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Quick help please- FIL on way to hosptial (Mental Health)

(32 Posts)
Armadale Wed 11-Dec-13 15:57:16

I started a thread here somewhere yesterday asking for advice about FIL's anxiety..today he has lost it a bit- details sketchy but hitting walls, smashing furniture etc. Ambulance and DH on way round there.

Can anyone advice me what is likely to happen and what questions DH needs to ask at the hospital? Will they automatically keep him in? Is this an opportunity to get him on some proper meds? What do we do if they let him out tonight?

HoopHopes Fri 13-Dec-13 23:24:00

Hi, good gp is being helpful.

Only thought was if he saw the Gp today then he would not have had taken all the tablets before the gp suggested it and then he would have needed the rest tonight?

My only thought was maybe he is struggling with going from working to retired? How to fill the days with purpose? Wonder if he can be encouraged to do things, when more stable? If not already? Whether it it swimming, more interest in gardening to a woodwork course or whatever?! Worth looking to see what groups or things are on in your area maybe? Or volunteering, using his skills to help others when able to?

Armadale Fri 13-Dec-13 22:39:50

Just a quick update-

DH not yet broached MH team as couldn't get away from work to see him yet.

FIL went to GP today for a blood test and his GP asked him in for a chat, which was good. The main thing she told him seems to be he can take all his medicines in the morning if he wants (he spends all day watching the clock for the next tablet- it has literally become a full time job), but DH rang him this evening and after a couple of sentences he said he had to go as he was due for a tablet, so obviously he is ignoring the GP's advice....it is very frustrating

clio51 Thu 12-Dec-13 17:26:54

Can't go back in to alter mistakes on kindle predicted text
forget 150mg should read care!!!
And acute on going mh.

clio51 Thu 12-Dec-13 17:22:29

Hi

Yes different areas have different protocols, they call it crisis because you are at crisis and need help ASAP.
This is why my gp went via them to get me seen asap and in the system.
Where I live we have primary care(General mh issues) and secondary 150mg(acute ongoing my) this is why I got assessed at home to see which group to be put into. In my area you only get a cpn(community physcharic nurse) or care coordinator and psychiatric intervention if you are secondary care!
As said Google your area geriatric mh and see what there assessment is,it should tell you and give you some insight as what to expect.

Good luck x

HoopHopes Thu 12-Dec-13 14:21:44

Obviously different areas have different protocols, but the difference between crisis team and being under a mental health team is that a crisis team literally deals with the particular crisis ( and in most areas will only support someone over a few weeks), and so are not going to do the detailed assessments, care assessments, ongoing support that may be needed. Elderly care for over 65's is different at adult mental health care that Others have shared about. Worth looking up on the Internet what is available in your area.

All areas of NHS have waiting lists - referral max time on NHS for any condition is 18 weeks ( having had to wait 17 weeks for a physical condition of my baby I know it feels ages), but that is the disadvantage of free health care, a wait. It can be shorter. No difference between mental and physical issues - if in crisis go to gp or a and e and they will act to deal with the crisis, otherwise wait and be treated and assessed by normal route. The advantage if a team rather than crisis is in a team you are allocated one named worker who you see regularly if accepted on the team ( a care co-ordinator), whereas crisis teams work 24/7 and it is often a different person each time ( they do not want people depending on crisis teams instead of usual support systems as crisis teams are small and support large areas of population for short periods of time).

Sounds like your FIL would be better with a named worker than a crisis team approach - as he was too scared to go to the hospital. Perhaps if he is like that again do not use an ambulance but go in a car or taxi as less scary? Elderly health care teams do something adult ( under 65) care do not do and have experts in people who are over 65, with awareness of issues facing the elderly and can assess for any underlying illnesses common in that age group, which may be helpful - it may have a different cause?

Sounds worrying, but great he has you both to support.

Armadale Thu 12-Dec-13 08:01:32

Thanks Clio, I'm sorry you have had such a rough time and appreciate you sharing your experience with me.

I haven't really had any experience of things like this before- it all seems so meagre to me- if your leg was broken they'd whip you in and sort it out but they leave you for two days for someone to visit in your situation- it seems all wrong, really.

By the time DH left yesterday FIL was back saying he was OK and didn't want any fuss- I think we will have a hard road to get him to seek help.

