I have spent ten years of my life in psychiatric hospitals/secure units. AMA

[Fermatslittletheorem]

I'm bored, should be revising for exams.

So go ahead, ask me anything!

sorry, OP, don't mean to de-rail with two posts about my friend.x

Do you have any information about whether / how a patient can be forced to comply with meds please?

What is the most important thing a nurse can be or do for you?

Thanks very much for this thread, @Fermatslittletheorem. It is wonderful to have the benefit of your insight and experience.

I so much agree with what you said at one point - that although everyone is encouraged to talk about mental illness, it is really only things like depression and anxiety that are "acceptable" and welcome and de-stigmatised.
Despite schizophrenia being so common, it is left to one side, and people with schizophrenia seem left out of the conversation.

My son is intermittently psychotic and is on a secure ward at the moment. He has been diagnosed with schizophrenia, but I'm not sure that the diagnosis really means anything. It just seems to be a way of saying that he has a long-term vulnerability to psychosis -- and there could be lots of different reasons for that. I don't think schizophrenia is one illness at all

He is usually very unwilling to talk about himslef so it is really great and helpful to hear your first-person accounts. Very many thanks xx

How compulsory treatment orders work is that they're not very nice tbh. It is violating. But then if you've spent lots of time in and out of wards and under crisis teams then I guess it's a way of life. Sorry for not dressing it up as there's no good way to look at it.

Please take care of yourself when you're around him - not because he's a danger but because it's so draining. I know when I'm on one I can go on for hours about what such and such message I'm getting but no none of it makes sense and it's circular so even the most sympathetic listener won't be able to make sense of it all and will end up tired and baffled.

@Mamabird3 Thank you for wanting to be an RMN - difficult job but hopefully very worthwhile.

The best nurses are those who take the time to listen and are non-judgemental and caring to everyone, regardless of diagnosis. Lots of patience and kindness and listening skills. So the obvious things really! But also understanding that emotions are valid and not necessarily a sign that someone is at risk and should be restricted further (e.g. not allowed off the ward). Positive risk taking I believe they call it! But not playing with people's lives. Difficult balance to achieve I know!

You are obviously able to put yourself in the shoes of the patient, which I think will really help make you a great nurse.

I hope you and your brother are doing well now?

@StripeyChina sorry I went offline for a bit.

I am on a community treatment order (CTO) which means that I have to have my medication or I can be taken straight back in to hospital on a section, without them having to wait until I am really unwell again. They can only put you on a CTO when you are on a section 3 or some home office sections (but I don't know much about that. I think it is a 37/41). So they can't put you on a CTO if you are in the community or an informal inpatient.

My CTO drives me crazy because I have to have medication which as @Handay has said, is pretty rubbish. From the other side though, I know my family love me being on one, and they panic when I am off it because they know I will stop taking my meds and end up dead or in hospital.

I am surprised your friend isn't on a CTO and a depot to be honest. Maybe because they have to ask the nearest relative's opinion and it sounds like his nearest relative may not give permission. Does he get admitted on a section 3? If a patient's nearest relative disagrees to a section 3 then they can't be sectioned, unless the AMHP (approved mental health professional) applies to displace the nearest relative through court process. That's the only reason I can think of for him not being on one, since he sounds quite seriously unwell. Although they are restrictive and the doctors and AMHPs have to choose the least restrictive option.

You sound amazing for giving him so much support, but as @Handay says, don't let this affect you too much. I also can go on for hours about how Satan is going to impregnate me and destroy the world and I am evil and his pawn, and will not be convinced by anything you say. Particularly if you try to tell me that he doesn't exist. If you tell me that then I won't listen to another word. It is tiring and baffling. And weirdly I am extremely logical when I'm psychotic so I will have you tied up in knots even though you know you've missed something!

Flowers to you . And to you @Handay

@AlphaNumericalSequence I'm sorry your son is unwell. There are several different types of schizophrenia, but also it is different for everyone. There are different symptoms and you can have different combinations. You can actually be diagnosed with schizophrenia just with negative symptoms i.e. no hallucinations or delusions, which goes against what most people think.

