People in mental health crisis are experiencing slightly more than a mere thought about suicide. They are psychotic, disorientated, actively trying to end their lives, not sleeping, not eating
Not necessarily. People in mental health crisis present in many different ways, they don’t all have the same symptoms. They’re not all suicidal. They don’t all stop eating and sleeping. Not all are psychotic.
Someone admitted for EUPD Crisis (on a 3-day pathway normally as time in hospital is proven to worsen EUPD past a 3 day admission in most cases) is likely to present with low mood, self harm, risky behaviour, possibly suicide attempts, they often report feeling disconnected from reality and sometimes report panic attacks, hallucinations and hearing voices. The difference between someone in EUPD crisis and say someone in bipolar crisis or suffering from a severe psychotic or depressive episode is very obvious to staff. The patient with EUPD usually has a long history of suicide attempts, chronic self harm and admissions and may have ‘psychosis with behavioural elements’ on their notes.
Psychosis is often not taken seriously when mixed with EUPD (a very risky move by staff, as you do have the occasional patient who is psychotic too and gets missed. I don’t agree with dismissing psychosis until you’ve observed someone for at least 24 hours). However I’ve also observed patients trying to present as psychotic to get admitted, eg only showing psychotic symptoms when they think staff are watching.
But the differences between PD psychosis (which is often transient, trauma-related and more dissociation) and true psychosis is often clear to staff.
Most non PD psychotic patients IME try to hide or mask their symptoms and might display disinhibition, try to leave (needing sectioning) and their psychosis normally responds to medication. It doesn’t wax and wane; a psychotic episode is hard to miss as symptoms can’t be easily hidden. Staff will take into account their history too; a diagnosis of bipolar, schizophrenia, drug induced psychosis, a serious suicide attempt (particularly the first) tends to get people admitted. If they have a PD diagnosis and multiple past admissions have failed to help, or they have a history of OD, DSH or ligatures on the ward they’re less likely to be treated as an inpatient.
I’m sorry the paramedics gave you false hope. But they don’t have access to your full history which is taken very seriously when deciding whether or not to admit.