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How does the Mental Health system work?

• Message 1.Ìý

  Posted by TheRealSportyGirl (U1723427) on Monday, 15th August 2011

  I have posted a couple of times about my sister who has for years had problems with drinking too much (had a number of detoxes etc) but has also been on various anxiety-reducing drugs for about 30 years.
  
  After her last detox she also came off (gradually) a lot of her tablets & for a while she was really happy & energetic, although still drinking but not to the same extent.
  
  She now has had a number of (what the medical profession have said are) psychotic episodes. After one of these she was put onto a mental health ward & discharged a few days later. Now she is having them again & has said she wants to go back to the hospital. They won't take her because they say she is not a "danger".
  
  So - does she have to make a serious suicide attempt - or threaten some-one else - before she can be treated?
  
  I know it's not simple. I know lots of people here have experience of this kind of situation. I would appreciate any advice.

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• Message 2

  , in reply to message 1.

  Posted by StargazerwithOscar (U14668197) on Monday, 15th August 2011

  So sorry to read about your and your sister's problems, RSG. I'm sure her GP could refer her for further treatment, especially if you went with her for the appointment and reinforced her case with your own input. For you, I believe that the Princess Royal trust for Carers (and you ARE a carer in the sense that you obviously care very much about your sister) are very informative and supportive. Don't worry yourself into illness - it's best to start the ball rolling to get some help. Well done you for being so supportive, at least she's not alone as mental health patients so often are. Good luck and sorry I don't know any more personally. My mother's mental health problems were down to Alzheimers. and the AS were very helpful for me, but not apprpriate for you.

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• Message 3

  , in reply to message 1.

  Posted by carrick-bend (U2288869) on Monday, 15th August 2011

  I'm not an expert, but the MH sectioning requirement is for the patient to be perceived to be a threat (or "danger") to themselves or other people.
  
  If alcohol is involved, it is notoriously difficult to get the NHS to take responsibility for the person.
  I think a "dual diagnosis", which includes specific MH issues, needs to be made.
  
  Maybe this site will give you enough information to ask more questions?
  
  
  
  Best wishes.

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• Message 4

  , in reply to message 3.

  Posted by merrylatestarter (U10475559) on Monday, 15th August 2011

  My OH was very depressed and anxious last year, but because he was not suicidal, or a threat to me they wouldnt take him into hospital because they said that they were so very short of beds. We had a support team come out every single day for about 3 weeks when he was at his worst. After that they would come about 2 or 3 times a week. They were always at the end of the phone if I needed extra support. They were marvellous, and I dont know what we would have done without them. I hope you get some help, its very lonely trying to do it by yourself, even if, like m, yourve got a supportive family.

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• Message 5

  , in reply to message 1.

  Posted by The Giddy Kipper (U10918464) on Monday, 15th August 2011

  Hi RSG
  
  I have a bit of experence in this area as a manager of drug and alcohol services supporting people with substance use and mental health problems, though as every area is a bit different it's hard to talk about these things on a generalized basis, isn't it?
  
  I suppose my first question woulf be whether your sister has any other mental health input either before or since her ward admission; a CPN or floating support worker? Was there provision to see an alcohol worker whilst in hospital/ is she in contact with alcohol services/ does she want to be?
  
  If you are in England there should have been (doesn't mean there was, unfortunately) a review of the 'dual diagnosis' arrangements in your area, which were meant to bring substance use and mental health services much closer together. Technically a 'dual diagnosis' doesnt have to be made by a professional, if a service user states that they think they have mental health issues that they believe would be more effectively treated seperately from their substance use, then that should be good enough ( equally a mental health worker referring to a drug service and vice versa) The old situaton of being batted backwards and forwards between people saying ' you need to stop drinking first' 'No, you need to see a mental health worker first' shouldn't exist anymore. In an ideal world.
  
  
  
  

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• Message 6

  , in reply to message 1.

  Posted by strawberrysunrise (U10452397) on Monday, 15th August 2011

  in my experience it very hard to get any help for anyone who is a danger to themselves,
  
  just make sure your sister is not left alone, hard work but worth it.
  
  
  
  

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• Message 7

  , in reply to message 1.

  Posted by Borsetshire Blue (U2260326) on Monday, 15th August 2011

  She now has had a number of (what the medical profession have said are) psychotic episodes. After one of these she was put onto a mental health ward & discharged a few days later. Now she is having them again & has said she wants to go back to the hospital. They won't take her because they say she is not a "danger".Ìý
  
  I'm sorry to hear that your sister is experiencing psychotic episodes, they can be very frightening.
  
