Friend suffering with severe mental health problems coming to stay - what do I do?

[inventinghannah]

This post contains some discussion on mental health problems, please don't read if you will find that triggering.

I'm not sure if anyone is around at this time or if this is the right place to be posting but I don't know what else to do.

Apologies if any of my language below is incorrect, it's not my intention to offend anyone.

A friend of mine has been suffering from mental health issues for a while. Multiple suicide attempts over the last few years and has been sectioned under the mental health act a few times. I feel awful for saying this but I tried to remove myself from the situation, it was getting too much for me to handle and in the past, when she's suffered with depression and confided in me, it's really brought me down too (at one point I didn't leave my bed for days) so I stepped back to protect myself. I also never know what to say to her, what I can do or how I can help. My friend has other friends who are far better equipped to help and support her than I am.

I had a call from her this morning to say that she was in hospital again after telling a mental health worker that she has been contemplating overdosing. Said she had gone as far as buying the pills but never took them. She asked if she can stay with me for 1-2 weeks. She lives alone and the doctors have said she needs to be around someone for them to agree to discharge her. I have since had a doctor call to confirm this, note down my details and have me assure them I will call the police if my friend never shows up or goes missing.

I'm happy for her to stay and I want to help but to be honest, I'm terrified. Mostly that something will happen when she's here and I won't know what to do. But also just generally, I have no clue how I should act around her.

I'm completely overwhelmed. Any words of advice are very gratefully received xx

You call the doctor straight back and say you have changed your mind and you aren't up for being on suicide watch for your friend in your own home!! And a vague 1-2 weeks sounds ominously open ended. What if in 2 weeks she is no better? Does she stay forever?

Honestly - you aren't happy to have her stay, not in the state she's in at the moment. Call back and tell them you can't do it.

Precautions: hide the knifes/paracetamol/potential ligatures. However anything can be used to self harm - tv leads, broken can of coke, recycling items. So the reality is that you can reduce the risk but not eradicate it.

keep alcohol, coffee to the minimum.

exercise daily together, a swim or walk, gym visit. Meditation?

borrow a dog

Positive activities: uplifting music/films, running her a relaxing bubble bath, girls night in with pedicure, face mask, deep conditioner on hair.

have a good bedtime routine and hopefully this will rub off on her

Good luck. You are doing a really kind thing.

Is there any support the hospital or Community Mental Health Team (CMHT) can provide you? I assume they will re supporting your friend!

I would say that you are not supposed to be her counsellor, just be her friend as you normally would. If you can, be there to listen to her and encourage her to use her strategies/phone numbers if she needs them. Keep an eye to try to ensure her safety, and if you don't think she can keep herself safe call her emergency numbers or 999.

Most importantly make sure you are looking after you. Do you have support yourself as I would expect her your friend to have any emotional resources to look after you right now. Can you take time out if you need it? If she needs someone with her all the time, is there anyone that can sit with her so you can take a break if needed?

When my MH is poor I find it helpful to have a calm, clean and ordered environment (which I can't always maintain myself). And to do things like watch a nice film (something calm
and upbeat) with blankets and tea. To try to get out for walks (outside and exercise are great for MH). Ideally near the sea for me (obviously not possible for everyone!) as it calms me and lifts my mood for some reason. Perhaps ask your friend if anything similar helps her. Often mental health professionals get people to make a list of things like this people with mental health difficulties can do for self-care. So she may have a list already.

What's your friends diagnosis? Is her main issue depression/anxiety or does she have a diagnosis that comes with other symptoms?

Best of luck to you both. I hope your friend manages to pull through this one 💐💐💐💐

Also ring the doctor back and ask them for a plan of what to do if things go pear shaped, who to contact night and day, what the warning signs might be, ask if she has any prescribed medication which can deescalate her.

if she is close to overdosing or actively overdosing ring 999

if shes struggling walk into A&E

there will also be lots of numbers MIND, the Samaritans that you can both call for support. Both have websites

And yes look after yourself. You’ve got to be steady and fine within yourself to effectively help her out. It’s very kind of you

You don’t have to do this. I know this would be hard, but also doing this would be hard. However you do say that she is a friend, and that you seem OK with being a support but mostly don’t really know how to? If so, then although I’m not a current expert, I would…
Ring them and say that in order to go ahead you would need a chat with them where they tell you specifically what they feel the risks are, and what to do in any scenario (ie when exactly do you call, who do you call). Say if you are being put in a position of responsibility for risk, then you need a full risk assessment. Ask for that in those words. Also then make it clear how long this is for, 1 to 2 weeks is very vague.

