Mental Health Ward

That sounds like the kind of care plan your son needs Imperfect. I hope you can take a breath now and get a little well deserved rest.

I just hope that al goes to plan for him now, Imp. I think you have been so stressed and deserve some relief for yourself and DH. My best wishes for a good outcome for everyone concerned

Its a psychiatrist who would be involved rather than a psychologist. Psychiatrists are medics with specialist training in mental health and can diagnose mental illnesses and prescribe medication. Psychologists are a different profession, don't diagnose and can't prescribe medication. Sounds like your son saw a junior doctor in psychiatry on assessment and they will also cover wards and day hospitals.

Thanks Jane - slipped up there - oh for an edit button!!!

Thanks for your good wishes all. Little steps and he has really needed us to advocate for him, but hopefully getting there!

I have a=emailed GN to ask again about a mental health forum as I haven't heard back - this sort of post belongs there as it will soon get lost here.

Thanks for the update Imp. It's good to know that he's having appropriate help and although it doesn't relieve you of all the responsibility you feel, it's a start in his recovery and rehabilitation, in a safe place, and gives you a breather. I think a mental health forum is an excellent idea and would be a great support and information resource for those of us who have, or have loved ones, with mental health concerns.

I am hoping that this excellent care plan will relieve you of at least a little of the worry. It does seem that once you got past the lengthy admission process the appropriate help was forthcoming. Sadly some patients do not wait through that long process and vanish over the horizon. Thank goodness you were there by his side. Well done

Thank you both xx Just opened a home-made bottle of red wine and it tastes like sloe gin... A good start to the evening ha ha xx

Having double-checked, it is actually a psychologist that will head up my DS' assessment team.

The consultant gave us over an hour of his time on Tuesday and did explain that diagnosi rests on several factors:
Clinical - what is the medical history? What symptoms is DS presenting?
Personality
Physical health
Life stressors
Global assessment of functioning - how does DS' mental health impact on his life.

We feel we can usefully add information to the assessment process so we have written, by invitation, to the consultant and are in the process of writing to the psychologist too as we will not be able to be present at the meeting he has with DS today / tomorrow.

Frustrating then that the consultant clearly had not read our email and not acknowledged any receipt of it. If it was a fellow professional writing to him, I suspect this would be different and as articulate people with important things to add, this is concerning. But we plug away!

Imperfect, I am glad that everything is following the approved procedure and your son is getting the help he so desperately needs and you too are getting some respite

I got involved in the mental health system some years ago with an elderly relative who suffered from severe depression and was sectioned. His psychiatrist I found deeply unpleasant, an opinion I discovered later I shared with most of the professionals who had to work with him. and the ward so rushed that my relative did not have a bath or shower for three weeks because he needed supervising and he could not do a strip wash in his room because of a physical disability.

My saviour - and in another similar family situation - was the local Community Psychiatric Nurse. They rarely get a mention. But in two different parts of the country, with two different mental conditions in elderly people, I found their help, advice and ability to turn out to the house at short notice to deal with mental health crises, saved the day and protected my relatives and myself from further misery and harm.

My daughter was a CPN now an Admiral Nurse,she struggled to support her patients and their families due to a lack of resources. No hospitals or clinics to provide the treatment and safety so often needed. It's difficult to give everyone the time and support they need when you are out there on your own.

Oh well done Imperfect. It sounds as if he is getting the help he needs now. Unfortunately we have to battle to get what we need from the N.H.S. now, but the actual staff can be wonderful.

Imp - so glad that your son is in a safe place and that he has a consultant that is including you and soliciting your input. Our experience has been the opposite; the family have been almost completely sidelined and shut out - which is ironic as my father-in-law holds a national post as carer advisor on best practice in mental health.

Thank you all. xxx

Tin hat time. Sometimes the family is part of the patient's problem. Some people particularly request that families are not involved. Staff cannot discuss care of a patient with others without the permission of the person. This is the patient's right however frustrating it is for partners or parents.
However, staff can listen to what family members say without disclosing anything to them. This may contribute to care planning.

