Can I get an appointment with my DM's GP about her mental health without her knowledge?

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My family and I are really worried about her. She is severely paranoid which is having a huge impact on her and my Dad's quality of live.

She is extremely suspicious of people in authority and in the medical profession so would never contemplate getting help. She believes people are tapping her phones, surveilling her constantly and breaking in to her house to steal documents and the whole town is conspiring against her. We are sure this is not reality.

Ironically however, she knows this would be perceived as 'crazy' and is extremely intelligent so would not mention this to anyone but her closest family.

My Dad takes the brunt of her anger, fear and anxiety about this, and it has become pretty bad in last year. Not sure how we can help her but she is in a complete state and Dad has had about as much as he can take. She won't go out now and will only take about her fears in the house through codes and notes.

Any experience of this or advice about how we can help her if she doesn't believe there is a problem would be very much appreciated.

When my mother was getting ill, I phoned her GP and talked to him about my concerns. He pointed out that he couldn't discuss anything with me, patient confidentiality - but he did listen, and I know from something Mum said after an appointment, that he did bring it up with her. And he also knew my mother well enough to ask whether I wanted her to know I had called him, and was fully understanding when I said no, because she'd probably hit the roof if she thought we were interfering, however good our motives.

So - do see if you can get an appointment (or at least a phone appointment), so you can discuss your concerns. But be aware that while you may be listened to, you may not be told about what action (if any) will be taken, or anything else - unless you can get power of attorney (which I think has changed its name.)

Thank you Ebear. I will try. I wish she would go to her GP but I can't see it happening on her own accord. Despite some ongoing physical health problems she hasn't been for years (possibly even a decade) as she believes they are all incompetent.

i don't think we would ever get right of attorney or similar as she knows how she needs to appear to the outside world if she needs to - it's quite bizarre. She is actually a very intelligent person.
I want her to get better so much and just wonder just whether a course of counselling or meds could work wonders... I can't see how she would ever be persuaded though!

You can definitely speak to the gp about somebody else to raise your concerns, you should do that.

My friends DM had paranoid schizophrenia (which this sounds like), but also was very good at putting on a front when necessary, managed to fool a lot of medical professionals.

In the end, they installed secret hidden cameras in the house to show the professionals what was really going on. You can get small cameras quite easily and cheaply these days. I gather the fall-out when the DM found out her family really were spying on her was not pretty, but they felt like overall they had to do in order to get her help.

That's interesting, thanks...I will read up on paranoid schizophrenia. It sounds so serious but I suppose we need to face up to the fact it is.

I am torn as I don't want to 'betray' her... She already feels most of the world is against her but I suppose by not tackling it we are in fact 'enabling' the problem. It's tricky as I am concious I don't want alienate her as at least she still confides in me.

I don't know how my Dad copes. I am mentally exhausted just spending a weekend with her.

It's a very difficult disease to deal with, but you're right that by allowing her to continue this way you're enabling it.

One way to look at it is that by keeping her secrets you're not really helping your mum - you're helping her illness keep its grip on her. By getting treatment for her you're giving her a chance to get better.

You can get a lot of support and help through the mind charity www.mind.org.uk/information-support/types-of-mental-health-problems/schizophrenia/#.UpvGDGtYCK0

I hope things get better for you all.

Thanks - that resonates! Going to sleep on it now. It's the first time any of us have asked for help or advice as we're a bit of a 'stiff upper lip' type family but something has to be done. Any other people with similar experiences, I'd love to hear...especially if you we're able to persuade a family member to get help.

How old is she? Could it be dementia? My mum was paranoid at the beginning after a series of small strokes. Hers centered around my dad - she was convinced he was having an affair with the man across the road.

Your father is her next of kin so he could speak to the gp but prob wouldn't have a chance from what you have said.

They definitely need help. I would call her gp first and see what they say.

I can take a fair amount of skill to know how to break into somebodies delusional framework so it may be beyond a GP in the time frame they have. I certainly agree that a mini mental state needs to be done but certainly if your Mother has paranoid ideation, she will be truly on her guard at GP questioning and this will actually feed into her beliefs in the short term. This does need investigating if it is affecting her life and family functioning. Your Father has a right to ask her to seek help too. It may be necessary to refer to the over 64 yr services (EMI) for a more specialised and skilled assessment. You need to be able to 'trigger' the paranoid ideation in a controlled and skilled manner so as to garner information and assess its severity. This may not be achievable by a GP.

Yes. I used to be a GP's receptionist (a nice one). You can definitely make an appt to discuss your concerns.

Thank you all. She is late 60's. I agree that a GP would definitely not be able to break through on a first visit however skilled they are; she is so expert at maintaining a state of normality where necessary. I will however try and get an appointment about her from hopefully a nice receptionist like zombie to see if/how she may be referred. I will look into EMI too as I have not heard of this.

I don't think schizophrenia is very likely, as she has enough insight to realise her thoughts would appear illogical to others and AFAIK this would not be considered psychosis?

It may be severe anxiety or one of the paranoid personality disorders.

Good luck with the GP.

Hi Mignonette or anyone else that knows... What does EMI stand for and how can I access it? I keep getting the record label when I google it. Thanks

EMI means elderly mental ill, I think.

Sorry, yes Ebear is right. Apologies for not writing it in full. It's just the abbreviation for the whole service of elderly mental health.

Probably better looking for 'older adults' services as many services don't use the term EMI now. Try googling the mental health trust for your area to see what they offer.

I would reiterate the advice to speak to your mother's GP - you could either make an appointment or write a letter listing your concerns (that can be very helpful as there is then a detailed record in her GP notes of 3rd party concerns).

Older Adult Mental Health Services are different in each area and are usually accessed by a referral from the GP, rather than self referral. They are skilled in trying to engage with people who may not want to see them. A good GP will also try to find a way to see your mother and make a preliminary assessment and management plan.

We shouldn't be trying to make a diagnosis over the internet - I work in this area and it's sometimes difficult enough making a diagnosis face to face!

Hope you manage to get some help, it sounds like a really difficult situation for you and your family.