To ask if crisis teams/ out of hours teams

[User473830]

Are ever helpful.
My adult dc called the mental health out
Of hours team last week. They seem to just suggest making a hot drink or having a bath which obviously isn’t possible in the early hours of the morning when you live with others. Aibu to ask has anyone ever had a more helpful experience? Disclaimer I know they are lucky to have access to these services.

One entirely negative interaction with them as an adolescent, then several further negative interactions with them as an adult.

Lots, of platitudes. They like platitudes. A degree of sympathy and suspiciously synthetic empathy, and precious little in the way of practical help, suggestions, or worthwhile discourse.

To be honest, I'm not really sure what it is that they're expected to do. Mental health care and psychiatry is such an esoteric black art that I don't really believe they know what they are doing themselves. It's the ultimate case of requiring a magic wand while being conspicuously lacking one.

Sadly in my area at least patients do seem to have quite a negative view of the crisis team.
I am not currently in that team (social worker) but about to move over - our other teams often pick up the slack but unfortunately the support we can offer is limited - are they taking any medications? Is there scope for an increase or change in meds? It’s very hard at the moment and lots of people are struggling. Feel free to PM me if you need any advice.

It 2ould to know what is expected from them because besides providing a listening ear, advice on how to try to calm down and relax without medication, or to call for an ambulance to be taken to hospital, what else can they really do in the middle of the night?

At times yes. But the threshold for actual intervention is really high these days and probably even higher with the current crisis.

I don't see why having a hot drink is impossible in the early hours when you live with others though. Or, tbh, a bath. And I would expect the people living with someone in enough distress to need to call OOH overnight to understand the reason for the slight disruption running a bath would cause.

What did you want them to do?

I can only say that the crisis out of hours Mental Health Team has been brilliantly helpful on several occasions. Genuine kindness, understanding and happy to talk for as long as necessary. And then an instant report sent to the daytime staff who follow up the next day.

My dsis works for a mental health crisis team. She works extremely hard with her clients in order to support their mental health, but there is a limit as to what she, or indeed anyone else, can do. If she gets a call in the middle of the night, she will talk for as longs as needed to the client. She is not able to do a home visit by herself, but will notify police or paramedics if needed.
OP, what advice would you have given to her if she had phoned you instead?

The lady didn’t really want to talk. He told her that he wanted someone to vent to. She said considering the time you should go to sleep if you can’t have a bath or a hot drink.

Sorry, him not her.

There are lots of mental health helplines for people who need to vent.

I know you’re concerned about your son but it doesn’t sound like he needed a psychiatric nurse?

I can't say they ever have been, in my couple of decades of the mad life.

I think people often expect crisis teams to be able to change how they are feeling, and are disappointed when they can't.

Things like having a bath or a cup of tea to focus on the present and getting through the next 10 mins are the sort of things mental health staff often suggest. When people are at risk of hurting themselves then it is normal practice to try and focus on getting through a few mins at a time until the urges get less.

I've known crisis staff to do amazing things - a time a colleague negotiated with a psychotic patient to let the family member go they were holding hostage is one. But we have chosen as a country to elect a government who massively underfunded mental health services and the result of that is that the bar for getting help is very, very high.

I agree with the above.

No mental health professional can change how someone feels but A lot of people do expect this.

A crisis team could help with medication, arrange an admission or even call the police if the crisis is that urgent. They can also look at brief solution focussed coping strategies with someone. They aren’t really there as a helpline to provide a listening ear though.

I wasn’t expecting her to change how he was feeling. It’s always sold by the day team that if he feels low he should contact them.

I contacted a crisis team last year as I felt suicidal. The CPN listened for about 30 seconds then said he would send a report to the consultant which he didn't.

He made me feel stupid so I won't ever bother again.

Well there are good and bad workers in all services . And those workers have good and bad days. Not sure you should make a global judgement 'all crisis teams are useless' based on one interaction with one worker. I would suggest you advise him not to be put off and to still try again if feeling bad again as another time might be different.

I guess their main job in many ways is risk assessment actually. Deciding if someone needs a 999 ambulance right now or can wait until tomorrow or actually doesn't need urgent input at all. That may not feel very useful but it's a big part of the job. Listening and trying to provide some strategies is another but possibly if the worker assessed a low risk that night and follow up in place the next day they might have had to get on to the next call if they had high call volume and lots of people waiting.

I've been in the mental health system since I was 17 and I'm 56 now. Even before cutbacks my local service is crap. I've phoned the crisis team quite a few times and got nowhere, each time hoping I'd get someone who cared, but that's never happened. Last year was the last time I'll bother.
The irony is when I've seen the psychiatrist ( half an hour every 6 months and I'm supposed to be grateful for that) they send me a copy of the letter that goes to the GP, and each time they say I'm aware of the crisis team if I need it. Yeah, right

OP what did you want them to do? I’m asking very genuinely. Your son should of course ring if he needs to but you clearly feel let down and it would help to understand what you wanted them to provide that they didn’t? You said he just wanted to vent but did he/you want something else too?

Very mixed feelings on them.

Some superb experiences; the lady who spent twenty minutes of every half an hour on the phone to me throughout the night until my psychiatrist came into work and the psychiatrist at the hospital who went ape shit with the police for putting me unnecessarily on a 136 when I was in hospital and asked for the room door to be kept open and then went to open it (terrified of closed spaces)...

For my specific diagnosis they aren't very useful though most of the time and it is usually best to get my own team involved as they understand the issues and are best suited to help me.

i’ve been discharged from service since january, in a catalogue of errors which is currently under investigation by the Trust.

in my experience, crisis teams are brilliant if you can actually get hold of them. during office hours you have to speak to Duty at the CMHT and i have found them to be rude, dismissive and seemingly exasperated by mentally ill people needing support with their mental illness from a mental health team.

i have had suggestions such as ‘go for a walk’ oh, ok, i’ll just take my giant panic attack and go outside, that sounds ideal! or a hot drink, or a bath. i’ve found myself saying no, i really need someone to help me, i’m in crisis, you can see my Care Plan and been told that ‘someone will call you back’ and the nearer to 5pm you call, the more they try to get you off the phone so the Out of Hours team have to take you on.

i live in an area where the mental health trust has been in special measures for years. there are in-patient beds, but no staff on wards. care co-ordinators are under pressure to process and discharge people ASAP to boost the figures. this sounds paranoid, but i’ve had it confirmed by someone who works for the Trust and who is taking my case on for me.

i take antidepressants and antipsychotics, am on opiate pain medication for arthritis and have valium and sleeping pills on my repeat prescription. nobody reviews me, i just keep getting the meds and adding to the stockpile!

blimey. that was an essay. can you tell i’ve been shielding for 60 days now? cabin fever is setting in with a vengeance...