I'm glad your son seems to be getting fairly good care. That must be a great relief and it's much better than many horror stories we hear of mental health services nowadays.

Jane, this has happened to me many times, patient confidentiality is taken very seriously here. I ask if I may pass on information which relates to my daughters health, they agree and I do but they do not comment . Patient confidentiality allows the hospital to tell me my daughter has been admitted but never how she has attempted to end her life , they can be sued if they do break it.

Jane, we are very aware that families can be seen as an unwanted 'hazard' and we have trod carefully, but feel that the consultant and psychologist have recognised that we are 'sensible' people who have something of value to add to the conversation.

We are both professionals, educated to MA level and both have some training in psychology- and for my part, autism too. We know some 'stuff' and are quickly learning more, but don't try to be 'know it alls' or impose our ideas. We have found the best route is to set out our DS' medical history and what knowledge we have about the impact we see on our son's life 'functioning.' In this, we have been very articulate.

We also greatly appreciate that the medical staff are dealing with a lot of demands and that our DS is only one of many they are trying to support. However, I have been cross this week because the consultant actually asked us to write to him about DS' history 9 days ago. We duly took time and care to build a medical timeline which we sent last Friday, knowing he would meet with us and DS this week. He never acknowledged receipt of the email, clearly had not read it when we all met and then told us he was handing everything over to the psychologist. However, he then failed to provide us with contact details and failed to pass on the info we had sent which would have been pertinent to the psychologist meeting with my son yesterday. All very frustrating and I cannot help but feel that the Consultant might have shown more courtesy to a fellow professional.
Thnakfully, the Ward Manager forwarded what we had written today and we are now in direct contact with the psychologist.
We do feel we have had to be somewhat 'vocal' - not our 'style', but my DS' needs would not have been so well served if we had stayed silent.

P.S. We have established with my son and those who care for him that what his father and I share can be treated with 'transparency' and therefore shared with DS. DS and I talk daily and he tells me anything he wants to, I know his key nurses and I am aware of all his meds. I do not think he holds anything back fro me, but that is his right, of course. I am never in a position of trying to wheedle information or wondering what next, other than if he initially attends a meeting on his own. Then he tells me all about it anyway. Again - that is his choice, but helpful as I advocate for him.

But if your son is detained under the mental health act Imperfect his nearest relative must have been informed/ consulted and does have a right to a certain amount of information. The nearest relative is strictly defined in the mental health act, so it’s easy to work out who it is. It’s not the same as next of kin, who can be chosen by the individual. If he’s married or living with a long term partner then that person is the nearest relative. If not, there is a hierarchy. Are you aware of this?

Yes indeed nightowl and I am the nearest relative. Even so, I have found it hard to find out when meetings were to take place and have had to set aside whole days to attend as 'timings' on the days have not been determined until late on.
Sobering to know that had he lived 2 months longer with his girlfriend the nearest relative would be her by default (after six months of living together). It is a 'young' relationship and moving in together has been one of the stressors. She is lovely, but - and I really am NOT a possessive mother - it would have seemed wholly inappropriate to us for her to have this role. And I think she is mightily relieved that she doesn't!

I know nothing of being detained under the mental health act, my daughter has never been sectioned , there have been times I wish she had been but she has never been seen as a risk to anyone other than herself and attempted suicides doesn't warrant being detained forcibly

Hello imperfect. My son is currently under a section 2 as well (although his will turn into a section 3 - which will have some advantages on discharge for him). Slightly different circumstances - my son is severely autistic, non-verbal, has severe learning disabilities and is seven and a half hours from home. He has unfortunately not been sectioned because he needs clinical treatment but because his previous care provider (a tesidential home) initially served under 2 weeks notice. The did extend if but the way they served notice meant there was just no time to arrange the very specialist care he needs (the local team did try) & hospital admission was the only way to keep him safe.

