Woeful mental health care ...

What exactly and specifically should 'they' do? I've already outlined in some detail why addressing the needs of this widely disparate group is so difficult.
What are the actual answers?
I'm not saying this to be annoying. I just know that having something specific to ask for helps.

I've written before about the effectiveness of support groups. For people with similar problems.
I've had experience of these from both sides, and can't understand why they don't seem to exist now. For one thing, they don't cost much to run. Individual therapy is costly and may need to continue for a long time.
That's my idea for something specific.

That's great. There already are support groups for families of people with specific mental health issues so maybe an up to date directory of them available to families would be useful?
A system of updating medical notes online would help so that if a person became unwell out of area attending medical staff could easily access relevant info. Obviously the IT glitches would have to be ironed out.
A patient 'passport' with relevant info on it in case of emergency might be useful (but most patients would decline them I feel)
Well that's a start anyway.

I do think there needs to be better 'joining up' re health notes and easier access to them between health authorities. If someone with ANY 'libe' / ongoing health problem moves surgeries / local authorities, I wonder f there could be a prioritised system for sending their notes on.

A.n.other penny dropped yesterday as I was explaining for the umpteenth time that my DS has a diagnosed personality disorder ... that this ALWAYS needs highlighting and ALWAYS needs further explanation. It is important because he doesn't process information easily - and especially when he is stressed and is unable to articulate his needs - he often says ' I am feeling okay' - meaning 'that moment in time' when he has had terrible episodes. His notes could do with a 'special box' - maybe in red to highlight his specific needs.

And wouldn't it be lovely if doctors actually had enough time to read the notes before they see the patient...

'live' not 'libe'.

And as I have got started this morning ...

A&E AHYWHERE should take on a patient coming to them with MH needs in the same way that they would respond to anyone presenting a physical need. It is truly abhorrent that people who are in dire need are being asked to return to their 'home' health authorities.

A&E units are not set up for psychiatric emergencies. A harried medic is not able to deal with a long term personality disorder presenting as an emergency. A&E depts are most often in general hospitals which may not have access to psychiatric specialists. Personality disorder is hard to treat and its usually a question of management rather than some sort of emergency quick fix. Not what you want to hear I'm afraid but it's the view from the other side.
Is there an emergency clinic at your local psychiatric hospital? They often have an emergency outreach team but I can quite see how you'd be referred back to people who know your son and his condition.

A.& E in a general hospital cannot treat mental health illnesses, my daughter has been admitted many times over the years, they treat the damage of an overdose or cut wrists then discharge the patient . The patient needs a psychiatric hospital and these are always full,and not in every town, this is why many with mental health problems end up in police cells in an emergency for their own safety .

You're illness does not define you. Your strength and courage does.
Remember you were given this life because you are strong enough to live it.
Sometimes, the people around you won't understand your journey, they don't need to, its not for them.

The sad thing is, Mindfulness, is not for the any mental health illness but if you care for someone, maybe it's for you.

Jane10 I completely accept that A&E don't have the necessary expertise and resources and can usually only 'treat' presenting symptoms, and at best patch up, give calming meds and a referral to MH services. My issue is when faced with someone suicidal / in dire need and an apparent wall goes up. Yes expertise is not readily available and typically there is no immediate access to a bed, but sometimesdesperate people are turned away. My niece was turned away recently and then tried to commit suicide. My son has been spoken to very unhelpfully at the admissions desk before now when he was already in crisis - putting him at further risk as he couldn't cope and left.

Understanding, manner of staff . attitudes to care ... there are training matters to address. And the entrenched 'You are not being treated under this health authority so go back to your provider' when someone has possibly gone as a last resort and may be miles from their 'local' support without means to get ot it.

I am not seeking to 'blame' anyone or have a moan for a moan's sake. We all know the money and provision is not there so it is a case of working with the little that is and trying to improve it. There are issues that could be addressed through training and policy changes.

Illtellhim 'Mindfulness' seems to be the latest 'stop - gap' while people are awaiting CBT / talking therapy. There is an online course that people are encouraged to sign up to - free through the NHS, but It is not right for everyone. However, people are being asked to try it and then 'see' if they still need counselling afterwards. Some people are already very mindful / spiritual people and it can seem very patronising and just mean a deferred wait for real help.

