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Undiagnosed mental illness/mental health crisis and help available if patient refuses to engage

24 replies

Lkjh098 · 30/12/2024 02:20

Hi,

Just is more a warning I guess, but I invite any advice or guidance from anyone with experience of the system.

My brother is in his 30s. Has had MH issues since his late teens. We have an abusive (narcissistic) father. It started off as major depression and OCD as a young adult. My father did not deal with it well. He continued to mistreat him, was physically and emotionally abusive. Didn't want him to study or work away. Did everything in his power to emasculate him. My brother never held down a job. Had trouble maintaining relationships and friendships. Spent most of his waking hours in our home with my father (who had his own company and WFH). Then our father left our mother a few years ago and things have continued going south but at an alarming rate. My brother eventually became psychotic around a year ago. He never sought treatment outside of occasion counseling with a private psychologist who managed to convince everyone that the issue was spiritual and we should be able to manage him at home.

His psychosis got worse. He thinks my mum is trying to kill him by adding cleaning product to this food. He acts erratically placing random objects in random places and responds aggressively if objects are moved. Defecates and urinates on the floor. Smeared soil over the floors and walls of the living room. Refuses to let my mum clean anythjng. Walks around the house naked. Leaves the house door wide open over night and responds aggressively if told to shut it. He's taken our dad's old and filthy duvet which he's slept on for a few months. It is soiled, as are his clothes. He refuses to allow anyone to clean these. He took said duvet and0 slept outside the house. He doesn't eat properly (diet consists pf honey, peanut butter and granola). He barely sleeps. He throws fruit at my mum, spits at her, pushes her, has broken qall her crockery. He hallucinates- often has conversations with imaginary beings, admits to hearing voices.

We have exhausted all avenues to get him diagnosd/the help he needs: GPs, first response, safe guarding, his private psychologist, the police over the past 1-2yrs. Every single one just directes us to someone else, and each one claims not to be able to provide care to someone who does not consent to care. Finally we called an ambulance to conduct a welfare check. They arrived 4 hours after the begining an "episode" during which he was sleeping outside. We arranged the ambulance on the advice and direction of first response who suggested that following a welfare check, they'd be able to arrange a mental health act assessment and decide if he needs to be detained involuntarily. My brother reacted aggressively towards the parademics who deemed him as alert and having capacity. They called the police and left. The police came and arranged a safeguarding assessment of my mother in the coming days.

So in the end, my brother will not get the help he needs. My mum has (finally and after much urging) agreed to move out. I doubt my brother will live to see many more years living alone in the state he is in. He is emaciated.

This is the state of mental health provision in this country.

Thanks if you managed to get this far.

OP posts:
Lunedimiel · 30/12/2024 02:27

Sounds horrendously difficult. Sending you best wishes.

Nogodsnomasters · 30/12/2024 07:28

Have you spoke to your local crisis team? They can absolutely arrange a bed for him in a mental health hospital. He absolutely needs medicated and they will do this.

I'm so glad your poor mother has agreed to move out. This must be so stressful for the both of you.

Dixiedot90 · 30/12/2024 08:01

Hi OP. Mental health nurse. I’m so sorry you’re all having such a hard time. You need to contact his GP again and advise them that you’re going to make a request for a MHAA through your local crisis team. When you speak to the duty nurse ask to send over a summary of your concerns in writing. Include detail about the nature of his hallucinations, risk to self (even through self neglect) and risk to others (becoming increasingly aggressive towards your mum for example)

Lkjh098 · 30/12/2024 13:53

Is the local crisis team first response? They're the only point of contact we have wrt a local crisis team. I have been directed to them by everyone (GP, ambulance, police, psychologist) and remain in regular contact with them. They reiterate at each contact that without his willingness to engage with them for an assessment they cannot do anything.

A parademic called me yesterday before the ambulance arrived and said they'd only usually consider a mental health act assessment if he's in a public place?

We're getting conflicting information from everyone and keep getting passed from one point of contact to another.

OP posts:
Dixiedot90 · 30/12/2024 18:20

With all due respect, a paramedic isn’t an appropriate person to be taking advice from. The information they’ve given you is incorrect.
Police can enter a property under section 135 and detain someone for a mental health act assessment.

Have you spoken to the crisis team manager? That would be my next port of call in your situation. Make it clear that you’re requesting a MHAA as ‘nearest relative’.

You could seek advice from a mental health charity if you keep going in circles, perhaps Mind or Rethink

Lkjh098 · 30/12/2024 18:59

Dixiedot90 · 30/12/2024 18:20

With all due respect, a paramedic isn’t an appropriate person to be taking advice from. The information they’ve given you is incorrect.
Police can enter a property under section 135 and detain someone for a mental health act assessment.

Have you spoken to the crisis team manager? That would be my next port of call in your situation. Make it clear that you’re requesting a MHAA as ‘nearest relative’.

You could seek advice from a mental health charity if you keep going in circles, perhaps Mind or Rethink

The crisis team are sick of me calling them. They keep repeating the same thing: if he doesn't engage with them they cannot assess him.

The police were there. They saw the state of the house. They heard my brother claim my mum was trying to kill him by adding cleaning products to his food. They did nothing. The parademics asked him what the date was and who the prime minister was, then decided he was alert and had capacity and then left.

We called safeguarding today regarding my mum. They're yet to attend for an assessment. We also calling social housing. Even with a report of abuse from safeguarding and the police, we've been told my mum is likely to wait 20 years before being offered alternative accommodation (besides emergency accommodation in a hostel which she is refusing).

