How to cope with someone with erratic behaviour due to a mental health issue

Certainly our OP waiting room seemed to be full of policemen. I suppose the buck stops with them when people's behaviour gets difficult and others can't manage them.
Adult Mental Health services need much, much more funding.

Aveline seems possible that police officers have now become part of mental health admissions teams as some kind of business model that the police may not have agreed to?

Individual psychiatrists are usually very kind and professional. It just feels that the Uk doesn’t have a very workable and managed admissions system, and discharge is haphazard too. I don’t even know if it’s a question of underfunding? Although it clearly is part of the problem.

Long term underfunding with more realistic workforce planning involved. Can't magic up more, well trained and supported staff!
I bet the Police are pretty fed up about it.

Aveline

My family member was usually OK if he took his meds but he said that it restricted his thinking and every now and then he'd stop taking the pills. Havoc ensued. He did the daftest things and caused no end of trouble. Eventually he'd go too far and be re admitted to hospital (where he easily accessed cannabis and booze ). On discharge he'd sack his CPN which they accepted! Back to square one over and over. Never the same SW, CPN or Psychiatrist so we'd have to go over everything again.
That was in the good old days before Covid!!

" On discharge he'd sack his CPN which they accepted!"

They cant do anything else Aveline unless he is very likely to be a danger to self or others. Unfortunately "danger" doesn't include distress and great difficulties, it means physical or VERY serious proven abuse.

Let me explain the funding system. When a` new referral is accepted not the MH system then funding is released for that person.

This means that unless there is good reason (ie the user is a danger to self or others OR is poorly BUT is responding to help, ie there is some point them being on the books, they are Discharged.

Then if they are re-referred, money is released again. this is not what MH workers or trusts want, it is a national decision MH workers realise its much better to "keep people on the books" even if they are non repsonsive because treatment can be accessed more quickly.

Same as in physical health really except of course its a completely different dimension in term of problems it courses for family and in the community.

And the reason you get different people is because of the difficulty in finding stable staff and funding them too. A lot of psychiatrists are locums as permanent positions hard to fund. As someone familiar with MH systems since 2002 I'd say the real cuts started around 2016. there were cuts in inpatients beds before, the most expensive resource, but other resources shrunk after them.

Locally there was a "re-organisation" in 2017 which was basically a cut back exercise, when a lot of local community MH centres - accessible, "pop in", centres, disappeared in most areas.

But before we go OTT on difficulties MH raises for others, lets remember that most people who access MH services are needy, frightened, sometimes suicidal, and not abusive nor aggressive - severe depression and anxiety, people with psychosis living in states of nightmare but not harming others!

wyllow3 - I know all this very well as unfortunately I worked in psychiatry at the time!! That didn't make it any easier!

Indeed - you clearly know the score too. Just as more people need help, and some of the shame in openly talking about it is at last receding, resources are shrinking and devastated.

All sorts, I’m sorry for your troubles. Thank you to all those who shared personal stories of the difficulties supporting or getting help for loved ones with personality or mental health problems
The combination of bpd and bi polar is such an awful thing. It may be possible to get drug therapy for bi polar but the personality disorder may endure the patient resists meds or therapy

Ten years of destroying public services has left police as the only 999 service responding

Wyllow3

Indeed - you clearly know the score too. Just as more people need help, and some of the shame in openly talking about it is at last receding, resources are shrinking and devastated.

Just to be completely clear any shame surrounding mental health does not lie with the individual nor their families. It lies with the Nhs and its procedures.

ronib

Wyllow3

Indeed - you clearly know the score too. Just as more people need help, and some of the shame in openly talking about it is at last receding, resources are shrinking and devastated.

Just to be completely clear any shame surrounding mental health does not lie with the individual nor their families. It lies with the Nhs and its procedures.

If only that were true ronib. There’s still a lot of shame felt by some families who have relatives with mental health difficulties, and a lack of tolerance and understanding in society.

Wow this is morally wrong. Wrong wrong wrong

I shall calm down in a moment. Just looking for my moral compass …..

ronib
"It lies with the Nhs and its procedures."

no, no, no...

I can recall asking to a CPN in 2007 at length and she described how she sometimes didn't tell people what she did because people thought she must be "nuts" too by association.