So the bottom line is that there needs to be more psychiatric hospitals/units which also have an emergency dept. Staff there are more likely to be understanding than receptionists at busy A&E depts.
My suggestion of some form of 'care passports' could include info on what to do in emergency.

If we do want to start up some kind of pressure group on Gransnet I think we should begin with something of low cost. Because we know that the NHS is already short of money and have to choose their priorities.
Whatever the political rights and wrongs.
In theory, my first choice would be more provision for long-term hospital care, but in practise, this would be so expensive, it's not going to happen.

Yes. The current assumption that community care is best needs to be challenged.

Priory clinics are well known for treating the mental health of celebrities, but did you know that 85% of the Priory’s services are publicly funded at a cost of appx. £650 per night? £159m was spent on placing patients in out-of-area beds in 2016-17, up 47% on £108m two years previously. In 2016-17, there were 5,876 mentally ill patients who had to travel out of their area for treatment.

My brother-in-law, who lives in Cornwall, has twice been sectioned in recent times and neither time was there a bed to be had in the whole of Cornwall, Somerset or Devon. Instead he was taken by private ambulance to the Priory Clinics in Bristol and Southampton respectively.

More money should be targeted to provide local services and NHS Trusts should stop paying lip-service to the needs of carers and actually do something more to support them.

GA I am impressed by your knowledge and it is facts and statistics that I feel I lack at the moment sand will need to gen up on to become more articulate in protest.

Simple things - a 'safe' place e.g. sideroom in A&E as someone with a disturbed mind doesn't need the extra stress of waiting in the main waiting room.

Just found out DS1's MH referral has been received. He has been sent a letter inviting him to a 'telephone triage' on Oct 9th. NOT appropriate. We already know his needs - urgent meds review and dialectical counselling. Now waiting on a phone call from his 'Primary Care Plus Team to ask for urgent appointment- told they may not phone today. Have gone back to drs surgery to ask him to bring pressure to bear for a face to face urgent appointment.

Have managed to stay very calm, measured and articulate, but so distressed and angry. What part of 'suicidal / angry episodes / breaking furniture / self-harm / neglecting self care / only able to take diazepam for a short time as a stop-gap, DOESN'T suggest 'urgent?'

Okay - big breaths and rant over ... So we wait for now. But thank goodness I am not at work and am able to give this time and chase and chase.

Imperfect, sadly our family has had thirty years of involvement with mental health services and in that time we have made many representations to Primary Care Trusts, the government, MP's and direct care providers. Our experiences mirror yours in very many ways, but we are a family of activists and so knowledge is often, not power, but the key to being heard. If it's obvious that we have done our homework it means that at least we will be taken seriously enough to occasionally gain access to the decision makers.

After trying unsuccessfully (as a family) to get him help beforehand, my brother-in-law was once in crisis during the Christmas period. He was paranoid, delusional, hearing voices and terrified - he was acting bizarrely. When contacted by my father-in-law on Boxing Day the manager of the crisis team declined to take any action. I called the manager myself - and when he still refused to act I told him that the phone call was being recorded and would be used in evidence at the official Inquiry when my brother-in-law killed or harmed himself or somebody else, as seemed a very likely outcome at the time. The police and a social worker then turned up within an hour and my b-i-l was sectioned and in hospital for many months. I did make an official complaint and, with my parents-in-law, had a meeting with the head of the PCT to outline what had gone wrong and to ask for written evidence of actions taken by the PCT to ensure a similar situation wouldn't happen again. When there is an Inquiry after an incident of harm my father-in-law is now often invited to sit on the panel as a voice for Carers, he also helps to train Mental Health Professionals and is often a keynote speaker at MH conferences. (He's also just been nominated for a RCPsych Award - I'm very proud.)

I hate to hear of others, like you, who are battling with mental health services because I identify so much. If I were to write a book about our experiences it would read like a dystopian novel and I'm heartsore when I think how many people are struggling with the same issues.

