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 issue with private psychiatrists is that my family member was turned away (and I quote!) as she “is a severe case, we only offer short term support for low grade issues, you’re better off hassling the NHS” - two separate private places said that.

The issue being, we had already waited 6 months, and were told it was another 3 months before we could see a psych on the NHS. This was an urgent referral from her GP as the MIND counsellor and CBT had sent a letter as she was normalising suicide, had made clear plans on how and when to do it, and had already almost succeeded twice.

We have the money for private. We have nowhere that will see her. I don’t know if the issue would be solved if we lived in London, but Birmingham, Leeds, Nottingham and Leicester have nowhere that will see her privately.

Zerofuchsgiven, I’m so sorry about your sister 💐 I hope you are getting any support you need.

I work in CAMHS, and a huge part of my job is assessing overdoses/self harm/suicide attempts.

Obviously I can’t give a specific clinical opinion/advice, but I can speculate based on my pretty large experience.

Firstly, overdose and self harm are extremely common. A&E departments see multiple such presentations every day. So, while such an event is extremely rare and troubling for a families life, for clinicians it is a daily task.

That’s not to say that such presentations don’t need careful assessment and treatment. All need to be assessed, paying close attention to ongoing risk and the presence/absence of severe mental illness. Factors at home, and the wishes/capability of parents, are also very important.

Generally admission is only as a last resort - ongoing suicidal plans, not willing/able to work with services, lack of family support etc. As a general rule, treatment at home is preferred over treatment in a psychiatric hospital.

Why? Scarcity of beds is one of many factors, but it’s not just about that. Most overdoses/self harm just don’t NEED hospital treatment. Admitting a young person to a psychiatric hospital can be a drastic, upsetting and harmful thing. Clinically it may well not be helpful, and can on occasion be harmful. Inappropriate admissions can also “clog up” the system, meaning that deeply mentally unwell young people who cannot be treated at home then struggle to get admitted.

So, I could speculate on the reasons why this young person was not admitted, though I could well be wrong:

• overdose may not have Ben severe/life threatening, and may have been self harm as opposed to suicide
• absence of severe mental illness. That doesn’t mean NO mental illness, but might not be so severe as to rule out home treatment
• willing to work with services
• supportive family
• finally and perhaps most crucially, patient and family wanted them at home.

Hope that helps.

It is hard to find beds for people who really need them.

There would be an even bigger bed crisis if everyone who has taken a small overdose was admitted to hospital. It is always best to be treated in the community if possible.

Self-harming and feeling suicidal doesn't always mean that an admission is needed. It is much more complicated than that.

If my husband was admitted every time he felt suicidal he would spend most of his life there.

I know it is scary OP, but she has been assessed by CAMHS and right now she is best at home with people around her who love her.

My dn went through almost a year of talking about/2 semi serious attempts at suicide during a very difficult time in their life. They were eventually offered an hours counselling each week and AD's (which they chose not to take). It is a terrifying time especially when it is not clear if they are crying for help/support/attention or serious.

Both times dn was sent home and in hindsight it was the best place for her.

Are you aware the mental health budget has taken a massive cut? There aren’t enough resources (staff, beds) and the threshold for care is high, particularly inpatient care. I hope your niece gets help and support including from her family and friends.

Btw I have had mental health problems since childhood so I’m not without empathy. But I’ve long stopped expecting anything much from the nhs apart from my medication.

DD found the Crisis team useless - saw a different person every time, so they asked the same, what she considered stupid questions! They’d promise to ring at a certain time, when she was free but didn’t - and then rang, when she was in lectures!

Inpatient mental health nurse here echoing other posters really. There are so few mental health beds in the UK, that the benchmark to get admitted is now incredibly high, and especially if she was willing to engage with community services she would have been deemed to need community follow up.

To be honest although you can be admitted to mental health units informally (I.E, with your agreement) in reality the only people who really get admitted these days are people detained under the mental health act that can't / won't engage with community services / take medication and are also an immediate serious risk to either themselves or others.

