Leaving psychiatric hospital when unwell

[EmeraldIsle100]

My DD early 20's has bipolar, depression, and bpd and is currently in hospital. She was in our local hospital but got moved to another hospital about 100 miles away because she needed to be on observation and our local hospital didn't have the resources to put her onto observation. She has subsequently been taken off observation.

She is awaiting a transfer back to the original hospital but there are no beds available there. She is really scared and incredibly lonely in the new hospital which is nothing like the original hospital and her mood is going downhill badly.

She is telling the doctors that she is improving so that hopefully they move her back to the old hospital but in reality her mood is low. She feels incredibly low and thinks she needs to change her medication. If she tells the hospital this they will most likely keep her in for at least 3 weeks to supervise the change of medication.

She cannot cope with the thought of 3 weeks at the new hospital. She is struggling to get through the day and I am really worried that she will take her own life which she has tried to do on several occasions by paracetemol overdose.

Given her terror of the new hospital I think that thing she would be better off wcoming home, seeing her key worker, GP, psychologist, friends and family than being miles away from home and lonely and isolated. She could maybe get a bed in the old hospital sooner rather than later. I hve taken time off work to care for her and she could also see the Crisis Team if necessary.

I would appreciate any advice, thank you very much. She is completely terrified in the new hospital.

Personally I would ring the hospital and explain she can no longer stay with you, I would also state that you are no longer willing to be responsible for her and that you are handing responsibility back to them.

I agree with this. I am surprised that the hospital put the onus on you to call the police, which is what is implied from your thread above and not quite clear.

You might have to put in writing that your DD can no longer stay with you, i.e. make her homeless if you are not happy to have her discharged to your care. This will likely not happen imminently but is worth bearing in mind. I don't want to scare you(!) but to encourage you to set your own boundaries for yourself.

I am sorry that your DP got caught up in this. These things can be so hellish.

Sending masses of hugs to you.

If I were you I would not go uncontactable. Once you have calmed down, make your own position clear to the hospital and to her. Work out how you are happy to be contacted and let people know.

And, get support for yourself. I keep on coming back to this but you are not the only parent who has been through what you have been through. You might find as well that talking to her RC elicits different responses to talking to the nursing staff.

Erin it's so kind of you to post.

Earlier this evening I told hospital that DD told me she was going to stay at her dad's. They told me that she wasn't allowed stay at his as she was under my care and if she decided to stay there I was to ring the police and tell them she was a detained person. I was fine with that.

Less than an hour later the hospital spoke to her father ans told him DD could stay the night at his????

I am probably a bit too soft for my own good but I want to make her homeless. I dont actually want to but how long can she believe she can intimidate me? I am telling the hoslital tommorow that she is not coming back here and they can work it out.

Today I got a conviction that she will harm me badly in one of her rages.

I feel so sorry for DP he is lovely and tried so hard. He does so much for her. I have been with him for 5 years but maybe it is too much for him.

Thanks again to you both for replying, I am feeling more normal now.

You're right Erin I will stay in contact, it is the best thing to dk.

After today it's very apparent I need to get some support. I can access it free through work.

I am kind

You are going through hell at the moment. There is every possibility that different people at the hospital told you and DD's dad different things with no handover between the different people on the hospital side. This happens in hospitals. People are people, even MH staff, and MH services are terribly under-resourced. Handover should happen between staff but it does not always, and people do make mistakes. I am still that the hospital put the onus to report DD missing on you, but I am not MH services and they may be following protocol.

My opinion is that cutting contact is kind of...childish? Not in every case but it is a last resort IMO. Your own safety is your priority though. You do not have to respond to her every phone call, message, and so on, but if you do decide to cut contact I consider it adult to at least explain to the other person why. If you feel that threatened by your DD you can discuss this with the police on your own behalf. I am Very Boring though when it comes to these things and draw largely from my own experience.

Getting support for yourself seems wise.

Erin apart from being kind you are pretty astute. This whole mess ocurred at about 7.30/8 ish this evening and several nurses mentioned that they were nearly finishing their shifts and would pass on the message!

