Is psych admission possible without a&e? Trigger warning : suicide attempt.

[Pimpernella]

Hi,
Our daughter took an overdose on Sunday night. A&E was hell - people sitting there with broken limbs and dislocated shoulders all night. Some had been there 16 hours and still not seen a doctor.

We were luckier as she needed urgent treatment. She was later admitted onto a paeds ward.

The first day was ok but the susequent shifts wouldn't allow her to have the curtain closed despite me telling them that with ASD, the ward was overwhelming for her. Somehow she saw this as my fault. My daughter is also furious with me for answering the questions camhs asked when she couldn't and they looked to me. I was really trying not to do this.

Anyway - she told them she didn't want to go home and that she still wanted to die. They then discharged us.

She won't talk to me. Tonight she told my husband she wants to be in hospital that she absolutely is going to kill herself and can't stay here.

We rang the camhs crisis line. She said someone would ring us within 48 hours. We said this was no good and she replied we had to go to a&e and that she had to end the call and put the phone down.

When asked, our daughter doesn't want to go and sit in a&e all night again despite her intention to end her life and says she won't do anything tonight.

She won't go away from home - just anywhere - as she doesn't want to be with me. DH can't take more time off as he is missing promotions at work due to his 'situation at home' (overheard being discussed in open office by a collegue) and we need to protect his income as I have had to give up work to care for Dd.

Is there another way to be admitted if I ring her team tomorrow?

We had a CETR a couple of weeks ago where her psychiatrist said her ASD meant admission would not be in her best interests.

Please - if you have a negative opinion, don't post. I can't take much more.

Hi OP,
So sorry to hear about your DD, how devastating for you and your family.

Can I ask what urgent treatment your daughter received when she was there?

She had two IV bags to counteract the paracetamol.

Also something else went into the canula. Don't know what. No-one explained anything at the time. Nurse told us about what the bags were for when we went onto ward the next day. I could have asked though I suppose.

Yes, a direct admission to a CAMHS unit from home is possible. However, these days it is less common due to the pressure on beds and the threshold for admission.

Another possibility to avoid A&E is DD could be given open access to the general paed ward (although in the case of an overdose depending on the ward and time of day they may still direct to attend A&E in that situation for emergency medical treatment) to be admitted there while waiting for a CAMHS inpatient bed.

If you don’t think you can keep DD safe but she won’t attend A&E call an ambulance.

Have you had social care assessments? A carer’s assessment for you and an assessment via the disabled children’s team for DD.

Thanks for replying. She is less sure this morning but I will make some calls today.
I don't actually think an admission is the best thing but if today she is still insisting she can't be safe then we are running out of options.
We have had social care - they nearly broke us. Luckily once dd's psychiatrist stepped in and overruled, they passed over to health. I think we have been rerefferd since things have worsened but I really don't want them.
I think a carer's assessment has been mentioned.
Thank you for helping.

From the limited information in your posts, I don’t think at the moment DD will be admitted to a CAMHS inpatient unit. Beds are at a premium and the threshold is very, very high.

I also wonder whether DD thinks it is going to be a ‘cure’ (not really the right word but I get think of the word I mean at the moment) for the way she is feeling at the moment. In my experience, sadly, that often isn’t the case.

When you had social care involvement before was it from the Disabled Children’s Team and is it them you have been re-referred to? If not, ask for a referral to them.

I have been through a mental health crisis with my ds who is non verbal and has asd. I would not say that the admission really helped. There are very few options locally in our area. Many young people go out of area. The unit was poor. It was subsequently closed due to safeguarding concerns. Can you afford a private psychiatry referral? This might be your best option. Or can you get some care in the home from an agency? I would avoid mental health care in hospital if possible. It is pretty shit.