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

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 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.

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.

ronib

I will shut up after this but a young policeman explained that much of his policing in London involved taking individuals to hospital for mental health treatment. He said he had signed up to catch criminals!

My son and his partner are both police officers and say this repeatedly - much of their working week is taken up by dealing with people who have mental health issues.

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!!

I will shut up after this but a young policeman explained that much of his policing in London involved taking individuals to hospital for mental health treatment. He said he had signed up to catch criminals!

Wyllow3 yes of course it’s not only lithium levels. Am just a bit brainwashed by a family member on this point. Yes definitely a mix of anti psychotics is needed. Yes persevere with treatment.

Dee1012 are you in a position to appoint someone to hold power of attorney?

I once had a neighbour with mental health issues. We lived on the top floor of a tower block with just the two doorways facing across a hall. There were times when he could be very charming and you would not have guessed there was any problem. However he could snap and go into meltdown without warning. He should never have been placed in that housing situation.

He would pop out of his flat when he heard the lift arriving. and harass me for money when he heard me go in or out. If I refused he could become verbally very violent. I was scared of him although I never showed it. So I used to creep up the fire escape from a lower floor and sneak in. I oiled my lock so he would not hear my keys turning. I was a single woman living alone. My best tactic was to try to avoid him.

One day he cut my phone wires and that was when I bought my first mobile. Another time he cut off my door knocker with a bolt cutter. The police arrived, searched his flat and found the bolt cutter (which had has stolen from a nearby house). They arrested him for criminal damage and kept him overnight in the cells. He was bailed to appear in court but did not appear.

Of course there was then an arrest warrant out for him and the police turned up. That evening he attacked a man in the city and was arrested again on much more serious charges. I never saw him again. I was told that he was later allowed back with a police escort and his social worker to collect his personal belongings.

Treatment atm is very patchy. there is a huge shortage of inpatient beds is the fundamental problem for those even :"danger for self and others".

However it can be treated in the community when the service user is willing to take the meds.

Many people function well, work, are OK in families especially if they have been helped to understand the symptoms and watch out for them. Its not just lithium, btw, there are several there mood stabilisers and measured dose antipsychotics.

Its when a personality disorder is added to bi-polar that it gets extreme because of the sometime inability of the person to admit anything is wrong with them.

Never give up trying to get help is my advice.

ronib

Just to say that bi polar, formerly manic depression, has been recognised as an illness for a very long time. It does surprise me that given the level of havoc caused to the sufferer, family and friends that no cures are being researched as far as I know. Although gene therapy is a future hope.

It seems that there’s an imbalance of lithium which I don’t understand and if this is properly regulated then a good or better quality of life is possible.

There’s also a hereditary component and probably individual circumstances and experiences will have an impact.

The current treatment plan in England does appear to involve a hospital stay with a discharge plan into the community with a social worker allocated and treatment at home.

I think the illness may change in the older person. At the moment due to pressure on Nhs beds, some patients may go home only to be readmitted very quickly. Although to be fair, treatment of this illness has always been problematic.

I care / support a close family member with Bi-polar disorder, they also have a Borderline Personality diagnosis.

They have never been admitted to hospital or had a social worker...every little bit of support has had to be fought and argued for.
Sadly any aggression they feel is directed inwards and we've experienced suicide attempts and horrendous self harm.
Two incidents spring to mind;
Cut themselves badly and I called the Crisis team...the advice was to 'pop them in a cab to A&E', he's a big guy, over 6"3 and solid. I can't pop him anywhere he doesn't want to go!
A suicide attempt when he was discharged from the hospital at 4.00 a.m with no coat, phone or money etc on a freezing Feb' morning...it was only due to the actions of a lovely security guard at the hospital who called me, that he got home safely.

I live in fear of what will happen to him when I'm gone.

Blondiescot it’s brilliant that you were able to care for one grandson. You must have a very secure bond and that will help him later in life.

Blondiescot depends on the severity of the illness and maybe where you live. In England there is the ability to section a patient and that is on a monthly renewable basis where the safety of the person is in jeopardy.