  You say that >>They won't take her because they say she is not a "danger".<< but you don't say who 'they' are, so I'm not sure who you or she have approached for help.
  
  I see another post has a link to information on 'sectioning' but your sister doesn't have to be sectioned to be treated in hospital and nor does she have to be in hospital to be treated.
  
  Does she have a Community Psychiatric Nurse (CPN) involved in her care? If so, contact them and if not go to her GP and ask them to refer her to the local Community Mental Health Team (CMHT) or ask the CPN or GP to contact her Consultant Psychiatrist and ask for an emergency out-patient appointment. If you can't get help by exploring these options, then you could try contacting MIND for advice on how best to proceed, their helpline is very good and might even be the first place you contact. Here's the link
  
  I hope the situation doesn't deteriorate to the point that you and your sister would need information on 'sectioning' but if you should in the future, the MIND information is much more accurate and up to date than the Ö÷²¥´óÐã link given above. You can find it here
  
  I hope this is of some use and wish you and your sister all the best.

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• Message 8

  , in reply to message 6.

  Posted by What larks (U14260755) on Monday, 15th August 2011

  in my experience it very hard to get any help for anyone who is a danger to themselves,
  
  just make sure your sister is not left alone, hard work but worth it.
  
  
  
  Ìý
  
  I know of two young women local to me who have 24/7 care in their own homes because they are in danger of self-harming. Wherever they decide to go, the carer goes.
  
  Yet others get little or no help. I have never been able to work out our puzzling "all or nothing" way our services work.

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• Message 9

  , in reply to message 7.

  Posted by TheRealSportyGirl (U1723427) on Monday, 15th August 2011

  Thanks to everyone for your sympathetic & helpful replies.
  
  The fact is that I live 350 miles away from my sister - my mother lives very close to her but she is in her eighties and though she tries to keep me up to date with the situation it's difficult for her. When my sister is unwell it's not possible for me to really understand what help she's being given because she tells me all sorts of different things.
  
  I am going to visit them in a couple of days & while I'm there I will try to find out exactly what the situation is re the support both of them are getting - I know my sister has a crisis number she can call, and is also getting some form of counselling. When I know more about what's going on I will be in a better position to follow up. The Mind site looks very useful.
  
  Thanks again

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• Message 10

  , in reply to message 9.

  Posted by SerenaT (U14961490) on Monday, 15th August 2011

  I hope you don't mind me joining in but a lot of people with dual diagnosis find this website helpful
  
  I hope things work out OK for you and your sister. It is so very difficult.

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• Message 11

  , in reply to message 10.

  Posted by TheRealSportyGirl (U1723427) on Monday, 15th August 2011

  Serena - of course I don't mind! The concept of "dual diagnosis" - which earlier Giddy Kipper & carrick-bend also mentioned - was new to me, so I have looked at the links. I do think she has been caught to some extent in the "sort out the alcohol/sort out the mental health" see-saw which Giddy Kipper mentioned.
  
  My sister does have an alcohol counseller but she (my sister) has always been adamant that she doesn't want to stop drinking, she wants to be able to control it. It's clear to me that there is a complex interaction between her mental state & her drinking - which in a way I suppose is true for all of us.
  
  Anyway, she has been admitted to a mental health hospital tonight (because she said she'd taken an overdose, which she hadn't really, but must have felt that was the only way to get the help she needs). Let's hope she does.
  
  Thanks to all.

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• Message 12

  , in reply to message 11.

  Posted by What larks (U14260755) on Tuesday, 16th August 2011

  I've got a friend with substance abuse problems who also has some mental health issues. He had psychiatric care in the past and was told that although there may well be some underlying psychiatric problem, it would be very hard to diagnose while he still took drugs; more importantly it would be very hard to resolve.
  
  He has got the drug use under control. His mental health problems are much, much better and the real person is coming through .
  
  

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• Message 13

  , in reply to message 11.

  Posted by The Giddy Kipper (U10918464) on Tuesday, 16th August 2011

  Sporty, it might be worth seeing if a social worker can see your sister while she is on the ward. I know it's difficult when everyone is throwing suggestions on a mb, and the situation can be different in each area ; but 'technically' ( ie doesn't always happen ) you should be able to ask for a social services assessment whilst someone is in hosp. This, at best, could be an opening for referral to practical support services, at worst, her name us on a bit of paper in case there's a next time.

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• Message 14

  , in reply to message 13.

  Posted by carrick-bend (U2288869) on Tuesday, 16th August 2011

  I'd agree wholeheartedly with that - I've got parents with complex MH issues - I got the SS sort of on board before a cris (there have been many, lately) had been reached and am so glad to have their support.

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