Ellie Diana
@ellie_dianab
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#Psychiatry 🧠| Also a human, #borderterrier + cat mum 🐶🐶🐱 and #artist 👩🏼🎨 - follow artwork on Instagram @prescribe_art . RT doesn’t = endorsement.
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The last weekend and what has happened to me over months thanks to
@TEWV
birchward have been too much please please someone someway hold this trust to account. I’ve recorded much of it here and a friend has hard copies but it must be shared and not left to this brilliant lady.
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8 years since I volunteerd in a Psych inpatient unit, today I start my forever career in Psychiatry ❤️.
@RCPsychTrainees
@rcpsych
#CT1psych
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@BBCR1
sunrise on the way home from TITP 8hrs after we were getting down to prodigy,
#lastphoto
#TITP
http://t.co/eWwzFOoVZ5
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@Mayz131
Much of your tx sounds ableist and gaslighting. I get your fear of a psych unit (living that hell right now) SEDUs with PEACE pathway training can be ok. a formal or informal advocate might help. Once institutions realise there is a witness to their behaviour they can change.
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@autisticpuffin
This comes from them already deciding you’re EUPD which we discussed that whilst they list sx from ICD10 they don’t actually explain how it applies to you. So that’s where the boundary setting and DBT all come from. Confusing the dismay at being misjudged as manipulation 🙄
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#RCPsychLive
as someone also on immunosuppressants. Very familiar feelings expressed by Dr Leanne Tozer on shielding. Would love to help with things like virtual teaching/QI. Thank you for sharing your experiences and ideas, I hope all Trusts utilise shielded trainees’ skills!
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@Shrink_at_Large
Being on the patient side has sickened me to the pit of my stomach I’m not sure if I do survive the iatrogenic harms of this autism vs pd thing I can morally return to psych. So many psychiatrists trained (barely) in stamping eupd labels of traumatised females but not one trained
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#imnotjustadoctor
and I probably wouldn't be one without painting to keep me sane!
#istandwithjohann
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@autisticpuffin
I agree but this is their issue not yours trust me to be even writing like that arrogant. I always write my notes as if my patient is sat looking over my shoulder - ie would this be upsetting? There are plenty of psychs who can do this brilliantly!
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@judyskt
@autisticpuffin
Of course there are people who meet the criteria, do really suffer, may be standing on bridges or SHing daily and then being stigmatized by the very people who are meant to care when they’ve suffered huge trauma and rejection in life. For balance there are brilliant caring staff!
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@judyskt
@autisticpuffin
From my experience it’s not something that comes from lectures in medical school or clinical placements (though I had an excellent tutor who would always encourage us to think about the different diagnoses and not to rely on prior notes. It comes from culture from teams and wards
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@judyskt
@autisticpuffin
it becomes a term for patient staff often find difficult or that they want to quickly put in box or reduce down a large waiting list. Sometimes it becomes a term staff call each other which is particularly sick.
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@tewv
@BrentKilmurray
since when was it my responsibility NOT as a ‘Psychiatrist’ as your ‘PATIENT’ to ensure boundaries are in place and I’m treated as an out of area patient and to locate an eating disorder service in a trust it doesn’t exist.
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Imagine being an Anorexia patient which can carry suicidal ideation/attempts. Imagine being seriously physically ill with that illness and all of a sudden commissioners instruct inpatient and cmht settings to discontinue your care cause they don’t want that ‘risk’ on their patch.
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#Vcare
mental health patient transport used by
@NHSEngland
NHS mental health services. If you know, you know. My latest injuries caused by the use of assault, straps (supposedly banned in the NHS) and handcuffs causing profuse bleeding due to their tightness. I’m osteoporotic,
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@Lara_Fergie99
@elysiumcare
I just don’t get it. Where is the evidence for treating people who have most likely suffered significant neglect and rejection trauma with…neglect and rejection 😞 all the going back to nothing thing will do is cause people to go well sod it I’ll go crazy as nothing else to lose
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@autisticpuffin
‘Wanting and hoping for good care’ seems to be a EUPD pseudo-symptom a lot these days. Gosh we must have a lot of cancer patients wanting the right care running about with undiagnosed EUPD!
