At what point do people need extra professional intervention?

[allaboardtheskytrain]

A distant relative of mine seems to be having some kind of breakdown. Not showering, crying a lot, dry heaving, curled up on the sofa most of the day.

They are already on anti depressants but their anxiety has spiralled out of control- the GP knows and they've spoken on the phone and been told they can increase the dose but seem unable to make the decision whether to do so or not.

They have a partner who is just going out to work as normal, not really looking after them very well IMO. I'm going round when I can as are a couple of other people but I feel out of my depth here. Is there still a community MH team these days? If so can anyone else call them?

There is a CMHT which normally the GP would make referrals to. You could see if there is a local crisis team and call them and raise a concern. Be aware that services are very stretched though and you may find nothing happens as they don’t sound like they are a danger to themselves or others. What area are you in?

Sadly agree with @Scutterbug they don't sound like they'd meet criteria for extra intervention. What do you think gp should be doing? I would also assume the partner has to continue to go to work, very unfair for you
To judge them as I'd assume there's is the only current income for the household?

Would they agree to an appointment with a private psychiatrist? That would be the easiest way to get a review of the medication carried out and assessment of any other treatment that could help.
An initial appointment would be around £300 so not a huge expense.

Took my DD26 10 years to see anyone above GP level for severe MH issues I'm afraid. That's the state of the support available. It sucks.

So it seems.

It's not something I've got much experience with which is why I asked. It's staggering that people can be in that state and not have anyone to help them. I thought there would be community MH teams available but I guess they're overstretched like every other service.

It's a huge expense if there's only one income that's not a big income

They have a partner who is just going out to work as normal, not really looking after them very well IMO.

This is a bit unfair; bills and mortgage/rent still need to be paid. If one person is having a crisis, then the financial pressure on the other can be even greater

I guess so but it sounds like she is in real crisis so I would have thought that most people could make sacrifices by cutting back on unnecessary expenses to free up that amount. Or family and friends could contribute?
Maybe I am out of touch with the reality of some people’s lives (and I am grateful that I am not so financially stretched that I couldn’t find £300 in this type of situation)

You sound very out of touch! And quite judgemental

If I was in this situation, I couldn't get £300 together quickly even with as many sacrifices as possible. Unfortunately I think alot of people would be the same. OP I really hope you can find a solution 💐

Anyone can self-refer to these services.
https://www.nhs.uk/service-search/mental-health/find-an-nhs-talking-therapies-service

Also resources on the MIND website and there might be a MIND centre/hub in their town.

Apologies

The problem is it's not just £300, is it? Mental health won't be fixed by one appointment, or indeed in some cases, by ongoing appointments.

OP they should start with contacting the GP. If they feel fobbed off they should keep at it. The GP should be able to signpost to groups and agencies that can offer support, as well as reviewing medication. You could also look online for mental health charities who offer advice and support, such as Mind.
Sadly if you are hoping for referral for counselling, there will be a very, very long wait on the NHS, and they may never get an appointment.

From experience of a close relative's depression, they only started getting support after attempting suicide. Even then it was crisis support for a couple of weeks, a change to medication, and a follow up chat with the team a few weeks later. There were two more suicide attempts, and several arrests for their extreme behaviour. On all occasions they were taken to hospital, but were always discharged, often with very little, or even no follow up. About 6 years after a referral was made for specialist help, they got an appointment with a psychiatrist. That turned out to be monthly medication reviews in 10 minute appointments, not at all what was hoped for or promised.
The moral of the story is the person themselves, with support from those around them, will have to seek and perhaps pay for ongoing help. Almost impossible when they're in crisis.

Also, like others have said, don't judge their partner. They have a lot to deal with and would perhaps appreciate someone like you stepping in to offer help. Maybe start there, see what you can do to help support the person who is unwell.

It’s simply not true that you will never get an appointment OP, maybe that’s the experience if you go via a GP, but the poster above who recommended self-referral to IAPT was right. Your relative can do that and should be triaged quickly, speaking to someone within a couple of weeks. That team will then eascalate/refer on for suitable care.