To think hospital should not have let out actively suicidal person

[runnermum1974]

I don't want to reveal anyone specific so I am going to keep what happened very general:

Friends find a friend in acute distress and actively suicidal. They take suicidal friend to the hospital, and tell hospital the serious thing their friend was doing to be actively suicidal.

Hospital staff take away suicidal person for questioning. Suicidal person does not want to be in hospital - so they tell the hospital that they were just attention seeking and should be let out. The hospital let out the suicidal person and tell their friends it's fine (even though they were engaging in very risky behaviour).

AIBU to think that the hospital should not have let the suicidal person out so easily? They were told by the friends what the serious actively suicidal thing the person was doing - and an ill person does not necessarily have insight to know they need to be in hospital. Even in the unlikely event that actively suicidal behaviour was attention seeking, should they still not have got help? People who are really suicidal do not say so - so actions speak louder than words!

[Sirzy]

Not enough information to judge the situation. But if she was assessed by suitably trained staff who then deemed it not to be a risk then yabu. If she wasn't then perhaps yanbu.

[ScarletStar]

Were drugs involved? I'm just asking because I had to get someone sectioned when I was at university, and the assessing team were determined to send him back home to me because they thought he was a long term drug user, despite the fact he was trying to throw himself into traffic. It was horrendous, worst day of my life. I eventually got him sectioned after basically refusing to take him back with me.

[Nomama]

They do more than just a ask a couple of questions. They do quite a lot of watching and probing and asking seemingly daft questions too.

Relax a little and do what the powers that be here remind us to do: look after yourself, don't give too much.

Oh and keep talking about it so you don't get into one of those horrible self blaming loops.

[WorraLiberty]

Sadly the hospital can't keep the person against their will

They'd have to be sectioned

[SaucyJack]

Rightly or wrongly- there simply are not the resources available to section even 10% of patients reporting suicide ideation.

And that's assuming it would even be clinically beneficial to do so.

[MinesAPintOfTea]

The hospital can only keep people in against their will if they are sectioned under the mental health act here. Its not easy to do that on the say-so of friends of the person for obvious reasons to do with not knowing what your relationship with that person is like.

[runnermum1974]

No drugs involved. It was only a nurse who assessed - not a Doctor.

[Sirzy]

That "only" a nurse could well have had substantial training in mental health.

[Finney2]

A&E units see so, so many people every day who are suicidal. Most of them are not actually suicidal, but are in need of medical intervention to help them get their mental health on an even keel. Teir GP and community mental health teams are best placed todo this.

There are not infinite hospital beds. In fact, there are very, very few in-patient mental health beds. The hospital has to decide who is most at risk. They mostly (but not always) get it right.

[Electryone]

What type of hospital ate you talking about, a psychiatric hospital or A and E at a general hospital? Not really enough information, Psychiatric Liason Nurses who work in general hospitals (at least they do here in Scotland) are highly trained and specialised. Under the Mental Health Act here to they can "detain" a person if they are at all concerned about their safety until a Doctor arrives to assess the person. A mental health assessment is a bit more than a few questions to.

[runnermum1974]

It was a general hospital a&e. I would go into detail but then that might reveal too much about the people involved, if they read this post, so have to keep it general. .

[BrianTheMole]

No they shouldn't op, until a thorough assessment has been done. I know of two occasions where this has happened. Person A was a voluntary in patient, and managed to talk her way out, despite friends and family voicing their concerns. That night she went home and took a massive overdose. Fortunately she is alive now, but only because a friend broke into her flat and found her. The damage to her body from the overdose is life changing though.

Person B went to the hospital and begged them to take her in as she knew she was going to self harm. She was assessed, asked if she had put her own make up on that morning, when she said yes they told her there was nothing wrong with her. So she went home and killed herself.

[SilverDragonfly1]

I'd hope it was a psychiatric nurse- both times that I've been involved in helping someone suicidal, that was the case. But if the person said they were not suicidal then there is nothing the hospital can do- they certainly can't detain them involuntarily. As someone upthread mentioned, there are not even enough places for people who want to be in a secure ward, let alone those that don't.

Unfortunately, until this person is prepared to accept help, there is nothing your friend can do, which sounds terribly harsh but really is true.

