Daughters sectioned in psychiatric facility

[SpiderExtinction]

I think I'm posting this because I am so tired and worn down and just needed a place to chat.

My daughter was sectioned in March this year and has been in a psychiatric facility ever since. She has improved a lot from how she was. Back in February she suffered with psychosis which is complicated with severe anxiety, depression, a learning disability and possible autism. She stopped eating, drinking, sleeping, using the toilet, even moving. She still has a poor appetite but has improved greatly with all the above.

The only thing that she has regressed with is talking. Since May, she has displayed selective mutism. I also found out that she had been showered by a male carer which would have traumatised her - she's scared of men. Her closing down like that seemed to coincide with that incident. Does anyone know if male staff are meant to shower female staff one to one?

We are working towards her discharge but it seems to be taking so long for anyone to make any decisions about anything. Planning started in June and we still have no decisions made. Each week drags on and seems like it's all going round in circles. They keep trying to push a 'gradual' return home which I know would be traumatic for my daughter. Her admission to hospital was immensely traumatic where she had to be taken into the ambulance and hospital against her will. If she came home and then got taken away again, this could potentially cause trauma for her again.

She has indicated to the social worker twice. that she wants to come home. Professionals agree that the clinical environment is having a negative impact on her now, yet nothing is moving forward. I'm just so tired.

Her section ends on 30 September. If nothing is sorted, am I allowed to just go get her? She's 19 by the way.

I also specialise within LD and Autism as have many years experience prior working in this.
Has she had a full Speech and language therapy assessment?
Might be worth asking if she can be placed onto a community treatment order which means she could be discharged from section and hospital be released home but with conditions.

I'd also be asking for section 117 discharge planning meeting to be scheduled

I think from a safeguarding pov, as they are aware she has SM, which means she is literally unable to voice her feelings and thoughts especially those which are high tariff, they MUST err on the side of extreme caution. She should not have been showered by a male as this is something a person with a voice might reasonably object to, and she is currently unable to voice an objection. So don't risk it.

Tbh when my DC was in full burnout we switched to baths; the shower was too much in sensory terms and showering them at all would have been experienced as painful. Being naked in front of any person would have been experienced as an indignity and traumatic. Being naked and made to shower in front of the opposite sex even more so.

I think you have a case against the hospital for aggravating her condition.

For when you feel better and she is home safe with you. It’s mistreatment a of disabled person.

@ArseInTheCoOpWindow I agree it sounds like she needs to be home but as my
Posts below indicate there is a process unfortunately

If her section ends on 30th and it hasn't been renewed legally there isn't anything holding her in hospital.
However this would be poor practice for the hospital who usually would have either applied for another section or in the week or so leading up to it ending started the section 117 discharge plan

Good god. The showering. I’ve had family members sectioned in hospital and they have never been showered 1-1 by a male. This is deeply disturbing to read. It’s not at all unusual for female patients to have a history of sexual abuse so why they think this is acceptable is beyond me. I hope she is feeling more like herself very soon.

@ArseInTheCoOpWindow When you say she needs low demand, do you mean not requiring her to do lots of things? For example, when she comes home, they are wanting carers to come in and shower her every day. I personally think that's too much but is that the kind of thing you meant? I am considering looking more into what happened with the showering as I think they have aggravated her case. They knew she was uncomfortable around men so there's no excuse in my opinion.

@off I'm so sorry that you also went through this but I'm very pleased that you recovered and that gives me hope for my daughter. I hope you don't mind me asking but do you remember everything that happened during that time? I'm wondering if my daughter will remember all the trauma or whether it will be blocked out.

@Echobelly Thank you 😊

@kiptee she has an IMHA who is really good. Yes she is detained under section 3 which expires on 30th of this month. When you say legal aid is free, does that mean she can have a solicitor if she needed one? She has recently had a mental capacity assessment and as far as I am aware, they deem her to not have capacity so we need a Best Interests meeting for a decision to be made. I am not sure if she has had a full speech and language assessment. I know she has SALT involved but I'm unaware of what they are doing or have done with her. They don't tend to tell me much information.

@AutismProf I agree with you. They deemed her to be giving consent to showering in front of a man because she got undressed voluntarily. They took that as consent. I disagree because she tends to do as she is told because she's scared so it's not consent in my opinion.

@Silkiebunny I am so so sorry to read what your son went through. That is truly heartbreaking to read. Thank you for the offer to PM, I will take you up on this.

Hi @SpiderExtinction legal aid for appeal is free and I assume the IMHA has advised previously of how to appeal and the process etc? The ward will have a list of solicitors. I would expect in the next two weeks you will learn if they will discharge or apply for section again. If they apply for section it will be for six months and there is right to appeal once during this time or as a NR you can apply to end discharge via hospital managers.
I wish you both all the best and I'm happy to advise you more on this post

Sorry @SpiderExtinction on the weekly ward rounds/ review (different places call it differently) you should be getting an understanding of how her treatment is going and if a discharge is likely. Your IMHA can support during these if she consents

Thank you, I really appreciate it. I haven't been advised of any processes unfortunately, I've had to research everything myself to try and understand as much as possible.

Her RC is not wanting to section again so it's looking like she will be discharged, it's just taking so long to sort anything. We are 3 months into discharge planning but nothing has been sorted or decided. Is this usual for it to take so long making decisions?

