Dd and mental health, could do with some quick help please!

[HairyMcLair]

Dd is 20, she’s had mental difficulties from a young age (traits of ocd, anxiety, depression, eating disorder). She was diagnosed autistic last year, she’s now on the assessment pathway for adhd as well.

In the past few years she’s seen crisis team through CAMHS and through adult services. It’s all been unhelpful, and has been traumatising for dd as they do nothing, don’t address the issues going on, and discharge her without actually doing anything. She now finds it difficult to engage with anything like this.

She’s on fluoxetine, which her GP was able to prescribe when she turned 18. I don’t know if this has helped or not.

The last couple of years dd has been at uni in London. We’re a good 4 hours away from there.

Her mental health is rubbish right now, so she came home on Saturday. She spoke to a gp today (about possible adhd) and admitted how low she feels, and how she doesn’t care if she lives or dies.
The GP then spoke to me, has said I either need to call the crisis team or take dd to see a duty psychiatrist at A&E.
At this point dd feeling like this has become normal to us, but I know the Gp is right. However dd is adamant that she doesn’t want to see anyone, although she doesn’t really care if I make it happen. She feels that because she hasn’t made a suicide attempt or isn’t self harming (she does, but in more subtle ways), she won’t be taken seriously, and past experience backs that up.

So what do I do? She’s home until tomorrow, but wants to return to London as she has lessons on Wednesday. She has promised to come home at the weekend so she’s not alone.

There are so many more details, but if I go into it all no one will read this, and we really could do with advice. Dd knows I’m posting this, and is happy for me to do so.

Choosing between crisis team and A&E - which would be the most helpful at this point? Any advice will be great!

So sorry for what you and your DD are going through. I'd say crisis team probably better than A&E, purely because A&E will be a long and horrible wait. Good luck

Sorry, a few more details in case they’re relevant.
The GP was clear that whilst adhd may well exacerbate her mental health, it’s important to not assume this is the cause, she could be bipolar (I don’t know much about that, but her mood swings are very similar to her brother’s, who is diagnosed ASD/PDA, and is also suspected adhd). Her mood can swing dramatically throughout each day.

I'm so sorry your dd feels this way, mental health is so difficult to deal with as everyone is different.

I'll probably get flamed for this but I would go to A&E whilst she is home and you are present.

You can always follow this up with the crisis team, but I'd want to be there whilst she is assessed and then together you could make a decision as to whether it's safe for her to return to uni. It's 4 hours away and if things take a turn for the worst it's a long drive.

Thinking of you all. I hope she gets the right support

Not sure I'm the right person to be advising as I haven't successfully supported anyone through this.
However, when I was suicidal engaging with services which were previously traumatising and were likely to be so again was not helpful.
What was helpful was doing things that would sooth my soul. For me that was being in nature and being in the company of gentle and understanding people, being able to escape the things that made me feel worthless. Having the company of animals to spend time with.

Those were not quick fixes but helped a slow recovery. What stopped me actually acting in the suicidal feelings in the moment was the love of my family and the hope that one day life might be better which I got from reading about people who had come through tough times to brighter days.
I couldn't envisage coming through myself, the darkness was all the future I could see, but reading about others who had felt that way but eventually made it through fave me enough of a crumb of hope.

No idea if that's helpful to you, but it was my experience.

Thank you for the replies, still torn on crisis team vs A&E!

@SoCunningYouCanStickATailOnItAndCallItAFox thank you for that, I hope you’re doing better now 💐
I feel like I’ve spent the last two or three years trying to distract her (not sure I do a very good job of it!), but right now she just doesn’t care. If she’s busy she’s not really ok, but manages a bit better. At the moment she has too much time on her own, which is really bad for her.

Hi OP, I’m sorry you are going through this, it must be such a worry
I’d speak to the crisis team in the first instance 🌸

Are you familiar with services in your area? Is there an on call psychiatrist at A&E? In a lot of areas the A&E MH team are nurses/ practitioners. Is there a psychiatrist attached to the crisis team? It may be worth calling the crisis team and finding out how services are structured and what help would be available for each option ie is prescribing an option/ referral to crisis support services/ home treatments

I'm doing better now thank you. 💐
The key for me in the end was understanding myself and shaping my life to include the things that lifted me up (different for everyone) and reduce the things I struggled with, and time, and talking to good sounding boards, and reading to understand my experiences and thoughts.

I really feel for your daughter she has a lot of challenges and early twenties is a really precarious time as the structures of earlier life start to reduce and the lives of your peers start to really diverge properly for the first time and the race that life can feel like at that time starts to feel like it's looming.

I skipped uni and got a job which was live-in and involved being outdoors a lot. The live in structure (good supplied too) and fixed times if the job really helped when the free form of uni life would have been a disaster.
It gave me a scaffold to do a soft launch to adulthood.
I then went to uni later when I was less vulnerable. The self discipline needed and unfavorable comparisons against fellow students uni entailed was not good for me in those dark days.

I would go down the crisis team route, for me (someone with ADHD) I would find A&E really stressful and would feel bad for taking up there time even though I know that’s what they are there for. Crisis team usually sort out an appointment/assessment with a psychiatrist pretty quickly (within 48 hours) though this may have changed and they maybe able to offer advice over the phone.

The GP said there’d be a psych at A&E, but admitted she didn’t know the services well in this area, so she may be wrong.

Dd saw crisis team in 2020, during one of the lockdowns, apart from the first appointment it was all on zoom or teams, and she wouldn’t/couldn’t engage and was discharged.

A difficulty right now is that she’s still registered with the GP at home, not in London, but if we know when appointments are we can hopefully work around that and get her home more regularly.

I rang crisis team, the mental health nurse spoke to dd, who was clear about how she was feeling, that she doesn’t care about anything right now, that other people want her to get help.
The nurse just said to have a think about what she wants, then dd said something along the lines of “well I want to die”, so the nurse said well that’s your choice. Is this standard practice as she’s an adult?

I’m very aware that dd may ignore all sorts of advice and only remember things like this, which may be taken out of context, but this is what she’s taken from this conversation.
I’ve googled the local A&E and can’t find any info about whether there’s a duty psych.
When she was with crisis team a couple of years ago they wouldn’t talk to me at all, as dd is an adult.

I can’t force dd to want help, but I don’t really know what to do.

Can you afford private help? Maybe DD could withdraw from Uni this year - with the aim of returning when her mental health is better.
Maybe her medication isn’t quite right - when was this last looked at and considered.
The other option (maybe) if for her to go to a clinic to get care - but again this has a cost.
It’s utterly appalling your DD is facing this. The mental healthcare in the Uk is an utter shambles.

We couldn’t afford private at all.

I’ve brought up dd postponing uni for now, but I think she feels this would be worse, and moving home would probably be more stressful to her (we’re all autistic here, it’s not a very peaceful environment!).

She feels maybe another phonecall to the gp tomorrow to see if she can up her meds, and I think we’re going to try to make sure she comes home every weekend so she’s not at a loose end, which makes her spiral.

Just checking in to say I hope you got through to GP or some other support. Have been thinking of you.

Thank you!
Her usual GP rang up, and as she knows dd was much more helpful (no disrespect at all to the other gp - it’s difficult to gauge dd if you don’t know her!).
She’s upped her antidepressants, but with a caveat that dd comes home regularly to collect them.
Dd is back in London for now, but returning on Saturday until after Easter, so hopefully will have a chance to really wind down, eat relatively normally and sleep.