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.

So sorry you are going through this, I know how terribly frightening it is.
If you don't already belong I suggest joking the private FB group entitled Parenting Mental Health. It's a wealth of advice and support and has been a lifeline for us.

How awful! I so hope you've got some help from here and finding a way for her to stay.

My son took his own life 9 months ago. He was just 20 years old and I wouldn't want to wish this on anyone. He is (hopefully) at peace now, but I have a lifetime of torment and 'what if's' to go through.
I don't have any sensible suggestions, but please fight with everything you have to get your daughter the help she needs. She is screaming out to you all. My son kept it all inside and no-one had any clue that he was in torment.
Good luck

Suicidal ideation is very difficult to manage and the mental health team don't always get it right.

However, she's admitted to the ward so she should have had a decent assessment.

If they're still intent on letting her home it suggests that either:

1. She is no longer suicidal, or they don't believe in her intention to end her life.

Or

1. She is still suicidal but they don't believe that this is due to a mental illness and feel she has capacity to make that decision.

Neither of these really helps you. Make sure you get your disagreement with their discharge plans noted.

You could refuse to take her home but her housing need isn't necessarily the ward's problem. They could just give her the number for the council housing department and send her on her way.

Does she actually have a diagnosis as this is probably the key here.

It's very strange. For them to be looking to discharge her, she must be downplaying her risk (obviously this could be to get out so that she can do something). You need to know what she is telling them but as PP this has to be with her consent as she is 18. Defo give them copies of concerning texts.

If she has EUPD they will be keen to discharge her.

@SausageCrush I'm so sorry for your loss x

If she is attempting on the ward, then they may say that the environment is harmful, hence the discharge. If she has a diagnosis of EUPD then even more so.

It all sounds so distressing for you though

Thank you so much everyone for your advice, after calling the staff nurse, and some calls to the ward from her friends too (I didn't ask them too, but bless them they were so concerned) they're going to review her on Monday with another consultant and evaluate discharge. I don't think there is any way she reasonably could be discharged, and we have evidence that we made them aware of exactly she intends to do if she is released. I also raised it with PALS, but late on Friday so not expecting to hear back until tomorrow- at least they are aware and hopefully can intervene if things don't go the way she needs.

@SausageCrush I am so sorry to hear of your son, and so sorry you never had the opportunity to talk to him about what he was going through. It goes without saying I will do everything within my power to protect my DD, but I realise how fortunate I am to be in a position to help her.

@justchecking1

Suicidal ideation is very difficult to manage and the mental health team don't always get it right.

However, she's admitted to the ward so she should have had a decent assessment.

If they're still intent on letting her home it suggests that either:

1. She is no longer suicidal, or they don't believe in her intention to end her life.

Or

1. She is still suicidal but they don't believe that this is due to a mental illness and feel she has capacity to make that decision.

Neither of these really helps you. Make sure you get your disagreement with their discharge plans noted.

You could refuse to take her home but her housing need isn't necessarily the ward's problem. They could just give her the number for the council housing department and send her on her way.

Does she actually have a diagnosis as this is probably the key here.

There has been cycling of diagnoses, anxiety, depression, borderline personality disorder, and she has been medicated during panic attacks but they have not given her anything long term, which I really want to speak to them about tomorrow. I have a close family member with Bipolar and medication was life changing for them, I think there must be something that could help my DD.

@baldafrique

If she has EUPD they will be keen to discharge her.

I didn't realise EUPD was the same as BDP, why would that make them keen to discharge? I'm panicking a bit now as that was the most recent condition mentioned.

If there’s a diagnosis of BPD then they can’t treat it hence why they may want to get her discharged as they could argue that they’re not doing anything for her. As her nearest relative you can also request a Mental Health Act Assessment. So if you go into the meeting tomorrow and they are not willing to pursue it, then you can say you’re formally requesting one and one has to be carried out. The Mental Health Act assessment will assess whether she needs to be sectioned. You can also state that you’re not willing to have her home as you feel you cannot keep her safe and they have to take that into account when considering discharge planning. Might be a good idea to write down all the points of concern you have about her mental state and wellbeing, and the concerns being raised by her friends about her definite plans. You can also say that you want it noted that you would consider it negligent if she was discharged and they have a duty of care towards her regardless of diagnosis. Good luck.

With EUPD you can get stuck in a cycle of admissions and wanting to be in hospital because it offers a safety net of sorts.

Acute wards are also not therapeutic. Patients sometimes end up learning different ways to hurt themselves from each other, again something that patients with EUPD can be quite susceptible to.

The decision as to whether or not to discharge will be a difficult one. If she can be kept safe at home, discharge is better. It sounds like in this situation it might be useful for her to stay until she has started medication and her mood has stabilised a bit (but I'm not a professional, just someone with experience of poor MH and the MH services).

It might also be the case that your daughter is asking to leave, in which case she can't be detained unless she is sectioned.

You should be able to be part of the ward round tomorrow, to get a clear plan. Following discharge she will also be under the crisis team. I know there's lots of stories about poor support from MH services, but there are times when the system works well to give people the support they need.

No advice OP but sending lots of love to you, I can't imagine the strain you're all under

Suicidal ideation, which I have experienced, is not the same as being suicidal. Ideation is thinking about suicide, but with no actual intention to take one's own life.

Thank goodness they are reassessing her.

SausageCrush

If there’s a diagnosis of BPD then they can’t treat it

Not sure what was meant by this, but I want to emphasise that BPD can be treated!