Our son has never been away from me for more than a few days before (his residential home was very close to home and I saw him about 5 times a week). It is very very difficult for us all having him so far away (it was the closest space with a bed). We have been encouraged to keep in contact and the hospital have been seeking a lot of info from us - obviously different in his case as he doesn't have capacity (although as he is over 18 and we don't yet have deputyship they don't have to - I am relieved and pleased they are keeping us involved). The setting of the hospital is rather lovely and the therapies on offer - such as gardening etc - look good for my son. I like his psychiatrist - it is just far too far away. I hope he settles enough to be able to access the therapies (not convinced he will as he is very bewildered and doesn't understand why he is there - and just wants to come home). He is getting OT and SaLT intervention and it sounds as if they will reduce his drugs (a good thing to do while there as he does struggle with meds changes and they're a bit of a mess).

He is likely to be there for around 3 months as that's how long it takes to set up his own team and accommodation locally - with Xmas in that time period I would be surprised if he was back here before January. I am already worried about how I will get to him if it snows.

I am also the nearest relative being a few weeks older than my husband.

My son is in a locked ward & not being aware of the terminology I worried what that meant. In his case it just seems to mean he can't leave the ward without supervision & the ward is highly staffed - which for the him is the same as his life in the community as he has 24 hour 2:1 care when he is home as well. The hospital are getting him out and off site a lot which is good and he needs that.

The local team here are being very supportive and have started the work necessary to bring him home.

I hope your son's time detained under section will help him get the help he needs to move forwards with his life. Sectioning feels so brutal (at least it did for us - even the big burly support workers with us at the time were in tears) but I know that positive things can come from it - I hope that's the case for your son. If your son does move onto a section 3 (after 28 days iirc) it has some advantages as it means he would become entitled to aftercare. People in the know tell me that's a good thing!

Nezumi, my heart goes out to you. We are only 60 miles away, but that distance feels hard at times. I am so sorry that your son has to endure this hard time of transition in his care, especially as you say, it is bewildering for him. Would he be able to come home for Christmas, or is that likely to be too much of an upheaval for him?

Thank you for the info on Section 3. I think this is a very likely next step as the Consultant said the 'big plan' is, at point of discharge, to refer my son to a day centre which is very local to him and that he would be expected to visit 3-4 times a week. He would be under the umbrella of this place for 13 weeks and the psychologist and OC that he sees at hospital are also based there so there would be a sense of continuity.

DS had already gone to the ward as a voluntary patient, but was then sectioned because he was having violent outbursts. He is very calm now, but has come off all his meds and is having nasty withdrawal symptoms. We can see that he has journeyed from depressed and sleeping 15 hours a day for three months, to manic, awake for 5 out of the last six days and writing thousands of words a day - which is his coping mechanism. What he is writing is actually very good, very rational and he is very logical - just in hyper-drive at the moment.

We have found that communication between nurses varies and some clearly shouldn't be in the job, but the ward manager, consultant and psychologist all seem to be reasonable. We always pray that my DS will feel 'heard and understood' - when this happens he is willing to engage and will do what is asked of him. If he feels patronised, he struggles!

Well, enough wittering on for now. I guess we have to be thankful that our sons are in safe places and work to make the best of it, but I am so sorry that you are having to bear separation and naturally fretting for your son.

Withdrawal is so hard. Even supposedly simple drug switches (e.g. from lorazepam to diazepam) seem to cause major problems for my son. I'm definitely happy for them to do any necessary drug withdrawals there.

Unfortunately I can't really think of a way to get him home at Xmas. He would think he was coming home for good and god knows how we'd get him back. He also can't be around his brothers at the moment - he came home for two weeks before being admitted (to give the LA time to try and put something together)- and our teenage children had to move out. It's sad because he loves his brothers - just is very overreavtive to them.