Nicola Slawson and Guardian readers 

When I leave someone suicidal I’m scared they won’t be there the next day

From supporting a suicidal young man to being held at knife point by a child, social care professionals recount what keeps them up at night
  
  

Sad girl lying in bed
‘It’s a fear that finds you not just at work but on your lunch break, during the commute, in the bath, everywhere.’ Photograph: Milos Kreckovic/Getty Images

Leaving a suicidal man in the hands of colleagues was hard

During my eight years in social care, I have struggled, like everyone in support roles, with the dreaded fear. It’s a fear that finds you not just at work but on your lunch break, during the commute, in the bath ... everywhere. I recently supported a young man in his early twenties who has a long history of mental health problems and was alcohol dependent. It was the anniversary of a bereavement, and he was intoxicated, self-harming and suicidal so I spent hours with him calming him down and putting plans in place. I stayed late – you do in this role, it’s not 9 to 5 – but the time came when I needed to hand over to my colleague.

You have to trust your team when you leave someone like that. But then you leave after having been in an intense crisis situation and you close the door behind you and you’re in the street with people just walking their dogs, doing normal things. You go home thinking over everything you did and wondering what you’ll be told when you go back the next morning. Senior support worker, Sussex

I worry when people with mental health problems are in crisis and have no support

Time constraints and a demanding caseload mean that at times I feel I’m just putting a sticking plaster on situations as we’re expected to work fast from assessment until discharge. I worry about the individuals that fall through the net. IAPT services appear to cherry pick those with low level support needs that will provide them with the best outcomes This leaves those with more substantial needs who have suicidal thoughts, or dual diagnosis unable to access counselling or cognitive behavioural therapy. I worry that genuine care for people seems to be missing from the service; my colleagues have judgmental attitudes and a lack of empathy. When I’m not there, I fear that people won’t be visited unless they hit a crisis. Even then, I worry about the lack of support from the crisis team. We’re meant to take people to A&E, which is a waste of NHS money. They often refuse to help so the police are called, who can’t help. All they need is some additional daily home treatment to get them through it.

Mental health social worker, Lancashire

Who looks after older people with advanced dementia?

In the past I’ve worried about the people we’ve looked after who were incapable of being alone because they had advanced dementia. One would walk around outside in the middle of the night, claiming they had been kidnapped and needed to get home. The police wanted to detain another under the Mental Health Act but the doctor refused. We have also reported numerous instances of service users being abused physically, emotionally, financially and sexually, only to be told by the relevant authorities they were private matters between husband and wife. Not enough is done to protect people. That is until it is the carers at fault and then people are up in arms about it.

Community team leader for a home care agency, North Devon

I was held at knife point by a five-year-old, but being taken off the case just made me worry about the family more

I worry about not having sufficient time to spend with families to really make a difference. My time is so thinly spread that I’m having a mediocre impact at best. I fear for families that are offered support but, due to caseloads and lack of funds, this doesn’t come to fruition.

One family sticks out in my memory. The dad was disabled, the mum was attending IT courses to help her get back to work and they had three children under seven, the oldest of whom had significant behavioural problems. The family felt like they had been passed from pillar to post and that the health team, school and social care were letting them down.

I have been held at knife point on two occasions while working and one of the incidents was in this family’s home. It was the normally well behaved middle child, aged five, who held the knife to my head while I was trying to help the older one. The parents were devastated and called the police themselves but no further intervention was offered. I was pulled out of working with them and it was stepped up to a social worker who didn’t know their history. The family had to retell the story, which must have been frustrating considering that the eldest child took a good year to put her trust in me.

Family support worker, east Midlands

We are humans, making human decisions. What if that decision is wrong?

You can’t always be there to make sure everyone is OK. Leaving work when someone is sick, substance affected or suicidal makes you fearful. I worked with a young woman who had experienced a lot of trauma and struggled with mental health issues. One afternoon she said she was having hallucinations and was concerned she may harm someone as a result. I took her to A&E and stayed three hours late with her. You try to make a difference in the social care sector, but there are always worries, especially given that we are humans, making human decisions. What if that decision is wrong? You often second guess yourself and wonder: “What if I had done that differently?”

Resident support worker, east Sussex

I hate not being able to make a difference when it really matters

I worry about children getting stuck in one part of the system and missing out on support that would make a difference. I was working with a 13-year-old girl last year at risk of child sexual exploitation who was recommended a different care plan to what she needed. Within a few months it was discovered that the girl had been groomed by an adult offender on the internet and he was arrested. Only then was she moved to the appropriate child protection plan.

Senior family support worker, Surrey

If you are experiencing suicidal thoughts, the Samaritans can be contacted on 116 123 in the UK. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here.

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