There's never been a time, or certainly not in the last thirty years, when they'd admit a teenager for feeling low and taking a few tablets. And that's a GOOD thing. My time in an adolescent ward broke me. I've been in several adult wards which were fine — not a holiday camp, but fine — but the adolescent ward was nothing short of abusive. And many other people I've spoken to have had the same kind of experience, of adolescent units being far, far worse than general adult wards. Not all adolescent wards, but a worryingly high proportion, are damaging, dangerous, abusive places. If you care about her, do everything you can to avoid the need for admission.

When I was last admitted to hospital it was literally because I'd ripped out my IV and was walking out half dressed from the ward in the middle of the night where I'd been admitted to after a major OD and there was a blazing row between the mh team (who said I'd be dead if I'd wanted to really die so was nothing to do with them) and the police (who were called by the ward after the mh team said I'd every right to leave) and the ward.

I was taken several hours away to England where I was assaulted and threatened repeatedly by another patient and told by staff if I'd wanted to be safe then I shouldn't have gone into hospital (though not sectioned I wasn't given a choice as I went or was sectioned and that'd be even worse so went with them). I was told not to report it because he was ill and didn't know what he was doing (which was rubbish because he stood there grinning the whole time and only assaulted me on the ward which was full of women (supposedly he couldn't understand how to behave with women)) - the staff disappeared into the locked office so they'd be safe it was up to other patients to help me. He'd come into my room and threaten me as well. When I left I found he was going to cmht as well and was told I'd just have to put up with him as he's too ill to know any better, I still experience problems with him. The police when told said he's well known to them and the "routine" is they must involve cmht who say he's ill so the most that happens is he gets put back in hospital where he assaults someone else, even women's aid told me the same thing.

There was nothing to do, no tv, nothing, just sitting around. I was told of other patients who had ended their lives because I'd "stolen" a precious bed (a family member had recently ended their life so that was the most hurtful thing they could have said to me). One patient did a runner on leave and her family were on the ward with other patients (we weren't allowed in our rooms during the day so were all together) and they were begging for some help being told it wasn't their problem as it was her choice, another person was found dead (out on leave after they lied they were fine - again patients and family were together and their family were understandably devastated). I couldn't just leave as I needed hospital transport due to disability which couldn't be arranged at very short notice due to being in another country (I'm in Wales and cross border funding except in emergency was a problem).

I was there three weeks. Every hour of every day I wanted to leave, I was going out of my head with nothing to do and terrified. Staff would ask how patients were but refused to spend time talking to them as too busy. I refused to unpack my suitcase they'd packed for my admission.

It was utterly devastating and severely detrimental to my mental health.

I now won't go to hospital for anything and have no trust in services.

I've no family or anyone to help me. I'd never consent to going into hospital for anything.

It's nothing like what you think it will be.

There was a teen on the ward I was on (it was an adult ward) and she was utterly terrified the whole time because she thought she'd be getting support and help and didn't. In the end I helped her get an advocate and they helped her leave back into the community. She stays in contact with me and is now doing very well.

Bugger that was meant to be a PM, sorry for the essay.

I was going to put on the thread that she's better off being supported in the community and at home. MH wards are very frightening places. The only other time I've be admitted someone tried to burn the ward down (as patients are allowed to smoke) and staff refused to do anything other that tell them to stop it.

Why would you leap from feeling a bit low to mental health problems?

Why can't people be sad, or have an off day anymore, without people needing to fix it.

cd didn't you read that she's under CAMHS? Plus, taking overdoses goes beyond having an "off day". Dunno about you, but my "off days" involve deciding I can't be arsed with housework and watching TV instead, not poisoning myself.

There’s hardly any mental health beds available, a lot of mental health units have been shut. The fact she has family is enough for them not to consider offering her a bed (family can keep an eye on her). Mental health services are very limited and stretched. Hospitals are seeing attempted suicides on a daily bases and can’t offer help to everyone because there’s just not the facilities

She is diagnosed with depression and is on medication for it so yes I believe she is genuinely unwell.

