To find a lot of psychiatrists uncaring

[Sevendaysaweek]

Dn 19 has been admitted to a mental health hospital. I’ve found out today that she told her community consultant how low she was and that she felt at risk. He dismissed her feelings told her she had got through it before and that he was fond of her. Then told her she would see her worker the next week. The worker left suddenly and didn’t even tell dn she was leaving. I’m thinking to complain to pals as this could have been prevented and I feel so sad for her that it hasn’t been.

Your thread title is inflammatory and dog whistling and doesn't reflect your actual concern

One psychiatrist either made a mistake or just didn't have a crystal ball but you decided to post a thread suggesting that most or all psychiatrists do not care about their patients.

He said he was fond of her. He tried to give her hope and remind her that she'd been able to cope before. That suggests the exact opposite of doesn't care to me.
He very likely did not know that the care c/o wouldn't be there.

If anything is worthy of a complaint it's that the care c/o didn't give notice and/ or there was no cover

I do not see that you have any evidence that her psychiatrist did not care still less that all psychiatrists are uncaring.

Not everyone who requests an admission needs one- I'm not saying that's true for everyone. The hospital environment, depending on her current needs, may not be seen as the best longer term solution for her treatment. Community care can be a better option, and I can assure you that it's not about not caring- it's about assessing the whole situation and trying to work out the best plan of care- which sometimes the patient and the family may disagree with. Admission for a short time (sections) to establish risk, doesn't mean a longer term in a secure facility is ideal- and in fact can at times be detrimental.

No-one who is begging to be 'sectioned' should be because being 'sectioned' ie detained under MHA. This should only happen if you don't accept voluntary treatment. Therefore if you are begging to be admitted you are agreeing to voluntary treatment so QED you don't need to be detained.

@DougRossIsTheBoss I think you need to step away from this thread.
You have obviously had a tough day and sympathise but your responses to this thread are not constructive.
OP I'm sorry you are disappointed with the treatment but the information you give, or have, doesn't give enough info to make a judgement. Perhaps try to work with her HCPs rather than assuming the worst.

@DougRossIsTheBoss I cross posted with your last comment which was constructive

Fair point
I should have hidden it
I really should have

I’d complain that the support worker left without cover for your DN. I would not complain about the psychiatrist “dismissing” her feelings as you don’t know if that was the case or not. In addition, relapses often cannot be prevented, only prepared for. It’s why there are care plans done and followed. Recovery from depression isn’t straight forward. Climbing out of the hole involves some backsliding and stopping to secure your grip as you go. But the good news is she is in hospital so shes not been let down. She is getting care. So many don’t.

It makes me sad that you seem to put a post up about your niece on a daily basis.

If you have a genuine concern for/about her then talk to her or the appropriate professionals.

Like all other high stress jobs. They can't afford time wise to piss about with platitudes and soft focus cheery words. They are run off their feet.

Your generalising a whole profession based on one person? YABVU.

@DougRossIsTheBoss if someone is begging a psychiatrist to put them in a hospital because they're aware that they aren't in control of their actions and are hallucinating, then yes they should be sectioned. The fact that my DSis almost died and it was sheer luck which defies all logic, that she didn't, proves my point.

God it must be annoying to be in one of those really specialist difficult jobs that everyone thinks they can do eg diagnosis and treat based on a short 3rd hand mumsnet post.

We know that assessing suicide risk accurately is
extremely difficult.

I don’t know why you’d assume that it’s difficult because of laziness or nastiness or lack of caring.

It’s simply difficult clinically.

I think I would not be assuming your niece was let down. Maybe that's true, I have certainly met some psychiatrists who are idiots.

But it's also the case that patients do not always make the best assessments of what they need done for them. Sometimes they feel more vulnerable than they are and it isn't necessarily the best approach to validate that feeling.

Nc1962
Again no you are incorrect
I really do know what I talking about in this
Criteria for being 'sectioned' are
-Have a mental illness of a nature and/or degree requiring treatment in hospital

• present a risk to your own health, safety or that of others
• such treatment is not possible without detention under the act

If you are asking to be admitted you cannot be 'sectioned' because you are by definition agreeing to have treatment and detention under MHA is only possible if you are refusing treatment no matter what symptoms you have or how ill you are.

If you are using 'sectioned' just to mean admitted to hospital then maybe you are right that she should have been admitted I have no way to tell

Sectioned though is incorrect. It isn't an official term but it usually means 'detained under MHA' and this will only be necessary and therefore will only be legal if admission or treatment is refused

Lots of people ask to be admitted to hospital every day. Far far more than we would ever have beds to contain so we have to make choices on the basis of risk: benefit and because we are humans and the future is hard to predict we sometimes get it wrong.

If someone is harmed do you really think it has no impact on the psychiatrist and they don't care? Of course we do. Again we are human.

If someone is badly harmed as the result of a poor judgment then there will 100% be an official investigation. That could be internal or external if the harm is very bad. If it's suicide you can expect a trip to the coroners court to explain yourself to the coroner on the public record. This is every psychiatrists worst nightmare. Of course there are consequences if we are wrong. It's just totally wrong to say there aren't and we are all acutely aware of those.

Most people ask to be admitted mainly in order to feel safe because they believe that can't manage how they are feeling themselves.

