MH crisis - would an ambulance have been justified?

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DP had a crisis in the middle of the night, and, for the first time ever, I considered calling an ambulance. Would I have been justified?

He's been depressed, or on the verge of depression, all the time I've known him. He's been on ADs, on and off, for the last few years. He went to the doctor a few months back and asked if he could go back on them. Since then a few things have happened to knock him back. He's on the waiting list to see a psychiatrist and a counsellor.

Last night, he called me out of bed at about 1 (he was still sat in the lounge). He said he was having bad thoughts, and didn't want to be alone. He was crying (not usual for him). I asked if he wanted me to get an ambulance and he said no, he'd refuse to go with them (so no way I could get him to A and E on my own). He did say, however, that he'd thought about asking me to do that half an hour earlier, but then denied saying it five minutes later.

Would a call-out have been justified? My practical thought was that, if I could get him admitted, he'd see the psychiatrist quicker than he would otherwise. However, not only did he say he didn't want to go to hospital he was also drunk, and I was worried they'd think he was that way because of the alcohol, rather than the other way round.

It's not the first time I've seen him like this (he's been worse in the past) but it was the first time I've considered an ambulance, mainly from the referral point of view. He's 'ok' this morning, as much as he has been recently, that is, so I'm not worried I didn't call them last night. But should I have done so?

I think someone being with him was what he needed last night and you were there. But if you had concerns about his safety or you couldn't be there I think presenting at A &E would be reasonable. I'm not sure about an ambulance if neither of you were in immediate danger.
If you haven't come across it this charity provides really good support for men with mental health problems. It has helplines, which might be another option.

www.thecalmzone.net

Do keep telling your DH to tell you if he's feeling like this, it is dangerous and you need to know, you could also contact Gp again. Hope he gets the help he needs.

Thanks, All. I honestly couldn't have got him to A and E any other way. The only hope I would have had is him being faced with paramedics and realising I was being serious. It was difficult enough persuading him to go to bed.

Haven't come across CALM before, so thank you. And I'll maybe speak to the doctor - I've spoken to them more than once about him. He said he'd speak to his boss today - I'm actually likely to bump into him at some point today so I'll double check with him if he has or not. Again, it wouldn't be the first time I've discussed DP with him, either.

Thanks for replying. It means a lot.

I can't imagine an ambulance would come out to you. And if you went to A and E you'd probably just sit in the waiting room all night. Unfortunately I don't think there is a way to fast track out patient appointments. Sorry that you are both going through this

Can you agree some strategies with your DP ?
I think if this were me I would literally make a list of helpful things I could do and refer to it with him.
Could be anything from a cup of sweet tea and a chat to calling help, ringing Samaritans together, 999 etc. Having said that, you need to keep yourself safe and well so don't put all the onus on you to sort out problems. He needs to be referring to that list himself too.

The only way you could fast track an appointment is if he was a danger to other people and police were involved. All a&e would have done would have been to keep him sitting in the waiting room all night until he'd sobered up, maybe see the crisis team and then discharged.

He'd be better off helping himself by keeping off the alcohol while he's feeling like this and go back to his gp.

It would be a waste of resources as he had already said he would refuse to go with them

You should ask your GP to call the referral service and ask for his appointment to be brought forward- there are systems to do this. Going to A and E is not a great experience unless a person is at risk of a n act of suicide but there are Crisis Teams that can assess at home if things are worsening. Your GP should know how to access these. Hope you're ok.

It would have been pointless to call an ambulance as he'd not have gone with them anyway.

You need to ask your GP for the phone number for the local Crisis Team, they're who you call for a mental health crisis, not an ambulance.

That said, alcohol is a depressant drug and will make his depression much worse. It also disinhibits behaviour, so will make him much more likely to act on any thoughts of self harm. It also stops the antidepressant meds from working properly, so he really needs to stay off alcohol while his mood is so low.

If he'd have gone to A&E last night, they would have kept him until he sobered up, then had the crisis team or the hospital liaison psychiatry team assess him. It wouldn't necessarily get his outpatient psychiatry appointment brought forwards.

Make sure that you are getting support and time out. It's very hard caring for someone with mental health problems.

How many miles, ( sorry can't work out how to tag) hope today is better, I've been where you are and it's so stressful.
Thinking of you.

My local crisis team won't see anyone while they are under the influence of drugs or alcohol, so would be taken to a&e to sit overnight and given time to sober up, then sometime today would be seen by crisis team, in my area this assessment is done by mh nurse and/or SW. They wouldn't be admitted to a ward unless its the absolute last resort and even then it would be hard to find a bed.

There are no easy answers, yes to both of you speaking to his GP, he needs to engage with any help offered, it isn't all on you, you can't be all things to him.

Short story, back several years ago, I hit a very low point, I have been known to mh services and under a psychiatrist for 30 years now, I had been asking for help for weeks, (cpn, sw, duty worker, out of hours GP, crisis teams), they assessed as I hadn't done anything they couldn't help, I drew into myself, 3 days later I took a massive od, I woke up several days later in ICU and was stepped down once awake to HDU and then medical ward, then the crisis team came to see me and declared me fit to go home alone, my care package had also fallen apart at the time, I wasn't functioning mentally or physically and explained that but apparently, I was "fine", thankfully my sw stepped in and persuaded them to admit as she knew it was just a matter of time till my next attempt, the fact I didn't attempt while I was in ICU / HDU or medical ward "showed" I was ok.

So what I'm saying is, you both esp your OH need to stress what is happening, that you can't keep him safe when he is in danger of attempting and that he is struggling to do the same. Otherwise and I have seen this happen many times, it will be left to you, with no support for either of you and a prescription and a 6-month review.

I have a family member who has suffered from serious MH issues. There was an incident when he had psychosis and an ambulance was called. It was very scary.

They were able to get him to A&E and section him where he received treatment and is now fine.

If you are worried enough then yes, absolutely call an ambulance.

Also, I’m really sorry your partner is going through this and I hope you have someone to support you as it is just as hard for the family.

I suffered from terrible MH problems in my 20s. I have sat in A&E and told them I was suicidal and they just said 'oh dear, well, just try to calm down' and sent me on my way.

Even if an ambulance came out, there's not much they would do tbh in my experience.

My sister had a psychotic episode last year and I took her to a walk in clinic. This resulted in immediate referral to a psychiatrist (crisis team). She then got the help she needed.