WIBU to try and get friend sectioned?

[FundraisingWoes]

And is it possible to section them in this circumstance? I'm relatively confident that I wouldn't be unreasonable to try and get them detained and get them help.

A friend has been in and out of psych hospital this month as a voluntary patient. They have been self harming and have had two wound infections during this time. The first one they took the antibiotics for as they were still in hospital and it cleared up.

This time they have been seen by minor injuries due to other incidents of self harm and have been given antibiotics. They are refusing to take the antibiotics.

I am at my wits end, I have been watching the infection get worse and spread to their other wounds. I took them up to minor injuries today as they needed stitches out and both myself and the nurse tried to talk some sense into them. The nurse quite clearly told them that if they didn't take the antibiotics then the infection would get worse leading to sepsis if left untreated. Nurse even said 'take your fucking medication!' in a nice way, not threatening, but she was obviously concerned. At the moment she said that there is nothing that she can do as my friend has capacity to make their own decisions. However she also said that next time my friend is there if they haven't taken the antibiotics then she will send her to the big hospital for IV antibiotics.

I am really worried, my friend has been suicidal recently and I'm pretty confident that they are refusing to take the antibiotics as a way to end their life. I've been trying to read through bits of the mental health act, but it's a bit unclear on refusing treatment for a physical health condition. Does this class as being related to their mental health condition as it initially started with deliberate self harm?

What would happen if I took them up to A&E currently? Or do I need to wait until they are showing signs of septicaemia so that doctors no longer need consent to treat them as it's emergency life-saving treatment?

They have visits from the mental health team every other day. The MH team know they're not taking the antibiotics but aren't currently doing anything about it. I want to scream at them, this is so dangerous! My friend clearly isn't thinking straight, but professionals seem unable to do anything to save them!

What can I do??!

but might she go if the police went and talked to her.sometimes a bit of peer/adult/authority pressure or kindness or care can help?or paramedic.there are in some areas mental health ambulance cars working now too.

Can I be the lone voice to assert the persons right to remain in control of their own life?
OP, what makes you so insistent that your friend's wishes should be overridden?
I sincerely hope that at no point in my life anybody interferes with my wishes for my future. Anyone attempting to do so would not be a true friend.

If you're worried for this person's safety I would call the emergency services

Without sounding horrible, mental health services are under so much pressure, lack of beds etc. The threshold to be sectioned is high, even if you as a friend believe them to be at risk now. When you compare her and say another 200 people, she may be the most well, and therefore in least need.

It's an awful position to be in as a friend. But if the MH team are visiting every day they are the experts on what can/cannot be done and will know more then any police/ambulance crews that could attend to her.

For what the advice of a stranger online is worth my advice would be to just be there for her as a friend, be someone she can talk to, try not to only talk about the antibiotics/suicide but a way in which she can imagine a future without so much pain. She might be building walls against the medical teams visiting so if you differentiate yourself from them you may reach her in a way they can't. Drop in with cake, make her a meal, talk about things that don't matter or just listen to what she wants to say....

Regards getting her treated, she generally can't be forced to take the medications unless she is deemed to lack the capacity to understand the risk to her life in not taking them.

i.e. if she demonstrates understanding and ability to make an informed decision, in that not taking the medications could lead to the loss of a limb or her life and that she accepts this she is able to make that choice and any doctor who gives the medications could lose their registration if they ignore this choice.

If she's legally minded then she may even make an advanced decision to refuse this specific treatment so that if she becomes unconscious/goes on to lose capacity then treatment will still not be able to be given and she would be allowed to die.

Of course what normally happens is we keep badgering the patient until they get so bored and frustrated with the argument that they agree to the treatment just to put an end to the matter. This in itself is legally dubious and impinges a patients autonomy but is a more generally accepted practice especially if life is at risk.

To be honest if she has a mental health team seeing her every two days then she is doing well. It is very difficult to be sectioned these days and for hospitals to force treatment. All you can do is keep an eye out for signs of infection becoming more serious.

