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.

Psychiatric hospitals don’t provide any therapeutic input typically. They aim to keep the length of stay as short as possible so discharge will happen very quickly.

Due to covid the situation is to reduce contact as much as possible and some people have ended up isolated in there rooms so it is to be avoided at all costs.

Longer stay hospitals are around where you get therapeutic input but the process for referral is hard and they are a really mixed bag.

If your friend is willing to go she wouldn’t be sectioned but would be admitted formally in most areas this would be through the crisis team. The gp would speak to her psychiatrist and would make a referral.

Hopefully she is allocated a CPN asap and can be referred to Psychology

This is coming from a position of someone who has been in hospital and works in mental health.
M

Admission is always a last resort. Bed shortages are pandemic to the point that often only those needing detention can get admitted, certainly in London. And that's without covid19.

Because only the most disturbed patients get admitted, they can actually be quite scary places to be.

Add shortages of staff to the mix, and they're really not somewhere that you'd choose to be.

However, crisis lines and A&E would be an option if your friend really thinks they need it.

@Howmanysleepsnow - thank you but I’m not sure how to send a PM.
It sounds like she’s nowhere near the threshold for being admitted. Her treatment at the moment amounts to a weekly chat with her GP (and there’s nothing he can do apart from chat) and the promise of a CPN. She had 4 phone sessions with a psychologist but when she tried to talk about a traumatic event that she believes triggered this she was cut off and told not to talk about it as this was just some ‘here and now therapy’ - it essentially amounted to advice to be kind to herself and a ‘safety plan’ that said helpful things like ‘have a nice bath’.

This is so frustrating!

So do meds not really help BPD? (And I so mean Borderline Personality Disorder). Is therapy he way to get on top of it?

I think she'd be better off to ask for a crisis team referral. The GP cannot arrange admission anyway.

She could also self refer to IAPT for therapy. It will all be phone or Skype at the moment. They might or might not accept but it's worth a try. The wait list for face to face specialist psychology will be many months.

DBT is helpful for BPD if she can get on a waiting list.

Meds don't really help BPD much no. Often they do get prescribed but they are very unlikely to be the cure.
I am afraid that here and now therapy is what is usually offered. Talking about the cause may not help as much as you might suppose. The idea that things can be put to rest by talking about them doesn't really pan out in practice and the advice is more about learning coping strategies in the here and now.
Therapy isn't actually mainly about off loading to someone its about recognising unhelpful patterns of thinking and behaviour and changing them and that is hard work.

DBT is indeed the evidence based therapy for BPD

@KilljoysDutch

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.

As a fellow person diagnosed with BPD, I hear ya and that was my experience for years until I was able to get DBT. And even after DBT although mostly helpful I had a bad period again and the MH team dropped me. Only by presenting at A and E could I even get listened to much of the time, let alone anything else. But if DBT is available in your area, and for the OP's friend as well, I would take it if given the chance.

I manage a liaison mental health team. We see around 200 referrals a month,around half to two thirds of these people have harmed themselves and/ or have suicidal thoughts. We discharge almost all back home with either Crisis follow up or appointment with their community team,very few are admitted and even fewer informally. We have to risk assess and decide on the safest plan knowing what resources are available, current evidence suggests that people with personality disorder don't do well in in patient settings, treatment is around learning how to manage emotions and response to situations. DBT may help but accessing it can be a very long wait. We discharge people every day who present an ongoing risk to themselves but if the risk can be managed in any other setting than hospital it will be.
I am close to retiring after over 30 years in the NHS,I am old enough to remember when there were sufficient beds to admit people into. That's not to say that personality disorders should be in hospital but what helps most (psychological interventions) is so under resourced that people end up in crisis repeatedly.
There is a constant flow of media coverage about the importance of positive mental health and seeking help, in reality actual NHS help is very limited and most 'low level ' needs ( and some higher) are pushed to the voluntary sector or self help.
I think your friend should contact her Community team and say she is struggling. A GP would be very unlikely to be able to admit to hospital in any situation without assessment by mental health services.
At a very basic level people who have insight into their needs and are engaged with services are unlikely to be admitted. Slightly aside from this issue I do think that many community mental health teams have failed to meet peoples needs during covid, people want face to face contacts not phone calls. We have seen many people in the past few months in A&E who came as they knew liaison services have continued to be available.