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@jamesldowns
Important to ask as well because of the dangers of certain methods (all are dangerous of course) but poison ingestion/fluid loading/certain substances/objects/risk of perforation and although rare boerhaave syndrome which is life threatening.
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@DHSCgovuk
@GOVUK
received
#shielding
letter 4 weeks ago, registered online, all of the above and still no promised ‘priority’ delivery slot. Can’t get a
#supermarket
delivery and left in the dark despite multiple phonecalls.
#COVID19
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@doctor_oxford
reading
#YourLifeInMyHands
in the shadow of Vesuvius in Italy, frank and inspiring, hope its also Hunt's holiday reading!
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@TEWV
@BrentKilmurray
you have deliberately, knowingly and violently repeated the very traumas you were meant to be helping me with and knowingly sending me to somewhere that would ruin my chances of recovery, life and career. That is why this has happened.
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@tewv
your consultant told me to hang myself cause I ‘had capacity’ he hadn’t assessed it. When I did as I was instructed your actions were then critical to me when I did and conveniently you’d have to get rid cause ‘risk’
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Some ‘friendly advice’ hull royal, perhaps reign in your security staff. Woke up to get coffee, got to ward doors quickly surrounding by 5 healthcare staff AND 5 security’gloving up’ ready for a fight against 1 anorexic patient not touching anyone. You’ve already been warned and
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@lovebillybragg
@raj_psyc
@suzypuss
@subodhdave1
@TrudiSene1
@jsbamrah
@adave_NHS
Can give both patient and psych trainee perspective: as patients were told it would just be monitoring vital signs but were then handed out leaflets suggesting it was also recording full imaging with no idea who was ‘watching’ us. I would imagine this could be hell if paranoid.
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Disabled man starved to death after DWP stopped his benefits | Disability | The Guardian. Let us never forget
#sicknotesunak
the stigma and hatred your government already inflicted upon our most desperate in society.
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that is my unethical undignified placement for ‘treatment’ against my wishes in an area I am employed is it not. When you’re already at rock bottom and some individuals decide to add that extra warm fuzzy feeling. Would this happen if I had pneumonia on a resp. Ward I cover?? 🤔
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@TEWV
your nurse consultant would have nice private little chats with me often diverting or blatantly lying certainly on the final day when forcibly manhandled into a van with no belongings which you had promised to my face with a ward manager would not happen
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@Mayz131
@NHS_ELFT
The bold bit is the crucial bit. Can’t be judged during Anorexia. E.g I was suicidal multiple times in the last year and had never been in the prior 32 yrs!Hunger (low bms) can cause irrational anger. Black and white thinking caused by starvation. BUT all revert in AN recovery ❤️🩹
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@HealingMindsTW
Unnecessary, traumatising and often undertaken at time of significant bodily changes and fluctuations (puberty) & a time when the mind is vulnerable to the sense it makes of this.
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Bitchward
@tewv
you had made me so hopeful when you accepted my referall last year that I could finally cover - I really was ready despite the many wrongs in my life that year I didn’t want to use manage them with AN anymore.
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@Shrink_at_Large
in how to diagnose adult autism without LD so how can they possibly make a fair diagnosis? The dehumanization and cruelty from repeated hammering a square post in a round hole is monstrous and if it doesn’t kill you it destroys your life.
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@Mayz131
And I see it all the time in me, in fellow patients and on here. The pain of overcoming that trauma hump we’ve been numbing makes us run back to the starving/the drug again and again or it morphs sh/suicide/autistic breakdown/bulimia/psychosis/PTSD many mislabeled EUPD
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@ONS
As one whose heart was restarted at New Year and who works in MH the reasons seem abundant. MH is still the 3 class citizen in health care and it’s getting worse yet the cause for highest mortality in the young working age. Services have no where near the funding we don’t offer
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@BBCNews
Shops open, people arguing over 1 vs 2 meters yet still no update for the
#shielding
stuck at home. What is happening after June 30th? We have lives and carreers we need to plan too.