People STILL use that gesture where you point a finger at your head and wiggle it as if to say, "nutty"

People say of someone who had a bit of a wild evening, "oh, she was mental last night".

Lots of people are scared of someone with MH problems, not because they are hostile, but scared because they don't know or understand.
People will keep their children away from someone they know to have MH problems.

The highest killer for men between I think its 25 and 40 (may have got ages slightly wrong) is suicide because of shame of speaking up and asking for help.

What I meant by this is that it’s so very difficult to get treatment, other European countries don’t use the police to take ill people in to hospital. It’s difficult to access the right treatment even if you manage to get a bed. It’s also difficult to stay in hospital long enough to make sure that the treatment is working and doesn’t need a rethink. It’s difficult to readjust to life back home.

Basically the Nhs doesn’t always have the correct procedures in place to save young people in psychosis.

I am very sorry that in addition to all of this, there’s then prejudice and misunderstanding.

Although I was guilty of calling for Prince Harry to be stripped of his title and to be called Mr Henry Mount batty Windsor… but of course I wouldn’t wiggle my finger at him and call him nutty. Point is that mental illness even reaches the royal family!

The police dont take people with MH problems straight to a ward.

If they need to be in a police cell they will be given a psych assessment there.

If they need help they are taken to A and E and an assessment is done there.

It then depends on if they are assessed as needing in patient treatment, which is very very hard to get: they may or may not be sectioned, which is a legal process where a service user is detained under the MH Acts and can be treated without their consent.

I'm not sure what you mean by " doesn’t always have the correct procedures in place to save young people in psychosis."

There are treatment guidelines and correct procedures, for young people in all sorts of distress, however its resources in carrying them out that are lacking.

We’ve received the news that the buyer for mum’s flat has sadly died meaning we’ll have to put it back on the market. I’ve WhatsApped my sister with this news. I’m just hoping this doesn’t set her off again as she was already hassling me about when ‘her’ money was coming. Not now for quite a good while I would guess. I had to unblock her to pass on this news. I’ve left her unblocked on WhatsApp for now. It would be good if she can be calm and I won’t need to block her again.

Wyllow3 on the young people with psychosis, please take it as a given that a&e sometimes fails to act appropriately. Not always.

Yes I looked up the procedures for police custody with mh. This is not the way mh patients are admitted in advanced countries like Germany.

I once asked a retired doctor why we had such a difficult time with mh admittance and was told that it’s to protect our basic freedoms. This threw me. It was argued that because patients can be sectioned and the denial of liberty is such a threat to the way we live and our values, that it can’t be made easy. I am still puzzled by the remarks.

We can't have people locked up without good reason. I know it can be screamingly obvious that a person is literally out of their mind and a danger to themselves and others but there can be much more subtle presentations and I know that people can put on a very good face to professionals (while their families tear their hair!). Deprivation of liberty is very serious and it's right that it's taken very seriously and by professionals.

I understand that the reluctance of the authorities to admit people for mental health reasons is to do with protecting basic freedoms, but I’m always puzzled by the apparent lack of concern for the freedoms of other people who can be abused, injured, and even killed by patients suffering severe mental illness. My own sister set off with a carving knife to kill her mother in law. Luckily she was intercepted by her husband before she arrived at the destination and the doctor became involved. Years of treatment followed, and still continue, but she was never admitted to hospital at any time during all these years.

This is why it's often a police matter.

Aveline the police don’t want the responsibility of mh. Surely Germany also is concerned about it’s freedoms?

If I have a severe issue, why does my need for treatment impact on the psyche of the rest of the country? Surely my needs should be paramount?

The police may not want the responsibility, nevertheless, it's their job to deal with individuals potentially a risk to themselves and others.
I don't understand your point re your need for treatment.

If a person has a known history of bi polar over a period of say 40 plus years,
why are they denied timely treatment and support? Why the incredible hysteria surrounding admittance to hospital?

I spent 22 years trying to cope with my psychotic paranoid husband because he was ill and not bad. A long and dreadful time. Mental health services were involved and he was sectioned several times. Also regularly admitted on a voluntary basis.
I had to eventually think of myself and I left. He went to lived with his father and eventually was permanently admitted a secure ward where he lived for several years until hisc death. I lost my younger years until I was 46.

Coolgran65 you have my sympathy. What a hard time for you and your family.