@SpiderExtinction you can request a risk assessment around personal care and if she is expressing discomfort then it is her right to decline this.
Also you could write to Hosp managers and pals with these concerns. It seems to me that she is incredibly vulnerable and it is wrong being supported by male staff members. If she doesn't have Capacity then she cannot consent to this. You could also raise a safeguarding concern with your local multi agency safeguarding hub at your local authority

I thought the IMHA would be covering a lot of this and supporting a complaint against the shower episode that’s outrageous - I can see there are people with IMHA experience on the thread, can those posters explain how much of this should they be tackling?

@SpiderExtinction legally they cannot detain her when the section has ran out. Possibly she could agree on an informal basis but could leave at any time.
They should now be shortly presenting a solid section 117 plan. I think community treatment order also would be good as she would be supported in the community. My advice is work with them

IMHAs can only support with being held under the mental health act. However we can express wishes to clinical team and arguably I would have raised the showering issue as a urgent safeguarding referral. I'd email consultant directly, contact LA safeguarding and commence internal safeguarding procedures

However our remit is under MHA only. A general advocate supports with other issues

Sorry I would also ask for referral to community learning disability teams and if she isn't in a LD acute mental health unit there should be a LD nurse who could visit also

Spider I have few, fragmented memories, mostly of a feeling… of being far away, mind running at a different speed, having a stiff, heavy body and controlling it being like operating a marionette from a great distance. Noticing that someone's been talking to me for a bit, or that I need a wee, but it's more like seeing a delayed broadcast from a long way away, about irrelevant things. I'll be honest and say I do have a kind of memory of some emotional pain that's like… the pain of nothingness, a sort of yawning-open pulled-apartness. But I couldn't tell you from internal experience alone how long it lasted, even approximately. Even at the time, I couldn't tell the difference between ten minutes and three hours, so the memory is similarly distorted. It's mostly a blank area in my memory with just these few scraps of glimpses, but the way I was experiencing existence was so different then that the bits of poorly-defined memory don't make much sense. You can probably tell from how vague and impressionistic this description is that being in this state is something I don't remember well.

Are you sure about exactly what happened? I worked in an organisation where people would sometimes come to on discharge from a psychiatric hospital if not ready to live alone/go back to parents. A male staff member might get a female organised for their shower i.e. remind them they need a shower, check they have a towel, toiletries etc but they would never go into the bathroom with them.

Hospitals might be different but that certainly wouldn't have been considered normal or even possible where I worked.

I would have a huge issue with being showered by a male that I did not know and considering her condition I’m sure it would have been traumatising….definitely request again that this does not happen and if possible that she is not treated by male staff

@SpiderExtinction

Your poor daughter. It does sound like autistic burnout, my 15yo hit this earlier this year. At her worst, it presented as severe depression, exactly the same as your daughter. But treating as for depression - encouragement to get up and do things - will make it worse.

It can take months / years to recover and as a PP said, low/no demand is the way to go. Daily showering, unless it's her choice, would be awful.

Her nervous system is heightened, she will be more sensitive to everything - smells, sounds, touch, taste. Everything will trigger a flight/fight/freeze/fawn response - fawn looks like agreement/consent but it's essentially agreeing because it's too hard to speak out.

There's Viv Dawes book on autistic burnout. I'd recommend that. Also Instagram "peaceful parenting" - her tips relate to PDA but they apply well in a burnout situation. Essentially, don't demand anything of your young person, which means don't ask questions. It's really tough! But it does work.

As an example "what do you want for breakfast" triggers anxiety, she's having to make a decision, she's not even sure if she's hungry, she doesn't know what she wants or what's on offer. So I just make something that I know she's eaten before, bring it to her room and leave it. At first it didn't always get eaten. Then it did. Then she asked for a slight adjustment. Then something totally different. It took about two months. Just to get some interaction on breakfast. Some days are better than others. It's not a linear recovery.

We're five months down, she will eat two meals a day, a lot of food gets put back. She will very occasionally sit outside for a few minutes but most days is in her room. She rarely leaves the house and only with me, and I have to be prepared to bring her home the second she says it's too much. The exception is her music concerts - that's her special interest and the dopamine hit she gets from it overrides everything else.

Check out Autistic Girls Network for help and advice too. Best of luck.

@Iwasafool The staff told me and my mum that there were no female staff available and she had to have a shower every day as it's hospital policy. In her care plan, it describes showering as being 1 to 1 staff so as not to overwhelm her. It has also been told to us by staff that she needs help washing her body and hair so I would assume the male staff member did that for her.

They said it happened twice but as far as I am aware, no female staff were present as they said they had none available.

I don't want to cause problems though because other than that issue with the shower, the staff have been great and I am grateful for what they have done with my daughter. But those 2 incidents have affected her, I can definitely tell and the times line up.

Glad to hear that she is slowly getting better, that’s great. Sorry to hear that a male was with her when she showered. It isn’t ideal but does happen when there is a lack of female staff. There aren’t any blanket rules about personal care and gender and I don’t think it would be helpful or practical to have them.

I’m saddened to see someone on here mention that the person who helped get could be an abuser. That’s one of the reasons the industry is struggling for staff. The majority of
people working in care do care and are not abusers. I bet they would be devastated if they knew that’s how people viewed them. It’s absolutely understandable that your daughter would have a preference though and now the hospital know about it, they should stick to it.

Have you spoken to pals at the hospital about the shower incident.

I’m not sure on the rules but I often chase up Ward Managers, PALS, community workers, social workers etc for my son - but he has schizophrenia so rather different. I basically ring every contact I have and governance officers etc until someone gives me answers.

id also contact local carers forums and support groups they might be able to advise and help more.