#DailyBriefinguk
#coronavirusuk
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@tewv
you made all these promises that you could change this and that social situation and a promise of so many therapy sessions that fell well short, you got the specialist autism team in to explain why this time I was suffering with autistic burnout and suicicidality.
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so label a person who has clearly attempted
#suicide
as
#EUPD
and even those qualified would prefer to label this
#self
-harm and
#misadventure
, belittling, minimizing & diminishing someone’s deepest, darkest distress with terminology we’d not be applying to men in these circs
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Just the latest life changing, life threatening
#anorexia
comorbidity you’ve caused by slyly moving me to a non-SEDU for my ‘safety’ when I was so unwell with AN
@TEWV
@BrentKilmurray
wernickes encephalopathy
@AgnesAyton
@rcpsychEDFac
@HopeVirgo
@beccyjanehealey
@CareQualityComm
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@NurseVictoria2
@Mayz131
What a concerning view, we are going to have a lot of deaths in a and e if nurses think they only have to bother with their objective opinion and not the subjective view of the patient…
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@Lara_Fergie99
Agree and I’ve always point blank refused in all settings general, SEDU,community. Weighing is so integral to maintaining anorexia I think one day perhaps in decades we’ll look back and realise it caused more harm than good. There are other ways of assessing physical improvement
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Severely underweight with multiple fractures and dislocations. I didn’t want to go for good reason but I didn’t touch them. Whilst I continue to experience the ‘other side’ I will continue to share it with absolute honesty.
@CareQualityComm
@DHSCgovuk
@Ofstednews
@DHSCgovuk
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And this folks is how anorexia patients are getting left on the scrap heap. Palliative care actually seems an extra in this madness. 10+ years of NHS service as a doctor to be treated like this
@rcpsych
@rcpsychEDFac
the lack of ethics here has put me off that career for life.
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Pretty terrifying, pretty isolating, and suddenly the only way to get any care is palliative. This is where we have come. A once capable, keen, able psychiatry trainee broken by services
@rcpsychEDFac
@PHSOmbudsman
@HopeVirgo
@beatED
@rcpsych
@BrEDSoc
@PEACE_Pathway
@AgnesAyton
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@Shrink_at_Large
@Mayz131
As an autistic with AN I’m terrified of where this is coming from, clearly they want to drive the numbers down. Yeh you might handle a stressful situation with under or over eating but it’s not going to last long enough for significant weight changes or for set point to come back
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7 x files of
#FOI
from 1 Trust, another Trust due. I’ve only read a couple of pages but the contradictions, the lies, a senior consultant going through my belongings after he’s rid of me to another unit w/o permission and the misuse of
#oxevision
we were promised wouldn’t happen
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Just watched
#TalkingToAnorexia
- the most insightful and accurate explanation of the illness I have seen to date. Well done
@louistheroux
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I sense my time is up (33) but
@rcpsychEDFac
@AgnesAyton
@rcpsych
@beatED
@HopeVirgo
please continue what you started to do in bringing awareness to this abhorrent practice and stopping it before more vulnerable people are forced to die too young.
@BBCLookNorth
@bbchealth
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local cmht has declined me for the reasons above he still to tell me to go there. This has been going on for on a very long time
@tewv
@BrentKilmurray
your SEDU consultant told me to hang myself as ‘i had capacity’ this was witnessed.
@bbchealth
@gmcuk
I’m not covering anymore
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You clearly failed since you sent me to a psychosis non ED unit. Your failure are embarrassing.
@rcpsychEDFac
@AgnesAyton
@hopevirgo
and many others are aware appalled by your trust. The care co seems to have h hearing problem
@tewv
as it doesn’t matter how often you tell him my
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@lovebillybragg
@raj_psyc
@suzypuss
@subodhdave1
@TrudiSene1
@jsbamrah
@adave_NHS
Essentially privacy and dignity issue and staff workload unchanged. Could have died regardless and staff still had to spend 48 hrs doing constant obs as well as repeated NEWs. Massive waste of money and at some point probably a safeguarding concern when it inevitably is abused.
