Getting really worried about my neighbour...

[penguin11]

Hi,
I'm new to posting (so sorry if I get this wrong!), I need some advice, as I'm not sure what to do next. I live in a semi-detached house with thin walls with the neighbours. They are a lovely, but a very private elderly couple, but the lady has becoming increasingly more and more depressed....for the last 2 years she's probably left the house about once every couple of months (max) and in the last few months I can hear her raving at her husband through the wall....

I have spoken to her husband who can't seem to get her to their GP and thinks he can keep things going himself. He himself is now very fragile and weepy, as no one can live like that without getting depressed themselves.

I asked my GP if she could help as I was so worried that she's not getting any help, but it came to nothing (think they are prevented by confidentiality stuff and the neighbour simply wont go to the GP)...

I have called one of their cousins who said that the couple have stepped away from the family, so they can't do much...

So what shall I do? I am so worried that it will end very badly.
What would you?

Ring you local authority safeguarding team and they will talk it through with you and take appropriate action if required. The call will be logged so they will be 'in the system' so if things get worse they will have evidence it has been a long term issue.

Oh dear. You sound lovely, but i'm not sure what more you can do.

Continue to support the husband as much as possible, even if its just a smile or a nod.

Encourage HIM to visit his GP and tell them about his wife, be completely honest with the Dr, more may be able to come of it that way?

I have tried so hard to encourage him to go to the GP, but he doesn't seem to be able to get her to go, and he's not assertive enough to get them to visit.

I don't want to upset the husband, wont the safeguarding team make it obvious it was me who called?

You can request they are not told, it sounds like there are mental capacity issues. If the wife has dementia / mh issues and he is not getting appropriate treatment for her it most certainly could be a safeguarding issue. It could be the push he needs to realise this is not going to get any better without professional medical help.

Oh and the GP / medical services should be very responsive if safeguarding is an issue.

Have a chat with the safeguarding team they will deal with it if needed.

Thank you so much for your advice, I will contact them

They will not rush into a full on investigation as if it can be dealt with informally that is the preference ( much less paperwork) unless someone is in imminent danger.

You are doing the right thing as they clearly need help and are not able to access it for whatever reason.

And please let me know what happens as I am Worreid about them too now !

Hi thanks for your posts notjenkins.
I called the safeguarding team, who 'logged the call' and they were very helpful, but said it was a 'health' issue mainly so I need to try and call their GP....not that they've ever responded before!
They also can't do much as I'm not a family member, which I can understand.

...worried that my call and attempts to get help for them will be a great paper trail of warning signs to look back on when it all goes horribly wrong...

I don't know which "safeguarding" team you called? Was that Social Services? The problem is all services are "guarding" their boundaries because they are so stretched.

You seem to be the only person concerned about this couple. I think you need to "take the bull by the horns" and be a bit assertive and go around there and ask the man if you can go in to have a chat with them. You will then have more idea of what is going on. I imagine they could be living in some kind of squalor. I think you need to tell them that you are so worried you are going to try to get them some help, which is so much better than trying to be anonymous. The family obviously don't want to know - how heartless.

I think you can then call the Community Mental Health Team (CMHT) which is made up of social workers for mental health, community psychiatric nurses. I think I'm right in saying anyone can make a referral and request help. They should then go out and assess the situation.

You could try phoning MIND or RE-THINK (google for numbers) and get advice from them as the best way forward.

Here only gp's can refer to the CMHT so it may vary from area to area. There are usually assessment groups before people reach CMHT level here too so it might be worth contacting your gp for advice as they will know the procedure in each area. If adult social care, gp and any other service not any use then sadly I cannot think of other avenues.

If you think the person needs to be assessed under the mental health act then it is the case of finding out who to do it. Think that is why the police so often get involved as services pass from one group to another .

Yes here cmht is not a self referral either as you need to have a diagnosis first.
Did you tell the safeguarding team that her husband is withholding medical treatment by not taking her to the doctor ?
Is it an elderly person with dementia or another condition ?

Apologies just read the op properly.

If the couple both have mental capacity to decide about their medical treatment and are refusing help there is nothing that can be done.
If you suspect that one or either have lost capacity and need help it is a different kettle of fish.

