Do ambulance crew really believe someone with serious mental health issues will be helped at A&E?

[SpringTime2020]

The other thread about ambulances made me think about this.

I was taken to A&E by ambulance a couple of times some time ago due to my mental health. Both times the ambulance crew reassured me I'd get the help I needed but both times I got no help for my mental health at all.

Honestly, no wonder these people are making repeat calls - they are probably desperate!

[quote SpringTime2020]@Bonkerz - I'm sorry to hear that. How is he doing now?[/quote]
A year later he jumped off a 30ft bridge and thankfully he's alive but has life changing injuries. He came out of hospital 6 weeks ago and we still have no mental health support.

@CovoidOfAllHumanity

I think you will succeed more in changing the system than in changing every individuals practice

In our area as part of the Covid A&E avoidance response they got paramedics to ring the telephone triage service on a professionals line with the patient as another option rather than A&E and if the person could keep safe for maximum of 4hrs to see a MH worker at home then they saved an A&E trip and Covid exposure
At the Maudsley I know they used to have a psych A&E that they could take people to instead of the general hospital.
As I said all the same outcomes up to and including admission are available to the triage service and the crisis team as via A&E. The 4h wait is probably about the same too. So all in all I think this is a good system
We also have a MH emergency car with MH nurse, police and paramedics that goes out to people who are suicidal so as to do the MH assessment at home not A&E.
This also breaks down stigma and is an opportunity for training (I am afraid that some people in the police, ambulance service and A&E regard mental health staff as a useless waste of time as much as they do our patients- you have seen such attitudes on this very thread from some posters)
I personally think these are the kind of good ideas that we need but we need to get past people thinking that going to A&E will always result in admission as it won't any more than any other assessment route.

Those do sound very good. I have to say though we'll have to agree to disagree re: changing the system rather than individual practices. Practices can change very quickly when brought in in the right way - I've seen this often in nursing. Changing the system? So slow! The attitudes towards MH patients and staff sadly doesn't suprise me, though it is shocking.

I don't believe people expect admission in A&E. I just wondered why it seems less likely. I mean I can answer that in that the staff are often bank and also have pressure to discharge so don't have the time to properly assess. Unfortunately, what I have come across was desire to discharge with no attempt at proper assessment. In my case looking back I needed a bed. At the time I just wanted help, any help but was sent away from A&E with nothing. Even if they'd given me something to help me sleep it would have helped. I'd had 3 months of insomnia with only a couple of hours of sleep per night - no wonder I was psychotic! I was then back in with OD. And this is again where the NHS gets it wrong. By not helping someone you just end up with them using more resources. And of course this happens in physical health too.

@Loopytiles

The problem isn’t the paramedics, the problem is the massive shortage and quality of NHS mental health services.

Oh absolutely as I've already said many times. But by not giving someone false hope you could save their life. That's got to be worth it, hasn't it?

* Wow, glad you're not a hcp. *

It’s in everyone’s interests I’m not!!!

Was told when my son was having a mh crisis that police would take him to a&e to be assessed. Police said no not true .
System is in crisis
I have no idea whst to do or believe right now but being told different things by different agencies is not helpful.
SW didn't seem to know either
Awaiting CIN plan.
Hopefully some sort of assessment.

@CovoidOfAllHumanity

Again it is a resource thing though isn't it? They can only meet demand by having fewer sessions and less qualified therapists Long term therapy with a qualified and experienced clinical psychologist is like gold dust. It's hugely costly and not everyone who could benefit can have it only what are deemed to be the most pressing cases.

Oh yes, of course. But it many cases it would be better for the patient not to have 6 sessions that are ultimately going to make them more unwell. It is much better to wait for proper therapy. In my mind the 6-10 sessions is like poking some people with a stick.

Nhs website

An A&E department (also known as emergency department or casualty) deals with genuine life-threatening emergencies, such as:

loss of consciousness
a sudden confused state
fits that are not stopping
chest pain
breathing difficulties
severe bleeding that cannot be stopped
severe allergic reactions (anaphylaxis)
severe burns or scalds
stroke
major trauma such as a road traffic collision feelings of self-harm or suicide

So it wasn’t “false hope”
They fact that such tight resources meant that on both occasions - you weren’t able to receive the treatment you felt you needed, does not mean the paramedics were giving you “false hope”

@CovoidOfAllHumanity

Lots and lots of people want to train in clinical psychology and have the ability to do it but the NHS doesn't train many of them because it can't afford to employ them. No

Really? Such a shame.