They told me the onus was on me because DD is an adult and can make decisions for hersef (eff knows where the Section came into play).

I was chucking a major wobbler when I said I would cut contact. I am not going to cut contact with the hospital but I won't respond to DD's texts which are just going to fry my head further (head already banjaxed).

DD failed all her A levels after getting all A & A* at GCSE. She has applied to do an Access course in Sept but is scared because she is struggling to concentrate. She used to be the biggest bookworm on the planet but can't read now. She has worked part-time since she was 14. She applied for her driving licence recently and our GP has just returned medication list to DVA so she isn't optimistic.

Thank you for replying tonight, I really appreciate it. I genuinely can't tell others what's going on. I hope you have all had a nice day. Goodnight!

The astute thing is in part born of experience. Yes, messages get lost during handover. You can ask to speak to the nurse in charge on any particular shift. This person is typically more senior and has more of a sense of what is going on; downside is that they are likely more busy and may not be able to speak with you straight away.

Ach,. Not to dismiss what your are going through, but I know loads of people who did what your DD is doing from an academic perspective, messed up at various stages of the socially prescribed growing up process when it comes to GCSEs / A-levels / so on. She'll get there. I feel for her on the loss of concentration thing. I get distressed when my concentration goes! It comes back, but I am an avid reader and get distressed when I can't do it.

If you stop replying to her text messages, she will likely stop sending them soon enough. Boring but true. You might be able to stop your phone from pinging/buzzing when she messages, specifically for her number. I do this when I need to feel less jumpy about a particular individual getting in touch with me.

Hope that you managed to get some rest.

Erin

She texted insincere apologies and texted to say she was home last night. All of it is complete bullshit. I don't want her back but will get more abuse when that conversation starts. I think I will turn off the phone.

Turning your phone off at times to get a propper break can be a good idea. I generally text my husband to explain what I am doing and why and that I still love him first. Use today for yourself, can you spend it doing something you enjoy? Definately get some support for you it will probably be quicker through work than NHS but if there is any limitation on how many sessions you can have it might be worth getting on the NHS waiting list now too.

I've felt unsafe when DH was last unwell, so I know how hard it can be. I am very angry with the MH team ( not our own as we were on holiday) for putting me in that position, not only for myself, also for the effect that it has had on our relationship and my ability to support him. I have a complaint about it ongoing at the moment.

Your daughter is asking you to treat her like an adult and that works both ways. As an adult we have to take reponsibility for our actions and the effects that they have on ourselves and others.

Turning your phone off at times to get a propper break can be a good idea. I generally text my husband to explain what I am doing and why and that I still love him first.

I second this approach, not that you asked for my opinion. Remember, if she texts or calls you you are not obliged to reply to her texts or even to read them, and you are not obliged to answer the phone to her nor to listen to the voicemails that she leaves if there are any. These are your choices as an adult. They might have consequences for your DD, such as her feeling rejected or unsupported which is why I think NoLongerAnxious's strategy of making one's own position clear is a sensible one.

I have been on both sides of this, your DD's and yours. Those relationships are still intact, and we are all still here.

Sending for you

I am not answering texts or picking up calls. She is at her fathers. I think she will ramp up the calls and the texts will start to become vile.

Then the threats of suicide will start. I am already mentally preparing my response to police etc in the event of her killing herself.

I can't take her back after last night's display but I am terrified of the potential consequences. I suppose I am going to have to take her back.

I will take Erin's example and text her to tell her my phone is off and why. If she kicks off I just ignore.

I texted her and she has accepted her blame without any excuses and vowed to do everything to get better for herself and me. I have the house to myself and the sun is shining. I am going to enjoy today and talk to the doctor on Monday. Thanks for all your advice, you have no idea how much it helps to get advice from people who understand completely.

I suppose I am going to have to take her back.

This is not the case. My parents have refused to have me live with them on more than one occasion. I am not saying that this is what you will have to do, but it is not as if you are obliged to have her live with you if you do not feel as if you are able to cope with it.