It's very very difficult - and there is no easy answer. We went through this with our then DiL and saw the situation exacerbate until an incident took place which resulted in our GS coming to live with us for nearly two years. We had - naively - assumed that she would be committed to psychiatric care until she was better, but that didn't happen. Instead, she was admitted voluntarily - only to discharge herself a couple of days later, a pattern which kept repeating itself. As someone else has said, it is like living on a knife edge, as you never know what is going to trigger that person to have an episode. There is help out there, yes - but sadly, unless the person themselves has reached the point where they realise they need to seek - and more importantly, accept - that help, there's very little anyone else can do.

nanna8 A maintenance treatment plan in England for bi polar includes blood tests usually monthly to monitor lithium levels. Even so, this illness is very difficult to treat.
Sometimes behaviours have the effect of alienating families as there can be a very manipulative and aggressive component. There are also very high and very low days.

I would add that children can be very badly impacted but eventually good coping mechanisms can kick in! Schools need to focus on supporting child carers.

I have also experienced this in my family. The big problem is that the one who is I’ll will totally deny it. They live in a different reality which is so damaging for the rest of the family. We had to get our family member committed which involved police coming round. They were very good and understanding and things did improve after medication and a too short stay in hospital. Things are fine just now but we all live on a bit of a knife edge because you don’t know if or when it will happen again. Normally this person is the nicest, kindest and most thoughtful person which in a way makes the contrast worse.

Just to say that bi polar, formerly manic depression, has been recognised as an illness for a very long time. It does surprise me that given the level of havoc caused to the sufferer, family and friends that no cures are being researched as far as I know. Although gene therapy is a future hope.

It seems that there’s an imbalance of lithium which I don’t understand and if this is properly regulated then a good or better quality of life is possible.

There’s also a hereditary component and probably individual circumstances and experiences will have an impact.

The current treatment plan in England does appear to involve a hospital stay with a discharge plan into the community with a social worker allocated and treatment at home.

I think the illness may change in the older person. At the moment due to pressure on Nhs beds, some patients may go home only to be readmitted very quickly. Although to be fair, treatment of this illness has always been problematic.

Allsorts, just to pick upon one thing you say, "there is no help out there".

There is:

The Mental Health system is functioning although it is struggling. Accessed either via GP or, look up how to get mental health locally. Locally there is a phone line to what is called "Single Point Access" which you could ring for advice. MIND have a national helpline.

Most areas have different treatment groups for over 65's, but generally still arched through a Single point of access.

As I said above, most localities have Carers' support lines and can advise on local MH resources.

Go here www.mind.org.uk/information-support/helping-someone-else/carers-friends-family-coping-support/support-for-you/

You don't say how close that person is to you, ie whether you are living with them or whether they are a close relative, because what I said applies to someone living with you or dependent only on you, where you literally cannot get away.

maddyone has given very wise and sensible advice as regards someone close but not living with you.

Aveline is right regarding the police. I'm sure its patchy, but they have been very kind to me, although I did have to, persist, but thats the same with everything.

Please don't give up trying to gets some help. It may be a situation that can be eased for you, at the very least, by talking over with one of the telephone lines above. for long term ongoing help there are sometimes specific groups for carers/relatives - it may not cure, but help you endure.

I have been in this situation with a family member. It's awful really. I sometimes thought that we suffered more than the person who seemed oblivious to the havoc they were causing for others. However, I know that the Police are a vital last resort. In my job I used to see lots of policemen with patients in the waiting room at OP. I was sometimes (but not always) impressed by how they managed these difficult people. One in particular sticks out in my memory. He was so kind and thoughtful to an elderly highly distressed individual.
It takes all sorts I suppose. Calling the police is a scary last resort but can sometimes be the catalyst for starting appropriate treatment.

I asked him first to give me a break Allsorts. (stay with his mum, where he has "crashed all his life)

He was and is receiving treatment from MH people - similar diagnosis, bi-polar 1 (different from bi-polar 2, google if interested). He did collaborate as in accepting meds and MH referral as he couldn't sleep or rest at all when the worst Bi-polar kicked off and did accept it was intolerable for me at that point.

and as time went on I realised NPD. it then reached such levels of abuse I had to call police and change locks - on the advice of HIS MH people..