If the wife has lost capacity and the husband is making unwise decisions on her behalf it is a safeguarding issue.

Thanks for your posts, they have been really helpful.

I'm taking every opportunity to try and encourage the husband to get help. I think it looks like I will just carry on waiting and keeping an eye out, and using many many excuses to pop round and see if they are ok. I work from home, so if there is a sudden change I...well I guess it's just the police that's left to call for help!

The husband isn't so much making unwise decisions, more he can't get her to the GP (she's very resistant and agressive) and that he seems quite afraid of getting help and of the consequences - he's a different generation and probably still remembers the old asylums. He is also getting very down (as anyone would living in such circumstance), so may have lost confidence.

Just from some of the symptoms I'm guessing she has very deep clinical depression, she has lost all perception of reality, doesn't leave the house, is very 'blank' and won't get up and dressed until late afternoon, and maybe the start of dementia? But that really is a best guess and probably wrong.

I did try the CMHT - their 'crisis helpline' was brilliantly an answer machine (what's that about?!) and when I finally spoke to someone, they said they need a referral from the GP or at minimum a family member to be calling. But they really only have crisis services for known patients....can see why A&E and the police are always locally talking about the impact of mental health on their services.

Thanks again, it's been really good to get advice and not feel so alone with my worry!

How awful (but not surprising) that this elderly couple are "falling through the net" as it were. I think you are right in thinking the lady has severe depression (as one who know the torment of this illness, it is almost always worse in the morning, and there is definitely a desire to stay under the duvet) so she is doing quite well to be up by mid afternoon. However more worryingly you say she is "out of touch with reality" and that is the major symptom of a psychotic illness. The trouble then is that people don't believe there is anything wrong with them, so resist getting medical help. I don't think you're wrong at all - in fact I reckon you are "on the money" with it, and yes the man may well be depressed himself.

It sounds life the man is actually afraid of his wife if she is very aggressive and people suffering from psychosis can be very scary. She has probably warned him that he must not get the GP involved. Can you possibly go in and talk to both of them about getting the GP involved as you are very concerned for them, and feel they need support. Can you be assertive if the lady is aggressive. Could you make it sound like it is your idea to get the GP in rather than the man's idea to sort of "save" him as it were.

If this doesn't work I suggest you write to their GP (if you know who it is) with a copy to the CMHT for older people. Services are usually separate for under 65s and over 65s. If you spell out the problem as you have on here, it may well trigger the GP to make a visit - let's hope so. It is a serious situation because psychotic patients sometimes have to be sectioned under the Mental Health Act for their own (and others) safety as they simply do NOT believe there is anything wrong - they think it's everyone else who is wrong. You could try contacting your local councillor (or send him/her copy of the letter)

People do have a right to manage their own lives, even when they are elderly but you are describing a potentially dangerous situation where the only person who knows what's going on is you.

The only other thing I can think of is Age Concern (think that's what they're called now) They aren't mental health oriented as you will know but must have come across similar situations in the past.

I'm SO glad you live next door as you seem to be the only person who is concerned for this couple, both of whom need help and support.

Just seen on the Mental Health thread entitled "How do I help my DH" and someone (last poster) nickname "Favourite things" has provided a very helpful link about contacting a GP about someone else.

It is great you are around to check on things and are bothered.

The problem with CMHT's is that they are very small teams serving large areas and if they were open to all people they could not serve their own patients. But a gp can refer a patient for assessment by a CMHT. Equally a gp can refer any patient to a crisis team, assessment under mental health act referral etc. I guess we need to remember that all hospital consultant teams need gp referral and mental health are the same. If anyone could contact dermatology every time they were concerned about their skin, or ENT if had a sore ear etc they would not be able to do their jobs. Whereas there are some very sensible people who would use open access sensibly sadly not everyone would. Yes there is different provision for over 65's in mental health which could be helpful but not if they do not want it.

But it is a shame the husband will not go to the gp themselves.

Is there a family member that visits you could raise concerns with? They may have more chance of getting a gp to listen or them to go to one?