Schizophrenia - questions about diagnosis and support

[SlipperyNipple]

I'm going to try and be brief because I have to take the kids out.

My brother has had mental health issues since he was about 17/18. At about 19 he had a psychotic episode and was sectioned and given a diagnosis of hash psychosis.

He has periods of depression and is almost silent, he has delusions (one that he is a god), he has some times had thoughts about hurting people. But most of the time this is low level and he does not accept he is ill. So will tell one doctor all about it....then get referred to a specialist and tell them there is nothing wrong and he just has a problem with our mother (his main carer).

Because he does not accept he has a problem a lot of the time it is almost impossible to get him help.

In the last 5 weeks he has gone into a psychotic episode. He is hearing voices and seeing spiders come out of the walls and telling my mother stuff that she can't bring herself to repeat to me. He was so scared the other night that he finally asked to go to the doctor.

They went to A&E and he talked to the doctor there. He told him everything. The doctor said that all he could do at that point is give him some sleeping pills.

The next day my mother phoned the GP and could only speak to a locum (sp?) who said they had to go through the proper procedure. Then there was the weekend. Now my mother is going back to the GP with my brother and hoping that he will tell the truth and ask for help.

I am convinced that my brother is schizophrenic - the specialist saw him and said oh hash psychosis and dismissed him after five minutes and said there was nothing wrong. I was under the impression the psychosis sits under the umbrella term schizophrenia and there is no clear distinctions between the different problems. So it doesn't make sense for the specialist to have dismissed him so quickly. I should say that my brother has not touched Cannabis for some years (if he does it certainly does bring on a psychotic episode).

I want to know what we can expect from the doctors, what should they offer and how quickly.

It's been so hard to get him help that I wonder if paying for a private consultation for a diagnosis might be worth it. But I couldn't afford the ongoing price of drugs. So can you take a private diagnosis to the NHS so that they will provide the other help. (Antipsychotics, CBT anything else).

Oh dear that is very long but we are very scared. My brother is 6,4 and very strong and he smashed up my mothers living room the other day. We desperately need help but are not getting any. I am scared that he might one day hurt my mother because he has such negative feelings about her.

I'm going out for a little while but will be back later. Any advice you have would be very gratefully received.

Hello first off can i say how great and how much help you Will be to your brother. Second let me tell you my diagnosis so you can see where i am coming from i have type 1 bipolar (episodes episodes episodes of mania and depression which with type 1 involve involve pychosis ) but the possibility of ofme being scizoaffective has been raised (which contains episodes of bipolar and schizophrenia but unlike schizophrenia it is episodal).

I suggest you look up your local crisis centre and take him there. If he needs immediate attention they will give it to him and if not the referral to a psychiatrist Will be quicker mine took 3months sadly it is a under funded area. Secondly when psychotic i am not normally a threat unless i perceive someone to to be a threat so dont argue with him. I often smash things but have not yet hurt anyone physically inferior to me as they are not a threat hth. Secondly when someone is psychotic it is important to understand that they need leeway and are going to behave a bit bad so pick your battles very carefully only intervene if the action may hurt someone. Don't lie to him and avoid eye contact as this is intimidating, always stay calm and in control and try to make sure you sit or lie at a level lower as again this is less frightening. Do not argue with him that hallucinations are not real instead say i know that you can see them but i can't. These are just a few points to help you help him while you are waiting for help. I hope they are useful and please try to remember while smashing furniture is scary he is not actually hurting anyone. Any further help or listening needed i am happy to help.

Rethink and Mind have helplines.

I think next of kin can request an assesment if they are concerned a relative may be a danger to themself of others. I don't know much about it but the helplines may be able to tell you about it, or maybe another poster will know. Sorry you are having so much trouble getting help.

If anyone is in immediate danger, call the police. They can section someone briefly.

So sorry to hear this. Ime it does sound like it could be schizophrenia but there are other options like bipolar or psychotic depression.

Is there a mh community team in your area you could contact. Or the GP - obviously you can't expect a GP to tell you anything but you can share your concerns! Police if he is going off as a last resort.

Hoping he can get the treatment he needs so badly xx

I only took drugs once it was also cannabis and I also had a bad psychotic episode needless to say I never took it again but I personally feel my pychosis is worse since taking it, but I don't know if that is possible.

Get the number for the local crisis team and give it to your mother.
Also it's worth her getting involved with local carer's organisations - they can be a huge support and can also advise about how to get the right services in place.
You could also suggest to your Mum that she contacts local social services to request a Carer's Assessment - she is entitled to one as a carer and that may provide a way in to accessing services for your brother.
Going back to the GP is a good plan, specially if he will agree for her to go in to the appointment with him. She should then ensure that the GP is referring to adult mental health services and that the referral clearly states suspected psychosis. He needs a thorough mental health assessment by adult mental health services. He may also need medication which again should be via adult mental health services, not just the GP.

This is really important -> she needs to keep herself safe. She needs to call the police ASAP if she feels that she is any danger whatsoever

How stressful and worrying for your Mother (and for you). I hope he gets the right treatment and services soon.

All good advice already given by others.
My few bits to chuck in
Psychosis can happen in many types of mental illness, not just schizophrenia, for example depression, bipolar, PTSD, postnatal depression etc., as well as drug induced.

Yes, you can pay for a private consultation but have the consultant psychiatrist direct your NHS GP to write out the prescription so you only pay on-going NHS prescription charges (or your brother does the NHS prepayment certificate which caps total annual costs at the one of fee (I think c£130) and all scripts are covered).

This is often the case with private insurance - they pay the private costs but the NHS picks up the tab for the prescription via your GP.

Yes, you can also ask your private psychiatrist to refer you back into the NHS system for things like CBT if you so wish.

Hope all goes well for you all.

Sorry, should have added that your brother will likely still need to be referred by his GP to a pschiatrist. Although some places do offer self referral (google private pschiatrist) it might be best to be referred.

Sorry I should have come back before and said thank you for all the input which is very helpful.

It seems that the doctor has referred my brother to the mental health team so we are waiting for them to get in touch. Considering he is in such a bad way at the moment I'm surprised that they are not being quicker.

It all comes down to if he will walk in and actually tell them what is going on. If things don't go well then I may consider a private doctor WithanAnotE - thank you for the information.

Anyway crossing my fingers.

Hi - agree with others, for acute episodes go to A+E and ask to talk to the on duty psychiatrist. But for long term diagnosis ask gp for immediate referral to adult mental health services and tell the gp you want a mental health assessment. He could have a CAF to see if he is a vulnerable adult, be assigned a Social Worker as well as support from the menta health services. Your Mother can request a Carer's Assessment. If you ask for all the correct assessments adn don't get them you may find that telling them he may be a risk to his own and others safety and that you are recording that you are telling that information and if they fail to act within an appropriate timescale and he then hurts someone, you will show your documentation to services and hold the person who has failed to provide assessemnt and support responsible. It is amazing how saying such things makes Gp's/other NHS workers realise they have safeguarding responsibilitis!!

Wishing you and your brother the very best x

He was taken to A&E and was in very bad shape. Doctor sent him away again with some sleeping pills.

Loads of people tell me of all the services that are available and what should be happening and seems to bare no resemblance to the service we are getting on the ground....which at the moment is absolutely nothing.

That's dreadful. Did he get a mental health assessment?