A relative with a severe mental illness was section quite a number of times In the first few years of the illness that started 20 years ago. They are more mentally ill now and a physical illness that they choose not to get treated is potentially life changing. I have seen a definite change in policy and the police never seem to intervene now and sections seems unheard of even when relatives can see it is needed.

However much I think "why don't they force them to have the treatment" I also think we no we shouldn't force people to take the medication or the treatment against their will.

Are you sure it's an ending their life strategy. I know someone bi polar who usually gets delusions that her meds are poison when she's having a bad patch. The MH unit resorted to crushing the tablets & putting them in her favourite yoghurt last time.
I'd ring their GP & ask for an emergency telephone appt. I can usually get same day tel appt even when theres no face to face appts for 3weeks, I suppose a 5min tel call is easier for them . Then if the GP is really concerned he can escalate & see them also if need be. I found MH teams & staff are only usually concerned I'd you're actually suicidal there & then, not spiralling down.

My friend has also noticed a change in policy. They were sectioned multiple times as a teenager, and have apparently been sectioned for less than what their behaviour has been recently. But that was 10-15 years ago, things are very different now.

Diagnoses are Depression and ASD. It's definitely a life-ending strategy as opposed to a delusion or paranoia.

Friend seems ok today, I've been checking closely for any signs of septicaemia, but none showing yet. The moment I see any we will be going to A&E.

Suicide rates are higher in the asd population, so it could be that she's had enough and this is her strategy to end her life. I'd be inclined to say that this is her decision.

That isn’t true yesicancancan - the term ‘nearest relative’ is no longer part of the Mental Health Act and it was never the case that only the NLR could request assessment under the Act.

I’m really sorry you are going through this
But she has a right to refuse treatment

I would think it very wrong if you could get someone sectioned for that.

I have had A&D all my life I’d say - only treated as an adult but knew something was wrong as a child

I do consider it my right to exit when I want to. Sorry.

Contact the crisis team, as hard as it is to see someone close to you go through this, they are usually best placed to make decisions over care. Any pathway is best with their support, sectioning really isn't always the best choice for someone.

Also you say they see them every other day, is this their mental health support worker or someone else?

Few people can be forced to take their medication and.she has the right to refuse tablets, cannula, iv antibiotics or.going.to hospital.
Could the crisis team assess her reasons and understanding..

I personally am unsure about how unwell you have to be before you get any help off the MH teams.
I had a bad very real hallucination for the first time on Sunday, phoned the crisis team, who just documented it. Phoned the cmht mon who promised to call back. They didn't. I called again tues & got asked to see my gp. I'm under a psychiatrist with a diagnosis of schizoaffective disorder on high dose anti psychotics btw!!
I saw a gp thurs who said he 'wasn't worried'. Well I'm worried!!

I'm sharing that just to say I'm not sure how ill you have to be to get seen let alone sectioned.
I've been psychotic & violent & suicidal but never been sectioned.

Your friend may well feel suicidal but in my experience that's not going to get her sectioned.

I suggest that you take her to a&e at a main general hospital if she lets you, or call an ambulance on 999 (don't feel bad because sepsis is dangerous); say you are concerned about sepsis & the magic word 'sepsis' should get the drs doing a septic screen & any treatment she needs.
If she then refuses treatment they could then call in the psych liaison team.

I do wish you luck x

I've seen my friend this morning. The wounds appear to be healing somewhat. The first one that got infected is nowhere near as bad as it was - less pus and less swelling. The others are still getting worse, but then they are a few days behind that one.

Obviously I'm still going to keep a really close eye on them as I know this doesn't necessarily mean that they're going to fight off all of the infection, but it feels like a good sign. I don't think my friend knows what to feel about it though. I think they're disappointed more than anything right now. Hopefully one day they'll look back at this and be relieved.

Good glad the wounds are beginning to improve, hope your friend's mood improves too.

Hope things start to get better soon