@gogohm

Depends where you are. My dd has had excellent emergency care at a&e but the hospital has a specialist mental health suite staffed by mental health nurses who made her feel like they had all the time in the world to talk, so important. The drs too were good eg when she needed a drip (not eating is one of her issues.) they were also good dealing with me, her parent and the emergency in home team were good

I'm so glad to hear you had a good experience. I have also had many good experiences too.

We also have a mental health suite but the complete opposite of 'all the time in the world'. You are just made to feel a nuisance.

If you were ravingly manic or psychotic a bed would be found somehow somewhere and you would get dosed up with some meds. You would clearly meet a threshold for admission and effective treatment would be available.

Emphasis on the "somehow, somewhere". The nearest bed that could be found for an ex-client in the run up to Christmas was in the Midlands. The client lives in Sussex. (Mind you, that's an improvement on a couple of years ago, where the nearest available acute psych bed one weekend was in Glasgow!)

But I agree entirely that services for PDs, PTSD etc are really incredibly poor, and that there's nothing like the public concern for poor MH services that there is for cancer, MND and other diseases. And even within the area covered by one Trust, there's a huge disparity between services in different local areas.

@Bonkerz - I am so, so sorry to hear that. Those are the very real tragedies that happen when you lose all hope. It is so sad A family member jumped off a bridge, she didn't make it.

@maxbabi

Was told when my son was having a mh crisis that police would take him to a&e to be assessed. Police said no not true . System is in crisis I have no idea whst to do or believe right now but being told different things by different agencies is not helpful. SW didn't seem to know either Awaiting CIN plan. Hopefully some sort of assessment.

Oh, @maxbabi - I'm sorry. What you say is so familiar. I went through it with my ex-DH. Being pushed from pillar to post, being told different things. You feel you are banging your head against a brick wall. The confusion and just not knowing what you can try next. It is exhausting. I hope the CIN plan will help. At least then you will have regular meetings.

Mental health services have been cut to the bone at a time when they are needed the most. It's disgusting. But I would assume the paramedics were saying what they thought was best at the time. They probably thought they were being kind, as I understand it they have very little mental health training.

I say things to reassure people that I know aren't true. For example, I care for people with dementia. One lady often becomes upset because she doesn't know where her mum is. I tell her she is at work or out shopping etc and redirect her to something else. I wouldn't tell her she's 92 and her mum has been dead for years. Yes it's a lie but it's for a good reason.

My friend took an overdose in the midst of a mental health crisis. She received great support on a mental health ward (albeit in a different county. However she is a doctor and her husband is a consultant. If it weren't for this I highly doubt she would have got a bed.

There needs to be much better mental health support and the process to get it should be straightforward. Unfortunately I just don't see it happening for a long time, and certainly never under the Tories.

@Toanewstart23

Nhs website

An A&E department (also known as emergency department or casualty) deals with genuine life-threatening emergencies, such as:

loss of consciousness
a sudden confused state
fits that are not stopping
chest pain
breathing difficulties
severe bleeding that cannot be stopped
severe allergic reactions (anaphylaxis)
severe burns or scalds
stroke
major trauma such as a road traffic collision feelings of self-harm or suicide

So it wasn’t “false hope”
They fact that such tight resources meant that on both occasions - you weren’t able to receive the treatment you felt you needed, does not mean the paramedics were giving you “false hope”

I don't see your point? I wasn't given any help atall from the mental health team. So being told 'you will finally get the help you need' and 'they will find you a bed' was in deed false hope. I didn't feel I needed any particular treatment (I was far too unwell to be able to think straight about that) - it was hcps who felt I needed it - hence paramedics mentioning a bed.

And so many of us feel we are given false hope - are we really all wrong?

Jeez, some caring paramedics try and help you and you want them educated to do it your way? Very ungrateful.

Perhaps the kind approach helps with others. Those with the decency to have graditude.

@EllaVaNight whilst I agree with you it has only been possible to.cut them.to.the vote because MH Trust after MH Trust CEOs publish report after report indicating that needs are met via CQUINS , etc. The reporting lacks transparency and honestly and those on six figure salaries are not held.to account. This is as much an NHS, CV building issue as it is a Government issue.

Bone not vote.

