How do i go about getting a menal health asessment for dss today without getting him sectioned?

[Marne]

Dss (19) is having some kind of breakdown, he wont talk and has shut down, i have no idea how he's feeling or if he wants to harm himself, Dh has just taken him to gp and they have referred him but will take few days to hear back, the gp could not do anything else as dss refussed to speak, where do we go from here? can we get him assesed by mental health team today?

Firstly it is not easy to be sectioned, I know many people who attend a bipolar support group but when ill actually find they are not often sectioned some who are severly depressed find it hard to be admitted even though they want to be and are a danger to themselves they usually only section in my group if the person is manic and a danger to others and themselves. But if he is then it really is better for him, he will get help quicker rather than 3 months between pychiatric appointments (average time here between pychiatrist appointments) pychologist appointments are often weekly but they cant diagnose or give medication. So getting sectioned is a quicker way to treatment so really dont be to worried about that I know its easy for me to say . You can get him assesed by crisis which would probably be quicker.

How do i get him assesed by crisis?

I am trying to talk to him to try and decide if he is a risk to himself but he just looks at me and says nothing .

The only way you can get him seen today is by taking him to A&E, however if he won't talk to them either it will be very hard ot assess him and they may send you home again.

If he is found to be a real risk to himself sectioning may be needed, so don't go in with the idea that you don't want that to happen, but chances are that he can be supported at home (knowing your backstory that would have to be your home rather than the other one....)

This is one for coventry and warwickshire but if you phoned one they might be able to direct you to your local one. Alternatively type your area and mental health crisis in the search engine, or you can try A and E as Madmouse suggested.

The GP can request for him to be seen immediately. GP's often have very limited understanding of mental health and often miss key warning signs. I would hassle the GP again, ask for an urgent referral and the mental health team are obliged to assess him within 24 hours - usually by two specialist mental health nurses first and if they feel that he needs extra support, a psychiatrist. This does not mean sectioning, but if they feel as madmouse has said, that he is at severe risk to himself, then he may have to be, unless you feel that you can cope with managing the crisis at home.

Alternatively, as mentioned above, take him to A&E and point out that the fact that he is not talking is a sign of just how unwell he is.

One other route you could try is your local Community Mental Health Team - phone them, tell them how unwell he is and say that the GP has referred but as a non-urgent but that you are seriously worried about him and feel that he needs a much quicker assessment. Lay it on thick and they might increase the urgency of the referral.

Apologies for the essay! I work in mental health and know how difficult these things are, especially when you don't really know who you should be contacting! I hope you manage to get some help and support soon.

quickest route is a &E and wait (so is not that quick) for on call psych - prob a trained psych nurse who will run thru some questions - if they happy and you happy to take him home and manage him there maybe [pending urgent psych referral) (who else is at home? will he be on his own? has he had episodes before? has he self harmed before? etcetcetc ) you should be given crisis team number to call.

but - he is 19 so an adult so he has to be the one seeking help; if he wont then ultimately if he poses serious risk to himself or others then sectioning would be only way. tho if they happen to have a free bed and you refuse to house him (does he have elsewhere to go?) he could maybe be admitted voluntarily.

Thank you for your great advice, he is still here with us, we have been trying to get him to talk all day, he's now saying a couple words (mainly yes and no) but is still not very responsive, when dh and i walk out of the room he follows us so he obviously wants to communicate with us but just can't. I managed to get him to fill in a mental heath depression form so we could see how he is feeling, he scored 3 for most of the questions and scored 2 for the question about suicidal thoughts. I'm still very worried but i think we will be able to look after him until the referral comes in a few days.

I work in a mental health access and assessment team and we take walk in referrals from individuals off the street, GP referrals and referrals by family members. We do see people that same day but are only 9-5. Your GP would know if your area has a similar team? We always screen referrals so we can action urgent cases. If you feel the GP may not have made the referral seem urgent, you should call the team to whom the referral was made and express the concerns you have for your son. As other posters have already suggested, a trip to A&E is an alternative - we have a psychiatric liason team who see clients who present at our A&E with mental health problems. The fact that your son has let you see his depression screening form indicates to me that he wants your support. I'm not sure which depression form you used and how the ratings work ie what a 2 or 3 score mean but if he is having suicidal thoughts AND plans, then you need to get him support asap. By the fact that he is following you indicates that he doesn't feel safe to be alone, I would stay with him (even through the night) just to be on the safe side. Best of luck.

summer, a '2' means that he has thought about suicide for half of the past 2 weeks, a '3' is all the time.

Dh has just spoken to dss's mum and she wants me to call in social services to get him acessed. I dont know what to do, how do i find the phone number? will anyone be able to help now (as its gone 5pm).

Marne, I think the best thing to do today would be to take him to A&E.

Your poor DSS, hope he gets the helps he needs ASAP.

