Does anyone know how to get admitted to a psychiatric hospital?

[Justnotfeelingit]

A friend of mine is suffering from BPD and is fighting against suicide every day. Due to COVID restrictions she has only ‘seen’ a psychiatrist via the phone and has yet to be assigned a CPN. COVID aside, the system has let her down horribly. She is seeing her GP tomorrow and wants to ask to be admitted to hospital for treatment. She really believes that without it she will be dead very soon. She is on her third drug in five months and things continue to get worse rather than better.

Does anyone know if a GP can do this? Or does it have to be a Psychiatrist? The physiatrist is almost impossible to get hold of so I hope it doesn’t have to be her.

Sorry to hear about your friend and she is doing the right thing looking for help. Would she allow anyone to come with her to the appointment? I think if someone is at risk of taken their life (or someone else’s) they are usually admitted...obvs there’s a difference between being admitted and being sectioned - i personally don’t know what leads to being sectioned but hopefully someone else will
Be along and clear it up.

I hope your friend gets the help she is Seeking

It takes more than a GP for a section. A relative was sectioned. After presenting at A and E. is she in contact the crisis team?

I'm very sorry to hear about your friend. Do you know if there is a Crisis Team in her area? The GP will definitely be able to refer her. They will visit people at home and liaise with psychiatrists.

If she feels immediately at risk now or any other time, she should go to A&E and should be assessed by the mental health team there. She may not be admitting into hospital but there should be some plan to support her in the community.

There's a free, confidential, text based service called SHOUT which aims to 'get people from a hot place to a cooler place' ie help avert an immediate crisis. Here's some information about it www.giveusashout.org/

Best of luck

I'm sorry to hear this. I hope the GP can admit. I didn't know this person personally but a friends friend actually got ignored by the system too until the police actually put something in place for them to be sectioned.

I'm sorry to hear this. I hope the GP can admit. I didn't know this person personally but a friends friend actually got ignored by the system too until the police actually put something in place for them to be sectioned.

Is she is 'in the system' which is sounds so if she has a psychiatrist, then one option is to phone the crisis team. Their aim is often to try and support in the community though, and will only refer on if they believe there is absolutely nothing they can do (which is often subjective). Another is to present at A&E, neither is guaranteed though, the system is either very hard to access, or admits people who would fare better with different support. Hope it works out okay, you sound like an amazing friend.

In my trust the GP would contact MH services who would then look at either making an appointment with the community team or a referral to the crisis team for additional support. Either the crisis team or community team can request an inpatient bed if they feel it is necessary. It doesn’t have to be a psychiatrist that does this for an informal admission. Alternatively, if your friend doesn’t feel able to keep herself safe until she can see the GP she could either self present at A&E to be seen by the MH team there, or phone the MH access team (or equivalent in your area) who can arrange for a crisis follow up if necessary.

My mum was admitted last week. This was after weeks of phone appointments with gp, crisis team etc. Eventually crisis team did send people out, when a space came up they offered it to her. She thought about it overnight and then went.

I hope your friend gets some help. It's very hard at the moment, with lots of services being so shut down.

Thank you. To answer some questions, she goes to face to face GP appointments alone as they won’t let anyone else in, but she FaceTimes me from the appointment so it’s almost like I’m there.

I don’t know about a Crisis Team, that’s never been mentioned. She is awaiting a CPN, is that the crisis team? She was told the wait could be a long time due to COVID.

She’s been to A&E a couple of years back after an overdose. They pumped her stomach and sent her home with no follow up.

It also quite hard to get admitted with BPD (unless you're sectioned) as the preference is to treat it in the community for a variety of reasons. Wishing your friend all the best.

wolfiefan she wouldn’t need to be sectioned if she is agreeing to treatment and wants admission.

The GP could arrange emergency assessment by the duty psychiatrist.

OP, Healthcare professionals vary in their attitude to BPD. Some can be extremely unsympathetic. Would your friend like you to go to the appointment with her in case GP is an arsehole?

It isn’t always the best thing to admit. But that’s in normal times when can’t support is available.

Sorry Lockdown. You’re completely right.

She's already under secondary care, with an assigned psychiatrist. She will be under the care of a Communtity Mental Health Team, athough she hasnt yet been allocated a CPN from that team. I would contact them.

The GP would also be a way in. If the GP thinks she may need sectioning, s/he can call on professionals to assess her mental state.

The most efficient way currently would probably be to present at A&E I'm afraid.

If she is happy to go voluntarily then that removes some of the hurdles but ultimately if there a shortage of beds (and there always is) they won't admit her to a unit unless they absolutely have to. They will offer support at home instead but this is very variable.