Sometimes it would be wrong to agree to this because
For some conditions (especially medication non responsive ones) admission is only a short term respite and doesn't make any long term difference
If a person is admitted every time they feel they can't cope then this becomes their default option and their only coping strategy and they never learn any better strategies or develop community support networks because they are always just admitted (briefly) to hospital
They may in fact be better off in the long term to learn ways to cope with their symptoms without admission

Mental health hospitals are usually not a haven of peace and tranquillity sadly. They are full of people who are floridly psychotic, manic and behaviourally disturbed all crammed in one space. At any one time it's pretty likely at least one person will be creating a disturbance, shouting, not sleeping, behaving in an alarming way.

Admission is highly likely to happen for florid psychosis and mania as these conditions often can't be safely managed outside hospital and require medication treatment

Admission is highly unlikely to be offered for personality disorder because this requires long term psychotherapy which is not available in hospital.

For other conditions eg depression it really depends on the severity and risk but it is always a last resort and usually medication will one of the main purposes. Yes there will be OT groups, short term group psychology and nursing but fundamentally you would not be admitted just for those unless it was to a very specialised unit eg a personality disorder unit would have a commitment of many months

I'm not a psychiatrist but I've no idea how some people imagine they can magically produce beds for everyone who wants them.
There are a very limited number of mental health beds and not much mental health investment full stop.
This is not because psychiatrists don't care.

I love my psychiatrist. Shes a really insightful, gentle woman. After my first session with her she did sophrology with me before I left and a little hypnosis too. I'm not in the UK though.

I've had dealings with psychiatrists for different reasons over the years and can understand what you're saying. For me though i prefer it this way. I like the objectivity and rational approach. Often the situation I've been in (psychotic father for example) is so chaotic and distorted, someone who is just going to assess things clinically is exactly what is needed.

Unless the OP, was in the room with her Dn, when she had this consultation when the consultant apparently dismissed her feelings, then how does she know what exactly was said or offered or done?
Also, if her Dn is under care of psychiatric team then as part of her care plan would be having crisis teams numbers for calling out of hours etc.
Not sure what op meant by begging for crisis team?
Patients and relatives often feel or report "nothing is being done to help me" but what they actually mean is "nothing that is being done is what I wanted to be done"
@DougRossIsTheBoss.. Articulates it better than me, but basically patients might want admission and might want certain treatment however it may not be in the best interests or the right thing for them. Patients and relatives expectations of what is right / best treatment plan and what resources are available to doctors doesn't always correlate with the reality

[quote nc1962]@DougRossIsTheBoss if someone is begging a psychiatrist to put them in a hospital because they're aware that they aren't in control of their actions and are hallucinating, then yes they should be sectioned. The fact that my DSis almost died and it was sheer luck which defies all logic, that she didn't, proves my point. [/quote]
The thing is though if they are aware of that, they're in a better position than the 3 others who are hallucinating but absolutely deny there is anything wrong. They would be prioritized ime. It's not because psychiatrists are uncaring it's because there is a v limited amount of beds and they are pretty much always full.

Many psychiatrists and MH staff are very caring. I’m sorry your niece had a bad experience.

Many people go into MH professions because they’ve been through it themselves and want to give back and help others.

Crisis teams are limited in how many patients they can take on, and if she’s had it before and didn’t benefit from it they won’t advise it again.

They also try not to keep people in hospital longer than absolutely necessary, partly because patients get de-skilled for coping when they leave, or pick up negative behaviours from other unwell patients, or sometimes it’s simply bed pressures. Eg they may need the bed for someone who absolutely cannot be at home due to acute psychosis or mania.

Unless she’s at serious risk or being titrated on new meds there’s no point in her being kept as an inpatient. If she has a home and supportive family (and community psychiatrist so I’m assuming she also has a lead practitioner or outpatient therapy) crisis team won’t be able to add much.

@WellQualifiedToRepresentTheLBC

Sadly, empathy can be a difficult trait to maintain when you are training to be a consultant. They are the engineers of the body, not the priesthood, if that makes sense. Sensitive caring types do not survive the road to that career.

I'm a bit puzzled by this comment. Would you say this about, say, paediatricians? And aren't psychiatrists focused on the mind more than the body? (Obviously there is some interplay there, but they're not like cardiologists or surgeons.)

OP I’ve just realised you posted the other thread about EUPD.

Presuming it’s the same niece, EUPD is rarely a reason to stay in hospital unless the person is in crisis. There’s a 3-day admission pathway for EUPD that staff try to stick to.

As someone else pointed out, section under the MHA is only if a person refuses an admission, not if they accept it or ask for it.

Many patients with serious conditions are Informal patients but with the understanding they would be sectioned if they tried to leave when so unwell. Others are sectioned because they lack capacity to realise they are unwell. Sections are usually removed as soon as the person responds to treatment and has capacity or agrees to stay.

Unfortunately certain EUPD behaviours like repeated self harm, ligature tying or going AWOL and being found near a rail line/cliff edge can lead to immediate discharge as the MDT can argue the hospital admission is making the patient worse and community treatment would be better for her.

You want empathy and understanding, you need a Psychologist.
You want a medical perspective you need a Psychiatrist.

I think the problem is a lot of people expect both jobs to be interchangeable and they really are not.

I think, most Psychiatrists are probably going to be a lot less soft and fluffy than a Psychologist. I suppose it's a bit like your local GP and a Consultant. The GP will probably offer more support and know you more as a patient, the consultant gets the job done, offers the therapy/medications, makes sure the patient is stable and the gives back to the GP.

Your DD should feel supported by her Psychiatrist, but I do think there is a fundamental difference in how they relate to their patients.

I want to add this is my view from what I've experienced, I understand its different in other mental health settings.