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@DrKateLovett
@RuncimanRoss
Thank you so much for this. I had submitted a question to the RCPsych website about training and shielding. It’s so hard trying to have discussions with Trusts and Trainers about future training atm. I’m so glad this will be covered! 👍
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Hope psych maintains its standards lost in other specialities: truly protected teaching/supervision, a desk, a computer, drinks...a toilet.
8 years since I volunteerd in a Psych inpatient unit, today I start my forever career in Psychiatry ❤️.
@RCPsychTrainees
@rcpsych
#CT1psych
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I face a journey back to the gastro wards if this can’t turn around and realistically it won’t since as it stands I don’t even have cmht or AN expertise but my consultant here is fighting that too 💪💡 ‘many hands make light work’ and just maybe I’m over the worst of the torture.
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Non-med family, only person in my year at comp to apply for med. 4 rejections. Year working in care home and supermarket & MH volunteering. Reapplied: 3 offers. Almost left med school, illness, Loss of fam home & finances. Now psych CT1 with leadership pgcert
#mypathtomedicine
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I have gone from a specialised meal plan on a
@TEWV
SEDU of at least 1500kcal to less than 2 biscuits a day and fluid sips with meds. With a severe to critical bmi. There is no expertise here to quickly recognise AKI, refeeding risk etc
@rcpsychEDFac
@beatED
@AgnesAyton
@BrEDSoc
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New FY1, worked 2 wknds already, hospitals surviving thanks to selfless staff working unpaid overtime, show us resources,
#showusthe7dayplan
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@lovebillybragg
@raj_psyc
@suzypuss
@subodhdave1
@TrudiSene1
@jsbamrah
@adave_NHS
Effectiveness in terms of prevention of harm extremely poor. One ‘attempt causing LOC took 50 mins for staff to realise or respond to and another cause again LOC took out c3 and 4 vertebrae resulting in a neck brace for months. Not sure oxyvision picked up either.
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Can’t really endorse
#choosepsychiatry
anymore if this is the stigmatizing attitude of colleagues
@wendyburn
@DrKateLovett
@rcpsych
@rcpsychTrainees
@Choose_Psych
. My membership of a WhatsApp group that does not discuss patients is kind of rearranging deck chairs on the titanic
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@autisticpuffin
@Mayz131
@jamesldowns
@fran3tic
It can work, just enough gain in SEDU for the mind to be more nourished and therefore flexible enough to consider recovery means recovery can be easier once out even on minimal gain. Had a friend who was a brilliant example of this. So proud of her.
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@wendyburn
@attendanywhere
I’ve had good experiences as a patient using it. I wish all trusts were using it as a video platform as there is a lot of variation.
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@laurie_ama52837
I’ll dip a toe in. It’s 2024, hate to break it to you but in medicine the term BPD was dropped long ago and it’s replacement EUPD no longer exists in ICD11 so we ‘clinicians’ don’t need help perpetuating harmful stigmatizing terminology. Looks like you’re still giving it a go tho
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@Mayz131
Used to hear 7 years quoted a lot but not all of that would be in services - expect 7 days in services unless you’re super special 🙃. My last relapse took 4 years recovery but I wasn’t at a critical bmi, it just was followed by 8 years fully functioning wellness
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@ONS
would you ever return following an attempt then? fam and friends walking away cause it’s ’gone on too long, it’s attention’ (if they’re dead or near it wasn’t) embarrassment, stigma, you need their love, support and inclusion most, so brutal is the loss of what ⚓️ you to the 🌍
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@HopeVirgo
It just creates the crisis we are in critically ill patients need urgent gastro and SEDU beds. Completely avoidable. If CMHTS treated AN like they do schizophrenia ie keeping chronic cases, checking in ready to catch the relapse then we wouldn’t be in this revolving door mess.