You are really hanging on to this thing about false hope. Paramedics are reassuring, that is their job as they take the medical emergency to the doctors who can assess and treat as they are able to/see fit.
What if they told someone they would be looked after and they later go on to die from injuries sustained, for example?
I really agree with a poster up thread who said you could talk to your therapist about why your are so fixated on what the Paramedics said to you and how feeling pet down by them can have such an impact on your MH

Let down, not pet

RosesAndHellebores I do agree the NHS is to blame too and believe it would be a lot better to cut out the many middle/senior managers who do nothing other than pointless meetings about nothing.

I don't believe it's the paramedics fault though or the fault of individual mental health professionals.

Wait for it
The OP is going to barrel in with how she’s not blaming the paramedics

So how make the thread about the paramedics??

Why keep harping on about the paramedics being wrong to “false hope” when all they were doing is telling you what a&e would have done had it had sufficient resources

So your thread should be about NHS and lack of resources for mental health

But that wouldn’t have got the attention you wanted from this thread. Hence the title you chose

@LakieLady

If you were ravingly manic or psychotic a bed would be found somehow somewhere and you would get dosed up with some meds. You would clearly meet a threshold for admission and effective treatment would be available.

Emphasis on the "somehow, somewhere". The nearest bed that could be found for an ex-client in the run up to Christmas was in the Midlands. The client lives in Sussex. (Mind you, that's an improvement on a couple of years ago, where the nearest available acute psych bed one weekend was in Glasgow!)

But I agree entirely that services for PDs, PTSD etc are really incredibly poor, and that there's nothing like the public concern for poor MH services that there is for cancer, MND and other diseases. And even within the area covered by one Trust, there's a huge disparity between services in different local areas.

Yes I completely agree. Those with EUPD have such a high risk of early mortality. But so many as can be seen on this thread really couldn't care less as it is mental illness not physical.

@EllaVaNight

Mental health services have been cut to the bone at a time when they are needed the most. It's disgusting. But I would assume the paramedics were saying what they thought was best at the time. They probably thought they were being kind, as I understand it they have very little mental health training.

I say things to reassure people that I know aren't true. For example, I care for people with dementia. One lady often becomes upset because she doesn't know where her mum is. I tell her she is at work or out shopping etc and redirect her to something else. I wouldn't tell her she's 92 and her mum has been dead for years. Yes it's a lie but it's for a good reason.

My friend took an overdose in the midst of a mental health crisis. She received great support on a mental health ward (albeit in a different county. However she is a doctor and her husband is a consultant. If it weren't for this I highly doubt she would have got a bed.

There needs to be much better mental health support and the process to get it should be straightforward. Unfortunately I just don't see it happening for a long time, and certainly never under the Tories.

Dementia care has very specific reasons for avoiding the truth. It can also be the same with delusions. We need to be able differentiate. And I agree sadly, nothing will change under the Tories.

@Toanewstart23

Wait for it The OP is going to barrel in with how she’s not blaming the paramedics

So how make the thread about the paramedics??

Why keep harping on about the paramedics being wrong to “false hope” when all they were doing is telling you what a&e would have done had it had sufficient resources

So your thread should be about NHS and lack of resources for mental health

But that wouldn’t have got the attention you wanted from this thread. Hence the title you chose

This is absolute rubbish and again clear you've not read the thread. I thought you were 'out' some time ago. If you had bothered to read my OP or this thread you would see I am talking about something very specific relating to paramedics. What is the use in telling someone they are going to receive treatment that may have happened in the past but not now due to resource cuts? Surely, that is misleading?

You think it is fine for paramedics to say this when it leads to so many people dying prematurely. Would you be happy with that if it was your family member? I find you extremely callous.

If you're not interested in the good discussion many of us are having then no need to post, just keep on scrolling. You do realise I'm an actual human being and when you are so dismissive about the fact I almost died, that my friend died a few days ago it really hurts.

@Awrite

Jeez, some caring paramedics try and help you and you want them educated to do it your way? Very ungrateful.

Perhaps the kind approach helps with others. Those with the decency to have graditude.

So my dead friend should just be grateful. Have you even read the thread? It is not kind to give false hope. I almost died because of it, many people on here have talked about this happening to their relatives and it lead to suicide. One lady talked about her brother jumping off a 30ft bridge. Does that really mean nothing to you? Oh but I suppose we should all just shut up because it's mental health. If it was physical health and paramedics were doing something (unintentionally) that was causing death you'd be saying something very different!