I was waiting for meds to kick in but the abuse remained. It was exhausting, him awake 24/7, manipulative and aggressive. I then suggested that we "stay together but live apart" as it works for many.

More abuse, then he tried to de-fraud elderly mum and brother came over from SA.

We'd already tried him having a spell in SA but he was sent back after 2.5 weeks. Brother said he was dangerous for his daughter and brought police trouble to door. (Not a good thing in SA).

Police again: he was arrested but not charged with coercive abuse.

Great guilt of course, because someone can be "Bad" but you know they are ill too.

But some people have to hit rock bottom before they ill accept help, this is well known amongst MH workers.

If only he had been prepared to take up offers from my sister to do semiprivate therapy. but if someone will not admit they need help, you have no where to turn in terms of hoping for a good long term outcome.

Yes, if there had been the levels of MH care just a few years ago it might have been different, ie working with us both, but its a skeleton service.

After his brother came over from SA and Ex was charged with fraud by police and bail conditions made him homeless. thats when I finally realised that a line had to be drawn under our 11 years and I filed for divorce.

I intervened quite a lot as I do know the system well he eventually got a place in warden supported accommodation.

Its a hard road Allsorts whatever decision you make. If he has got better before then maybe different?

the problem is, bi-polar can be treated with meds but any personality disorder cannot really. Only if the person "owns up" to their behaviour can you move forward together.

maddyone is right: there comes a point where you have to protect yourself in this only one life we all have.

There are usually MH support carers groups in most areas. Thats not a bad starting point Allsorts.

Such a very sad thread. Thankfully I haven't had to deal with too many mental health issues in my time and I really don't know how, with the total lack of support out there I would cope. Are we going to have to return to committing people into institutions as was the norm in the 50's and before, as the cheapest and safest solution? Of course I hope not but without support in the Community due to lack of funding, what are the alternatives? So sad.

A very difficult situation to be in Allsorts I really feel for you. As Luckygirl said keeping yourself safe is a priority. You do need a contingency plan in case things get out of hand and help from your mental health team although in most areas they are stretched to the limit I know.

My sister has long standing mental health issues. She has received treatment, including psychiatric treatment and medications for many, many years. Unfortunately she can become very nasty and vindictive and also she can be kind and loving. I have had to disengage on a fair few occasions and go no contact due to the venom she regularly spews out. When our mother was dying last year I reached out and hosted her, involved her in all arrangements and behaved impeccably (I thought and I tried very hard) but as soon as the funeral was over she was back on form making terrible accusations about me. That I ‘kept back’ items mum had told me were for her. I didn’t, I gave her everything. Insinuations followed that I was in some way trying to prevent her from getting her share of mum’s legacy. I wasn’t, it’s just that getting probate takes a while and we can’t legally sell till it’s through. My husband and I are doing everything to settle mum’s estate, we’ve emptied the flat making sure that everything left to others has been given. We’ve sorted out the selling, the legal work, probate, everything. My sister has done nothing. After the third accusation, mental health or not, I blocked her on everything to protect myself. I realise I’ll need to be in touch in the spring so we can arrange and go together to scatter the ashes, but I have to protect myself from her nastiness as I have needed to do before. Sadly she has nothing to do with two of her four children and therefore nothing to do with her grandchildren. She has been estranged by them because of her nastiness. Her mental health is poor, but I have to protect my mental health. I will always love my sister, but I’m afraid needs must.

I have been in this situation but thankfully, if sadly, he was also physically impaired so getting away was easy.
Making yourself safe is the priority.
The current mental health services are so weak and often have little to offer.
A long term plan in conjunction with mental health professionals is what is needed.

You walk away - safety first and try to difuse the situation

The tentative solutions don't have to be easy, you have to do what's right

But if you call the police, it aggravates the situation and then when they come home again, it is horrific being in that situation, with them knowing what you've done.

Really horrible.