To ask why my niece wasn’t admitted to hospital

[Youareenoughasyouare]

My niece who’s 17 took a small overdose at the beginning of this week. She was assessed by camhs at a&e where she told them she still felt very low. Aibu to think she should have been admitted to a mental health unit? So she’s safe?

The thresholds for admission into a MH unit are very high.

Does she live with parent/s?

Probably no beds

What do you mean by small overdose?

I think feeling quite low, and suicidal are 2 different things

If you mean by small overdose a couple if extra paracetamol, they may not take that as a serious attempt. And if she said she is feeling low but doesnt want to kill herself. Then they would have let her go.

I have had a lot if mental health assessments lately and they always ask 'do you intend to hurt yourself or others' if you say no. You seem to go through the same channels and waiting times as everyone else.

Its crap and I knows its worrying, but they dont have the money or space to you just detain people under the mental health act u less they really need to.

Unfortunately they can't admit everyone who feels low. If she has family at home and is not considered high risk then they would probably follow this up slow time.

I hope she gets the help that she needs.

There aren't enough beds to admit every young person who is feeling suicidal.

When they do get admitted, the available bed is not necessarily in the same area where they live, and can sometimes be hundreds of miles from home.

She should have been assessed by a crisis team, and offered follow-up support if she meets their threshold for this.

I have a relative who drank a lot, cut her arms badly, took a minor non life threatening overdose, then was really unwell and clearly disturbed whilst she was with her 1 hear old , an ambulance was called took her to hospital and 4 hours later she was discharged and had a visit at home 2 days later. The services are just overstretched and this was one of many similar incidents and there was no follow up support either from ss or any other agency it’s appaling

*year

The ED I work in sees between 5&10 overdose/self harm presentations per night. Sometimes it even exceeds this. The mental health services just don’t have the resources to admit everyone.

To be honest unless she said she was going to harm herself they wouldn’t admit her. Also generally if children (and adults) have support at home they do better at home with Camhs input than in a strange environment with lots of people they don’t know.

Did she take the small overdose with the intention of getting admitted?

I deal a lot with mental Health and have known people being dragged off train tracks or bridges, or overdoses that require stomach pump. They still don’t get admitted! If lucky they get on waiting list for psychologist and get seen within 6 months. Awful system

I work with teenagers who are living unbelievable difficult lives - long histories of abuse and neglect and the inevitable MH issues that brings. Most are at risk from themselves. Only two have been admitted as MH in patients in the two years I've been there and that after repeated requests from the people trying to support them in the community.

OP, I have had a relative not admitted after hanging herself. Most MH is managed in the community by the crisis team, the CPN and the GP, with outpatient psychiatry appointments as and when required.
Being admitted does not guarantee safety either- two of my patients killed themselves WHILE they were inpatients in a psych ward.

She's not high risk, there's not enough beds.
I looked after a patient once (I'm a nurse), who was actively trying to kill himself whilst in hospital and had to have 24 hour security. He was seen by a consultant psych and he couldn't admit him to a MH hospital because there weren't any beds. Not one bed in the whole country apparantly. He was advised to seek community MH services and was discharged. I actually refused to discharge him and I was threatened with a disciplinary if I didn't. My colleague discharged him in the end. I, and my colleagues thought this was absolutely disgusting. As it happens, I saw him walking around our town a couple of weeks ago. No doubt the trust would have been heavily sued if he had committed suicide though.
The country's in a mental health crisis.

One of my children was quite unwell, and when he was 15 CAMHS were close to admitting him. I did everything in my power to support him and keep him safe at home, as being admitted would have been terrifying and traumatic for him.

There's not the facilties, been there. I recommend if your family can afford it pay for counseling privately because the mental health services are overstretched underfunded and frankly not really any good

As PP said, probably no beds. The alternative could be a bed hours away - so she would be isolated from friends and family. Not good for MH either! Anyway, DD has been admitted twice after suicidal behaviour (out of 22 times plus) - there is no therapy, treatment (other than anti depressants), the nurses spend their time in the office.....There isn’t much to do....

The “care” in one place was so abysmal, I wouldn’t leave my cat there never mind a person!

A crisis house was way better for her; because DD could talk to the staff anytime day or night, and the staff were much more highly motivated than “nurses”. She actually felt better when she left; but I am not sure there are Crisis houses for under 18s?

Not so straightforward. Hospital is not the answer for everyone and as a previous poster said, admission threadholds are very high.

I imagine mental health units are not nicest place to be and unless there was a clinical need and they thought she would be safer in hospital than at home then she would be better at home in a familiar setting surrounded by people who love her.

I suspect this is not about funding in this case. If it was a few extra tablets, and your niece has support at home, she is better off at home than in a secure unit. They are not nice safe rest homes. Mental health units are full of very unwell patients, some who will be psychotic and have totally lost touch with reality. It is not a place that is conducive to good mental health.
Your niece will have had a mental health assessment. Lots of people feel low. Lots even think of suicide. But actually feeling actively suicidal is very different.

When people self harm/overdose its incredibly shocking and upsetting for families but unfortunately common place for professionals.

There has long been a huge drive to cut hospital beds to focus on community care. In my area there are aproximately 18 beds or so, to cover and our a+e sees many patients that overdose a day and cover half of a county.
What that means is that those 18 beds have to be used for incredibly sick people and usually those detained under the mental health act. Its a bit like if you reduced the beds in a physical hospital then all the patients that are admitted have to be used to hdu or intensive care patients. Certainly my trust has to place people short term in private hospitals, and its not unheard of for their to be not a single nhs bed in the country.

Community teams are now treating people that historically would have been in hospital, there are crisis teams etc that see people daily at home etc. There is lots of evidence that says people heal best in the community

@TheFirstOHN I too have fought sectioning for a relative and managed to get them kept at home with me with the crisis team visiting twice a day. So many people have very unrealistic expectations of what a mental health unit is like.

By the way, I found the crisis team totally shit.
But I think the relative was much better off at home with me watching them and caring for them. It was very tough on me and I found it mentally very hard. But much better for them.

While a small overdose and feeling low is probably quite scary for her family, it is way down the hierarchy of needs in terms of MH and would in no way result in admission where most of the kids would be in a far far worse state.