Make sure you plan for your limit (which might be 2 weeks) and what will happen then if your friend cannot go home or you are worried.

Remove paracetamol and all medications from your home and either lock them or give them to someone else.
Remove all knives and scissors.
You can’t remove all risk. So in your head, (sorry to be so clear), be prepared that there is a person who is still, at some level, actively suicidal - if you have children or other people living with you - reconsider. You cannot remove the amount of risks that a hospital can, it’s impossible. You need to be prepared to take that risk, and accept that you are providing a space for someone but that doens’t mean you are fully responsible for them. This is their life and you are not a professional, you are just a friend, remember your boundaries on that are quite important.

Then be prepared to have someone who is very all over the place. All you can do is offer a safe space and provide opportunities. Opportunities for eating, for talking, for walks, for watching TV, for washing. But your friend may not do these. You can’t do anything about that. She doesn’t want you to have the magic words that are just right. She just needs a safe space out of hospital.

So offer these things. But live your life and manage yourself. Just being there is your only role, but an important one.

Sorry when I say ‘ring them’, I mean ring the hospital.

I have spent time in psychiatric hospital. It sounds like the hospital is putting her on gradual release in preparation for her to be discharged from hospital.

I would assume that, for them to be doing this, she will already be stable and will be on meds that will have demonstrated that she is showing enough improvement to be preparing to go home. Otherwise, they wouldn’t be sending her out.

It sounds like she suffers a lot and I can understand why you feel worried. I would definitely ask if you can have a meeting with her psychiatrist and ask about her treatment, etc.

Thank you so much everyone, I really appreciate the late night responses.

I feel like I'm in a tricky place because I desperately want to help her, we've been friends for 15+ years, but I feel so out of my depth. The phone call from the doctor was completely out of the blue and I didn't have time to gather any coherent thoughts or figure out if I was ok with it all, so I just said yes it's fine.

She seems adamant that she will be better off outside of hospital and to the extent I can help, I want to. I know she has tried lots of meds and has said that the last few months have been a case of her wanting to get better but like she can't control her mental health. I don't know her exact diagnosis, it seems a bit like an ever-expanding list (that sounds mean but I'm only trying to be factual!). I know she has suffered from dissociative disorders as well as depression.

I'm happy to have her stay in the sense that I will provide a safe space, listen if she wants to talk, go for walks, dinner, watch films, whatever helps. But I'm very uncomfortable with the idea of being responsible for her life if things go downhill. Basically what PPs have said - I can be a friend but I'm not qualified for more.

There have been some really useful tips so thank you again. I've been running around getting rid of as many risks as I can within my house. Removing knives from the kitchen has really hammered home how serious this is, it felt a bit surreal before. I will 100% call the hospital/999/whoever, the second things look like they are going beyond what I can deal with.

I'm also going to call the hospital back tomorrow for any further details, clarification or support they can give me.

Great advice in here. I would maybe agree to up to one week if I felt strong enough. Definitely hide knives, drugs, razors.

But the second you feel you are in too deep, you call for help. And if you already feel you are in too deep, say no.

Massive responsibility.

What is it she wants or expects from you? She should be clear that you are nervous and will host her to a point but that if her behaviour frightens you, you will be calling the hospital.

I would ring the hospital and tell them that you can't do this. I understand the situation well. My mil was severely mentally unwell, but not suicidal. Even we, as close family members wouldn't have had her live with us. None of her children would have.

The difference is that she was a danger to others and it doesn't sound like you friend is. Is that right? It will still be incredibly hard.

The fact that she's been suicidal would make it so much harder. I think the previous posters mean well, but having to get into the mind of another person and hide any weapons she could use against herself would be massively anxiety inducing in itself. You are one person and you can't watch her 24/7.

She has no family who can help?

Good lord no. You'll come off worse.
Leave your friend in the hands of the professionals. It's best all round.
Sorry for your troubles though and I hope she finds the right care. 💐

I've had a relative who was mentally ill stay with us. We tried never to leave her alone. On the odd occasion when we were both out, our teens were told to watch her and if she left to go with her and phone us. She had an entire family around her and it was still hard work. I'm not sure I'd be up to it if I was on my own.

As much as I’m sure you were trying to help; I’m unsure if her staying with you is a good idea either.

you’ve already noted feeling drained when being her emotional support at times - it will be even more draining with her being in the house for 2 weeks (maybe longer), unwell and relying on your physical/ mental/ emotional support also whilst trying to keep your own head above water.

