Trigger warning - need advice on hospital process after unsuccessful attempt

[SENsupportplease]

My sibling took an intentional OD and nearly died 2 nights ago

She has been in AMU as they stabilise her

Will the hospital automatically perform a mental health assessment and how likely is it they will section her?

Will they listen to our concerns as her family members?

We are terrified that on discharge she will repeat and be successful

If she is sectioned involuntarily, the good thing about that is that she should then receive what's termed "aftercare" which is where the council and the NHS will jointly agree and fund whatever care they determine necessary to keep her safe until she is fully recovered, even once she is released from hospital. What I am not sure of is how you go about making sure she do indeed receive that.

Op I wonder if you are taking it on board all this blame and now somehow feel responsible. It's not your fault

Only if it's a section 3

I think the patient still needs to consent to having the n,r appointed

I feel angry

she went LC with our parents some months ago so I stepped up

to the best of my limited ability I was there for her ( I run a business 60 hours a week, have SEN children and am au-dhd myself)

we had her here for Christmas instead of her being alone, sacrificed sleep to support her, dropped everying on Friday to rush to hospital, I had to tell my parents

spent £400 on a locksmith to get into her home to help the cats

to be told I’m the main reason she attempted
That I am toxic
That I can’t be told anything

it fucking hurts

I definitely need to detach but then I have parents who want and are used to my support and need it here

@ThePurewhat does the right to be consulted mean please?

we don’t even know if she has had a MHA assessment

Thanks for the correction on that one!

I know it's difficult and you're feeling angry but try and step back, she's safe in hospital, you say she's been put on a section so she has been assessed by a doctor and is being kept in for her safety. A "nearest relative" is someone officially appointed who has rights to be involved in some aspects of care, sectioning and discharge planning, the patient needs to agree to having the nearest relative appointed. Your mum should know if she's been appointed, it's not the same as next of kin. The hospital social worker and mh team will know your sisters and your mums legal rights.

This right attaches only to section 3 the 6 month section which is rarely applied. It does not attaches to S2 the 28 day one or any other

No they don’t. The NR is a statutory role and the patient’s preference has nothing to do with it although they could in practice refuse to provide the contact details.

Looking at MIND online advice, if your mum is her legally appointed nearest relative this can only be changed or removed with a court order, your sister can apply if she has capacity. I'm not a mh expert.

It means that the AMPH has to try to contact the NR when an MHA takes place and has to ascertain their views but the main relevance is to check that the NR does not object to detention under MHA. They cannot request that a person is detained. There is only the right to object and not the opposite. The AMHP also has to notify the NR of the outcome of any MHA assessment and of their rights which are mainly to object and to discharge not to get a person detained.

You have tried your best to help. You do need to step back now for your own protection and concentrate on supporting your parents if they need you. It is a very sad situation but unless she chooses to help herself or accept help there is little that anyone can do. If she doesn’t want contact then I think you all need to let that be. As far as I can see attempts to force her into treatment are likely to fail and just alienate her more. I would take a big step back and just let her know that you are there should she want to be in contact.

She really needs all the family support she can possibly get right now because the NHS is notoriously shit in this respect. Ime the “mental health assessment” consists of about 5 questions delivered in a rushed, cold, unsupportive manner. Then she’ll be discharged with zero after care unless she’s acting crazy and threatening to harm herself there and then, in which case she may be admitted but it would still be voluntary. Very unlikely she’d be sectioned. They just don’t have the beds. You sound very supportive. I hope she has others to rely on too, to help support you also xx

@SENsupportplease sorry I didn’t read your updates when I posted the above. I agree with other posters. I might be time to take a bit of a step back

Is it officially appointed? Everything I’ve read implies it’s a legal default

I don’t think I am, sadly

i cant handle being blamed and I can’t risk her being in touch with my children

Fair enough. You are within your rights to assert a reasonable boundary.

Given that this hasn’t happened does that mean that she probably hasn’t had an MHA, and does that mean that my mum as NR can request one?

mum is being kept in the dark and that feels wrong given she is NR, while accepting that she cannot be told everything.

It is a legal default. You just are the nearest relative if you fit the definition. You can refuse to engage with the role and you can delegate it to someone else but the person can’t elect or refuse their own NR and you can’t volunteer to be it. It’s really only of much use if you want to exercise your rights to object to detention or discharge your relative from detention but not if you want them to be detained.

They have 72hours from her being put on S5,2 to arrange the MHA and she would need to be medically fit before it could happen so it’s very unlikely to be tonight. The AMPH will call your mum if she is identified as NR and they have the contact details. It’s likely to be tomorrow not tonight.

Being NR only entitles you to be informed of the MHA assessment and its outcome and not of any wider details of the persons care I am afraid.

You mentioned that she was living with the partner? If she has been living with them for more than 6 months they could be considered as NR so may potentially have been consulted? It would depend on if it is clearly a permanent split. If it is NR would revert to next on the list (your Mum by the sound of it) but if DSis is saying it's temporary then they may still be considering the ex?

NR can be delegated without court, so if partner is currently NR they could sign it over to your Mum.

I don’t think this would hold they have broken up several times so the six months isn’t consecutive

plus he isn’t there now

and don’t think he would want it he is wanting to be as far away from this shit show as he can get

Even knowing one had happened and they had decided against detention and the reasons why would be something

I genuinely don’t understand how someone who is saying she will kill herself can be considered to have capacity

thank you so much for all your patient explanations

(((HUG)))

this is so so so hard even without the additional difficulty if your own Autism.

please try to remember this is the illness talking! You well & balanced sister doesn't hate you & doesn't blame you the illness is blaming you because you're trying to stop it winning.

keep fighting for her & doing your best. But try to start accepting you don't have control over her or this situation & she may succeed and if so it will NOT be your fault!

support your parents, but don't be a (metaphorical) punch bag or scape goat.

xx

It is likely that she will be “assessed” by the hospital liaison team, as another poster said this isn’t the same as a MHA assessment.

They may ask your sister to agree to informal admission, but it sounds like she wouldn’t agree to that.

She could be discharged to the Crisis Team, who can request a MHA assessment if they feel that one is required, but if she is deemed to have capacity, and doesn’t have a psychotic mental illness, it is unlikely that the AMHPs would agree. In my experience, the crisis team do spend a lot of time battling with them. The Crisis Team will discharge her back to her GP if she refuses to engage with them.