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What are you scared of? Initially if you’d have had ownership been trustworthy and not behaved in such a despicable and frankly negligent manner you’d have had nothing to worry about. Now I will stop at nothing, no one else will suffer what I have.
@GdnHealthcare
@CareQualityComm
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@autisticpuffin
@TEWV
@BrentKilmurray
He’s such a gas lighter this one, there is literally not an ED service in my trust so I’m having to ‘choose’ palliative care and he knows it!
The inpatient treatment they forced me into in trust was spent home the last 3 weeks cause it was it was doing more harm as a non SEDU!
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Ward office blocking all requests to speak to anyone higher.
#immoral
from top down. I don’t know how clinical staff manage their lack of candour, you may be lower down but you have a duty to speak out.
#medicalethics
@TEWV
@beatED
@CareQualityComm
@rcpsychEDFac
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@SueMcCowan1
@conor_davidson
@rcpsych
@thriving_autist
@adult_autism
Would have expected 50s to be a crucial time, particularly for women who face menopause around this time and that could be the first time the mask skips or at least others actually notice it does.
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@HealingMindsTW
This. Weight restoration seems to be a time of significant psychological vulnerability particularly where starvation and weight loss has been serving a purpose e.g. numbing emotions & yet it’s a time when many services seem to discharge and thus revolving door ensues.
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@judyskt
@Shrink_at_Large
When it comes to recognizing autism in adult females most trusts unfortunately are completely clueless, no training, no service so the result is misdiagnosis, maltreatment and harm. I can’t speak for all trusts but can certainly for a far few. EUPD is a cheap way of ‘removal’.
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About a week later and it’s my TRUST and my COMMISIONERS that made the decision long enough ago for there to have been meetings and records…so which one is it
@TEWV
and do let me know when you find your morals, my concerns were 100%, as were those of dangers of AN deterioration
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@Mayz131
Well done for fighting May - imagine how dangerous this would have been if you’d have given up and just believed them!
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@AnLasair
I really wish we could take insomnia more seriously. There are genuinely really serious complications and knock on effects for severe and chronic insomniacs. I learnt the hard way suffering my first ever epileptiform seizure which the neurologist put down to a sleepless 72 hours.
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@Shrink_at_Large
🤢 have heard similar followed by the obligatory you are going to keep yourself safe aren’t you, yes. They they think documenting that protects them. Was recently told by a consultant to go hang myself as I have capacity, he opened the doors for me and I obsessed (autistic) on it
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@Shrink_at_Large
Did wonder whether there would be legal push back over the vouchers thing, denying people the same currency as a non-disabled person because they are disabled is surely against the disability and equality act. Also PIP doesn’t = unemployed for many it’s the reason they can work
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@Mayz131
You would not believe how many mother-daughter issues and estrangement I’ve come across in AN. Me and my very good AN friend in that camp. Mother turned down attending resus when they were trying to restart my heart following hanging and told her I may not survive.
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@DrKateLovett
@wendyburn
@rcpsych
@RCPsychTrainees
thanks 😊 already feeling very welcome! Following
@RCPsychTrainees
+ met a few in person!
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I have suffered cardiac arrest from hanging and literally held on to a tuft of grass for life on a sheer vertical cliff over the North Sea. Those are not easy states to get into. It’s incredibly hard for me just to write them but it upsets me more that people not qualified to
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@Nadia_Craddock
Agree & as an AN sufferer often find they can be so far from representing my experience - would love the opportunity specially having been on both sides of the fence and being ASD. It seems to be a case of who you know & often London/south centric where care seems v. different.
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@jamesldowns
And finally I’ll get off my soap box. If we did this 20 years ago there would be 1000s of medics, nurses, artists, entertainers, coaches, OTs, authors, campaigners, historians, researchers,scientists,chefs,lawyers etc etc who unnecessarily would not be here.