He was very successful in his work life and was known to be quite ruthless in his dealings with people- now he seems to need the approval of the docs and is very needy and needs them to like him- to the extent that he sees saying he is struggling would cause them hassle so he refuses to show it- It is very frustrating.

I think DH may go round this afternoon to see him if he can finish up at work in time, and will try and talk him into asking for more help

clio51 Wed 11-Dec-13 23:49:30

Hi.
Really don't won't to dishearten you about geriatric mental health help.

Don't know what part of country you live but it's very hard to get help quickly it takes months ie waiting lists.

When I was really bad mine was via gp referal to my crisis team, first I was given diazepam by gp 5 days worth whilst waiting. It took 2 days for mh team to visit me and boy was I desperate! They just spoke to me about what I thought brought it on, was I suicidal what was going through my mind etc. They came again couple days later again more questions, they know there isn't going to be much change because ads take a while to get into your system,I was given the phone no of crisis team,mh ward no of my hospital. I then got a visit of phychologist 2 weeks later to assess me to she if I what help I needed if any!!!
From then on I was accepted in the crisis team and got weekly visit and I could ring them anytime.it took 6mths!!!! To get to see psychiatrist and to be honest at the beginning I got the impression she just wanted to throw drugs at me no way! I didn't want to be a zombie!

Just want you to realize nhs is very slow even in times of crisis, they would rather you stay in familiar surroundings and not to mention no beds.

He is probably scared to death what's happening to him(I was at 54)
But yes that's an opening opportunity to get him talking and the more he talks about it the less embarrassed he will feel with everyone.

I don't know how much intervention your dh has or his dw with regarding his treatment as I can only speak for myself but certainly something to ask gp.

Armadale Wed 11-Dec-13 23:21:20

Really appreciate the heads up on the possible side effects, thanks. Will mention the Diezepan.

I think what Hoops said about the elderly mental health care team which has a psychiatrist to assess his meds is the way to go.

We have been thinking and he is also worried about drug interactions for some medicine he takes for a physical thing, so we could perhaps use that as a 'reason' to talk him into accessing that team to get advice.

clio51 Wed 11-Dec-13 23:11:04

Hi

You have just possible hit the nail on the head, the way he as been behaving WITHDRAWAL from citalopram. Don't take it light hearted he must of been going through he'll, it's the same side effects as starting up an AD. So hence me saying if he's got new Ad's he will have start up effects for a good few weeks(not everybody the same degree) so don't expect any great changes for at the min 2 weeks But as I said your gp can give him diazepam(valium) only say 2mg or 5mg which will help greatly but not all will give these out as there addictive not 2 weeks through. So ask for them from his gp.

I got given them as the ad's I was on gave me suicidal thoughts(which is common) headaches,insomnia,no appetite,cold /hot sweats. Just to tell you what you MIGHT expect from him.

HoopHopes Wed 11-Dec-13 22:34:04

Oh that sounds a useful gp appointment.

Yes, he has to be willing to engage with services in order to be helped, so sounds like seeing a gp and building up trust is a good starting place.

Yes, some people think a hospital is a quick fix, but really unless someone is needing physical treatment a gp or out of hours dr can do exactly the same referrals ( including getting someone into hospital) as an a and e dept, and usually without the long wait!! Gp's can refer for people to be assessed etc and crisis teams come to houses. As most mental health assessment and treatment is done in the community, there are community mental health teams ( such as elderly mental health team) if a gp feels someone needs more treatment than a gp can offer.

Armadale Wed 11-Dec-13 22:30:06

Forgot to say, turns out he has been off citralopram for months, as it upset his stomach, so he hasn't been having anything. GP tonight prescribed Fluoxetine 20mg 1 a day for him.

Armadale Wed 11-Dec-13 22:27:59

Hi thanks for the replies, sorry only just updating, Dh literally walked out of a job he was on this afternoon so he wanted to go back and get a bit straighter for tomorrow, so I went to keep him company.

Reading you posts it is perhaps not the fuck up I thought it was if indeed going to hospital could have made him worse and the gp can do all they can in terms of drugs- my worry is he is on his best behaviour in front of medical people and so it seems to be back to pretending everything is OK.