I hope your son gets well soon.

Yes, society accepts depression and anxiety and eating disorders but not mental illnesses seen as scary or kind of dirty. Schizophrenia is often depicted as being the homeless man who's really unclean and muttering to himself. Although to be fair I have looked like that when I have been really unwell, but lots of people with schizophrenia are clean and manage really well.

Do you know what care plan should be in place when someone leaves hospital after being in on a section 2. Lives alone and first section.

Thanks for this thread and I hope you remain well.

@fermatslittletheorem this thread is wonderful, thank you for starting it and responding so eloquently to the questions.
Can you tell me what non medical support you find of help to you? For example do you live in supported accommodation, or have an outreach worker, or do you access any MH resources, such as MIND or community activities?

Thank you so much for your honesty and generosity in replying to all of the questions on this thread, I feel I have learned a lot.

Have you worked, and/or how do you think your condition will impact on your working life after you finish your degree?

@bullyingadvice2017 To be honest I am not sure. I don't think there is any legal right to section 117 aftercare after a section 2 (as there is after a sec 3), but there should hopefully be some support in place. Maybe even the home treatment team for a bit. The person should hopefully have a CPN and consultant if they didn't before.

Fermat that is really helpful thank you so much.
I know he was on a Section 3 last time.
I think it's unhelpful his next of kin agrees with him that he 'doesn't need the meds' but there is nothing I can do. He probably DOES as although he can have periods of 'wellness' actually he is either not really functioning (unheated house, not washing, not eating regularly) or 'dancing with the spooks' outside the HoC - there are some times when he's in between but not many or for long sadly.

Re the support - he called me to say how frightened he was so of course I listenened. He talks to me about some parts of it that he doesn't share with anyone else. It was hard to listen to but i felt he needed that outlet. I just hope that was better than telling him he was talking nonsense? He is also extremely logical (and indefatigable!) when hyper so there is no way around it.
But yes it was pretty full on for a solid week, then nothing. I left it 3 days then called the hospital and they said he was in. Really sad.

He is VERY shut down emotionally normally but when hyper he will talk at length and in detail about his feelings which seem genuine to me - I don't know if that is all just part of the episode or if is that his inhibitions come down and he is less worried about the consequences of discussing them?

(sorry, I shouldn't be using this thread as such a sounding board)

It's just so amazing to speak to someone who is so forthcoming about their own experiences and to hear what others are contributing too.

@Usingmyindoorvoice Thank you for your compliments! I currently live independently, but have lived in supported accommodation for six years. It was very helpful at the time; I wouldn't have managed alone after so long in hospital. I also had 28 hours a week of support from an outside agency where they would take me shopping or to the gym or whatever. It was a bit too much time actually, and I felt like I had to "entertain" the support workers. We spent a lot of time watching TV which is not great, but four hours a day is a long time to fill. Gradually that time got shortened. At my last assessment I was offered 17 hours a week but I haven't had any support workers for over 18 months as I am at uni and too busy. I had the home treatment team after my most recent admission at the end of last year/start of this year, but that was just to supervise the oral medication I was taking until the depot kicked in.

There is a day centre in the city where I live, but I have never been interested in it. There is a lot of sitting around and I don't really like organised actvities like craft etc. I am not creative and I prefer education. I did do a computer course through the day centre which was good and got me really interested in computer science so I took it at A Level about 5 years ago and got an A*, which got me back into education. So I am grateful for that.

So there is lots on offer, but now I am so busy that I have no need for anything. I see my CPN every two to four weeks depending on how I am. More often still if I am very unwell (daily). She is great and I get on with her really well.

Aside from that, uni helps me so much as I said upthread, it gives me focus and self-worth and a distraction. It is hard to work while struggling with symptoms or more likely, med side effects. Also I have missed time through hospital admissions. But I keep going and I love it. I do around 35-40 hours a week work including lectures. Then I also see my family who live nearby. The rest of the time I spend relaxing.

