How to get somebody sectioned?

[Freshstarts24]

I don’t want to give too much identifying details but would really appreciate some advice. Adult dd, quite serious undiagnosed mh issues, not had any professional support since discharging as a teen. Now quite heavily reliant on drugs which are causing physical health problems and exasperating mh issues.
Outpatient support at this point is not going to help, she needs to be admitted somewhere but I have no idea how to access this? Where do I start? I know the drugs muddy the waters so I don’t even know what type of support to look at but the root cause is obviously mh.

Sorry but this is nonsense.

Spot-on advice.

Sorry to be blunt, but if this is true, I don’t think she’ll survive this year.
She is severely depressed, often manic, and has openly said she will kill herself.
I physically can not get her to an appointment. I couldn’t even get her to go to school so I’ve got no hope now.
I think she just wants somebody to ‘fix’ her and it’s so frustrating, because obviously she needs to help herself.

OP, I’ve not read updates but is there any way you could get a personal loan to afford private rehab for her? She sounds like my sister who was crying out for help - which is positive, as treatment will be much more effective then - but the only way it would work is if you dropped her in a car and admitted her somewhere. There was no way she would keep to appointments, and therapists would not help until she tackled her drinking and drug use.

Luckily in my sister’s case she had private health insurance which paid for it. It’s been transformative- she dried out, then was able to engage with therapy for her MH and change her life.

I’m sorry if it’s irresponsible to suggest getting in debt, I just empathise with how you describe her. If not private I don’t know about similar residential facilities that are state funded, presume PP’s mentioned charities to advise on this.
The fact she has the self awareness to admit she needs help is such a good sign so really thinking of you during this worst patch when you are finding that help (and ridiculous it’s so hard) x

I believe it would cost thousands and thousands. I can’t afford that sort of debt. I’m already in debt which eats away at my finances. It’s just not possible unfortunately.

Yes I think it is around 20k for the Priory month stay. 😞

I can confirm that @Bandolina ’s advice is 100% accurate.

When you say she’s ’severely depressed, often manic’…. Severe depression as a diagnosis would refer to a prolonged period of extremely low mood, self-neglect, usually psycho-motor retardation etc…. The key being that it’s prolonged (rather than periodic / changeable / sporadic / reactive to scenarios
‘Manic’ - actual mania (as in part of a bipolar affective disorder) lasts again for usually at least 7 days, and usually involves a combo of euphoria, pressure of speech, inflated self esteem, sometimes psychosis….

Often lay-people refer to ‘severely depressed, often manic’ but mean ‘extreme changes of mood’ (emotional instability, or EUPD / borderline PD)…. These conditions aren’t severe depression or mania, they can’t be treated effectively with meds (they require a lot of personal effort and patient commitment to a specialist psychological therapy called DBT)….. no amount of short-term admittance to an acute mental health ward will help with anything around EUPD-type presentations I’m afraid.

Even most of those who actually do fit the criteria of severe depression with mania (ie bipolar disorder) and are psychotic and in need of an emergency admission to stabilise their meds usually can be treated effectively in their own home under the CRHTT and don’t receive a bed.

I believe it’s very difficult for someone to be sectioned.

A relative of mine was sectioned many years ago. There had been a few police reports about their behaviour and the final straw was when they locked themselves indoors for weeks and I believe a neighbour called the police. The police ended up breaking the door through. A PP mentioned that the MH wards are not like the films. I can 100% agree with this, it was stressful for my relative. They couldn’t rest with the noise (there was a patient that screamed a lot, we heard them when visiting) and was harder for them to accept that they needed to be in there.

What an awful situation for you to be in x

Is she a danger to herself or others as in suicidal etc?

This has been our experience, a horrible catch-22.

This.

From experience with DB it's incredibly difficult to get any support when drugs are involved. He's turned up at A&E multiple times begging to be sectioned, suicidal and beside himself, only to be sent home after a few hours. We've always found the MH teams say it's an addiction team problem, and the addiction team say it's a MH team problem. There's no support and accessing in-patient treatment is nigh-on impossible. We end up paying for a private treatment centre for DB between me and my parents. It broke us but he's been sober and well since thank god

Especially if she is having thoughts of suicide, she needs to be assessed.
Sorry you're going through this OP.

Tbh I don’t know what I think she has. She’s been depressed for at least 5 years, was diagnosed with it as a teen and was on meds for a while. She’s always been adamant she has bpd (borderline personality) but I’ve never really agreed but I’m no expert.
She has more recently had what I would call manic episodes, massive highs and making really big and bizzare decisions, talking fast and just seeming generally all over the place but these could be related to drug use as they weren't always present.

