How difficult is it to have somebody sectioned?

[Aroundandaroundagain3]

I've posted on here a few times over the years about the problems surrounding my DM's alcoholism and the distress it was causing me trying to get her to engage with help. I finally took the majority advice and went NC had I've a blissfully stress free 6 months until today.

I had a call from the warden at her over 50's housing complex who does her best to support her, she said DM has gone downhill massively. She's not eating, spending all of her money on drink, has been incontinent, is in a right state with her appearance and hygiene and has had more falls. She has been going to other residents for help but refusing to engage with paramedics. Warden thinks she has reached crisis point and is having a complete breakdown.

She wants DM to be sectioned under the MH act and was calling me to let me know of her plans to contact the MH team and SS to try and get it done.

I don't have any direct experience but I don't think it's as easy as she might think.

How difficult is it to have somebody detained under the MH act? Do you think it'll happen?

I forgot to disable voting, ignore that

I also don't have much knowledge around this but I did at one point discuss this with my ex husband's medical team when he was having a bad mental health episode and they told me it was very difficult.

From memory it requires a paramedic/GP/social worker to actually observe the person in question in the middle of a crisis episode. Which is obviously hard if the individual is in denial and masking their behaviour.

But hopefully someone will be along with more knowledge on this.

Sorry you're having to go through this it sounds awful.

I've found it varies. She could be more likely to get arrested. Then she'd get seen. If she doesn't tick the boxes under the MH Act then they can't section her. She does in one way fulfill being a danger to herself, but she wouldn't be after being held and sobering up. The warden is doing the right thing because she is a vulnerable adult and rather than become homeless, she needs intervention now. In a nutshell, it's unlikely unless she agrees.

But other help avenues will be opened up.

Even more difficult than ever I suspect due to lack of resources. However the mental health crisis team might get involved.

My brother has recently had a serious mental health issue (paranoia and delusions) out of the blue really. We managed to get him under the crisis team, to be honest he could have done with an inpatient stay but there was no chance of that.

I hope your mum gets the help she needs.

Not as easy as you think.

You can have a MH assessment done - usually through a GP or crisis team - but they may suggest that she can remain where she is for her treatment - ie she does not have to come into a mental health hospital.

If they deem that she has capacity, then she can make her own decisions - including bad decisions, such as drinking alcohol, not looking after herself etc etc

There is a poster on AMA who is a mental health nurse - maybe you can message her directly.

Hope it does work out though for you both

It is pretty hard. But maybe in this situation as she is in sheltered accommodation and there’s a warden there it may be escalated. But alcoholism is more a rehab/ detox issue isn’t it? They can’t treat that in a psych ward alongside other patients can they? Although I know they are linked. It sounds like she would need pretty intensive treatment for that first.

It took 6 years to section my brother and he saw various people and the family begged for help. He had a serious MH issue.

Obviously I don’t know the back story here but for you to go NC and if she has a very very long history of this , then make sure they know over there so it doesn’t end up on your doorstep again if she loses her flat.

It’s incredibly hard but sounds like you have done the right thing.

Whether she has capacity is debatable as she does have an LD. Unfortunately I don't have POA or any access to her medical records but there must be a record of it on the system, if that changes anything?

I'm helpless as to what I can actually do about it myself as she cut me off as much as I cut her off, I tried for 5 years to get her to engage with help but she just wouldn't.

I knew it would come to this so I've been preparing myself for 'the call' for months. If she can't be sectioned it's only a matter of time before she's found dead in her flat I just know it.

I don't think alcoholism alone, and the associated behaviour, is something someone would typically be sectioned for. There would have to be evidence that she is dangerous to others, suicidal, delusional or something like that.

HCP with experience OP - it's hard to give specific advice without knowing full details but from the sound of it I'm not sure a mental health admission as opposed to her needs being unmet which is a social care issue. I would definitely suggest urgent referral to adult social care for self-neglect and a GP visit. ASC have legal duty under the Care Act 2014 to assess and GP holds responsibility for health. They may not want to admit her anywhere unless she is a danger to herself or others and her needs cannot be met by implementing additional support in the place she is now. From there they will also need to do falls referrals, alcohol service involvement and put in a team around the person. It's long, heavy lifting and I wish you all the luck in the world, don't be afraid to say no if this tries to be dumped at your door!

It's incredibly difficult to get someone sectioned and the details you provided in your post sound like they will use the fact she doesn't seem to be a danger to others as a reason to make it even harder

Alcohol dependence is an exclusion in the mental health act- you cannot legally section someone for it.
There would have to be suspicion of a co-morbid mental health disorder.

