To think hospital should not have let out actively suicidal person

[runnermum1974]

I don't want to reveal anyone specific so I am going to keep what happened very general:

Friends find a friend in acute distress and actively suicidal. They take suicidal friend to the hospital, and tell hospital the serious thing their friend was doing to be actively suicidal.

Hospital staff take away suicidal person for questioning. Suicidal person does not want to be in hospital - so they tell the hospital that they were just attention seeking and should be let out. The hospital let out the suicidal person and tell their friends it's fine (even though they were engaging in very risky behaviour).

AIBU to think that the hospital should not have let the suicidal person out so easily? They were told by the friends what the serious actively suicidal thing the person was doing - and an ill person does not necessarily have insight to know they need to be in hospital. Even in the unlikely event that actively suicidal behaviour was attention seeking, should they still not have got help? People who are really suicidal do not say so - so actions speak louder than words!

Yes and the 'medical criteria' differs depending on who's doing the assessing

The trouble is , it is really not easy to section someone so if someone is deemed to have capacity ie they understand the consequences of their actions, they are able to retain that information and they can repeat the consequences and they can communicate their decision then they have capacity so can make their own decision to leave the hospital. It may not be our decision but that does not make it right to ignore their rights or ride rough shod over them.
These days we cannot imprison people in a lunatic asylum as used to be the case, they have the right to make their own mind up about their treatment.
It is an incredibly difficult area but would we be happy if everyone who threatened suicide was manhandled into a secure hospital? A&E is not secure.

Ashtrayheart

Being pedantic, the "medical criteria" for detaining a person under the Mental Health and Treatment Act (as it is in Scotland) do not change depending on who does the assessment.

The variable factor is the assessor, who makes a judgement about the mental state of the patient before them. It is of course the case that the Psychiatric Liaison assessor (be that specialist nurse or a Dr) can make the wrong judgement, but in my experience that is not what happens in the majority of cases.

I told my CMHT I was suicidal for months and never got sectioned - not that I wanted to be anyway.

Even when I was psychotic and taking risperidone I was never sectioned. I live alone too.

Not sure quite what people do that get sectioned.

Mental Capacity Act
+
Mental Health Act
+
their own, reasonable, assessment
+
patient's own comments and wishes

=

^ not possible to detain at the stage you are talking about

You can be detained under s3 if you are well known to mental health services and there is little need for assessment. Alternatively, you may be detained under s3 following an initial admission under section 2.

So someone (in my case my dd) can have 2 very different outcomes from a mha depending on who assessed. But I agree the criteria doesn't change and that the differing factor is the assessor.

Yes, I have.

I work in psychiatry

I don't think it's at all easy to be sectioned in my area as the CMHT is overburdened with drug addicts, sorry to say.

Ok then I'm all ears at this easiness you speak of because we're obviously doing something wrong.

OP YADNBU.

I am disgusted in NHS provision for MH at the minute. Even those in most need (previous diagnosis/ suicide attempts/ anorexia/ severe self harm) are being sent home and referred to counseling.

I say this as a counsellor. Increasingly we are being referred people who are in need of psychiatric assessment/medication or just a safe place to be while they are at their most vulnerable.

The NHS is horribly failing patients with MH issues.

No, that's what I'm saying.

There is provision for beds for those that require them under mental health act law. It is the duty of the social worker arranging the assessment to identify one.

However, just because friends and family feel someone 'needs sectioning' doesn't mean that they actually do.

You're right, although next of kin's opinion is sought before the mha.

Yes, but only to make sure they're not in opposition. The decision to use the MHA will already have been made, in all likelihood.

My late h was suicidal on several occasions and didn't want help. He was intelligent enough to talk his way out of situations where he might be helped (admitted to hospital). He said to me that he just told the doctors what they wanted to hear so he could leave. He was prescribed antidepressants and saw health professionals regularly. He worked (plumber) for his mental health nurse the day before he killed himself. She had no idea when he came to do a plumbing job that he was suicidal. Next evening he killed himself.
How can a medical professional deal with this situation? If someone wants to commit suicide they will do it.

There is provision for beds for those that require them under mental health act law.

This may well be true. The problem is this doesn't cover anywhere near the amount of people who would benefit from in-patient care.

Absolutely. Sadly, in the current system, it never will. This is not unique to mental health though, unfortunately.

Gamer- I refused to have my dd home- I think it makes a difference sadly.

I wonder what it takes for someone to be sectioned too. Or just admitted voluntarily.

However, just because friends and family feel someone 'needs sectioning' doesn't mean that they actually do.

Actually I disagree with you on that. Family aren't always right, but a lot of the time they are best placed to really know the person and the subtle but worrying changes in their behavior that might otherwise be overlooked. Such as the case of my friend who discharged herself from a voluntary admission, despite her family begging the hospital to section her. After walking out of the hospital she attempted suicide just hours later. She did not have capacity at that time. A huge error on the part of the hospital.

It's very hard to get sectioned due to feeling suicidal - a relative of mine was very lucky as they did but not everyone does.

I hope they are now under cahms or crisis team now and both friend and friends friend are coping ok.

It's very hard to get sectioned due to feeling suicidal - a relative of mine was very lucky as they did but not everyone does.

I hope they are now under cahms or crisis team now and both friend and friends friend are coping ok.

her mums having to go down that route now ashtray.. it's the only way to get them to pay attention if they don't have anybody they can palm the problem off on.

I'm going to report my post.. it's a bit too ranty for my liking.. my apologies... it's a very frustrating situation to be in.

i'm sorry to hear about your daughter.. it's an awful awful thing to go through.

it's an imperfect system, and unfortunately professionals can get it wrong. And yes, MH services are traditionally the "cinderella service" where cuts happen first. It's not fair or right, but it is the reality.

That doesn't change the fact there are criteria for sectioning patients. These criteria must be met, or detainment would be illegal. Usually, MH teams to a good job, and make the right call, in my experience.

I don't know if the patient in the OPs case has been assessed correctly or whether they have been incorrectly judged to be a low risk and thus not in need of detainment. Actually, nor does the OP or any of us.

I agree there are probably many people who may benefit from in-patient care, but that's not the same thing as needing to be sectioned.

I can imagine that for those who are struggling with loved ones with a psychiatric illness, that this is of little comfort.