Is it a mental health crisis

[Mentallydeasss8]

If someone has mutiple visits to a&e due to attempts on their life in just one week.

Not according to my local MH team. I’ve been discharged with no follow up!

I would hope that someone would be admitted to a mental health unit in those circumstances.

You would certainly think and hope it would be viewed as such. Sadly that doesn't necessarily equate with reality.

Are you ok, OP? Is this you or someone that you care about?

It should be but no.

You can call 111 for help, OP.

Or Samaritans number is 116 123.

You can text "Shout" to 85258 for text support.

And there are resources here: https://stayingsafe.net/about

Just to add,

Firstly I hope you are ok.

Secondly I think (wrongly) many MH professionals see multiple attempts on life as a cry for help and feel if they give attention to it, it feeds it.

Incredibly dangerous philosophy and I think in years to come we will see a huge spike in negligence claims for MH treatment.

Not according to mh professionals. But to anyone else with an ounce of common sense yes. This is exactly what happened with my bf before he ended his life on the 5th attempt just discharged him after every attempt.

What if there's no space? I have no idea how many there are?

I would’ve thought someone would be sectioned, placed on secure unit or even arrested to keep them safe as they are a danger to themself. I’ve heard of very paranoid people being sectioned, but that is less of a danger than being actively suicidal.

I would be pushing for help, the squeaky wheel gets oiled

Quite obviously

I hope they get help

What do you think they might need in the next few days for them to be closer to "ok"?

Purplelovecats, I actually think they don’t see it as a cry for help but as attention seeking. That’s the problem.

It’s not as easy as ‘they should be sectioned.’ There are strict criteria to it. It takes 2 doctors and an AMHP and if any of them disagree whether they meet the criteria, they’re not admitted. And if they’re not sectioned, forget about a bed. There aren’t even enough beds for those who are sectioned, let alone those who aren’t.

In some parts of the country there are crisis houses which are a step between wards and the community. They are very good, but they too have criteria and if you are a high risk to yourself, they can’t accept you.

There also intensive support teams which support people at home daily for a short period of time. They are full to bursting and what you will get is a short daily visit to assist your current level of risk.

please don’t knock individual mental health workers. We’re trying really hard in extremely difficult circumstances. It is extremely frustrating for us when we can’t provide a proper service, because the services just aren’t there. Mental health services are frequently overwhelmed and with minimal resources available. I’ve been working in the field since 1986 and apart from a short period in the 90s when the asylums closed and money was pumped into community services, it’s gone gradually downhill all the way and it doesn’t matter whose in government.

You'd hope it would be at least seen as a situation where a person needed a lot of support, and that support provided. I know in my area it would only be deemed a mental health crisis if the attempts on their life were deemed to be a result of mental illness, eg the person was behaving irrationally due to severe depression, PTSD, psychosis. If the person was deemed to be thinking rationally, and say was wanting to end their life because their circumstances were just really rubbish (eg poverty, isolation, poor relationships) it wouldn't be considered a MH crisis by MH staff. And whilst I can sort of understand that logic, in that MH staff are there to treat mental illness, it's awful that no one takes responsibility for the people in need who don't meet that very strict criteria.

I hope OP that if you or someone close to you is going through this that there is some support that is useful, it's a horrible and scary situation to go through.

The mental health view is:
People who seek help because they feel suicidal are not viewed as a risk because they sought help. This means they want to cumunicate they are distressed by using a poor method to do so, not that they actively want to die.

One of the things to think about is what an admission will achieve.

MH units don't offer daily therapy (often none at all), interventions or counselling.

This is very interesting. Would you say then, that a mental health team would, in the main, want to provide medication?

No MH teams want the GP to provide medication and for depressed people to be managed that way. MH teams are dealing with severe and enduring mental illness.

Which is such a dangerous view to have.

I agree.

edit, it’s also very worrying that someone who’s suicidal due to not coping with life’s circumstances isn’t even considered to need help from the mental health team.

Which enduring mental health conditions are considered?

The mental health team will direct those feeling this way to seek support from online resources and GP referred CBT . They are not therapeutic teams but there more to manage the risk of severely mentally ill people.

Not really as the people who tend to do this type of behaviour do it repeatedly regardless of whether there's an underlying mental illness. It's most common in personality disorders rather than mental illnesses like schizophrenia & bipolar.
If the person is seeking treatment from a&e for the self harm there's not much more that can be done. Be supportive but don't get over involved or they will suck you in to their behaviour.

I can't speak for all services but this certainly isn't the case in any of the NHS mh services I've worked in or been involved in.

Expressing suicidal ideation/attempting suicide is a risk factor for a future successful attempt.

However the role of a secondary care MH team/crisis team is to try and support the person to link up with the right treatment/support that's going to have a positive impact on their overall mood and wellbeing, with the idea that improving their mood will reduce suicidal ideation.

There aren't the resources to offer a bed in a ward to everyone that expresses suicidal ideation or attempts suicide, unfortunately. It's far more common than many people realise.

And the difficult truth is that even with the right support and treatment, there will always be people that end up taking their own lives. It has been the case throughout all of humankind. You can't lock someone in a padded room 24/7 forever, people have agency and rights to live their life and we rightly have a high bar for removing someone's liberty. You can't prevent it directly, what you can do is properly fund and staff services so that people with mental health difficulties get the right treatment at the right time. Suicidal ideation is often a symptom of a disorder/circumstances rather than the primary problem.

Secondary care crisis services aren't equipped to offer the actual treatment people need, other than arranging for medication. So they direct patients to the right place.

The person in your OP is clearly in crisis and I hope they get the right support.

Tbh I don't have enough up to date knowledge of what the MH teams do now, there are more qualified people on this thread to talk about that. But in my area I'm aware that there is a general view that the situation has to be 'caused' by mental illness, and for there to be a treatment pathway. That might mean medication, it might mean the crisis team. It used to be the reason that people with EUPD (which typically means a high level of self harm and attempts to end life) didn't get really get a service as it was deemed to be 'not a treatable mental illness ' though I've heard that's softened a bit in the last few years.
I know that when people are admitted to hospital it is usually with a medication focus, ie to stabilise on medication and then move them back into the community for any ongoing treatment. Given MH wards are by nature not good places to be (ie surrounded by other people who are mentally unwell and may be loud, unpredictable etc) I can understand why inpatient stays are usually short term, and for observation of reactions to meds.

Nb for context my experience of this was from working in hostels and supported accommodation, we often had to call emergency services for people who appeared suicidal and accompany them to be assessed if they wanted us to. Hence hearing 'it's not a mental health issue, it's behavioural' or 'it's not MH it's a natural reaction and they have capacity/the right to do what they're doing'.