If she threatens suicide, tell her treatment team, or tell her to tell her treatment team. I am so sorry that you are imagining your responses to police etc. It is rare that someone in her position takes their own life, if that is any reassurance? Is she back on the ward yet?

Ah, no, you said she is at her father's. Will he get her back to the ward once her leave is over, do you think?

Enjoy the rest of your weekend!

Hi Emerald,

I hope you have been able to relax a bit today. If the hospital have been using your home as a place of safety under the mental health act then they need your agreement for this, so you definately don't have to take her back whilst she is under section. I take it that her name is not on the mortgage/tenancy, in which case you don't have to agree to have her back when she is discharged either. As a vulnerable adult due to her mental health the council are under certain obligations legally with regards to housing her and she would be high priority for housing. Social services would then need to assess how much support she needed to live independantly in place of what you currently support her with and provide her with that support. They will probably try to push you to support her first, but ultimately they have a duty of care to your Daughter.

Erin I will take her back to the hospital on Monday. I thought people with bipolar had a high risk of suicide. Would you mind telling me where you lived when your parents wouldn't let you home? Did it make you better or worse?

Longer that's very helpful, thanks.

The bottom line is I am terrified of not letting her stay here in case she kills herself. That is the threat I live under whatever issues arise. I don't want her here if she goes back to causing absolute havoc like before.

Since September last year when she first got admitted I have been able sleep. Now I am just frantic. Today I stayed in bed all day again.

If she sticks to her promise about not being agressive I could probably cope with her here but I can't go back to her intimidating me, kicking doors and breaking things. She is very strong when she is in a rage and I have been scared of her. I locked myself in my room with a chest of drawers a few times and have had her removed by the police.

Hi

I have nc'ed for this .I have a history of BPD and spent years in and out of hospital. My EX dh also had bpd, my best friend since childhood has bi polar.

I can tell you old hospital would of been comfortable because you learn how to play it to get your needs met. I had years of therapy and it continues a rollercaoster until I found my motivation to get well.

I was also told a lot of my problem was I was surrounded by people with MH problems. I did feel inferior to people to people who did not have MH problems. Been unwell as close as I came to losing my life numerous times. It felt far more comfortable than the fear of what I would do if I was unwell. If I fail ill , its because I was ill, If I failed when I was well it was my failure to own.

My Exh really did not want me to get well. His MH suffered in fact a few people around me had their MH go down hill as I got better. They had this fear od been abandoned .

One thing I realised was a lot of people around me did not want me to get well.

I was agraphobic but my ex used to try and get me to go to the places he wanted to..Never to where he really wanted to go.

I liked been in hospital. The expectations, responsibility were so much lower. I was once put on a different ward in my local hospital as it was full. I didn't really like that either so can imagine your DD won't

I don't know the answer for your DD but I do think not enjoying hospital is probably good for her.

My EX also smoked cannabis..IT made him really paranoid and helped nothing.

My psychologist is the one person I give credit to keeping me alive until I was ready to take responsibility for myself.

My best friend with bi polar.. I see her DH not especially interested in her getting well either..He is her carer. I don't believe she needs one and would be far better if he went back to work.

I am not sure if any of this is of help..There was a book around years ago stop walking on egg shells which was written for people caring for people with BPD because it is hard work.

Hope your post was extremely helpful and really interesting. I am glad you got well. Your ex sounds horrible so I'm glad he is an ex!

I almost laughed when you said you liked hospital and it's good that DD hates it. Deep down I suspected that of DD but because I'm still finding my way I was afraid to trust my instinct.

My DD was seeing a Psychologist in the old hospital and it was a big help to her. Looking back at it now the benefit was probably counteracted by the fact that DD liked being there so much that she wasn't sufficiently motivated to really try to get well.

Your insight into people's health declining when others get well just fascinates me. It's like a whole other dynamic comes into play.

Thank you for posting. From your post it is evident that you climbed back from the edge. That cannot have been easy and I am extremely grateful to you for sharing your experience with me. It really helped.