She wants someone to fix her
You want someone to fix her
Reality is that no-one can or will do it for her with no engagement on her part.
I am sorry. It is painful and difficult and worrying but there are no white knights or magic wands in the end you have to take some agency in your own recovery if you are ever going to get anywhere

Google who provides your local drug and alcohol services. They are all self referral. There will be a number to call and you have to start there. The NHS does offer inpatient detox but only to people with the most severe problems who also demonstrate that they have motivation to change and make the most of the opportunity by engaging with community services.

This.

Wanting to be sectioned is a contradiction in terms. If someone wants to be sectioned, they won't be.

If she's under MH services, you could contact them with your concerns....either speak to her worker directly or to the Duty Worker. Otherwise, in a crisis you can attend psychiatric liaison at A&E or your local trusts crisis line.

Wrt the drugs, as pp have said it muddies the water somewhat as its hard to assess what's mental health related and what's drug related. Routine mental health services will likely ask her to address her drug issue first. However in a crisis situation eg serious self harm, suicide attempt etc, the crisis itself needs to be dealt with first before looking at the reasons behind it.

Good luck.....mental health services are seriously underfunded so you'll need it xxx

You can usually request a Mental Health Act assessment via your local crisis team or Out of Hours duty team (social services)

That's what I helped my friend's wife do when her DH had a massive MH crisis. A psych nurse and GP rocked up at his house and, on the basis of his behaviour, issued a Section 136 that gives the power to detain.

He really unwell though, you didn't need to be an MH professional to realise that he needed treatment within about 2 minutes of talking to him.

Section 136 are issued by police, and in a public place.

Section 136?

The second you/she say that she thinks she has any type of personality disorder and that she wants to be admitted, is when you lose all chance of being admitted. Her behaviour is far too risky, they will say that admission will increase the likelihood of her harming herself.

She needs to focus on a drugs service before she looks at anything else.

Watch Gabor Mates Documentary 'The Wisdom of Trauma'. He talks about the current medicalisation of mental health and offers up an alternative view.

Gabor Mate would ask 'what happened to her?'

The other thing I would also explore is diet. A magnesium and vitamin b supplement would be really beneficial.

When people are running on adrenalin, the magnesium levels burn up quickly. This can heighten agitation and reactivity

Also, how is she sleeping?: is she very sleepy deprived and without routine? So many apparently benign factors can exacerbate mental health issues quite seriously.

It sounds like she may have untreated Complex Post Traumatic Stress Disorder and is self medicating with drugs.

Gabor Mate is brilliant, compassionate and optimistic about the potential for healing trauma and addiction. While you are in the process of seeking support, I would urge you to read some things that can give you hope. And magnesium, hydration, sleep , and love 💞

Lakielady you are definitely mistaken on the detail

In order to be detained under MHA you require
2 Drs at least one of whom is qualified under S12 MHA therefore usually a psychiatrist (could possibly be a GP) and an AMHP who is usually a social worker (could possibly be a psych nurse)

You therefore need a minimum of 3 professionals to detain someone. This would be for S2 or S3.

S136 is a police power which can only be deployed by a police officer in a place to which the public have access ie not in someone's own home. This is the power to remove a person to a place of safety for an MHA assessment to take place.

Personally I'd stay the hell away from NHS mental health services....they've certainly hurt me more than they've helped and I know of many others for whom that is true.

I also take issue with the 'people need to take responsibility for their own recovery'...yeah this is a lovely little phrase that absolves society from any sort of care and the obsession with targets and the off-loading those who don't fit into a neat little financial graph. The tories love this kind of thinking.

Many people do and have taken responsibility for their own recovery (I'm talking from mental health problems) as it has been clear that no other fucker could care less. But guess what? After decades of engaging willingly, throwing myself into everything offered, I am worse than ever. And I can see a point where I simply won't be able to engage any more, partly through physical and mental exhaustion and partly as the NHS has destroyed any goodwill and trust I might have had in them due to their repeated abuses of power, lies and the general dystopian hell that are mental health services.

Good luck OP. My main advice would be 'temper you expectations....drastically.'

I don't have anything to add that hasn't been said, just wanted to offer a hand hold. My best friend has been in and out of hospital since we were teenagers- half her life now. It is hard enough seeing her suffer like that and being unable to "fix" things, I can't imagine how awful it must be when it is your child.

@LakieLady I think you've given really good advice. Agency yes and no one is coming to fix things. It's really tough but it's the unfortunate reality. I hope she finds the right people to walk alongside as she recovers.

I get the sense that school was really awful for her. I wonder if she's ever really talked about it and had 100 percent empathy and validation? Schools can be horrific.