community mental health nurse. That was quite rare, but it did happen a few times where there’d be a community mental health nurse in the car with them to come and assess. And you don’t get put on a section immediately. Of course, they try and speak to you first and they ask you, ‘why are you out here? Why are you missing? What’s going on?’ You know, ‘do you need medical treatment?’ And they will ask, will you come with them? And if you do go with them on your own free will, you won’t be detained because you’re complicit. But if you do refuse to go with them, they will quite frequently say, ‘well, we’re going to detain you under a 136 and you have to come with us then’. Which in my case, usually I would, I’d understand, right, my rights have been taken, like to stay, I have to go with them or they’re going to drag me with them. And a few times I was quite defiant. Obviously, unwell people aren’t making the best of decisions. And so, yeah, there was a few times where they’d sort of take you by force, you know, like hand around the upper arm and like pulling you towards the car and things. which is bad at the time, but when you look back at it, you realise you did kind of need it at the time. So it’s easy to forgive them for that.
00:11:33 Interviewer
Gosh, that, yeah, that sounds an awful lot to come through. Just with the mic, if you just move your hair. So you’re talking about 136 suite. Could you tell me how that’s different from a hospital room?
00:11:52 Interviewee
I’ll talk about the Vaughan Thomas one because that’s the one in Warneford. So the Vaughan Thomas 136 suite. Vaughan Thomas is a male ward. I believe they have 16 beds for men. But the 136 suites are gender neutral. You can, you know, go in there regardless of what your gender is. And they are attached to the ward itself. However, they’re through a separate door with a scanner so patients can’t enter, that suite. Basically, it looks like it’s like a bedroom, it’s got a bed. Sometimes, some of the 136 suites I’ve been in don’t have bedding, it will simply just be a blue mat. Other ones I’ve been in have full bedding, full duvets and like pillows and things. Sometimes a telly if you know they were really fancy. Vaughan Thomas has a telly, but it’s always broken from what I know. It never worked. And the way that it kind of works outside of the hospital ward itself… so, it is attached to the ward, but it’s a separate cut-off room. So you can kind of hear what’s going on in the ward next door, but you’re in your own area and there’s a nurse in there with you who sits one-to-one, regardless of risk. If you’re in a 136, you’re always on a one-to-one nursing. There’s a nurse who’ll sit in there and usually they’ll have a clipboard, and they’ll be writing what you’re doing every 15 minutes. So it would be like, in my case, ‘Emily was sat cross-legged on the bed’. ‘Emily was eating a sandwich’, because they will offer you food and drink and things. And yes, you just wait in there until a mental health practice assessment becomes available to have, which means they need to round up, two psychiatrists and an approved mental health practitioner, which can take a while. So sometimes you’re in there for 12, 24 hours. They try and make it as swift as possible, of course, but you know, it’s not always possible. So you’ll be in there for quite a while until your assessment, and then you’ll have the assessment in there, and then the practitioners will go and have their little talk to decide what to do, and you’ll either be admitted or sent home.
00:13:55 Interviewer
Wow, that, yeah. Can you, are you happy to tell me a little bit about how you felt?
00:14:00 Interviewee
Yeah, so the first time I went into one, it’s not, you don’t really go, oh, what should I do now? Because, you walk in there, there’s a bed and a nurse and you kind of think, right, well, ‘I’m just going to have to wait here for a few hours’. So, you’re not wandering around thinking, ‘how do I be a good patient?’ You just, it’s just a place to exist really. A lot of the times I’d go to sleep because, there’s nothing in there but a bed, why not? And so, yeah, a few times I’d go to sleep. Sometimes you’d get a nurse come in and do physical observations. They’d take blood pressure, check your pupils, and all that sort of thing. There was a couple of times they gave me a diagram of a human body and you’d have to mark down any tattoos or scars or distinctive like features and things. So in my case, I wrote down where I had tattoos and stuff. And yeah, they’ll take that away. And it is basically just a waiting room. You just wait in there for an assessment. You don’t really get much interaction from the staff, unless of course you speak to them for such a lot of people in that state wouldn’t really. They’re not in the mood to be social. But yeah, you just wait in there. And so, yeah, most of the time I just went to sleep. You’re allowed your phone, I guess, depending on risk, most of the time you are. So I would go on my phone sometimes. It’s literally just like a bedroom, just with a nurse in it.