Dh is taking him home, his mum is going to watch him tonight and i will try and get his asessed tomorrow by crisis team. Dh wont take him to A&E as he doesn't think they will be able to do anything other than section him, i think we have left it too late today to get hold of anyone so will do it first thing in the morning. Feel so sorry for him and feel we have let him down, he looks at me with tears in his eyes, its so painful to see him like this .

I dont think they will just section him at a and e. He only needs sectioning if he refuses to go to hospital or refuses treatment,the best thing is the out of hrs gp id say then they may get the crisis team to assess him (24HRS) sectioning is a last resort.
I dont think you have let hi down you sound lovely hes lucky to have you all.
Let us know how he does if you can.

His mum said that he hadn't slept all night last night (just stayed awake but zoned out), is this normal for depression?

To me he looks like he has had a shock, maybe witnessed something, he's acting like someone would with post traumatic stress by just blocking everything out and beeing scared to close his eyes.

Depression does cause sleep disturbance yes.Is there any history of this or is there a chance hes had something happen,when did it all begin?

Does he or might he do drugs?Could be a drug induced psychosis.

DD is going to use my laptop now but ill pop back on later. Didnt want you to think id gone.

Like ledk I'm a bit concerned that there are drugs involved judging by the last post you wrote.

The gp asked him if he had taken or been taken any drugs and he did not reply (but then again he didn't reply when i asked him if he wants something to eat), i don't think he has taken anything but can't be sure, he's been with us all day and there has been no change/come down in his behaviour.

He is generaly a unhappy person, he was a unhappy child, what ever we tried to do to make him happy was never good enough (and we tried so many things), he's never been a good talker and has shut down once before but not for this long (only for a few hours and he was only 10 years old at the time), he's very sensitive, has never been in any trouble but has been a witness to a fight (a year or so ago) and refussed to go to court. He's always been extra sensitive and has self harmed as a child, his mum took him to be asessed for ADHD when he was 12 but he refussed to go to the follow up appointments so never got diagnossed.

Theres a huge family history of depression and ASD/AS, dh's mum took her life when dh was 11, dh and his sister have both suffered with depression (which is understandable), there are several family members with ASD tendancies and both our dd's on the spectrum.

The past few weeks we have been trying to help him look for a job and claim JSA, it has been hard to motivate him and he has refussed to phone up for job interviews as he is nervous about talking on the phone, maybe we have put to much presure on him and have expected too much from him? Dh started to get fed up with the fact he was showing no intersest in finding a job. Last week dh found him a job, someone was willing to train him up to work in a new shop that will be opening in a few months, dh phoned dss and he seemed positive and then the next day he is hardly talking and said 'he's not ready to work' and then the following day he's not talking at all to anyone.

We are angry with his mother as he has been like this for days and she hasn't phoned to tell us and hasn't got him any help. Dh told her on the phone that he was bringing dss home and she said 'i might no be here as i need to go and practice darts with xxxxx', i meen WTF is she playing at, her son is having a breakdown (i think) and she's off out with a friend, she expects me to phone social services and get him seen by mental health service for an asessment. She will go to work tomorrow as normall and doesn't seem to care what dss is going through.

you can call council switchboard for the out of hours social services number and speak to them - but as he with you and safe they unlikely to do anything overnight.
or they may advise you to take him to A&E.

given the hoistory tho your h needs to stop thinking of sectioning as a bad thing - it may be what he needs tho of course needs proper assessment first.
if sectioning wil get him help so be it. but really the threshold for sectining is high.... however like others said i would be cocnerned overnight tonight. can you lock the kitchen or drawers with knives etc ?

Have found a out of hours crisis service and dh is talking to them now.

They are going to try and push through the referral and get him seen by mental health team tomorrow.

Please be aware sectioning is not something that any mental health professional will consider unless it is absolutely necessary. If he is willing to get help then that won't even be considered. They will only section him if he was at risk to himself and/or others. It does sound like he has a lot of problems for which he needs help. The best thing is that you have taken action and help will be there for him to recover. I do appreciate how difficult this is but you are doing a great job.

Re work, I would suggest that leave this avenue aside for the moment and just have him focus on getting better. In the meantime, if dss is diagnosed with a mental health condition and is being treated for this, he can apply for Employment and Support Allowance. If he does apply, make sure he includes a letter from his GP/psychiatic team, to support his application.

Please let us know how things go for you all.

Crossed posts, that's great Marne.

re sectioning, to be detained under the mental health act takes a mental health practitioner trained in this area (called an AMHP) plus two psychiatirsts, one of whom has to be independent. To section someone actually takes time to organise - rest assured, you can't just turn up at A&E and be sectioned.

Thank you all so much, without your help i would not have had a clue what to do, dh is with him now being asessed by the mental health team at out gp surgery. The crisis team have been great and pushed for an asessment today so we didn't have to wait days. Will let you know how he gets on xxx