Urgent help please, suicidal DD being discharged from hospital

[urgenthelppls]

NC for this.

My DD18 is on a psychiatric ward at the mental health hospital in the nearest hospital. She really, really wants to die and was admitted after her most recent attempt at an overdose, but has been there before after previous attempts.

We have had several issues with her in their care, including them failing to remove the string of her jacket, which she attempted to use on herself, and it took several anxious calls to get through to someone on the ward, who found her blue in the face. That was last week.

Somehow, they have decided she is fit to leave on Monday. She is not. She is hell bent on ending her own life and I have no idea how to convince them that it's unsafe. She still has her phone and I have collated some messages from friends indicating that she will do it, and home is so much less safe for her than on the ward- we have kept all obvious dangers locked away for around 18 months now but we also live right by a railway bridge, there is a shop round the corner and just so many ways I think she could harm herself.

They took her to Tesco on Monday and she ran away from the nurses attending and had to be restrained by police. She is really, really going to do this.

Sorry for the incoherent post, this is very urgent and I need advice on how to push for an extended stay ASAP. TIA.

Sorry that you are going through this. What section is she on?

You need to get her sectioned, refuse to take her home saying it's not safe. Request an urgent meeting with her psychiatrist.

@Girliefriendlikespuppies

You need to get her sectioned, refuse to take her home saying it's not safe. Request an urgent meeting with her psychiatrist.

This.

Refuse to have her home.

I’m so sorry you’re going through this.

Thank you, I'm not sure what section she's under, will call now and see if I can find out, it should be in her admission notes? She was on an adult ward for monitoring after A+E and we really had to fight for her to be admitted, so it might be under voluntary. What section ought she be under? It's been very difficult to speak to the doctors, I've had 3 meetings with a staff nurse, but because she's 18 they don't seem that focussed on telling us all the details.

What does her consultant/lead nurse say? Can they discuss her care with you seeing as she's technically an adult? I would take this to PALS or the complaints department ASAP. And ask for a second opinion from another consultant. Have you shared the messages you've collated with the ward team yet?

Have you seen the risk assessments they have carried out and the care plan that is going to be in place when she does come out of hospital? What are their reasons for not sectioning her?

What will happen if I refuse to take her home? As she's an adult would they put her on patient transport or literally just let her out?

Does she have a diagnosis? This sounds very difficult to manage and stressful for you. Does she live at home with you? I would ask for a discharge planning meeting. Does she have a community mental health nurse? Or is she getting follow up from a home treatment team? I would be speaking to them ASAP with your concerns as they usually have to do a follow up within 72 hours of hospital discharge.

I do think it may be difficult for you as she is 18 and will need to consent to your involvement and getting information. She can withdraw that consent at any time.

Sometimes hospital is not the best place for people but if that is the case I would hope the medical team would be able to explain why, what the risks are and what the plan is to minimise those on discharge.

And, I meant to say I'm sorry you are going through this - it must be terrifying

@scaredsadandstuck

What does her consultant/lead nurse say? Can they discuss her care with you seeing as she's technically an adult? I would take this to PALS or the complaints department ASAP. And ask for a second opinion from another consultant. Have you shared the messages you've collated with the ward team yet?

Have you seen the risk assessments they have carried out and the care plan that is going to be in place when she does come out of hospital? What are their reasons for not sectioning her?

According to the person I spoke with on the phone, we will go in on Monday morning to talk over the care plan for her discharge, so I should get to speak to someone then, but if they say she is still safe to leave, will they just let her go?

How do I contact PALS? No contact details online for her hospital, only the address.

Is it an NHS hospital?

@scaredsadandstuck

Is it an NHS hospital?

Yes it is, on hold to the ward now.

@scaredsadandstuck

And, I meant to say I'm sorry you are going through this - it must be terrifying

Thank you, really appreciate the advice I feel in a much better position than I did half an hour ago. There is absolutely no doubt in my mind that she will do it if able.

I am so sorry you are going through this at the moment, she can be sectioned but it has to be from the relevant team (as in mental health professional, section 12 approved doctor). They must be in agreement to do so.
I would ask who is specifically looking into her case and advise you are hoping that she can be sectioned under the mental health act 1983 and would like the team to consider this.
They can section for different periods of time depending on how they feel is best.
I really hope you get some answers tonight

I only have young children but i tried to kill myself and self harm at the same age as your DD 16-18. My parents tried their best but it was the CAMHS team that prevented me from killing myself in the end. In hindsight i think my parents should have called 999. When i was 17 they bundled me in the car to the GP who just made me feel worse and told me to take a blue pill (lorazepam) that i just threw in the bin behind my parent's back. Mental health really is best left to the professionals

The details for PALS should be on the website. If there is a search function on the site try that. If you want to message me the hospital I can look for you (I work in NHS communications so am used to hospital websites!!).

