Mental Health

No I'm afraid not ga. I too wasted immense amounts of time and effort trying to get help for someone else to absolutely no avail. In this case, it was someone who was a danger to other people as well. No chance of getting a halfway sensible or helpful response. I really hope you fare better. Good luck.

I know what you mean ga. It's frustrating not to know what risk has been assessed and whether there is to be any intervention from the MH team if they can't give you confidential information. It might not mean they're taking no notice, though. Have you noticed whether they are stepping up contact and have they said you are correct to inform the police if you're concerned again? My son works in MH teams and on a psych ward, whilst he's completing his psych nurse training and he expresses the same frustration that you do. They don't want to alarm people they can't discuss cases with, try to be reassuring, and try to find a balance. But the bottom line is, if you have further concerns, shout out, and go a higher level.

a good friend of mine's daughter has been diagnosed with borderline personality disorder. She has attempted suicide twice and had one day where she had horrific hallucinations.

she lives in Kent and I must say from what my friend tells me she has been given all the help available. Including fortnightly counciling which began within a month of her 1st suicide attempt.

Unfortunately once again it does seem to be "a postcode lottery" gggrrrr!

It is indeed a postcode lottery. I am an amhp (approved mental health professional) and have to assess people under the mental health act. It is frustrating to have no real alternative to detaining (sectioning) people due to lack of services. It is equally distressing to detain people knowing they are likely to be discharged very quickly with no proper follow up. Hence the revolving door keeps revolving.

Picture this:
Relative (usually very placid, but growing increasingly aggressive of late) goes to Mental health Team office and starts smashing up the place - asking for staff to call the police and put him away. Staff say the equivalent of, "there, there then" and send him away saying that his CPN (who only works part time) will be in touch 'soon'.
Relative goes straight to police station and tells them what's happened. They assess him as being in urgent need and get a Mental Health Assessment done and he is sectioned: Result!! BUT - there is not a single mental health bed available, so for two days he's kept in a special custody suite before being sent hundreds of miles to a private clinic.
Twenty eight days later he is released - relative has been given anti-depressants; family have no idea if a care package is in place as we have had NO CONTACT WHATSOEVER from the Community Mental Health Team; relative has not been seen by GP (but GP phoned him to check he was okay!!); wasn't seen by CPN until eleven days after discharge - and relative is still in the same 'mind' as when he was first sectioned. Aggressive, angry and threatening!
(And I'm in bed feeling poorly - probably hence the lack of my usual optimism.)

That's a familiar scenario here in Greater Manchester ga. There should be a Care Plan (CPA) in place, and relatives should ask the CPN to go through it with them and the patient, and be told when it will be reviewed. Threatening behaviour should be referred to the police, and the relevant MH worker and/or visiting doctor will update custody officers should police have to make an arrest.

Sounds like a breakdown in communication if no MH workers have been in contact since discharge.

Oh grannyactivist this is such a hopeless situation to be in and so depressingly familiar. It seems like nothing has improved in the 35 years since I found myself in this position with my mother. Is he a danger to himself or to others? If so then tell the GP and say you're logging the reporting of this fact and if something happens then you will hold him/her to account. The GP should have the means to contact the AWOL Mental Health Team. It's always harder at weekends and holiday times.

My mother took her life in the end, she too suffered with schizophrenia so I know what it's like for you.

Hope you get back on your feet again soon.

Some years ago I was diagnosed as being clinically depressed, I was given anti-depressants and told an appointment would be made with a psychiatrist.

A year later I still hadn't been seen, despite chasing letters from my GP. In the end I paid for private counselling, which had a limited effect. I did finally get an appointment with a psychiatrist followed by three appointments with a therapist and that was it. I still suffer bouts of depression and don't feel I was helped at all by the Mental Health team.

We're not blood relatives, though he has been with the family for forty of his forty two years, and because he's paranoid he won't give the CPN 'permission' to speak to us. The CPN doesn't seem to understand what confidentiality actually means when. She refuses to give us ANY information at all; she seems to be afraid to talk to me and is being micro-managed by her supervisor - she's worried about every word she utters in case she gets ticked off by her boss. She works part-time in a team that is permanently under-staffed and under-resourced; she's new to the job and I suspect she may even be newly qualified.

My concerns for his - and others' - safety is on record with the police and with the CMHT; I have also written to the GP. I was an experienced social worker with a very good understanding of how to access services, but if the services don't exist, or are stretched beyond breaking point, it's impossible to actually get help before a crisis is reached. And even in a crisis the scope for getting ongoing resources is severely restricted.

I really do feel for people who are not knowledgeable or articulate or resourceful - and yet are dealing with the mental health services, trying to get help for themselves or others. How on earth do they manage?

grannyactivist (This is my very cynical view of the situation but I do think there is some truth in it.)

Unfortunately I am not in the least surprised at this! The idea of treating those with mental illness in the community sounds wonderful, until you realise that in management terms this is really a way to cut costs and that means less beds in hospital. These are still needed for those in a crisis who feel so ill they need a sanctuary and some security.

There is a possible Catch 22 here. If you feel you are unwell and ask to go into hospital, you obviously have insight into your illness so they cannot legally section you. Then your actual chances of getting a bed are much less likely as what fewer beds are available have to be given to those on a section. It is small wonder that a sick patient has to create mayhem to get a bed.

I used to work alongside a group of MH social work practioners up until ten years ago and this lack of bed space and too early release was a problem then. Those teams and rescources have since been cut to the bone.

