To think detaining under the mental health act

[User755]

Is often done to late when family relationships are already strained and the person has been left to end up seriously unwell. Speaking as a mother of a young adult with mental health problems.

I think the mental health act is a shocking piece of legislation. It is over used in many situations when voluntary treatment could be used. The poor treatment of patients and the attitude of some staff working on these wards is also a disgrace.

I’m sure sometimes it can feel like this
They’re reforming the act aren’t they - possibly to make it harder to section someone? I’m not sure

The patient must meet the threshold for sectioning. Lots of times it is when the person is at serious risk of self neglect. Suicidal with plans or at risk to themselves or others.
As a family member we feel the person needs to be in hospital now. Sometimes the person isn’t sectionable. They may agree to go to hospital informally - this is offered, they may agree to work the The home treatment team - an alternative to admission.
Hospital really is a place of safety.
Sometimes it’s takes weeks to co-ordinate a second opinion doctor, the ambulance and police. You may also need to get the council or a locksmith involved in case you need to force entry. For this to happen a warrant needs to be obtained from the local courts too.

Mental health provision is in my opinion terrible these days... There needs to be more early intervention and help for those who are becoming unwell and families around them. Particularly concentrated around older children/teenagers. Not to section in most cases but to properly help before crisis stage.

I feel if we overhauled this correctly itd help so many individuals, families, free up time spent by emergency services dealing with the fall out for years.
I'm ashamed of our provision for those in most need mentally.

@User755

I’ve been left to deal with my child’s very high risk behaviours. They are an adult but obviously I could never put them out on the streets so I have to have them living with me.

What sort of high risk behaviours? If they're a risk to themselves call an ambulance, if they're a risk to others call the police, the emergency services have MUCH more of an ability to get people the help they need than MH services.

Out of desperation we want time off caring, as another poster said of their parents but inpatient via sectioning may not be the best option given the current level of under resourcing. It is so so wearing.

My personal experience is that mental health care in U.K. is very inconsistent. If you suffer a severe mental health breakdown and need to be obtained, they do truly look after you in my experience. I have friends who are coping, in their eyes, very well and their needs have completely fallen through the net. So yes I rather agree you have to be seriously, seriously unwell to get help. But the care you can get then can be nothing short of a life saviour.

My dd recovered and now manages her anxiety and depression quite well. BUPA picked up about £8/9k, I picked up about £6k relating to ADHD which was undiagnosed and at the root of it. After the A&E crisis I telephoned the CAMHS nurse to let her know ADHD had been diagnosed. She laughed down the phone and said "well, I think she's too old for that at 17" . After a crisis that the NHS had £1000 to spend on an unnecessary admission she was assessed three times in three weeks (by MH liaison, by CAMHS, by CAMHs' sub-contracted therapists to reassure themselves they needed to do nothing for months and months). If as much was spent supporting people as it is ticking boxes and providing audit trails to prove they need do nothing, there would be so many more resources to spend on people's MH but the system seems set up to justify the most qualified doing as little as possible.

There should be more up front honesty and support over sign posting to alternative services and less resources spent on justifying care isn't necessary until crises are reached.

What's the alternative? Detaining people against their will when they have relatively mild MH issues?
This.

People are usually only detained when they are considered to be a danger to themselves or to others. You can and should access MH services soon enough so that it isn't necessary to be sectioned.

They won’t detain people that are a risk here.

I don't think the bar for detention should be lowered, but (as others have said) the national disgrace is that there is so little substantial support available for those with MH difficulties before they get to that point. It shouldn't be necessary in a civilised country for people to become that ill before the state is forced to step in and detain them against their will in order to offer them some help

@User755 I obviously don't know the details of your child's mental health issues. It's a tricky balance in that depriving someone of their liberty should always be a last resort. I would say though that if someone has a repeated pattern of failed discharges due to non-compliance with medications etc leading to serious relapses, Community Treatment Orders (CTO's) have been introduced a few years ago to enable people to get enforced treatment much earlier if appropriate. For example if someone with schizophrenia has a history of repeated non-compliance with medications and getting very unwell and aggressive when unwell, a CTO can mean someone can be 'recalled' to hospital very early on when they first start discontinuing medication. The idea is to stop people with serious mental illnesses getting too unwell before they end up needing hospital care.

@User755

They won’t detain people that are a risk here.

What happens if you call 999?

From my limited experience of this I agree with you OP.

I've not been sectioned despite suicidal intent,plans, means and attempts. You can be at the point of ending it all and nothing is done.

I think sectioning should be as hard as it is.

It's all the care and support beforehand - or total lack of it - that is the problem

The bar for depriving someone of their liberty should not be any lower. It should be the absolute last resort.
However, the support services for mental health problems before they reach that point need to be better much more accessible.

Sectioning is an odd thing. In some ways the threshold is very high. Too high. I say that knowing two people whose psychiatric team decided they couldn’t be sectioned as they weren’t a risk to themselves... and are now dead.

In other cases people are kept on section too long.

It’s also the case that sectioning isn’t really a means to recovery and it’s more a case of containing someone until they are no longer in acute danger. Most people at the stage of being sectioned are unable to engage in therapy and are not well enough to benefit from it.

Problem with detaining people before they absolutely need to be in a MH unit is that it will make people unwilling to be honest about their MH and afraid of seeking help even for minor problems as they'll be afraid of being locked up and losing jobs, money, family etc.

I dont think people are detained before they absolutley need to be. I think sometimes they are not detained when they need to be due to a lack of beds.

However I think what @OverTheRubicon and @Voice0fReason said is completely accurate, that sectioning needs to be difficult and a last resort, but the care beforehand is not enough.

Possibly this is what @User755 is experiencing that her child will be left untreated or inadequatley treated until they deteriorate to the point that hospital is the only option.

As for phoning the police and ambulance, though they can respond to emergency, unfortunatley they cannot arrange or force magic treatment where there is none. So many people brought into A&E are discharged and put on a waiting list. Using emergency services may save a life but does not guarentee fast track to adequate mental health services.