EXH Sectioned and being discharged to an unsafe environment

[anunseemlylovefordustin]

Basically, that! My EXDH has Bipolar I and addiction issues - he's been sectioned twice in the last two months - first one a section 2 which he somehow got discharged from within 24 hours (because I think they suspected it was drug related rather than BP-related, even though one had caused the other IYKWIM). Then after a gap of about 10 days he ended up being sectioned under a section 3.

He's being formally discharged today, and I think it's too early. Plus there are serious concerns about cuckooing (raised at his 117 discharge planning meeting) and safeguarding, because there are a lot of strange people in his house quite frequently and he has mentioned that they've stolen from him. He's going to be homeless on January 17th when his tenancy ends.

I saw him today (he's been on leave from the hospital for 4 days) and he was in a terrible state - shoes undone, no socks, sores on his feet and bruises on his hands, grey-faced and strangely dressed, and very shaky and frightened. He said he's fine but he plainly isn't.

I've called the hospital today to say that I think they're discharging him to an unsafe environment - I've done that previously also, as has one of his family members who visited him at home and witnessed a car load of men turning up and dumping off a woman who apparently was a friend of one of his friends and needed to stay there.

I just really don't know what to do. I'm so worried about him being discharged and then just falling through the cracks and ending up dead not long thereafter. I thought that the authorities had more responsibility for his safety post-discharge under a section 3 (and there was some talk of referrals to housing agencies and debt counselling/drug counselling services) but when I spoke to the hospital today there didn't seem to be anything in place at all prior to his discharge (planned for this afternoon).

Is there anything else that I can do that will get him some support after discharge? I don't mind being a squeaky wheel if needs be, but I don't know who to contact except the hospital and his CPN (the latter of which I've only managed to speak to once over the last couple of months).

I just feel so helpless! He's a good man underneath all of the problems and I don't want him to just disappear under the surface without a ripple once he's discharged :(

He is entitled to aftercare - you can find info on the Mind website or Rethink Mental Illness. I think it's called section 117 or 17 aftercare in law.

I advise calling the Cpn and asking for him to be referred to home treatment team/ crisis and resolution team (the name is different in different places). They have to assess people within 48hrs.

Other than that it's a crappy system and I assume he'll have to present to the council as homeless in Jan?

Good luck :(

I guess so, yes - and as a man on his own (I'm the resident parent for our daughter) he understandably won't be priority.

He's been under the crisis team previously, they have to visit more often don't they? I know the CPN said he just has to ensure he visits him within 7 days of discharge.

I'm just going to keep trying - at his discharge planning meeting (which the consultant invited me to) there was much talk of referrals to housing help, drugs counselling help, all sorts. But they all seem to have vanished. I know they need the beds freed up but he will just be in there again within a few months. Or dead.

I can't even be angry, services have been slashed to the bone and they are struggling so much. I'm just so worried for him.

My friend has similar problems. She can't cope living alone and is trying to get into supported housing. Meanwhile she is in safe/respite house where there is a worker present 24/7. They take care of her medication but other than that she is free to come and go. Might be an idea to ask if your area has this kind of service?

Do you know the contact details of his GP?

Do you know who will be responsible for his MH care after discharge? For example, do you know which team his CPN falls under?

I hate to ask this but - does he have any forensic history or history of interaction with the criminal justice system?

It's really tough x

He does have one incident (from just over a year ago) of affray (think that's what they called it). It's the first I've known of (and we were together for about 12 years total) and he was sectioned less than a week after. Would having a criminal record (he doesn't, as I think it hasn't gone to trial as yet) help or hinder?

I don't know the name of his GP but I do know the name of his CPN. I've managed to find out the name of the assigned social worker too, so I can try calling them tomorrow.

I hadn't heard of a respite/safe house, I'll see if I can find out whether that's a possibility. He sounds similar to your friend (in that he has capacity mostly, but just can't seem to look after himself). It's so sad, he's a shadow of the man he used to be.

RE forensic history I think I just felt more worried than anything, if he is not involved at the moment then I am not sure that the history makes much difference. This is not my area TBH.

The GP is in some sense overall responsible for his health (and documents around discharge planning "should" be copied to GP who will then have the most complete record, although this doesn't always happen in a timely manner.) If you know the name of the CPN and ASW are you able to Google them and find out which team in the MH trust they are from, then speak to the team manager?

My trust has crisis houses which are a step down from inpatient wards but these are not long term housing, more a 2-4 week intervention.

Also it is okay to step away from these things, do you have IRL care and support for yourself?

Not particularly helpful but just read your posts and thought you sound very kind. I'm sure your care and efforts won't be lost on your daughter now or in years to come.

It's such a shit system, I hope he gets the help he needs and you have some support and too whilst worrying about this.

What about social services ? They have an adult safeguarding team they might help?
The cuckooing is recognised as a safeguarding issue or report it to police via 101

Oh, thank you for the kind messages. They mean a lot.

I am fine and our daughter is absolutely thriving, she's a joy and luckily doesn't know any different than having parents who live separately, because we split when she was 3 months old. I have gradually (deliberately) become less and less involved with his issues day to day over the last couple of years since we split up, and I have lots of 'virtual' support from friends (and my family) who really get it, and who are as fond of him as I am but are only interested in supporting me.

So I'm a little more removed than I used to be, and don't get as stressed and frightened by it all. But I still can't help but worry about him and what happens to him, he's a decent man underneath all of his issues.

This most recent sectioning is the first one that I've deliberately not had any involvement with, said I don't want to be listed as his next of kin etc.

This situation really sucks. The police have been spoken to once about the cuckooing, by his parents, but nothing seemed to come of it and I wasn't directly involved so don't know the details.

Sigh. Thanks for the sympathy! This seems like an unsolveable problem. I hate unsolveable problems!

Maybe my call to social services tomorrow will bear some fruit :/

S117 aftercare provision is for supported accommodation (if that was recommended at dc CPA)
S117 is not a global eligibility for local authority or private sector housing or follow up . S117 It is for eligible aftercare needs

I recommend he see his care coordinator
Is there Safeguarding issues,eg financial exploitation, coercion

Regard crisis house it’s only an option if he’s in MH crisis and it’s time limited

Yes, I know that it's not going to help him with regular housing. At his discharge planning meeting they talked about supported housing. His CPN is his care coordinator but is impossible to get hold of (been trying for 3 days straight now at various times of the day). They're just so stretched, it must be an awful job.

I did manage to speak to his social worker though, who is chasing up the referrals in writing, so that's positive. And I've contacted the local organisation that provides independent advocates, to see if they can help him navigate through the very complicated system. Hopefully they'll be able to help.

Oh and yes, there are safeguarding and exploitation concerns :(

That’s good news. Advocacy service is a good way forward as well

Mental health advocate is good idea,I’m acknowledging it’s a difficult time.not easy at all