To be worried about mental health act assessment

[busyweeks78]

My care coordinator mentioned this a few weeks ago I think now but luckily I managed to convince her I would be better off staying at home. Today when I meet her though she’s said she’s asked for one to be done and it will be done tomorrow. It’s to do with concerns for both my mental health and my eating etc. If I end up up being detained will I be sent to an acute ward or an eating disorder unit?

Any advice please? I’m very worried

Strongly recommend you call Rethink Mental Illness. They can advise 0300 5000927

It'll be whatever is most appropriate for your condition and where there is a bed available.

Thank you.

Try to be as open with them as you can, including your preferences around community vs hospital.

I think my psychiatrist is doing the assessment is this usual? I thought it would be an independent person?

Round here, to be sectioned under the mental health act requires two separate psychiatrists to sign off, along with support worker or doctor to ensure your needs will be met appropriately. If they feel you may do better as an in-patient then maybe it'd be better for you in the long run to be as open and honest as you can with them so you are getting all the support you need.

I’m not keen to have inpatient treatment.

I think it takes 2 psychiatrists and an AMHP, I've had my psychiatrist be one of those to do it before.

Well no, you wouldn't be - that's the reason for them doing an assessment under the MHA.

They don't do them for fun - they do them to see whether you are so unwell that you need inpatient treatment anyway.

Did you get those bloodtests done?

The AMHP does the assessment and has to take into the account of two doctors (doesn't have to be psychiatrists but if you already have one it would be usual for them to be one of the doctors involved).

MitziK is right - they don't detain anyone for fun. There are very specific legal requirements to detain someone under the MHA. If someone is following a suitable plan of care in the community then that's far better for everyone concerned than you being admitted to hospital (less trouble to organise, for a start!)

So, if you really want to avoid it, be as convincing as you can about how determined you are to make things work at home. But please don't think anyone will be out to get you - that is extremely unlikely.

(My husband is an AMHP - I hear about these things regularly although am no expert myself.)

To detain you 2 doctors and an Approved Mental Health Professional (usually abbreviated to AMHPs, and are usually social workers) both need to agree your mental health condition is severe to the point that you are a risk to yourself or to others, and that you aren't consenting to voluntary admission. Since you mention you have an eating disorder, I guess primarily the issue is likely to be whether your eating disorder has reached a point that your health is now at risk. To best being detained you need to be showing that you aren't at any serious or immediate risk, and that you have a certain degree of insight into your mental health issues and are trying to engage voluntarily with services.

As for where you would go if you were detained, honestly it depends where beds are available. If your predominant issue is an eating disorder than at eating disorder unit would be ideal, but beds at these units aren't easy to come by so you may find yourself placed on an acute ward instead.

You will probably be put on an acute ward for assessment and then if necessary they would look for a bed on an ED unit or other unit that would help.

Try not to worry - just be honest with the doctors/AMPH and see what they say. Tell them what you would like to happen. They may suggest going in to hospital informally but if you are really against that and they feel it is necessary they may section you. If you feel it is the wrong decision you can take it to tribunal.

I hope whatever happens you get the help you need. Take good care of yourself

They have placed me on a section unfortunately. I’m being sent to the acute ward despite the fact the section was mainly due to not getting bloods and eating struggles. I don’t see how the acute ward is going to help me I mean I am struggling with low mood etc but not to a severe extent.

It's to make sure that you get treatment. You said that you were going to get the bloods done, but didn't. You obviously aren't eating, hence why your Psych was worried about your weight and ordered the bloods before Christmas in the first place.

You need to be there and I hope that you get the assessment, treatment and support that you need.

Acute wards aren’t trained to deal with eating disorders so they won’t know how to help really.

Sometimes acute wards get advice from eating disorders specialists, particularly if people have comorbid conditions.

I’m worried they might keep me here till I restore all the weight I’ve lost and find this ward very distressing.

@busyweeks78 - I'm sorry to hear that but I hope you will get some good support. You might find the routine on the ward encourages you to eat. The staff will be able to assess you to see if you need a long term placement on an Eating Disorder unit. The best advice I can give you is to try and embrace the things that could be helpful - talk to the staff, take meds, try and eat, sleep when you can and get involved in Occupational therapy. Keep posting here if it helps. I wish you well

They will try to stabilise you. It's not normal to want to starve to death and you have to try to understand that. I hope they can help in some way. Try to get them to give you therapy of some description. Are you sectioned?

thank you for your kind message unfortunately this ward isn’t even a very good acute ward. Last time I was here it took them days to read my section information leaflet to me and my named nurse didn’t even really speak to me.

Sorry, read back and you are sectioned. I'm guessing the eating disorder is pretty severe and life threatening. I know you can't see it, but they need to stop you starving yourself to death. Your life is worth as much as anyone else's.

Do you want to talk about presumably anorexia?

They might just give you a few drips to restore minerals and such in case you go into organ failure. Ideally you need counselling too though to get you out of this.

I didn't notice or know how quickly you can die until I was really unwell with vomiting and diarrhoea for a few weeks and in the ambulance my body seized. I was never so scared in my life. My neck and my hands seized. I was terrified I was going to choke to death and the pain in my hands and arms was horrific. I had low blood sugar, low potassium, low sodium and low magnesium. I was told that it was lucky I hadn't actually died. They'll be trying to get your bloods well again via IV or food. If you can't bring yourself to eat, it will be IV.

I really feel for you. I hope you have someone to visit. I hope you get better soon - even though you don't want it right now.

@busyweeks78 - I doubt they will keep you there long unless they want to get you a bed on an ED unit. Even then they might send you home while you wait. Once you see the consultant you can find out about leave. Have they said you will see the consultant tomorrow? Take one day at a time.