Leaving the NHS, the conference that never was and the impact of C19

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Well this week is going to be nothing like it was supposed to be.  Instead of heading to the British and Irish Group for the Study of Personality Disorder annual conference, I’m going to be isolating at home with a vague sense of unease, guilt about not doing more, and a growing sense that this is the worst time possible to be leaving the NHS.

Keir provides therapy, consultation, training and supervision via beamconsultancy.co.uk

Going to the BIGSPD conference is a highlight of the working year for me.  I was totally self funding so I’d booked my days of work, got myself an air B&B and was looking forward to hearing about some of the really big developments happening at the moment.  I was most keen to hear how much we are spending on Out of Area treatment for people diagnosed with ‘personality disorder’, or people who self harm, or people who feel recurrently suicidal.  Someone had contacted every CCG to try and get this information which has so far eluded me.  On top of that, we were going to hear about the future of training around working with those who get this diagnosis.  I was really looking forward to an update on the CALMED trial – this is a controversial study to look at the efficacy of Clozapine for people diagnosed with BPD.  I’ve got mixed feelings about this.  I went to a low secure unit the other week and everyone there was on it.  We can argue this makes sense because it’s for the people with the most severe problems but I have serious concerns that this is one of the dangerous things that happens when people are out of sight and out of mind.  The biggest thing I’ll miss out on is having a debate with the staff of St Andrews around the ethics of private mental health placements.  I’ve been looking forward to this for months and while I’m sure it will happen, there’s a definite sense of anticlimax.  Lastly, I wanted to talk about organisation centred care with @hoppypelican.  Thi is our wry take on person centred care where we argue you can only deliver person centred care if you target the anxiety of the clinicians/organisations working with people.

What would have been novel this year is that the Mental elf would have been taking the conference beyond the room for the first time ever, helping us to reach people who have never thought about this area before.  I’m often surprised by the amount of people who are really interested in this area but have no idea that BIGSPD exists.  The more people who think alike, working together the better I reckon.  Alas this opportunity is going to pass…

So instead of doing all the above, I’ll be trying to see if therapeutic communities can happen online.  Instead of leaving the NHS a week on Monday, I’ll be seeing if theres a way to stay on and help out while the crisis passes.  Instead of a brave new dawn I’m looking at the kind of evening sky that would terrify shepherds and wondering whether I’m doing enough.

I’ve read a lot of dystopian/post apocalyptic fiction in my time and theres a big part of me that wants to go and panic buy.  To get a gun and head for the mountains.  To break into warehouses and put aside stores for the future.  The heroes of these stories tend to be pretty well prepared and there’s an itch in my brain that sees people wandering through town with 200 rolls of bog paper that tells me I’m missing out.  I’m noticing the urge to hoard and instead, I’m trying to practice some of what I spend a lot of my time preaching.  Calmness, trust in others, a belief that this too shall pass and mostly a deliberate turning of my mind to hope.  I really enjoyed and was inspired by Hope in the Darkness by Rebecca Solent recently.  I’m going to leave you with a few quotes from it, and my own hope that we find ways to be together while being apart, that we show how much we are connected by keeping away from each other and that we can hold each other without being present.  Take care of each other, (but stay at home).

“To hope is to give yourself to the future – and that commitment to the future is what makes the present inhabitable.”

“People have always been good at imagining the end of the world, which is much easier to picture than the strange sidelong paths of change in a world without end.”

“Hope just means another world might be possible, not promise, not guaranteed. Hope calls for action; action is impossible without hope.”

“Inside the word “emergency” is “emerge”; from an emergency new things come forth. The old certainties are crumbling fast, but danger and possibility are sisters.”

“To hope is to gamble. It’s to bet on your futures, on your desires, on the possibility that an open heart and uncertainty is better than gloom and safety. To hope is dangerous, and yet it is the opposite of fear, for to live is to risk.”

Keir provides therapy, consultation, training and supervision via beamconsultancy.co.uk

Its a decent book if you get the chance to read it, take care of yourselves.