[Carriemoo]

I took a overdose at 18 and was taken into hospital where i told the doctor i was ok and didnt want to be there. I was told off for wasting their time and they released me.

I was then sectioned two weeks later properly as I had another breakdown and self harmed quite badly.

I think attitudes are changing. This was nearly 10 years ago though.

[Quoteunquote]

The hospital cannot hold onto them if they have capacity.

My friend's 20s old son, has a physical and mental disability, he has to take so many drugs, it also causes episodes,

he sometimes takes all of his drugs at the same time( he is on such huge does of diazepam to control his illness, he is on amount that would kill most people), to kill himself gets rushed to hospital, get treatment and discharges himself. over a weekend, he can be blue lighted to hospital three or four times, friend is medical trained and works for the NHS, she cannot get them to keep him in, he is a danger to himself and others,

we fully expect him to kill himself and or someone else, my friend is very aware of this, we expect it will be her.

when he is in hospital, they have the security and police next to him at all times, often they kick him out, and he instantly does another major action,

every couple of days for the last three years, my friend has to phone an ambulance, and the police, and go through a process,

We have almost no support for people with mental health problems in this country, families are on their own.

If you want help for your friend, have a whip round and fund it, they will never get what they need from the NHS.

My friend has had to have lots of time off work, with stress, she is doing a one woman care team, she knows they system inside out, yet she cannot get the support he so desperately needs, it is a massive battle daily.

[iamsoannoyed]

Depends really.

I would assume that the patient had been assessed by psychiatric liaison (either specialist nurse or a Dr).

BTW An assessment is more than asking "a few questions", such as "were you trying to commit suicide?", "No? Well off you go then".

If they had been assessed, and deemed not to be an immediate risk to themselves or others, then they cannot detain that person under the Mental Health Act. To attempt to do so would be illegal.

They can refer to community mental health teams- including the crisis team- though, if they think the person requires support but not in-patient treatment. I'm not saying psychiatric teams never make mistakes, but they do usually get it right.

I have never worked in psychiatry, and no longer work in A&E/Medical Admissions anymore, but when I was a junior Dr working in Medical Admissions and A&E we used to discharge people relatively soon after suicide attempts such as deliberate ODs (i.e. as soon as medically fit, which could be after only a few days or even the next day or later the same day in some cases). To my knowledge, none of these patients went onto commit suicide in the days after admission. And I think we would have heard if they had, as there would probably have been an inquiry.

If your friend did have had an psychiatric assessment, then I'd say YABU. If they haven't, then YANBU.

[attheendoftheday]

iamsoannoyed is spot on.

Of course, I'm only a nurse, so I may not know what I'm talking about.

[Funloving]

The person involved has to have a mental illness in order to be detained under the mental health act. A lot of people who have suicidal ideation do not have a mental illness.

[gamerchick]

you're having a fucking laugh aren't you? They don't help you if you're suicidal..even after repeated genuine attempts they will hoof you out of the door as soon as you're patched up. [/bitterexperience] despite having a diagnosed mental illness.

If you're a danger to the public they' 'might' sort you out or lock you up rather.. a danger to yourself isn't worthy.

So somebody who says they don't want to be in hospital doesn't stand a chance of getting any help. There's.no.money.

[ashtrayheart]

The trouble with mental health assessments is that if the person seems ok at the time of the assessment then they won't be sectioned. My dd has had 2 recent mha within a week, the second resulted in a section 3 as the staff knew her (she's been in hospital on and off for a couple of years) and the dr recommended a treatment order. She seemed fine to the first assessing dr as he had no prior knowledge of her.
Psych beds are full up atm- my dd is currently occupying a bed somewhere she shouldn't really be awaiting a transfer to long term secure.
The mh system is at breaking point.

[curiousgeorgie]

It's so difficult to get someone admitted with mental health problems. A friend of mine tried for years to help her brother and nothing did any good, even though he attempted suicide twice..

It's an overcrowded, flawed system

[ashtrayheart]

I hope your friend is ok btw x

[justmyview]

OP Are you talking about a recent event? If not, did the person go on to commit suicide? Very sad story

[creampie]

Actually, it's relatively easy to get someone admitted as long as they are assessed as requiring admission.

Unfortunately, the medical criteria for admission are not the same as that of family and friends demanding 'something must be done'

[gamerchick]

oh really creampie tried it recently?