Section 2 and spousal control?

[ARoomSomewhere]

Hi I have a friend currently in the Maudsley on a Section 2.
She has bipolar problems.

She is utterly convinced her husband 'put her in there' and is out to get her. This sounds like mental illness 'talking' to me but he is not a nice man, from what i know (from others not just her).

Anyway she thinks the HCP's will be showing him her phone and letters / post she receives in there. Is it the case that he could ask to be shown them? She also thinks there are cameras everywhere, including the little garden area. It is secure ie has a metal 'overhang' at the top of the wooden fence, a la prison style but i didnt notice any cameras?

she thinks her husband / the HCP's could possibly stop her friends visiting. Is that the case, even if it is okay with her for them to come?

I know this is a bit specific but would anyone know pls? I dont want to ask husband as it might cause upset and not do my friend any good. I doubt the HCP's will discuss it with me as I am not family.

Her husband will be her Nearest Relative under the Mental Health Act and whilst that will have given him the right to request she be assessed under the Act, to be detained under section 2 will take far more than the NR saying they think it should happen. She will have been assessed by an Approved Mental Health Professional, a section 12 approved doctor and another doctor, ideally one who knows her.

Her husband doesn't have the right to see her phone and correspondence and she can tell staff not to share information about her care and treatment. He has no control over who visits her. The staff can place restrictions on visitors if they have very good reason, but they can't do so just because the NR wants them to.

Your friend is entitled to an Independent Mental Health Advocate and should request one asap, especially if she is suspicious of and does not feel supported by her NR.

There will almost certainly be cameras in at least part of the ward garden.

Your friend sounds v unwell I’m afraid,and this can be upsetting & frightening
Her illness appears to be manifesting as paranoid ideation
Regard admission, 1 AMHP and 2 Doctor make recommendation for admission
Relatives/spouse opinion will be sought and the staff make the recommendations

Visitors will be at discretion of ward staff on premise it’s not detrimental to your friend welfare & recovery. But to reassure you it’s not arbitrary decision. Friends are important in recovery

Ward would seek her consent before sharing her information and most certainly shouldn’t disclose correspondence without her consent

I hope yiur friend makes a speedy recovery

Oh this is all very helpful thank you!
She used to be a high achiever and for financial reasons the house was put into her husbands sole name. She left her husband for 20 years, but never divorced. During which time she had a long term partner. Five years ago she returned to her husband but she has, unbeknownst to him, kept in touch with the long term partner, who visited recently. They had a bit of a kiss / cuddle in the garden.
Friend is worried that staff will discuss this with husband?
Also that staff might stop long term partner visiting her again? (he is not family after all).
Will the HCP's themselves read her phone / vet her letters?
She is saying they are and asked her to explain who long term partner was but i dont know how much of this is likely and how much could be delusion?

I want to reassure her. I have tried distraction and vague reassurances but it would be nice to feel a bit more certain?

Your friend will be entitled to request a MH tribunal to appeal her detention
For a S2 there are Reports written by
Nursing from ward
Doctors from ward
Social circumstances report By CMHT

Regard correspondence, and phone messages no staff won’t routinely read BUT phone may be removed if it is impeding recovery

Letter are Unvetted, unless there is reason to believe they contain contraband items

Visitors are at discretion of ward staff, taking into account her wellbeing and how it impacts on others on ward. Both family and friends & lovers are legitimate visitors so long as they behave themselves

The lover is however not the nok/spouse so won’t be consulted regard treatment decisions

visitors must be respectful of ward rules, may be subject to search if believed to be in possession of contrabands

Your friend will be allocated a key nurse, I’d advise she discuss the relationships with the named nurse

mostdays thank you. LipstickHandbagCoffee thank you SO much.

I didnt think i'd much chance (its quite specific) but you've come up with some really helpful advice thank you so much.

I really want to support my friend in the best way possible for her recovery. x

Happy to help & answer questions , hope your friend recovers
And finally friend can ask ward to refer to independent mental health advocate IMHA. The Independent Mental Health Advocate (IMHA) is independent of the care team

Usually once a person is stabilised mentally and on medication regime that works, the ward will start to plan for discharge and maybe some time limited home treatment team follow up and Community Mental Health team referral

Part of the issue is that she doesnt take her meds.
She's had around 5 major episodes(requiring short sections) over 30 odd years so doesnt think she 'needs' them. Her H agrees...
She is lovely, not violent or anything but gets quite delusional and has religious obsessions.

Medication compliance is a significant issue.team will spend time trying to get it right and mutually agree a treatment plan
Medication can be oral or injection route - this will be discussed

I agree (and am not impressed husband doesnt!).
She is on rispiridone I think but also an anti epilepsy one which she is not happy about. Would she be having fits due to bipolar? (she is not epileptic). Cant ask as not family and dont trust the H much. (appreciate he is not the one prescribing the meds however and I am sure there are good reasons for whatever she is on and have been trying to encourage / support her to listen to the HCP's and take her meds.)

Anti epilepsy drugs eg sodium valoprate are used in mood disorders
Doesn’t mean she is epileptic
And it can be effective treatment

The ward doctor can explain the meds and the rationale for prescribing

Ah thanks Lipstick i didnt know that.
I know she is very pissed off about it.
I just keep saying to her: 'if you want out of here, take the meds!'
I appreciate they might be changing them to get the right combo / some might not suit her but it is her 2nd MH crisis since 2012 so I think she needs to comply. Thanks again you've been incredibly helpful!

Bugger. She just texted me. It's now a Section 3 (as of this afternoon).
Will she be allowed to leave the ward for a walk with a friend with that? she is worried it will be for 6 months till she can have a 30min coffee with a friend :(

She can get section 17 as long as her RC is assured that her risk has reduced. That can happen quite quickly as long as she is compliant with meds etc

oh i hope so. i know she's desperate to go out for a coffee.

I asked her: are you being completely compliant with meds and not 'trying to escape'?

she said: 'in my own inimitable way'.

hope she is for her own sake! THANKS so much.x

S3 is up to 6mth and can be renewed.but with demand for beds RC and ward plan dc when your friend begins to stabilise and demonstrate medication compliance

Re s17 leave, it’ll start graded with grounds leave and progress to escorted community leave. To test out if she safe, and won’t abscond

So, (sorry for 20 Qus and appreciate none of us can know not being her actual HCP's, but...)

On a S3 do you usually have graded grounds/escorted community leave before discharge or does it just depend?

Yes It is usual to have graded s17 leave prior to discharge
Her RC and ward team make decisions based on presentation,risk,medication compliance amongst other individual factors

oh, brilliant. that's what i suspected but was not sure?! - makes sense.

Thank you SO much, LipStickHandbagCoffee you have been so kind.x