I also go to church where I have some lovely friends who are very supportive. Before my last admission some of my friends came and sat with me for hours to keep me safe and they also cleaned my kitchen when I was taken to hospital! They are amazing!

@MotherOfDragonite No I have never worked apart from some tutoring and a Saturday job in a shop as a teenager. This worries me as I feel unemployable. I will be 36/37 when I graduate and have no work experience to show for all those years. I worry that no one will want me. I also worry because I seem to be admitted quite regularly (four admissions in the last 12 months) and this will cause problems if I am in a job. It's hard enough to manage with uni but at least I am not putting anyone else out. Also I don't know how I will have my depot if I am working full time. It is quite scary.

@StripeyChina As much as I hate meds, I can see that others do need them, and it certainly sounds like your friend really does. As you say, I don't know what you can do to encourage him to take them.

I definitely think that listening is really helpful if you can cope with it. But letting it go on too long can make people more worked up and more convinced (if that is possible). I don't listen when people tell me I am talking nonsense, and it can either make me really annoyed or even make me laugh, depending who it is, how they say it, and how I feel at the time. I desperately want someone to tell me that I am wrong and it is not really happening, but when they do I think that they are not listening or believing me, and that they have been fooled by the devil. So you can't win really.

I don't know about mania as I have never experienced this, but it could be that the talking lots is part of that. I know that for me I won't talk about my fears with anyone when I am getting ill. Until I am really unwell and then I will be really open and tell every health professional who asks any vague question. It gets to the point that I am terrified and can't think about anything else so I can't talk about anything else. Can't gather my thoughts enough to distract people's attention away from me by talking about something different as I can in the early times of a psychotic episode.

What helps me when I am extremely psychotic is being talked to like a child. Because I am like a terrified child. Having my focus redirected. When people say "focus on me Fermat" and get down to my level (I am normally curled up in the corner on the floor). When they talk to me about normal things, especially if they don't expect a response. Recently when I was on a 1:1 in hospital, one nurse spent hours just talking at me about her life, and it was so helpful. She would occasionally stop and redirect me to focus on her, but apart from that she told me stories about her life and her dog and stuff. That's generally better than getting into a debate which you will lose because your friend will have spent hours and hours thinking about their delusional beliefs, and rationalising them. And even if your argument is better, they will just ignore you anyway.

Hope that helps, feel free to keep asking although I am going to bed now! Got an early lecture!

Thank you Fermat this is really interesting. I’ve been involved with commissioning support for people living with and recovering from serious mental illness, and your experience and insight is so valuable. I get what you mean about too much support, that must have been exhausting at times.
And I’m glad you’ve got your family and church around you.
I have tremendous respect for people living with SMI, and have often found a truthfulness and sincerity that can be missing in the general public.
Good luck with your studies, and don’t rule out tutoring, the world always needs Maths tutors!

thank you fermat
hope you get a good rest. x

@Usingmyindoorvoice Thank you. I do worry that I am too open and honest a lot of the time - like people are thinking TMI, why would you tell me that?!

@StripeyChina Thank you. Still tired though! Meds eh?!

Yes, meds... (a very 'mixed blessing')

But your'e doing an amazing job to be attending and progressing your degree. I recently had to stop some post grad study due to my physical health issues and the lack of structure and sense of failure is hard to cope with -I do admire you for keeping on keeping on.

And your openness here has been both educative and helpful for a number of people including myself so I thank you for that xxx

@StripeyChina Aw thank you Sorry you had to stop doing your post grad, hopefully one day you will be able to continue.

It helps that I love maths and so it is like a hobby rather than working! (Although right now when I'm revising for exams it's a bit tedious!)

Thank you. x
My friend is a Maths guy (former Olympiad medal winner)
My Maths is a bit more basic, lol. We talk of other things :)

Fermat I've read the whole thread and I'm in awe of you. You sound like such a lovely, strong articulate lady. I've learnt a lot from reading your thread.
I have so much respect for you studying and progressing your life. I wish you all the happiness/success/stability/nicestuff in the world ♥️

Sending hugs

@Hippychick78 Thank you, that is so sweet