I hope something works out for your relative.

ga I'm not an expert here. nightowl might be able to say more. The guidance we had in our MH training about risk of harm with seriously mentally ill patients is that high risk overrides confidentiality, and families/carers with some immediate responsibility for the patient could be given a certain level of information in order to manage risk.

Sorry * grannya* if you were a social worker you'll know how the system works....or rather doesn't. I didn't mean to sound patronising. I used to say all those years go, there is no such thing as a mental health service in this country. Nothing has changed by the sound of it.

Jesus, this thread makes depressing reading!

Two fragments from experience.

My bipolar son, now nearing age 40, has just about got by with services in London. His hospital treatment has been OK. Though when he was first diagnosed the wards were pretty scary. They're now much better run and in much better, new buildings. That's when he has to be taken into hospital. Most of the time, he's living independently. Provision of a flat, and he's not an easy person to deal with, has been good. But the CPN care and crisis team are erratic, and the staff seem to be ever-changing. As others have said, this business of 'confidentiality' being an excuse to slam the door on family and especially parents, badly needs to be sorted out. Services should be working with families shouldn't they, for the best result.

Here, in Leicester, the Mental Health inpatient wards are lethal, high death rates, complacent and appalling. The local newspaper and a local MP are both trying in their different ways to get things improved. So far, some new buildings have been built, which is good. But the management systems and bosses inside the buildings are unchanged. And that's dreadful.

The one Leicester CPN I know is superb, but he swears and shrugs re the system above him all the time. He seems to do good, reliable work despite the system, not helped and sustained by the system. But he is an ex-soldier, so maybe he learned how then!

to all for your comments. This situation has been ongoing for years, but every now and again things are so bad I can't imagine how we'll be able to move forward - and I'm grieving for the loss of the lovely young man who I feel is now finally lost to us.

I know the feeling granny act. I just grieve. I thought of doing some voluntary work in the MH field now that I'm retired but I'm not really qualified and I fear I'd just get too upset and involved to no purpose. So I stick with my garden and cooking!

Such a tragedy ga. I hope all is not lost. To see people deteriorate for lack of support and specialist knowledge is criminal. So many seriously mentally ill people need a high level of support and aren't getting it

I do feel for you ga. I think you have said before that your relatives nearest relative under the MH Act is his brother, who also has mental health issues. I don't know whether you have been able to explore the possibility of getting him 'displaced' through the Court. One of the grounds (as you probably know) is that the nearest relative is 'incapable of acting as such by reason of mental disorder or other illness'. Another relative or friend can then be appointed. Of course your relative (the one you are concerned about) has the right to object to this process. It would be the AMHP in the mental health team who would make this application.

I believe you are right when about high risk overriding confidentiality; unfortunately when someone is discharged from a section they are, by definition, no longer seen as high risk so the usual restrictions on confidentiality apply.

It is heartbreaking to read about people's experiences all across the country.

isthisallthereis have you thought of becoming an IMHA (independent mental health advocate). Their role is to ensure that patients receive their full rights and have their views heard. You would be given training and it is a very valuable role, with too few applicants. People like you, with personal experience and life experience would be ideal!

allthereis that is so sad. My son is also nearing 40 and so I can feel for you. Happily he has no such problems as your dear son though he's been through a terrible loss. Life is such a lottery isn't it.
grannya and isthisall ((((hugs))))

Can I just say a word for the Community Psychiatric Nurses. My experience has only been with these in relation to the elderly. In East Kent when the Psychiatrist from Hell was threatening to discharge my uncle from hospital and dump him outside his front door if I did not take him back to my home in Oxfordshire. It was the CPN who reassured me that that was an empty threat and no discharge was possible without his agreement and that wouldnt be until a satisfactory care home place had been found. He suggested suitable homes and my uncle spent six happy years in his care home before he died

Locally, with an aunt & uncle, after being abandoned by social services and refused a re-admittance to hospital it was the CPNs who visited and were the first officials to agree with what I had told both SS and hospital, that my relations, both with dementia and physical problems, were a danger to themselves and each other if left alone at home and needed to go into a care home. It kicked SS into action and while my uncle has since died his widow is still contentedly living in her care home.

Such a shame that our services are crumbling in this way. There is far too much passing the buck. There are gems of CPNs though - I have worked with them and am filled with admiration.

I am totally frustrated with the system, but I do have a great deal of sympathy for many of those who are stuck on the front line trying to administer it with too few staff and too few resources. The CPN in this instance is, I believe, newly qualified and although I suspect she's being micro-managed by her line manager I don't believe she should have been given such a complex 'case' in the first place; particularly as she is only part-time.

My own recent experiences with mental health services and provision have been truly shocking and depressing. I'm not going into detail because instance 1) concerns my eldest daughter, and instance 2) concerns work. All I will say is that I've encountered things that have made me very, very angry, and that takes some doing! I really hate how so many people working in mental health just don't seem to give a damn, and really should not be working with vulnerable people. (Please don't jump on me if you are a genuine caring human being working in mental health. I do know you exist, but unfortunately there are just not enough of you.)
Fortunately for my daughter, I am an intelligent and articulate person who, when roused, goes into superhuman mode and achieves results others have failed to get even close to!!! Sadly, I can't do more for other patients experiencing the same conditions, but believe me, I have made my feelings known in the right places and an investigation is being launched.
As to the incident I witnessed at work, the police (as previous posters have also noted) were the ones pushing. The mental health team were following through, but it was the professional with regular contact with this patient who was being a total *rse hole!!!