Heartsore is exactly it GA xx

Update.

Well, after spending nearly the whole day on the phone, we finally got my DS to be treated as 'urgent' (well, relatively) and some one is phoning him tomorrow instead of Oct 9th.

Funny old day really - have learned a lot about local mental health, his doctor, legal rights, advocacy, counselling, patient representation (P.A.L.s) and benefit support through Mind ...

Also so pleased that his GF has come over some distance for an unexpected visit - she has a kind heart too.

So, drawing a breath and maybe I will sleep better tonight.

I hope you get a quiet nights sleep imperfect you certainly deserve one. What a day, but you have had some success so well done. Only a mum eh? All good wishes. Sleep tightx

Raising a glass of white to one and all - here's to a better night than last night GNetters x

Another sleepless night. Just need to get this out somewhere ..

DS's case finally got escalated (slightly) he received a call from the mental health primary care team yesterday. He was too unwell to be able to answer the chirpy ' So how are you feeling ?' starter question. I spoke at length to the MH social worker who needed to assess him.
DH is not exercising self care, is increasingly depressed / anxious / angry / at risk of self-harm, is showing signs of schizophrenia, is constantly battling feeling suicidal, is writing suicidal messages on social media, ... He has 3 days of diazepam prescription left and the only 'plan' I have been given is 'take him back to emergency services if he needs more care.'
SW agreed he needs a meds review and would ' probably benefit from 1:1 therapy - we have been waiting for weeks knowing this. She will now write a report and it will be with a consultant in 2-3 days. The consultant will then write to invite him to an appointment.
'Will that be within the week?'
'Oh no, can't guarantee that - he is so busy.'

Brick wall....

Meanwhile his ESA claim has been rejected. Can't tell him - it would be a tipping point. Apparently he needs to be assessed for non-contributions based - we thought he had paid enough stamps in the last 2 years ... seems not.

MIND told me about P.A.L.S. - a patient advice and liaison service that I will contact today to see if we can bring any pressure to bear on MH services to move his case forward faster again. I also need to contact ESA and he needs an emergency Drs appointment for re-prescription of ordinary meds he needs to take. Plus I need advice on what next after diazepam at the weekend as he continues to deteriorate. So that's the day ahead mapped out - that and trying to make sure he at least eats something and takes his pills...

I feel that unless he actually attempts to take his life, no-one is going to do anything tangible to help him within the next 7 days at least.

I start a new job next week. I don't feel he can be left. I am stressed out and fighting the feeling of 'going under'. Ex H now looking at taking unpaid leave so he can take care of him. I feel like I am crying for help over and over and no-one is listening - so goodness only knows what this bright, beautiful, but very depressed young man is going through in his head. So much of this was avoidable.

Mental Health Care in this country is not just in crisis, it is broken.

I've nothing to suggest as you're doing everything possible and your conclusion that mental health care is broken is correct.
I have work and personal experiences of mental health services, it's never been well enough resourced but the austerity agenda has decimated support services with the obvious result that crisis services have broken. The police are the only public service that can refuse to respond to threats of. Iolence, suicide etc. The police are stretched to breaking point. Sorry Imperfect, I'm grumbling and stating the obvious.
I hope your son gets some effective help. You must be exhausted, try and look after yourself. sending positive thoughts x

Thank you lam. Better out than in for me . Burning lavender to calm myself and clock watching until l can begin to ring people. At least he is asleep at the moment and l have been out for essential supplies. Do a little window of respite.

Imperfect, I ache for you. Do take care of yourself , I speak from experience not self pity , years of worrying and battling take their toll . Take care please x

Annie, thank you for your concern. I know the toll it is taking and am exercising self-care, but it is hard. I have talked to MIND and Drs receptionist today (she was really lovely and completely understanding which does make a difference) but fundamentally, we are in anguish which won't be relieved until his needs are better met. Ex H will share some of the burden by having him next weekend and into that week if needs be.

Thanks again xx - I am having a 'lunch hour off' from all the phoning! Trash TV, Gransnet and chocolate

I understand, am in same place x