If you feel you are not being heard you may want to mention the road rage case in Brighton - a mentally unwell man killed a member of the public and the NHS MH Trust were found to be negligent because they didn’t listen to family members. www.google.co.uk/amp/s/www.theargus.co.uk/news/16991771.amp/ Be very clear that in your view you cannot keep her safe and she will die if discharged - you can also raise her discharge as a safeguarding issue with your local social services department. As she is an adult you can also refuse to have her home and say this makes any discharge even more unsafe.

I am so sorry your daughter is so unwell and that you are not all getting the support you need. Big hugs

Muster the evidence that makes you sure she is fully intending to take her own life and present it clearly to the meeting on Monday.

Try speaking to MIND before then if you can and get their advice.

You need to be able to make out a proper case for keeping her safe on the ward. Use the term "vulnerable adult."

If they are sending her home, and home is your house, then they cannot ignore your views. You have to be clear that you do not have the ability to keep her safe, so your home is not the right place for her. If she does not have a safe place to go to, then they cannot discharge her. Ideally you need an advocate, but they are presenting you with a tight time schedule - ask them to delay the meeting till you have an advocate on board - MIND should be able to help here.

When a young adult reaches 18 it becomes incredibly hard for families to defend their child. But you are being used as her "home" so they cannot ignore your views.

She needs to be sectioned under a section 3 of mental health act.

This section allows for a person to be admitted to hospital for treatment if their mental disorder is of a nature and/or degree that requires treatment in hospital. In addition, it must be necessary for their health, their safety or for the protection of other people that they receive treatment in hospital.

You need to advocate hard that it is the only way that she's not a danger to herself & others.

Good luck. I'm sorry you're dealing with this. MH services are so stretched but if she can get admitted hopefully it'll be a turning point.

Ward no help, want it in writing so if anything happens there is evidence of our dissent. Thank yous so much for the information and articles, I am going to include them in an email. I just cannot believe they are preparing for discharge given her condition.

Does she verbalise her intent to harm herself, to her nurse/consultant etc? So sorry you're going through this. I work in a psychiatric hospital and this happens all too often.

Sending strength and warm thoughts.

What is her diagnosis and what is her treatment?

Ignore the advice above about specific sections, Re s3, it’s incorrect.

Detention isn’t the real focus, it is not agreeing that she can be discharged. She can stay voluntarily for a long time. If you refuse to have her home that might delay the discharge, but it might have an effect on her.

Sometimes the discharge is being planned because the PT has plausibly started telling the staff that they no longer intend to die. And the staff believe them. You will need to prove or persuade them that it’s a deception.

A problem is, that if the PT is lying in order to be discharged, they may really not want to stay in hospital anymore and they may be finding it unbearable. Then you’re between a rock and a hard place. A section to detain, can then cause the PT more pain and more inventive and determined ways of self harm and suicide. Being detained, against their will can make the problem worse, rather than better. Being detained isn’t really a solution, although sometimes it can help wait out a crisis, or maybe try new medication.

The diagnosis and treatment is key to understanding what their plan is. It does sound very high risk to manage at home.

Have they said what the discharge pathway is other than to discharge her to her home address? Any mention of community treatment?

I have been in a similar situation but dd was 16. I was able to produce the Amazon order of paracetamol and a Stanley knife she had placed… it was very traumatic and stressful. Is she a voluntary patient? Dd also kept trying to discharge herself and staff explained that there were absolutely grounds for her to be sectioned and not just the 72 hour holding section. Being a in patient does have mixed benefits as we found dd got new undesirable ideas from the other patients! Has your dd convinced them she is not suicidal or do they think ward not the right environment? The running away would have been seen as a red flag on the adolescent unit where my dd was a patient and would have put discharge plans back.

Sending you a hug - I know this is an incredibly difficult situation.

So sorry to hear that you are going through this. No expert on mental health but when the hospital tried to discharge my elderly mum, I asked to liaise with the "Discharge co-ordinator". I asked to see the risk assessment which had to be signed off by the co-ordinator in order to discharge her. I asked for a copy 'to pass to our solicitor', as I disputed that she was safe, and that there were clear inaccuracies in the risk assessment which put her at risk. They agreed to hang onto her at that point.

Hope that helps you. Thinking of you.