I have been an out patient with the local mental health services recently. I was fortunate to get a triage visit to my home so I did not need to go to the unit for assessment. I have my bag searched and go through a metal detector to get into the hospital waiting room. They care for people with relatively minor to severe mental health issues, an unhappy teenager would most likely leave feeling far worse than when they went in. Seeing what support services can be accessed through her GP would be a good place to start.

I went to the GP crying my eyes telling her what was wrong, and she made an emergency appointment with the psychiatrist, who I seen 4 weeks later. Cutting a long story short within 16 months I was diagnosed as bipolar and on lithium. That is very quick! Some people can take up to 10 years to get a diagnosis. My psychiatrist has given me an antipsychotic to take when my mood starts getting high to help bring it down. In his words ‘if we admitted you this would be what we would give you, as you know when your mood is going high, it makes sense that you take it when you need it, and I’m sorry to say, but we can use the beds then for those that really need it’. And I 100% agree with him. Obviously if I am at risk to myself or others it would be assessed then. I’m in Wales- it shows the shortage of beds is everywhere. I am so grateful that I can mostly manage my mental health with ease, Only once before diagnosis and appropriate medication, did it become frightening and it was horrible, I wouldn’t wish that on anyone.
I hope your niece gets well soon, and gets the help and support she needs x

Probably just a cry for help
Her parents should get her a good psychologist and get her some help!

Kids here are taking overdoses and putting the whole thing on fakebook and Snapchat. The whole drama is played out online. It's almost become a one-upmanship.

It's fucking terrifying as a parent (( and I've reported a couple, turned out to be hay fever tablets )) and must be difficult for NHS staff sorting through those who seriously need the help and those who need other support.

must be difficult for NHS staff sorting through those who seriously need the help and those who need other support.

Honestly? I know a few people with very serious MH issues. There is no funding for MH, no support system, neither for the sufferers nor for the family who are then made responsible to look after them (see the ‘we allow if they have a supportive familyK which basically means can we outsource the looking after that person to family rather than do it ourselves).

The result is people struggling like hell and ending up committing suicide when they were deemed ‘not severe enough’ for hospital.

The issue here isn’t how hard it is for clinicians to decide who is severe enough. The issue is that there isnt enough money to actually support all the people who do need support and are ‘severe enough’ to need proper and adequate support.

The issue with private psychiatrists is that my family member was turned away (and I quote!) as she “is a severe case, we only offer short term support for low grade issues, you’re better off hassling the NHS” - two separate private places said that.

This is often the way. Private psychiatrists/psychologists are frequently operating as a one-man band. Nothing wrong with that in principle, but if a patient is high risk there is absolutely nothing the private psych can do to keep them safe (unless you count giving advice to the family).

Private inpatient psychiatric care is phenomenally expensive and beyond the reach of almost all of us, unless you get health insurance with your job.

OP, I am very sorry to hear about your niece's difficulties. If she has family who are capable of supporting her then she is far better off at home than in hospital. CAMHS staff should be able to offer advice to her family, and should be checking in with her regularly.

She feels she’s not getting support as her friend was admitted on a section 136 and placed on a section 2 and hadn’t even made an attempt on their life which is why she’s feeling that no one cares. I’ve explained it depends on who does the assessment.

@Tableclothing The first one we tried has offices all over the country, we figured that would be the best port of call as we can travel (to a certain extent) but they felt (after speaking to several of their Docs in several locations) NHS was better.

They don’t need inpatient at the moment - they’ve been inpatient 3 times in the past. (I’ve also been inpatient NHS and I still can’t decide if it did me more harm than good), but trying to head it off at the pass before that stage is seemingly impossible.

The first NHS psych we saw was horrific, would only offer mindfulness meditation. We asked for the Consultant at the next app, who was rather furious at that suggestion and has been absolutely epic, in fact I’m a little bit in love with her

But it has been a very long wait with numerous last minute cancellations.

hahahahaha!! trust me you should feel lucky they werent admitted.
one it probably would be on general wards because there isnt specialist beds.and two MENTAL HEALTH PLACES ARE SHOCKINGLY SHIT.have you seen the news?the state of mental health units and the devastation they keep bringing to our young people and adults of fucking disgsuting.