I'll talk to DH about the ideas you have suggested as clearly things can not go on in the way they have been.

thanks for all the advice and help.

HoopHopes Wed 11-Dec-13 21:48:09

And the gp is right - do go back to gp if feel worse, rather than hit a crisis point like today.

HoopHopes Wed 11-Dec-13 21:46:47

Hi, a gp can do everything ( and often more) that an a and e department can, so do not lose heart.

You can ask for an adult social care referral to be made if you feel that he is a risk to self or others.

It is rare for people to be detained in hospital as mental health beds have been seriously cut and unless he was a danger to himself then unlikely he would.

What sounds useful, if he would request it or accept it is a gp referral to elderly mental health care team. Who can assess and offer other treatments. Do you think he would ask the gp for that? Then a psychiatrist in the team can review medication as well as other mental health workers assess him and ensure there in nothing else going on or other needs not met. It would need to be a gp that did the referral ( a and e would not do that, just refer to a crisis team - which incidentally a gp can do as well).

If he deteriorates again it may be best to go to gp or a walk in centre or an out of hours gp ( unless it is a physical emergency) as the stress of going to hospital may not help and all gp and out of hour gp's can refer to crisis team if think he is in crisis.

Sorry for all your stress.

clio51 Wed 11-Dec-13 21:27:13

Hi

I was wondering how your FIL was doing, looked at the post to see if you updated but like you said you couldn't find it.

The title made me look tonight.

Oh dear that's a shame he didn't go in the ambulance, but he would of probably only been kept there for literally hours until an on call mental health consultant was available if one at all! He may have seen a junior mh worker who couldn't make the discision to keep him in. Also if he changes his attitude/appearance when he's in front of doctors etc he would just be asked lots of questions and would he of really told them the truth?
I think they would of sent him home with diazepam to calm him down and told to see his gp.

Did the doctor not give him any diazepam? He could do with some for a few days to calm his anxiety back down help him relax.
So as the doctor upped his was it citalopram? Or something as well? If so what are they as he will get start up side effects which for some is heightened anxiety(don't won't to scare you) so will be worse before better.

SnowyMouse Wed 11-Dec-13 21:00:05

Oh dear, Armadale Did he say he would go back to the GP if he feels worse?

HoopHopes Wed 11-Dec-13 20:45:15

Oh that is a really good point. And sometimes there are physical reasons that are underlying or exacerbates the situation.

Your dh should be able to leave him as he can be cared for by medical staff if you would appreciate a phonecall - if he has reception that is!

Armadale Wed 11-Dec-13 20:44:51

Ok DH just got back 5 mins ago.

All a complete fuck up.

FIL refused to get in the ambulance, said he was very embarrassed now, he had calmed down. By the time DH got there they had agreed he didn't have to go to hospital if the GP would come out to see him instead so DH phoned GP.

Ambulance left. GP called back and said couldn't come out but bring him in.

10 minute flipping appointment the result of which was a prescription for AD's and told to come back if feeling worse

Dh then spent 4 hours at their house trying to get things right.

Jollyb Wed 11-Dec-13 20:32:07

He will probably be assessed by the general medical team too. This will be to ensure that there isn 't any underlying medical cause of the deterioration - such as an infection.

HoopHopes Wed 11-Dec-13 20:17:25

Yes it can take ages for a mental health worker to come, as they will not be sent for until they have done the usual a and e wait often. They may have to come from wards or be busy seeing another patient. It is encouraging he is still there though, indicates being treated seriously.

SnowyMouse Wed 11-Dec-13 20:05:55

It must be very difficult for you fsad

Armadale Wed 11-Dec-13 20:05:25

Ah, OK, thanks.

I feel so helpless here but don't want to ring him as I know he will call when he has the chance.

SnowyMouse Wed 11-Dec-13 19:56:04

It can take quite some time for the mental health team to come and see people in A&E.

Armadale Wed 11-Dec-13 19:50:30

No it was brilliant, thanks.

I have not heard anything yet.

The ambulance came about 3.30, and they are very near the hospital, so not sure what is going on, he must have been seen by now, I would have thought. Possibly DH just can't slip away to call.

HoopHopes Wed 11-Dec-13 19:21:59

Sorry it was so long!!

How is it going?

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