I have no words left.

OP posts:
Luminousalumnus · 30/12/2024 19:04

And this would be my experience too op. There is no help available if the person won't engage until they are unwell enough to be sectioned. 'Unwell enough' translates as dangerous enough to the public. Dangerous to themselves or family and friends cuts little ice.

Autumnalmists · 30/12/2024 22:38

Does your DM own the house she and your brother live in? Or is the house solely in his name?

I wonder if it is her home or tenancy if making him homeless might trigger the help and support he needs as your DM cannot continue to suffer.

Scutterbug · 30/12/2024 22:42

MH services are so shocking.

What u would do, is every time he abuses your mother or breaks items, call the police. Be a real nuisance.

mitogoshigg · 30/12/2024 22:44

If your mum can categorically say to the police that is threatened by them then they can arrest and a duty doctor can decide whether to refer for sectioning. His behaviour sounds horrible but they can't section easily unless there is perceived danger.

Lighttodark · 30/12/2024 22:54

I’m so sorry. The ‘service’ is absolutely shit and not fit for purpose. All I can suggest is to keep contacting crisis and make clear he is a risk to himself ie neglecting himself not eating, sleeping outdoors etc and a risk to your mother. Push for a mental health assessment www.mind.org.uk/information-support/legal-rights/nearest-relative/sectioning-and-guardianships/

Lkjh098 · 30/12/2024 23:00

Autumnalmists · 30/12/2024 22:38

Does your DM own the house she and your brother live in? Or is the house solely in his name?

I wonder if it is her home or tenancy if making him homeless might trigger the help and support he needs as your DM cannot continue to suffer.

My dad owns it - my mum isn't on the deeds and he has threatened to sell it since leaving.

Most weeks i spend at least 2 or 3 days calling crisis team, GPs, my brother's old psychologist, the police (I have my own family and am currently heavily pregnant so this isn't sustainable - my mum has refused to stay with me and my family). I cannot stress enough the lenghts we have gone to have someone to listen to us and assess him. But each time we are told that he has capacity and their hands are tied.

The house is uninhabitable. There is feaces and urine on the floor. Soil smeared on walls. My brother is dressed in soiled clothes, he sleeps in the living room (with the door left wide open overnight). His bedding is soiled. He looks clearly emaciated. The paramedics and the police saw all of this last night.

Thanks so much for all your responses.

OP posts:
gamerchick · 30/12/2024 23:03

Nogodsnomasters · 30/12/2024 07:28

Have you spoke to your local crisis team? They can absolutely arrange a bed for him in a mental health hospital. He absolutely needs medicated and they will do this.

I'm so glad your poor mother has agreed to move out. This must be so stressful for the both of you.

Lol. The crisis team? I'm still not sure what they're for. They.will.do.nothing. crisis team indeed. They have a nerve calling themselves a service.

Mental health services have collapsed.

I'm sorry OP but the only thing your mother can do is make him homeless. He needs to be a danger to the public before he'll get 'help', it's shit all round but he might get a bed somewhere on a closed ward if hes lucky for a bit.

gamerchick · 30/12/2024 23:04

My dad owns it - my mum isn't on the deeds and he has threatened to sell it since leaving

Tell him to sell it. Your mother needs a push to leave for her own sake.

Dixiedot90 · 30/12/2024 23:06

Have you tried formalising a complaint? It’ll escalate his case and will mean someone else looking objectively at the crisis team’s decision making.

I can understand the thinking but I really wouldn’t recommend your mother making him homeless given how vulnerable he is - he could end up dead

Lkjh098 · 29/11/2025 18:40

Wanted to update this thread.

Almost a year and numerous mental health act assessments later, my brother is being sectioned today.

OP posts:
Imnotsobadreally · 29/11/2025 18:53

Lkjh098 · 29/11/2025 18:40

Wanted to update this thread.

Almost a year and numerous mental health act assessments later, my brother is being sectioned today.

Hopefully he will get the help he needs now OP. It’s sad that the system is so broken that it has to reach this stage before any help is available.

Egglio · 29/11/2025 18:56

I'm so sorry it has taken this long. I hope you now have the support you need to navigate his sectioning.

Redburnett · 29/11/2025 19:05

I don't understand why he cannot be sectioned since he is a danger to himself and others?
So sorry for you and your situation.

Redburnett · 29/11/2025 19:06

Sorry hadn't read update......

Twoshoesnewshoes · 29/11/2025 19:11

That’s good news OP, hopefully he will get the medication now that can help him.

Lullabycrickets23 · 29/11/2025 19:21

From experience regarding a close relative, they can section someone under similar circumstances. To be honest probably they are just not willing.
My relative was psychotic, probably not as bad as your brother. It happened that in an anger episode he got violent in his mother’s house. Not towards people, but was smashing some stuff. Police was called, came with ambulance. He calmed down by then, nonetheless he was sectioned for 4 weeks.
He didn’t agree. He wasn’t willing to engage. He was sectioned under the mental health act.
So, there is away and a law that would allow them. They are playing deaf.
I am so sorry for your family and I genuinely feel your pain!

MrsPositivity1 · 29/11/2025 20:30

Please god he gets the help he needs. I’m sorry it’s taken this long

SilkiePenguin · 29/11/2025 20:42

I am so sorry its taken so long for mental health and other services to offer any help when your DB and DMum clearly desperately needed it. Sending lots of love to you all. I hope they can find a path which helps your DB.

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