I think you need to call and let the hospital know you won’t be able to have her at your home but you can provide emotional support and will do what you can to help - but the reality is; if that isn’t enough, maybe it’s better she stays admitted until she’s feeling better.

You sound like lovely what a difficult predicament to be in. Whatever you decide is the right decision. I hope it goes well x

Call the hospital and say that the original call was unexpected but that on reflection you don’t think you can do it - that you are frightened.

I agree with this. This is such a massive thing to take on, it shouldn’t be your responsibility. I know she’s your friend, and you are being very kind, but you said your self that previously you were very affected by her mental health issues and had to protect your self, and took a step back. Which was the right thing to do. You are not qualified to take this on and it’s such a big ask of you. You are allowed to change your mind on this..

It's lovely you want to help. But what if it gets too much. Goes she have somewhere else to go? Would you feel able to ask her to move on? Do u have anyone to support you?

You've said you'll help so clearly that's something you felt ok to offer. I would suggest routine, routine, routine.

Tell her what time you'll both be getting up, what time you'll be doing breakfast, plans for day etc. she may have medical appointments to accommodate. Involve her in planning, where you're going, what you're eating etc. things to look forward to. Physical exercise is likely to be beneficial. No alcohol

You do however need an escalation plan if things do go awry - only accept a discharge if this is written and in place

You can see her preferred method of self harm (overdose) so make sure your home is free from medication if possible. You can ask her if she'd like you to keep hold of her meds, if it's a no make it clear that she change her mind any time

If you can do this for her you're a bloody good friend

This is so hard because I don't think you should even go out and leave her alone. This is what happened with Caroline Flack. Her friend popped to the shops and she had promised she was ok and wouldn't do anything stupid. She wasn't ok.

I have been in your position so I will be very blunt:

Medics are trying to palm a very sick person off onto a member of the community who is not even her family.

You need to do as @Xiaoxiong says. Call the medical team and tell them you cannot take on this responsibility. It is beyond your skill set. Write a note to your friend and tell her you love her and are deeply concerned for her, so it was a difficult decision but right now you know she is safest under medical care. You are not experienced in coping with her illness in this critical state and it could be disastrous for both of you if you attemtped to. The responsibility is too great. You will visit her often and check in by text or phone every day.

That's it. Medics should be ashamed of themselves trying to offload severely ill and dangerous patients onto absolutely unprepared members of the public who could end up with a crisis on their hands which will traumatise them for life.

I was a very people-pleasing put upon person in my twenties. Very bullied and controlled by my ill friend, But even I found enough spine at the last moment to say: No I cannot be responsible for her. And I'm bloody glad I did.

Sorry actually my post is probably really unhelpful, sorry if that sounded over dramatic or scary, it's just what came to mind

I agree

I think you are being very kind op but don't think it's very fair the way you were bounced in to this.

If I was going to take this on I would expect to be asked way in advance, have lots of information about what it involved and have time to consider my response. Whereas it sounds like your friend didn't give you much time to think this through.

Also, "She lives alone and the doctors have said she needs to be around someone for them to agree to discharge her." From this it sounds like staying with you is an integral part of her recovery and I think that is a lot to ask of a friend, maybe a bit too much tbh. There is also the implication that she isn't well enough to be released without you being there to look after her. Personally I think it would be better if you had been asked to look after her once she had completed her treatment. And "calling the police" isn't much of a back up plan is it?

I'm sorry, however much you genuinely want to help, and I hope I am wrong, but I do not think that any of this bodes well. It doesn't feel well thought out.

In your shoes I would also be very worried about what happens at the end of one to two weeks. What if she is still suicidal at this point? Are you going to be the one responsible for pushing her out to live on her own again? Do you really want to be responsible for making that decision? Two weeks is not very long in terms of recovery. What accommodation and support does she have to return to? What happens if she doesn't feel ready to go back after two weeks?

Sorry, but despite wanting to be kind and do the right thing, and given that you feel justifiably out of your depth op, I actually think that refusing this request might be the kinder thing to do. You could give the excuse that you are depressed yourself and don't have the inner resources to do this currently.

OP, you absolutely don’t have to do this. Just reading some of the tips on how best to look after your friend is crazy! You are expected to act like a medical professional - even though you don’t know the full diagnosis, putting your life completely on hold for her, for however long, completely rearranging everything, being on constant high alert in case something terrible happens. This is not on because you are not trained for this. I know you are trying to do the right thing, but this is so much.