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.

@Sevendaysaweek

They would have provided her with someone to vent to. She’s been left all her own.

ASFAIK round here the Crisis Team dont have the time to listen to people venting, however much they might wish to. They have to prioritise, and put very seriously ill people first.

If she needs someone to vent to, the Samaritans will always listen.

I think you've misunderstood the role of the crisis team.

She was feeling low and at risk so would have benefited from the Crisis team.

She was feeling low and at risk so would have benefited from the Crisis team

The MDT on the ward would have made that decision, not the psychiatrist alone. Clearly they didn’t feel it would benefit her on this occasion.

Crisis Teams are for people in crisis (not usually because they feel low or at risk or need to vent). Has she had Crisis Team before? If so did she engage with them and find it helpful?

It might be worth asking for a copy of her Care Plan (most trusts have a printable one for patients/relatives) as that should contain numbers she can phone if she needs help eg local support helplines or national ones like Samaritans and Shout.
Most care plans also have a list of coping strategies (agreed with the patient and sometimes called a ‘toolkit’) eg sensory strategies, calling a friend/relative, relaxation and breathing exercises, grounding etc.

@canigooutyet great post. Glad you are now stable.
There are rubbish MH professionals but there are also some fab ones and the difficulty is that people in a crisis don't always have the same view as those around them...

@Sevendaysaweek - I understand how worried you are. It is hard to be in your situation because all you can see is that your niece needs support and isn’t getting it.

But on the other side, there are many people who make suicide attempts and still don’t get ongoing crisis support, apart from being referred for NHS counselling/CBT. I’m not minimising what your niece is through but some of those people have no family support and are more unwell than your niece and they still don’t get ongoing crisis support or admitted to hospital, it is very much about getting people back out and into the community as soon as possible.

I’m met some psychiatrists and psychiatrist nurses who seem, at first, very cold and blunt. But I then learnt that when working with people in crisis, day in day out, it is really hard to maintain high levels of empathy and not burn out. I think becoming emotionally detached is a way to still do the job in a professional way and be able to sleep at night, after hearing truly horrific stories from people who have thoughts of suicide.

In an ideal world, your niece would have more support, but if just isn’t there due to funding and it so best for her to stay out of hospital so that it doesn’t start to feel like a “safe place” to her, and stop her learning to cope with her thoughts and feelings without being there.

But on the other side, there are many people who make suicide attempts and still don’t get ongoing crisis support, apart from being referred for NHS counselling/CBT. I’m not minimising what your niece is through but some of those people have no family support and are more unwell than your niece and they still don’t get ongoing crisis support or admitted to hospital, it is very much about getting people back out and into the community as soon as possible

I agree with this. Hospital beds are in very short supply and tend to be reserved for the most unwell people.

Many people are discharged with community support (even if that support isn’t instantly available) even if they still feel unready for discharge. Often families protest against discharge as they feel hospital is safer.

I think it’s a great shame we don’t have better community support programmes in place, or more halfway places where people can go for day therapy or short term residential placements to ease the transition from hospital to home.

To be honest, crisis teams are so overstretched and underresourced they're not fantastic either. You'll get an assessment, then either visits and/or phone calls of about 5-10 minutes daily (or less) to administer medication or assess current risk.

Mental health care is so badly short on EVERYTHING. Money, staff, resources, everything. I've been in the job 30+years and I wouldn't recommend it as a career. It's small wonder we get burnt out.

As an aside, I think the OP is over thinking the 'fond' comment. I look back at several patients I've nursed over the years and would often describe myself of being fond of many of them. It's not meant unkindly and I don't think it's particularly unprofessional.

My psychiatrist is really good, I see him every 3 months. You could never call him uncaring. All his patients seem to like him.

Thank you @dinosaurcookie. Hopefully this time it will be for more than a couple of weeks lol.

@Sevendaysaweek as others have said, crisis isn’t there to vent to. They have a short window of time to work with us of around 6 weeks. It’s not designed to vent. It’s designed to help us identify our issues, med changes and strategies of how to manage these issues we have at the time.

Assessments are made Constantly through the conversations with the MN nurses and psych who use these to help determine if referrals are needed to other mh services.

Even if she had been given support from crisis it doesn’t mean she wouldn’t be sectioned. My first time id been under crisis team for a couple of weeks.

MH services have been slashed to the bare minimum and in some areas it’s almost non existent. It used to be several psychiatrists working crisis department, now it’s down to 2 or 3. Although thankfully I’ve always had more than 10 minutes unlike pp.

Also crisis teams can be very hard to recruit for and retain staff.

It’s a high stress, high risk job, often lone working, going into people’s homes etc. Often you’re the person to decide whether the patient is safe at home or needs admission. If you make the wrong decision and patient takes their own life, it’s heartbreaking and you were the last HCP to see them. And you get called to coroner’s court.

It’s a very hard and stressful job so no wonder crisis teams are so short staffed.