From my experience, it's hard to get in to a psychiatric hospital. I have recently been suicidal , even wrote a suicide note, had a plan. They knew and hospital was never mentioned. Crisis team told me to have a bath and didn't offer anything.

Avoid in patient treatment at all costs, it’s detrimental to people. Not because the NHS is bad but because of the behaviours of others. I have been an in patient. People share by accident or design utterly awful thoughts and experiences in minute detail. Have seen people restrained and heard the poor girl in the next room smashing her head in to the wall repeatedly.

I hate to say it but taking overdoses isn’t always seen as a serious attempt at suicide. A psychiatrist would need to refer and it’s really hard to get admitted. Being a danger to others or yourself is the route. But saying and doing are different and they will basically assess your friends risk level.

What people are writing about BPD is also true in that some professionals are unsympathetic. Wishing the best and well done for standing by your mate.

Sorry to hear your friend is having a hard time and well done for being there for her.

It's such a difficult system to navigate. A CPN is usually part of the more general mental health team, with the crisis team being another team that can support people more intensively during a period of crisis. Being under the crisis team is usually considered an alternative to hospital admission. In my trust, the crisis team is the 'gatekeeper' for all the inpatient beds anyway so I would suggest trying to get her referred there would be a good option if possible. In my area GPs can refer to the crisis team, as can the mental health liason team who work in A&E, but I'm guessing this might vary by area. If you google the name of your local mental health trust + crisis team/home treatment team you can probably find out how referrals work where you are.

If it's considered necessary and she wants to go there wouldn't be any need for this to be under section, you can be admitted voluntarily. That said, as others have advised it is VERY difficult to access inpatient beds and I would warn that my experience of psychiatric hospitals is that there is very, very little that is therapeutic about them. I wouldn't say it is 'treatment' so much as a holding pen for containment where they will probably (heavily) medicate until they think discharge is feasible. I don't say this to be negative but I think sometimes people are very desperate to be admitted thinking that they will receive a lot of help or therapy or similar and my experience is that's really not the case, and it may be helpful to know this in advance.

I hope she gets the help she needs soon and best wishes to you both.

I hate to say it but in my experience with BPD amid other MH disorders she's lucky to even have an assigned psychiatrist. I did get one after the police took me to A&E when I was suicidal but after the care from that stopped all the care stopped. I don't have any help from the CMHT or even my GP. You need to fight really hard for her to get help because they will drop her as soon as they can. I hope she can get the help she needs and if it comes to it she should absolutely report to A&E as suicidal as it may get that help.

If she wants to be admitted she won’t need to be detained. Her GP can refer for admission as a voluntary patient.
Detaining someone is a big deal only done as last resort.
A GP can detain with a second approved person but it doesn’t sound like they need detention.

Thank you everyone for your feedback. I naively thought that being in hospital would involve therapeutic input, which is what she hasn’t had yet. It’s so frustrating watching her spiral and swing between self-destruct and being insightful and seeking help. Today she said she’s going to tell the GP how bad things are and ask to be admitted, but who knows what she might be thinking by the time of the appointment tomorrow.

The appointments can be tricky. I am there via FaceTime and often she says very little, leaving me to tell the GP what she had planned to say. However, the GP doesn’t know me and for all he knows I’m making it all up. I suppose he is then in the difficult position of not having much first hand information from my friend and having to go on what I am saying.

A GP can write a medical recommendation for detention under section. Another doctor approved under Section 12 of the Mental Health Act is needed in addition. The application for assessment is done by an Approved Mental Health Practitioner.
Where I work, theGP's input is rare.

• detention not assessment

The GP can’t admit, only mental health services can (A&E team or psychiatrist-CPN could be involved in the decision if she has one) He can relay concerns to the psychiatrist and make suggestions, but she’d need specialist review.
She won’t be sectioned unless she doesn’t agree to admission/ doesn’t have capacity to agree AND can’t be safely managed at home with eg. daily visits.
She can be admitted informally. This is a last resort if home treatment isn’t enough to keep her safe.
Admission may or may not be the best choice/ offer the best outcome. Other courses of action need to be considered too.
PM me if you want. I work in a role where I am regularly involved in these decisions.

Why the hell are people talking about detention under MHA? The person wants to be admitted. They therefore per definition do not need to be detained.

A GP cannot admit to a psych hospital. They can make a referral but they can not arrange admission. This would usually be via crisis team.

Admission for BPD (if you mean borderline personality disorder not bipolar) is very unlikely. The treatment is long term psychotherapy not drugs which will not be available in a general psychiatric hospital. Therefore admission would not achieve anything and so would not be offered. A 3 day crisis admission is likely the most that will be offered.

She should ask for referral to the crisis team and/ or self referral via 111 might be possible in some places.