about accessing MH help

[pinkie1982]

My family are having a complete nightmare with this. How do you do it?

My cousin is unwell. MH background of psychosis/depression. Had a benign tumour removed from his brain and a small part of brain tissue with it. Been off his medication for almost two years.

He has had a relapse. MH team assessed at home and said no risk so nothing they can do.

Finally got in to see his old Neuropsychiatrist, given different meds. He is getting worse, self-harming, thoughts of killing people and himself. Latest self harm was cutting is head with a knife.

They went to A&E where he was assessed by MH team and told nothing they can do. He was honest and told them of his dark thoughts and impulses. Hours later he came away saying his life was worth nothing so made him feel worse. He had asked them to lock him up to stop him hurting himself or others. No one mentioned Safeguarding to them.

Family are at the end of their tether and seems nowhere else to turn and no help available unless he actually carries out something drastic, which is what they are trying to prevent.

I understand beds and resources are limited but where else is there to turn? How do people get help?

No one knows?

He needs to go to his GP and be totally honest about his thoughts and request an urgent referral to the community mental health team so that he can be assessed further, key phrases include he cannot keep himself safe and he cannot guarantee the safety of others.
Does he have specific plans to commit suicide or harm others.

He has and has been assessed at home and in A&E.
Told them all everything. Asked to be admitted as he is scared what he is going to do. Still that's not enough and the advice to his mum is ring 101 if she needs police.
The whole point is safeguarding, prevention and treatment, is it not?

Sorry, accidental name change

Where does the neuropsychiatrist fit in? Can they not liaise with the cmht? It all sounds concerning but there are literally thousands that fit this profile- most are managed within community these days. Beds are like hens teeth leaving the cmht carrying really risky people. However from what you’ve said so far I don’t know why this hasn’t triggered community services. I’d try the gp and keep pushing. You can escalate a complaint via pals

Btw I’m a community psychiatric nurse

Ps if mum if that concerned about escalating risk to self or others it’s a 999 job not 101

Nothing will happen. I’ve gone through this a thousand times. MH services are very stretched and in any case I have concluded locking my son in a psychiatric ward does him more harm than good so I just have to put up with it!

999 won’t do anything.

999 always respond when I have a suicidal patient

Are you in a professional capacity then? They were too busy for me (not bitter, honestly!)when my son was destroying the house but probably would respond better to a professional.

I either phone myself in a professional capacity or a family member calls. What I’m referring to is imminent risk of suicide ie someone has left the home and has the means or intent to carry out the act.

I realise how difficult it is for family members. Many years ago my mum and dad had to try and cope with my emerging diagnosis of bipolar disorder- long before days of crisis teams and psych teams ina&e so I always try to look after the patient and their family

The system is on its knees- like I said earlier there are so many really risky patients that community teams are trying to care for. That means practitioners become accustomed to dealing with much higher thresholds for risk. It’s not ideal. I don’t think community care in its current state works but then who really wants to be admitted to hospital where there are equally high admission thresholds leading to wards full of very sick and very risky people

With regard to violence the only times I’ve managed to get police to attend is when there are threats to kill. Police are massively busy also

I know there is a strain on resources (I work in a MH secure setting). I have given PALs number to her. I was actually on training yesterday where there were PALs staff and I ran it past them.
It's just a vicious circle where they can't access the help they need.

He is under Neuropsychiatry as mentioned in the OP due to the brain tumour/psychosis/depression. His consultant is on holiday, although her answer the other week was to call the police.