August 25, 2017

I was diagnosed with Emotionally Unstable Personality Disorder (EUPD) in February 2016; I began my mental health nursing training in September 2016. I was warned by both my psychiatrist and psychologist, that during my training, I may encounter some discrimination against people like me.

Prior to starting my nursing degree, I had an occupational health appointment. When the doctor asked about my mental health, I explained that I had undertaken a course in Dialectical Behavioural Therapy (a form of cognitive behavioural therapy), had been in contact with services for almost a year, and that I was taking regular medication. The doctor still had a furrow in her brow; “My concern is that you were diagnosed very recently - when did you last experience symptoms?” I opened my mouth to respond, and then closed it again. I eventually managed to stammer; “Uh, well, that’s not really how it works. It’s not something that goes away; it’s something that you learn to manage”. The doctor looked unconvinced; “well really we would want you to be symptom free for at least a year. I just wonder if it would be better to defer for a year”.

I was shocked - in retrospect I was naïve to expect anything other than this response, but at the time I was blind-sided.

I left the appointment angry and frustrated, but not deflated. I called the occupational health department and asked if I could have an appointment with a mental health professional, to get a second opinion, however I was told that they do not have any members of staff who are specifically mental health trained.

I reached my first placement with no problems, excelling throughout the first term and feeling like I had really found my calling. Our office was shared with the individuals who manned the telephones out-of-hours; the calls they take are specifically from service users, when they urgently need to speak to someone. One evening, the individual on the phones came off a call and flumped himself down next to me. “You alright?”, I asked. He looked at me and sighed; “Yeah just same thing every time, like literally the same people calling. I know they’re having a hard time, but they just call because they want the attention, you know”.

He continued; “it’s mostly people with personality disorders, they call up and they say they are gonna hurt or kill themselves and I tell them they should go to A&E, but they won’t do that. You know I literally had someone telling me they were committing suicide whilst on the phone the other day, can you believe that?” He sighs and looks annoyed.

After the Christmas break, I started my second placement. One day I was in the nurses’ station with some colleagues and we were discussing a recent admission; “He agrees with the query about autism” I said, “but doesn’t feel the diagnosis of EUPD is correct”. One of the nurses turned and said, “Oh well he would say that”, another nurse continues; “that’s what they’re like, they’ll tell you anything.” I said that he didn’t seem to have any marked problems with his emotions and seemed fairly calm, considering he was going through a difficult time at the moment. The nurse explained to me; “that’s what happens, they’re very calm and they’ll be really friendly with you, then all of a sudden, when they don’t get their way, they’ll kick off”. I felt dismissed and stuck. I couldn’t challenge them as a student nurse, due to what they would perceive as a lack of expertise, and I couldn’t reveal my service user experience without risking losing their respect in my position as a student nurse. This dilemma continues to follow me around, slowly chipping away at my resolve.

My university provides clinical supervision for student nurses. During my second session I, for the first time in my training, felt confident and safe enough to disclose my diagnosis. I explained my experience so far within my placements and asked for advice on how to manage these difficulties. When it came to the question of whether I should disclose my diagnosis, there was uncertainty from everyone in the room - particularly from the lecturer present, who firmly stated she felt she could not advocate me disclosing as it may pose a risk to me. She felt that there was too high a chance that I would receive negative treatment and that it may affect my learning experience and opportunities. My lecturer believed there was a high likelihood, that my mental health condition would be judged unfavourably by my fellow mental health professionals.

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