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Original poster

I'm a mental health nurse - ask me anything

46 replies

toadabode · 10/08/2019 18:42

Hi, I'm a mental health nurse working in an extremely challenging and volatile inpatient setting. My patients have very complex needs ranging from self-harm and attempts at suicide to challenging behaviour and substance misuse. It struck me when meeting my friends today how little they understand about what I do, mental illness and the mental health system. If you're at all interested, ask me anything :)

OP posts:

Summerfalls · 10/08/2019 20:26

Are there ever situations where particular psychiatrists don’t believe certain conditions ‘exist’ so therefore don’t tend to diagnose these and diagnose something else instead? For instance I have heard of a psychiatrist mentioning a lot of people don’t believe bipolar type II exist’s, I wondered if that was their own belief or if they meant in general, I wish I had questioned it further. Do you ever come across this type of situation in your opinion?

IrishGal21 · 10/08/2019 20:46

Melancholia was taken off the dsm in the 80s as they felt it was not worthy. Now some docs are campaigninh to get it back on as they believe it is important to include it, non resistant type depression often forgetten about

Original poster

toadabode · 10/08/2019 20:47

@Summerfalls I've actually never come across a psychiatrist outwardly denying the validity of a disorder classified in the DSM, though have come across those who appear to over diagnose certain conditions. They'll tend to have a bigger than average number of patients on their caseload with X, Y or Z diagnosed when compared to the wider population. The same can be said for some prescribed medications - doctors will often have their 'go to' medications of choice and will use them across a wide patient group, sometimes when the medication isn't classed as a typical first line treatment for the condition they're treating (this really pisses pharmacists off!)

OP posts:

beccarocksbaby · 10/08/2019 20:55

waves hiya fellow RNMH, I work in female PD 16-25 year olds :)

WonkyDonk87 · 10/08/2019 20:58

Waving too RMN in CMHT but my heart belongs in AOT

Summerfalls · 10/08/2019 21:01

thank you for taking time to answer my questions. I have more so sorry in advance! I find mental health in general quite interesting subject. Do you think personality disorders are those conditions that are over diagnosed? Or as I have previously encountered in hearing said that they can sometimes be ‘waste basket’ diagnosis when some one doesn’t fit neatly into one box as you previous mentioned when explaining some people have multiple diagnosis over the years.
On the subject of doctors having their go to medications, I have noticed quetiapine seeming to be one used a lot for various conditions. I myself am currently taking it for reoccurring depression along side an AD, haven’t been taking it for very long so can’t say if it will help!
One more question ketamine infusions for severe reoccurring depression what is your thoughts on this?

IrishGal21 · 10/08/2019 21:02

Places like Australia are more progressive as they treat the individual not like in the uk where people are just treated generally and given generic antidepressants

JazzTheDog · 10/08/2019 21:07

Also RMN, working in a functional mental health ward that used to be Older Adult and now accepts all ages due to staff shortages and ward closures. This means that we also have patients who are in for dementia assessment and diagnosis.

Coffeeandchocolate9 · 10/08/2019 21:22

Do you think there are any environmental causal trends? Does your personal and professional opinion differ on this?

beccarocksbaby · 10/08/2019 21:34

Places like Australia are more progressive as they treat the individual not like in the uk where people are just treated generally and given generic antidepressants

That's defo not my experience of secondary services - we are very heavily audited in regards to individualised care and holistic treatment. I personally love the person centred approach.

nowifi · 10/08/2019 22:35

toad thanks for the work that you do, my Mum has been sectioned many times and everytime I'm there to visit her I'm amazed at how the staff cope.

My question is more of an observation really, the ward/hospital my Mum has been in is so cold and uninviting. I've often thought how they could make it more homely even a few nice sofas would make all the difference, the place seems so clinical. Do you think this matters to the patients and would have a beneficial effect to make the places a bit nicer? I know there is no money for such things just an observation really.

