Overdose + hospital + police notified?

[Eleanor04]

Was in A & E very recently. Through the flimsy curtain, could hear a patient talking to a doctor about a paracetamol overdose after a row with her partner. She had young kids and was seeing a CPN regularly. Doc said that they'd have to alert the police and that the pysch team would be down. (At that point, she should have been taken into a side room, surely.) The woman seemed unhappy about having prolonged medical treatment which apparently was what was required. I left but, as I was doing so, could see a policeman escorting her through A & E to the exit. She was crying - saying that she'd had enough of 'services' etc.

I found this disturbing. I guess by this stage, she'd decided not to stay in hospital but couldn't someone other than a male police officer deal with this situation, at least to start with? I don't know where the pysch team were but what about a nurse, a midwife if available (if postnatal issues were behind her depression) - an on call MHN?

I wanted to rush up to her and tell her about MN, about local support but, very obviously, I couldn't.

Was the hospital correct in saying that in (adult) OD cases, the police must be called in?

The police wouldn't have been called about an overdose. There must have been more to it than that. They might have been called if there was a concern for the children, or if there had been DV, but not for an overdose alone.

I guess these issues were in the doc's mind but I distinctly heard him say that the hospital was legally obliged to call the police in OD cases. Though perhaps, at that point, he didn't want to articulate his other concerns so this was diplomatic. Still, the sight of the young mother being escorted through A and E by a police officer was disturbing.

Police may have been called if the staff deemed her a threat to herself. They may have 136ed her and have been taking her to a secure unit for help.

Re the male police officer. I'm afraid with services stretched as they are you get what you're given. There are fewer female PCs anyway and generally the police are so busy that it's a case of whoever is free goes.

You know it's not really a bad thing. I had police involvement during my last breakdown - I'm now on their "vulnerable persons" list. All it really means is that if I'm involved in any future incident they'll attend quick smart and be "kinder" to me.

I try and be philosophical about it and treat it in the same manner as having a consultant-led pregnancy - ie lucky me!

I'm not sure what the sex of the police officer had to do with anything.

a) there are hardly any services left so the woman must be significantly unwell to still have a CPN

b) the police may have been notified if there had been an offence committed - drink driving etc. they chose not to prosecute me after a suicide attempt involving alcohol and medication in my car, but you have no idea what had happened so yeah, not really your concern

c) don't eavesdrop in hospital and then let the person know you were listening. crisis is distressing enough without well meaning referrals to mumsnet, of all things.

It's pretty standard for hospitals to report overdoses if it's as a result of a domestic situation especially when there are children in the house.

As far as sending female officers that's just not practical. It's the first available resource that's sent whether it's male or female

The woman's distress on leaving was very evident. But fair points. I'm sure there was more to this and hopefully the hospital made the right call. The wider issue of reporting overdoses is interesting, though, and, yes, hospitals probably makes that decision on a case by case basis.

It is possible that rather than escorting the woman out she was being escorted to a secure unit as she was being sectioned for her own safety. I know for example one hospital near me the mental health unit is a separate building within the hospital grounds.

I think this is very likely - it would seem strange that she'd be escorted out of the hospital with no prospect of treatment for the OD.

I was a police officer and have dealt with many people with MH issues who have needed proper psychiatric help, without any criminal element.
The psych team are spread so thinly that in my force area there was one team, that I was aware of, in the county, responsible for 5-6 hospitals with 4 A&E units, and it took HOURS and hours to get them to attend. Sometimes we would have to leave a vulnerable person on their own at hospital with no one to prevent them leaving, then the hospital would call us when they had left the site as they needed us to stop them harming themselves.
It was more likely we would find a bed for the patient and take them to that location.

Police/NHS collaboration for MH issues is awful but NHS don't have the resources neither do the police but we seem to tidy up lots of other agencies' jobs

Could be she didn't actually take what she claimed to. Perhaps her blood tests had come back and showed she was fine. It's not the first time I've known someone claim to have taken an overdose and it's discovered they haven't. It's not up to the police to transfer patients around a hospital. Hospital staff would do that

She may have chosen not to receive the treatment offered, eleanor - the Police Officer may have escorted her home.

I was recently in a similar situation - the patient I overheard was demanding a sling/bandage for his arm which was very badly bruised and infected. It was obvious that the patient was known to the staff for injecting drugs, and they warned him of the risks of not having his arm treated - but they had to let him leave.

I usually roll my eyes at people who jump on "offence" and week it out. But seriously, Wtaf? Are you saying police involvement = fake overdose attention seeking?

No wonder those of us suffering mh problems don't stick our heads above the parapet.

I think you need to mind your own business OP tbh. I can see you are concerned but A&E and the police deal with overdose patients every day. I think you can leave them to manage them in accordance with their guidelines. Nothing is as simple as it first appears.

Scarf - you were one of two posters on this thread who alluded to "fake od" - if in fact it were, is that not in itself indicative of mh problems?

It was speculation as to why she was leaving with the police as opposed to being treated. If it was a fake od there would be no reason for police to be involved for that alone.

You're absolutely right Grace a fake od is just as indicitive of mh problems as a real one but that wasn't what Giraffe or I were saying it was the police involvement element we meant. Clearly the od issue had been dealt with but there must have been another reason the police were there. Probably the fact the incident originated in an argument with her partner

actually, it's fairly obvious that this is a perfect example of prurience dressed as concern. do you slow down to look at car crashes, OP?

wait, not prurience. whatever the posh word for rubbernecking is. my meds make words fall out of my vocabulary!

In my experience, someone presenting at a&e with mh issues, that don't require any additional treatment from a medic (at a&e) but do require psychiatric help will either have one of two scenarios (usually)
One - they will be assessed at the hospital buy the mh assessment team and either admitted to a ward with a free bed or if safe to do so, they will be helped back home by the community mental health team.
Other times, the person presenting at a&e can be bought in to a "place of safety" Within a mental health ward under a section 136 where they will be detained for up to 72 hours and assessed by the assessment team as to whether admitting them to the ward, community mental health care or just going home would be appropriate. During their time on the 136 they will be looked after by the psychiatric staff from the ward (some of whom may be male or female so I'm not sure why you're concerned that the police officer was male - in general if we can on the ward, we will provide same sex staff to whoever is on the 136 especially if it's requested by he service user)
I hope this helps (from a professional perspective this is all I know as I don't work In the assessment team)

and the ward I was on was mixed sex anyway...

Mama
This must differ by area and resources. Round here there's no way the MH team would see someone home. They'd either be left to make their own way, a friend/relative called, or the police would take them home - if the police had brought them in.

Whist waiting under a 136 they'd be with police only - although a nurse might pop in now and then to check on them.

If she was refusing medical treatment then I suppose it would just go straight to the "police escorting home" stage, as she clearly wasn't getting ny MH help/admitted to a MH ward. Her comments about services would imply that too.

Other times staff will be very hostile to certain patients, especially those labelled BPD and/or who show up after suicide attempts that are viewed as not serious/a cry for help (nevermind that someone clearly needs help if they're crying out for it like that). MH staff can be much worse for this attitude. A cold good bye and a police escort to take you away to avoid "trouble". It's the most horrific thing to be in that situation.

It is very wrong, but likely as not there is no local help, and lovely as MNers are, they will just signpost back to services.

If you truly wish to understand the situation try asking on mental health forums, there was a thread on here called "lost souls lounge" too, and google stuff to do with BPD stigma/discrimination. (Who knows what her diagnosis is, but that one tends to show the worst side of this kind of awful treatment).

to all the health workers who treat patients with kindness and respect in these austere times.