In-patient care at the Priory?

[HildegardeCrowe]

My poor brother whose in his 60s has had terrible mental health problems all his life which have recently got much worse. He needs in-patient care for his depression/anxiety but has no money so our dear 90 year old mum has offered to fund it. She has very limited savings but money tied up in a valuable property. We’re thinking of organising 1-2 weeks at a local Priory hospital (£7k per week) and I’d like to know if anyone has experience of them. We can’t afford any longer but he’s in crisis and the NHS as we all know is so stretched that even people who are desperately mentally like my brother have to wait months for treatment.

What would you expect to be achieved in only 1-2 weeks of an inpatient stay?
Antidepressants take at least 2 weeks to work and therapy even longer
Average length of stay on our ward is 6-8 weeks. You are most unlikely to cure a chronic mental illness in 2weeks

Why do you want inpatient admission specifically for such a short time?
Most people are treated as outpatients these days unless they are a danger. If you just want him to see a specialist more quickly and start on treatment then she should save her pennies for a private psychiatrist consultation and therapy sessions
I doubt a short private inpatient admission will achieve much at all.

Has he actually tried going back to the GP and asking for NHS help? We are open for business and we are helping people who are seriously ill. If it's very bad he can ask for a crisis team referral and be seen quickly or in many areas you can self refer for psychotherapy via IAPT or the 111 option 2 crisis line.

Thank you for your advice. Brother has been on ADs for 30 years, been under crisis team, has had loads of therapy, visits A&E regularly with suicidal thoughts and has a lovely GP but here we are. He’s literally a gibbering wreck and in absolute crisis but there’s nowhere to turn. GP has referred him to psychiatry but the waiting list is very long.

The 1-2 weeks would just give him a break I suppose but agree it’s not long enough. Do you really think we’re wasting our money? Just utterly desperate and as he lives with my mum, it’s destroying two lives not just one.

I guess it depends on your expectations. It will certainly give them a break but a holiday would do that more cheaply.

If you are hoping for a cure or significant improvement in 2 weeks that won't happen. If he's a gibbering wreck right now could the GP not get the crisis team involved now straight away rather than waiting? It would at least be something for the immediate term.

Maybe someone will come along with a better experience but in my view psychiatric illness isn't a thing you can easily fix with a short private stay. Private is better for surgery and things like that where there is a quick fix. Long term illness doesn't fit that model very well.

I would go with the best private 2nd opinion you can afford and private therapy instead as that has more chance of effecting long term change.

If he hasn't actually been seen yet by psychiatry, then a private psychiatry opinion would be money better spent - and then funding whatever they suggest in terms of therapy, appointments etc.

Even private psychiatric hospitals aren't necessarily v nice places to be and not a lot will change for him in 2 weeks.

If he hasn't actually been seen yet by psychiatry, then a private psychiatry opinion would be money better spent - and then funding whatever they suggest in terms of therapy, appointments etc.

Exactly this.

Thank you. Yes maybe a private psychiatry opinion would be better then. We don’t know of anyone so would it be best to look at big organisations like BUPA Hospitals to find one?

Locked out of their bedrooms, not looked...

I'm not sure where you are but Spire Hospital bought BUPA so might be a good place to start. There are also BMI Hospitals and Ramsay hospitals that all offer private healthcare - would be worth having a look in your area to see what services and specialists they have.

BUPA will have details of consultant psychiatrists who will see your brother privately, but I think the best bet to to ask your brother's GP for a recommendation. So much of good care for the mental illness requires good communications between the different providers and the GP will have a better feel for local private services rather than BUPA . No knocking BUPA - used to work for them but GP is better placed.

I totally agree with other posters - get an emergency psychiatric outpatient assessment and take if from there. When I worked for BUPA, they allowed 6 weeks inpatient care for mental health issues and this was barely long enough and once you've started down that road it's difficult to pull back. If your DM needs respite, it might be better to pay for a psychiatric HCP to come to their home and for your DM to stay with a member of the family / hotel.

I'd agree about getting a private assessment first. Do you know what medication he is on at the moment? I know people that have been stuck on the same meds for years, and the meds have become part of the problem. Obviously any change needs to be well managed, but a fresh pair of eyes looking at your brother and his condition might well be the change he needs.

In my friend's case it was mirtazapine that caused the problem. He was on such a high dose it was both sedating and agitating at the same time, he described it like he was trapped in his brain. I can't recall what he is on now - and every person is different - but something less sedating actually made him more restful and able to engage.

Are there any crisis houses in your area? You can often self refer rather than needing to be referred by the CMHT or GP

www.mind.org.uk/information-support/guides-to-support-and-services/crisis-services/crisis-houses/

Agree, this sounds so sad, but also a marathon not a sprint. Go back to the NHS and make a (respectful) fuss, he needs a crisis team
Then you can spend any money you have on private psychiatry and also maybe practical support for him but also maybe for you and your mum. Caring for someone in this state is so hard, make sure you are also getting support either with your own mental health or with life in general like cleaning, frozen meals, babysitting, etc, to let you be able to help

I lived near a priory place- NHS patients were put there when there wasn't enough beds. And they were shit (friend ended up there on NHS). The rooms and food were nice though. No way is it worth £7000 a week. Avoid.

Does he live with your mother still and why she is funding the stay - if he is in crisis he would be admitted and do try and do what above poster said and don’t take no or take him to a and e and he will have a psych visit there and could be a start

Avoid.

Find a private psychiatrist, use the money for that plus any meds they prescribe (supermarkets or Boots are the cheapest for private medication prices).

Psychs have a much wider range of medications available to them and a lot of them will kick in within a few days, some almost instantly.

Also, they can determine if his current meds could be exacerbating then issue and most second line meds can be taken whilst weaning off the others if so.

Thank you so much for all your replies, so helpful. Have decided that a short inpatient stay isn’t appropriate but all poor DB wants is to be “sedated and looked after” because he feels so bad. His history is so long and complicated we’re not expecting an easy fix.

Am trying to find a private psychiatrist for an assessment but their waiting lists are incredibly long. He’s been under the crisis team before and has no faith in them and made several visits to A&E and been discharged back to GP. An urgent NHS referral has been made by the GP and he’ll probably get a medication review at the very least. If I was in a position to look after him I would but I live an hour away and work. Feel so bad for not only him but also my dear 90 year old mum who has the patience of a saint.

In our area MIND run a place called the Sanctuary which is like a drop in where you can book to go if you are in crisis for a number of hours daytime or evening and be looked after a bit and have support from staff who often have lived experience. People give good feedback from that.
I imagine it might be like having some of the nicer bits of admission eg staff 1:1 without the bad bits of rules and restrictions and very disturbed people.
Maybe see if they or another organisation run anything similar in your area?

This perhaps is a derail but it occurs to me that mental health services get a lot of bad press because they aren't really set up for what many people need/ want/ expect.

Inpatient admission is really for people with severe largely psychotic mental illness that requires medication treatment and the people are being looked after and kept safe whilst the drugs get to work. If you don't have a medication responsive illness (as many people don't) and your expectation is of a quiet therapeutic space then most acute wards are not that and never can be because they are catering for severely disturbed people.

Maybe we need more day hospitals or respite places.

Have you tried here? X

psychiatry-uk.com

I paid to see a really good private pyschiatrist. It was money well spent. I’m 57 with long term chronic depression/anxiety. It gets harder to treat the older you are.

Where are you?