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Only, it was only recently we discovered things like fixations with trains could just as easily be applied to female toys. In addition females are slightly better at masking due to social advantage but the effort can lead to huge meltdowns once home. I was mute till 7,
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@AgnesAyton
@jamesldowns
@jmw3cat
@TimetoChange
@beatED
@BrEDSoc
@MQmentalhealth
@MGedt
@rcpsych
@FREEDfromED
@ncmh_wales
@kingsedresearch
@RCPsychWales
Which is why SEDUs shouldn’t be washing their hands of those MH comorbidiries and risks transferring patients to units which then can’t manage the ED physical risks. All MH nurses are trained on MH and suicide but not all on EDs so SEDUs should never be getting away with this.
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@DrChloeBeale
@rcpsychEDFac
@beatED
Thanks for your honesty from a trainee psychiatrist in her 30s currently in a SEDU. I started sharing my experiences on SM this year after before always fearing stigma & being reported.But I felt there was a hypocrisy in hiding it whilst preaching ‘awareness’ and ‘speaking out.’
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b) invited the ward JD without either consultant or JD checking that was ok with you? Perhaps a future SJT/MSRA question …
@gmcuk
@BMA_JuniorDocs
@TheBMA
@MedEthicsAdv
@rcpsychTrainees
@rcpsych
@rcpsychEDFac
@wendyburn
@DrKateLovett
@AgnesAyton
Maybe I’m overreacting 🤷♀️
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@AlysColeKing
@wendyburn
As psych trainee, student mentor, ex whistleblower, felt this was fab article, honest on misuse of resilience + improving wrking conditions
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@Mayz131
Umm biscuits?? 😭😭 used to love veg but not worth the pain and unpredictable vomiting anymore. Only thing I could get away with is fully liquidised eg soup or if fruit smoothie or juice
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This unit wouldn’t know about
#MEED
or KCL risk or how to act
@AgnesAyton
@rcpsychEDFac
@beatED
@MaudsleyNHS
@EvolveHull
but I’m now hitting multiple concern and alert areas.
@TEWV
Birchward and
#commissioners
would have known this would happen given my preexisting vulnerability
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@jugglingjenn
@AnorexiaMyths
@OonaHanson
It was implied lots of extra cream would be enjoyed - I can’t think of a single anorexic who would enjoy that experience that is where a comparison was being drawn.. I don’t even specialise in EDs but u I have lived it’s hell 20 years with others
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@DoohanRachel
menstruate biologically at very low bmisc and particularly if on certain hormone or device contraceptive 2) they intended to refeed and increase your weight soon so it’s likely to reappear at some point - happy point for some, horrific point for others . 3) no waste disposal wc
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@DHSCgovuk
@CMO_England
Please stop justifying
#COVID19
deaths with comments about ‘underlying health conditions.’ You don’t have to be old and palliative to be ‘vulnerable.’ Such statements falsely reassure and encourage ‘Look after no. 1’ thinking.
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Making tramadol a controlled drug was well overdue in 2014. Pleased to finally see the vote to make pregabalin controlled too
#ARM2017
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Perhaps controversial but please don’t choose
#eatingdisordertreatment
to do as a consultant without specializing just cause you can’t cause you’re nearing retirement and you’re more bothered about your pension. It’s people like you that contribute 1/2 a page to a file this big.
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@Mayz131
I think it’s more common than we allow ourselves to be believe due to self stigma. During one SEDU admission I was one of 5 out of 15 beds that were taken up by medics covering the full age range & all specialties. I’ve never had an admission without health and/or social workers
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@rcpsychEDFac
@PEACE_Pathway
@AgnesAyton
@TEWV
@BK
@beatED
@rcpsych
@Psychautismcham
@DrKateLovett
@wendyburn
do any of these warrant the manhandling of a severely anorexic and autistic patient on the sly at 3am without any belongings,
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@Mayz131
@Lara_Fergie99
BMI depends on: age/height/albumin and fluid/constipation/dehydration/clothing/weight loading/time. It cannot be blanket applied. bmi 13 could equally die compared to the bmi 9 that people get stuck in their head as some kind of miracle but 99% would die before ever seeing it.
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I'm raising money to keep my pets safe and cared for whilst I’m in hospital. Click to Donate
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