Sexy Cinderella: A Quest for a 28-Day Lie Down
"Winterspaziergang" by marcostetter is marked with Public Domain Mark 1.0.
By Rebecca Waterworth
An AMHP’s tale from the frontline of delusion and decision paralysis. Part satire, part case study, and entirely true - a darkly funny reflection on what happens when systems crumble, beds disappear, and the AMHP is left holding the hot potato. All names, locations, and identifying details have been changed or altered to protect confidentiality.
Featuring a barefoot prophet, a surprise cameo from Vladimir Putin, and a haunting rendition of Sexy Cinderella, this story peels back the curtain on the surreal, maddening, and occasionally moving world of Mental Health Act assessments.
Because when no one else knows what to do?
They call an AMHP.
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Meet “St Michael”
A man with a rich psychiatric history and even richer social connections. Among his most recent acquaintances were Lucifer and Vladimir Putin, both of whom he claimed to have met during a brief stay at a psychiatric hospital in Ireland. According to him, he and Vlad enjoyed cigarettes together. I imagine Putin smoked Marlboro Reds. St Michael probably scrounged a Rizla off him.
Born in the Small Heath neighbourhood of Birmingham and raised by his mother, his early years were a rollercoaster with more loops than a consultant’s handwriting. His dad? Gone before he turned two - a fact he only recently discovered, along with his father’s name: “Finbar Furey”.
Yes. That Finbar Furey.
Allegedly.
This revelation sparked a spiritual pilgrimage to Ireland: a quest for identity, purpose, and possibly a duet with ol’ Finbar himself.
But like all modern misadventures, this one ended in A&E.
After discharging himself from the Irish system, hopping on a ferry, and enduring a barefoot cross-border journey on the Avanti West Coast, an unexpected detour landed St Michael in the loving arms of the emergency department.
“People were sending me on the wrong train… I thought, I’ve had enough of this - my stress levels went sky high and then Lucifer started speaking to me, so I said I’m getting off… and phoning an ambulance because I need to go home”.
Cue the Mental Health Liaison Team, scratching their heads and failing to get any information from their Irish counterparts (because apparently ‘international cooperation’ is still pending). So, they decided to do what they do best when things get murky - they “called” a Mental Health Act assessment.
Much to their disappointment, their 10:00 PM referral landed with their favourite dedicated AMHP - me - working overtime. My daylight run-ins with the liaison team were already legendary. They’d hoped for some reprieve by calling out-of-hours… but ended up with me.
Again.
_____
The Admission That Wasn’t
The reason for admission?
“He’s vulnerable”.
“We’re at a loss as to what to do”.
There was no active risk. St Michael wasn’t aggressive. He wasn’t suicidal. He was charismatic, dishevelled, missing footwear, and singing Sexy Cinderella in the dimly lit mental health room, pleading for someone to get him a horse and cart home.
Clearly, this called for detention.
• …Unless he agreed to go in voluntarily.
• …Unless there was no bed.
• …Unless they didn’t know what to do.
• …Unless the AMHP did it for them.
“No,” I said. “Explore less restrictive options”.
By 2:00 AM, the tide had turned. St Michael had agreed to a voluntary admission.
Problem solved?
Of course not.
Because in A&E, no solution is ever final until an ‘incident’ has been escalated to Gold Command, the AMHP has argued with six professionals, and spent so long in the department they’re clinically dehydrated and questioning their own capacity.
_____
The Standoff
The next day: no beds.
St Michael changed his tune. Denied psychosis. Claimed it was “just a stress reaction” related to “autistic traits” - a diagnosis he acquired hot off the ferry.
He caused mischief in A&E: meddling with equipment and triggering alarms - his rationale being that he used to be an electrician – though most of his wiring experience involved cars that didn’t technically belong to him. A stand-off with hospital security peaked when he refused to leave the toilet, threatening to “increase his disruption” if they didn’t let him out for a cigarette.
The hospital responded by arranging 3:1 staffing to manage his escalating antics - and threatened rapid tranquilisation.
The liaison team, ever resourceful, decided it was time to ask for another Mental Health Act assessment.
One doctor asked if he had any superpowers.
“I am Superman,” he said. “No actual powers though… just a gold card at Paddy Power Bookies”.
The other doctor asked the classic drugs question.
“Oh, just the usual - crack, heroin, crystal meth… but mostly I survive on a barrel of Guinness once a month, then hit the nightclub and clear the dance floor because I’m so positive in my dancing”.
Notes flew - clearly, this was top-tier psychiatric insight.
He informed the doctors, matter-of-factly:
“I’ve had over 30 admissions. I do it my own way, because I have that much experience in psychiatry”.
He then told them he’d prefer to go to the Priory - because they “treat him like a King”.
You can’t argue with that kind of seniority.
Following the assessment, the usual sacred ritual commenced: the professional discussion. For the uninitiated, this is when psychiatrists glance at the patient with a serene smile and say, “We’re just going to have a little chat”, before promptly disappearing into a corridor for what can only be described as an extended whispering séance.
The deliberation phase.
Otherwise known as the bit where the AMHP stands awkwardly nearby, while everyone forgets who’s actually making the legal decision.
And right on cue, both consultant psychiatrists presented with classic signs of Avoidant Decision Paralysis - a common syndrome triggered when risk is low, beds are scarce, and someone might write a complaint.
Despite his infectious charm and grand storytelling, the doctors didn’t trust St Michael’s explanations. They agreed he was “vulnerable and delusional”.
They wrote their Section 2 medical recommendations… and moonwalked out of the room.
_____
Let’s Be Honest
At some point, we have to stop pretending that multi-disciplinary means something.
In reality, it’s always the AMHP left holding the hot potato.
_____
Stuck in the System
St Michael, for his part, was surprisingly pragmatic about the doctors recommending he be sectioned - but asked to go in as a voluntary patient instead. He said being sectioned infringed on his spirit, but he recognised he needed a break:
“A 28-day lie down. Food, support, a counsellor - a level up”.
He agreed to an informal admission.
We had a plan.
The bed was pending.
The professionals relaxed.
The system exhaled.
He waited.
And waited.
And waited.
Five days, to be exact - detained not by law, but by inertia, a lack of beds, and the haunting strains of Sexy Cinderella echoing behind the blue curtain.
_____
Enter: The AMHP Master Plan
I returned to A&E on a rescue mission.
“I knew you’d come if I sang that,” he told me, mid-croon.
Working closely with St Michael and a consultant psychiatrist who’d survived at least one tour of duty with him, we pieced together a coordinated, supported community plan.
It was simple. It was smart.
It was approved.
It was a win.
Plot twist: The liaison team held an escalation meeting and decided the plan was “not suitable” - presumably because it didn’t involve detention, sedation, or a ten-page risk assessment.
St Michael was convinced they were dragging it out “for the drama”.
Honestly, so was I.
Back to the cubicle.
_____
The Moral of the Madness
When someone shows up in A&E barefoot, speaking scripture and singing 90s R&B, try not to laugh - or cry.
Just remember:
• We’ll be expected to fix everything.
• We’ll write five plans.
• None of them will be satisfactory - because the doctors have recommended detention.
And when it all collapses?
We’ll be expected to take the blame.
So yes - next time a man gets lost during an episode of psychosis, I suggest we cut out the middle steps and send him straight to the local AMHP office.
We’ll make him a cuppa.
With the Yorkshire Tea bags we’ve nicked from the Crisis Team.
We’ll find his shoes.
And we’ll do what we always do:
Try to save a system that’s already abandoned him.