R44Me · 11/08/2019 07:21

My question
How much of the 'average' in-patients problems are due to past events in their lives rather than a sudden illness affecting them
Your Answer
almost all of them

I feel it's a taboo to suggest to someone that their problems are due to their family members behaviour towards them/ the abuse they suffered as a child/ the fact their DPs died when they were young. Instead everyone is treated for their mental health problems as if that is the problem and not that the past should be dealt with.
Wouldn't it be better if people were encouraged to explore their childhoods to start with?
Doesn't happen ime.
I'm an old gimmer and only realise now how much effect things from my childhood affected my life. If I'd had the information earlier or counselling earlier my life could have been very different.

mindgoinground12 · 14/08/2019 00:15

I just wanted to say thank you, my oldest DS (know 19) has server mentla health problems, you guys have not always been perfect and people looking on the outside would think very restrictive but youve kept him alive in hopsital and particulay in camhs made sure someone else belived in him. Hes been in and out of hodpital since 13, longest admission being 11 months, hes been on sections 3, 2, 5:2, 5:4, 135, 136, MCA, in camhs acute, picu, low secure and adult picu (that one was traumatic for him especially) and acute. So we have some experince of the system.
Do you work with adults or kids and in which setting? (as picu, acutes, mother and baby, forensic, PD, eating dis can be so diifrent!
How do you feel about the overwheming diffrence between camhs and adults (in inpatient settings) particulay when someone transfers when 18. As when DS transfered he suddenly had a lot more responsibility and was allowed alot more and he got very overwhelmed and for the first few weeks went down hill, the structure was so diffrent without school etc.

asblackasyoursoul · 14/08/2019 00:24

Hi! I'm 19 and a student mental health nurse, soon I will be going into a psychiatric ward which I've not been to before (have just done community MH and adult hospital placement).

Do you have any advice for me? This will be all quite new to me, any tips at all? Thanks!

RedSheep73 · 14/08/2019 08:25

Have many of your patients completed suicide and how do you cope with that? Also, if you had umlimited resources do you think you (as a service, not you personally) could save everybody? or are there some cases that you don't have answers to?

Kiwiinkits · 20/08/2019 08:15

Mine’s about causation and direction of the causal relationship between Marijuana use and mental health. The two are associated but researchers seem to be reluctant to point to the direction of cause. So I’m interested in your view: does pot smoking cause mental health issues or do people who are struggling with their mental health just use pot more? Or both?

Kiwiinkits · 20/08/2019 08:20

Also, are you a Kardashians fan? So. Rob Kardashian. Would you tell him to grow up and stop being so self absorbed and lazy or would you medicalise his issues as mental health?

Phimma · 20/08/2019 08:29

How do we convince our son to go to the dr and ask for help? He has serious mental health issues.

darkriver19886 · 07/09/2019 11:21

What are you thoughts regarding Dissociative identity disorder? I was diagnosed with it in November 2017 buy find most doctors dismissive of the disorder.

Chocolate50 · 11/09/2019 18:58

I think OP has gone but I'm curious as a parent of a son with a severe & enduring eating disorder - I'm going to be honest its been a nightmare for over 10 years now. I've found that - not all - but most specialist services as well as community mental health services just cannot seem to get a grasp on helping my son. I've recently got a copy of his MH records just to see what's been going on as their communication is awful. Some of the actions & recording is hugely worrying. I'm not going to go into detail but trust me as I can see the difference in approach & care in comparison to his last care team.

I am aware that this illness is difficult to treat but it seems to me having been in contact with other people in my son's position that it isn't that uncommon.
What's your take on this? Thank you.

Lostandinsane · 11/09/2019 19:18

How do you tailor care towards the individual? How seriously do you take an individual's wishes or circumstances?

Oh, and don't say "almost all, if not all" patients have experienced trauma. I haven't, and I have a pretty serious diagnosis. It's patronising in the extreme to assume we're all damaged or traumatised. It's a way of "othering" people. Not to mention the potential for missed diagnoses because the person wasn't traumatised enough.

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