It's really hard. I had neighbours with an alcoholic (grown up) daughter who was a total nightmare. She nearly burned the house down while drunk. They couldn't get her sectioned for love nor money and ended up spending their savings sending her from rehab to rehab only for her to come back home and start drinking again.

One thing they did which was helpful - they went to every local shop and pub and made sure she was banned from buying alcohol. It did go some way to reducing her access to it.

It's really difficult. My DM is an alcoholic (recovering now), has bi polar and a whole load of other issues. When she was at her lowest even she wanted herself sectioned, she'd tried to commit suicide multiple times and was a danger to herself and I still believe others but she wasn't considered serious enough to be sectioned.

She could definitely be referred to SS/CMHT however depends on her capacity and what she wants- she could at least be assessed

It’s extremely difficult to get someone sectioned.
i have a sibling with severe mental health issues and we have begged and pleaded for help from the community psychiatric team, their social worker and doctor to no avail. This person has tried to kill themselves and ended up at the bottom of a gorge, and survived , to be in an induced coma for 3 weeks and then got signed off from hospital psychiatric team 2 days after they came out their coma. It’s unbelievably hard with very little support.

this person has been arrested on numerous occasion for their behaviour and still no support .

Ah I gathered it would be unlikely.

We've been down the GP route endless times, substance misuse services, counselling. I've made numerous calls to social services which didn't go anywhere and I was never given any information back from then as I have no legal right to the information.

She has been to A&E god knows how many times and sent away with a leaflet with numbers to call for help with the drinking but of course she never does.

She's a lost cause unfortunately. I say that with a heavy heart.

is it a council establishment or private? Sometimes the council ones can find getting action easier because they can access council services as an employee and not as an "outsider" Having said that however, I don't think what you have described is sectionable. It sounds to me more like she may be judged as temporarily lacking in capacity and possibly admitted to hospital without her consent which is not the same as being sectioned...alternatively of course it may be accepted that treating her physical issues won't change the longer term outcome..... If the establishment is a council one, then it may be decided that its no longer appropriate for her and she needs to move to a more supported place. If the residence is private then that would take longer of course and would be eviction.

It's council accommodation she's in.

The warden said herself that she doesn't think it's the right place for her anymore as she needs more supervision than can be offered to her.

Nothing you've said suggests she's sectionable currently. However if the council want her out and have a 'friendly' AMHP as well as SW available then it might change the likelihood.
General rule of thumb IME: it's harder to get police in particular to use their powers in the persons home, than outside it. (not blaming them)
I'm sorry you're going through this.

Are you in England OP? I don’t know about English legislation but it sounds as if she needs her capacity assessed around her understanding of the risk she is putting herself at if there is a question mark over it. This is easier said than done where alcohol is concerned admittedly. I would be wanting some sort of co-ordinated multi agency meeting under safeguarding procedures to discuss options in any case

We are in England yes.

I agree she definitely needs her capacity assessed. No idea how to access that though. I'm hoping the warden 'Sue' knows what strings to pull as she'll have council connections.

I don't hold out much hope for adult social services though. The last time I called them I got a very disinterested person on the other end of the line who pretty much asked me what I expected them to do about any of it.

I used to be a mental health nurse ,she can't be sectioned for being an alcoholic as its a choice to drink alcohol ,she can only be sectioned if its affecting l her mental health to the point that's she's putting herself or others at immediate risk ,to be sectioned under the the mental health act usually you would need two Dr's medical recommendations ( can be one in an emergency ) and an Amph ( approved mental health practitioner) to make an application for sectionining ,the police can also take someone to be assessed using section 136 of the mental health act if they suspect someone is having a mental health crisis in a public place

It's very hard.

I have a relative who is way past batshit crazy and the only time they get sectioned is if they are a danger to themselves and other people. Then it's mainly to enforce medication and they will only keep them in secure accommodation for the minimum time possible, as it's so scarce.

It might also be many miles away. So a more local/longterm solution is preferable but what that is, I don't know, as my relative is not an alcoholic.

My mother was sectioned. She was in a MH unit and on a visit home, refused to go back. We eventually got her back and it was the head doctor who initiated the section as my mother had shown she couldn't make decisions to keep herself safe. The section was in place for a few more months while in hospital then she was on a Deprivation of Liberty Order at the care home she moved to.

It happened pretty quickly due to the lead psychiatrist recommending it- if she is referred by a professional it might help. They did everything and my family supported it so there was little difficultly. The thing with sections is that they are constantly reviewed because ideally they aren't long term. But it could get her into a mental health facility at least temporarily.