We are writing with regard to the recent treatment of my partner, Miss Kate Heffer, at Lake House. Kate has been suffering with depression and psychotic episodes for approximately three years. Because her major presenting symptoms include severe bouts of anxiety and feelings of paranoia and persecution, it has obviously been very difficult to persuade Kate to seek treatment for her ongoing condition.
Kate has been under the care of Lake House unsuccessfully in the past, and was understandably reluctant to accept her GP’s referral to your service in December of last year. However, Kate recognised that she needed help and agreed to give the staff at Lake House the benefit of the doubt and attend a meeting with the psychiatric nurse as a preliminary to further investigations and/or treatment.
As Kate finds it very difficult to communicate, I had to speak on her behalf for much of this first interview, which was conducted by Mr Vijay Sawmy. During this first interview I took considerable pains to impress upon Mr Sawmy the following facts:
- Kate has definite “trigger events” which bring on bouts of deeper than usual depression, along with feelings of intense anxiety and an increase in the intensity and duration of the hallucinations she suffers from
- One of the main trigger events for Kate is interaction with medical professionals – Kate shares with many people an anxiety about doctors and hospitals, but during her illness this has increased to a remarkable degree and has hindered our prior attempts at successfully finding a treatment for her condition.
- Another major trigger event is the unexpected arrival of people at our flat, especially strangers.
Given these triggers, I stressed to Mr Sawmy that Kate would most definitely not benefit from home visits by the community psychiatric nurse. Kate herself pointed out that she had been seen at home by Michelle Hyder in the past and that this had been counterproductive. We both made efforts to stress that, in Kate’s case, home visits would not be appropriate.
All this brings me to the events of Thursday 28th of January.
Early that morning I received a telephone call from Mr Sawmy expressing his concern that Kate had missed an appointment on January 7th with Doctor Gopaul, and asking if it would be possible to visit Kate at home later that day. I reassured Mr Sawmy that Kate had missed this appointment due to the bad weather (Lake house's Voice mail stated all appointments were cancelled due to snow) at the time, that we had since booked a new appointment, and that this was not a cause for concern. I also informed him that, because I had taken some additional time off work to look after Kate, she was somewhat more stable than of late, despite a nasty chest infection. A home visit, therefore, was not necessary, nor, in light of the trigger events outlined above, would it be at all helpful.
Mr Sawmy seemed satisfied with this.
However, he telephoned again later that morning, again asking if it was possible to visit Kate at home. In this instance I passed the telephone to Kate in the hope that she would be able to reassure him that this was unnecessary and unwanted. Unfortunately, as often happens, Kate became distressed and unable to speak clearly. She passed the phone back to me and I once again spoke with Mr Sawmy and informed him that he should not come to the house that day. It was suggested that I bring Kate to Lake House but she declined.
About an hour later, Mr Sawmy arrived at our home with another nurse in tow.
Both Kate and myself regard this as a serious breach of trust. Mr Sawmy had been told repeatedly that a home visit – especially an unannounced home visit (not to say one that we had specifically and repeatedly declined) would do Kate more harm than good. Why Mr Sawmy and his colleague decided to disregard our clearly stated wishes in this matter is simply beyond us, and Kate has found the experience profoundly unsettling. Surely the CMHT cannot regard this behaviour as appropriate?
In the event, Kate of course refused to speak with Mr Sawmy. Indeed, she was terrified, and could not come out of our bedroom until she was certain that he had gone.
Once Mr Sawmy had gone and Kate and I had both calmed down, I telephoned Lake House to complain about the incident. I was told that the relevant manager was away on leave that day, but was assured by the admin team member I spoke with that this manager would return my call the following day before I left for work at 11:40.
No such luck. I had to leave for work on the Friday deeply concerned that Mr Sawmy or another CPN would visit in my absence and trigger a more serious incident.
That evening, at around 7pm, Kate received a telephone call from John Holder, a social worker. Kate was able to quickly reassure him that she was safe and well, but is obviously upset that he was involved at all, and is concerned that her case is being escalated unnecessarily.
All in all, this sequence of events almost seems precisely calculated to cause Kate the maximum amount of distress, and, I regret to say, makes it far harder for me to encourage her to seek further treatment.
A letter from Mr Sawmy arrived the following day, offering Kate an appointment on either the 2nd or 3rd of February. Kate does not wish to attend, and will not attend any further appointments at Lake House until after she has seen Dr Gopaul on the 10th. In his letter to Kate, Mr Sawmy notes that “Mr Mortimer [...] is not happy that we visited yesterday.”
Mr Mortimer is in fact bloody furious. He is furious that his advice was ignored. He is furious that Kate’s stated wishes were ignored. He is furious that the return phone call he was promised to discuss the matter did not materialise. He is furious that this sorry incident has eroded what little trust Kate has in the CMHT’s ability to help her.