I have heard mention about that book and will check it out.

Emerald, I'm glad you found that helpful, I hope it's right, Im pretty sure it is. DHs family abandoned ship early on in his illness way before he got a diagnosis and he's been homeless a couple of times, the most recent time with a diagnosis and CPN on his side he got housed very quickly. There is some useful info on homelessness/housing on the rethink website.

Sorry just realised how that could have sounded, I didn't mean to imply you were jumping ship. DHs parents kicked him out when he first got ill at 18 with no diagnosis and no support so its a very different situation.

Emarald RE living situation, my circumstances were somewhat different as I had a different diagnosis to that of your DD and was at a different age and life stage.

When I was a minor, I stayed in hospital until my Consultsnt and my parents agreed to my discharge. I did not particularly consent to staying in hospital but this did not have much bearing on the decision whether I should be an inpatient or not.

The second time when I was no longer a minor but did not have my own home yet, we explored my living with other relatives and were looking at a supported housing project which would have required me to be made homeless in order to be eligible for housing benefit which at the time made up part of the way that the supported housing project was funded. This never happened in the end. I was discharged home and left my parents' home soon after my discharge.

The most recent time I stayed in hospital until I was well enough to come home to my own flat. My parents would not have me home when my risk was high due to the fear that you describe.

Living separately from my parents is better for me and for them. The interpersonal dynamics between me and them are such that my living with them would, I would imagine, not be good for my mental health. It had been a long, shitty road but we are all still here and all still in contact with each other!

I had a lot of support from crisis services in my area who were brilliant. The most recent time, however, I knew the system and the dynamics well enough not to fight it. I can relate to feeling safe in the hospital and to surrounding oneself with other people "in the system" having mixed effects. On the one hand, one can feel understood by fellow patients, on the other hand spending time with people with MH problems can normalize one's own situation and keep one a bit "stuck".

Are you able to state your concerns about your DD's level of risk to the staff at the hospital. This is what my parents had to do, multiple times. I did not lash out towards them for the most part, it was more the "risk to self" bit than the "risk to other" bit. If you are able to state your concerns calmly and almost stonewall to not be persuaded, this tends to go better, IME.

emerald sorry everything has been so shit. I'm glad you had that conversation with the hospital though. Maybe now things have got to this point things will start to change/move for the better though.

I'm surprised at the amount of flexibility from the hospital…but maybe the form stated 'stay at parents' and didn't mention exactly who or where hence being able to go to dads. Leave has to be signed off by a consultant, not the nursing staff- it's not the nursing staff's decision to make! Unless they weren't sticking to that, which would be highly unusual.

I wasn't allowed back to my parents home (fortunately for me) when I was around your daughters age. I was on a section 3. Someone who has been on a section 3 can't just be abandoned- if you say you can't have her home, and if her dad agrees, social workers/staff will need to find her somewhere suitable to live, following her discharge from hospital. I ended up in supported housing for people with MH problems, and I actually think it was much more helpful than being in hospital!

You cannot have your daughter home with her acting as she does. She is a threat to your person and your property. The suicide threats are manipulative- it sounds like she is trying to make you feel responsible for her actions, and unwell or not that is abusive. You will end up having some sort of breakdown yourself having to put up with that sort of behaviour. Leaving home and maybe moving somewhere where she starts to take some supported responsibility for managing her mental health, and her behaviour, might be for the best.

Whilst the threat of suicide may have a manipulative function, this may or may not be conscious. If you respond to threats of suicide by acting as if the risk of your DD taking her own life is your responsibility, that is one way. Another way is to refuse to have someone who is at high risk of suicide live with you. This was the stance my parents took.

To my recollection I did not threaten suicide, but one of my relatives tells me I did, once. I was psychotic at the time and have no recollection of doing so but I do believe my relative.

Taking responsibility is a big part of it, as danger says. Under a Section 3 the state has obligations towards the patient - to keep them safe, essentially. MH services are sufficiently stretched though that this obligation has a tendency to leak onto carers, in my observation.