Sectioning under mental health
Discussion
How would someone go about this process?
Can't give details but I'm really concerned that someone I've known for many years (always a little on the spectrum) has deteriorated to a point where he's now a danger to himself by his actions? (To a certain extent by reason of his house being a semi he's a danger to the neighbours)
Basic steps would be good?
Can't give details but I'm really concerned that someone I've known for many years (always a little on the spectrum) has deteriorated to a point where he's now a danger to himself by his actions? (To a certain extent by reason of his house being a semi he's a danger to the neighbours)
Basic steps would be good?
Speak to 111 and they can put you in touch with the local mental health teams. If older then there will be an older persons mental health teams. They are busy and it can sometimes take a little while to get the cogs to turn but they are good teams.
If you drop in that you fear for their life they tend to escalate quickly.
If you drop in that you fear for their life they tend to escalate quickly.
Caddyshack said:
Speak to 111 and they can put you in touch with the local mental health teams. If older then there will be an older persons mental health teams. They are busy and it can sometimes take a little while to get the cogs to turn but they are good teams.
If you drop in that you fear for their life they tend to escalate quickly.
Thanks - Police are going to do a welfare check soon - hopefully what they see will result in social services being involvedIf you drop in that you fear for their life they tend to escalate quickly.
B'stard Child said:
Approaches to social services so far have resulted in no progress towards getting actual help
Have the crisis team been engaged or just regular services? I witnessed a friend have a serious mental health crisis and she knew to call the crisis team who were very good over the phone, ultimately leading to a short stay in the psychiatric ward of the hospital.
TLDR if they’re a danger to themselves and/or others calling 999 may not be a bad thing to do as people do recover from mental health episodes.
My Girlfriend had undiagnosed bipolar for many years and, somehow, during one of her episodes ended up in NZ where she was sectioned by the Police and then diagnosed.
When she returned here, despite her diagnosis, she wasn’t getting any help from her GP and was self medicating on prescription drugs and alcohol as she had been doing for the previous 15-20 years. We had to call 999 2-3 times when she returned from NZ as she was a danger to herself and others which got Police and Ambulance involved.
This is a very short summary of what went on, too much to detail here, but once in A&E she was sectioned for the first of three times. The level of care she got now means that she’s been stable for about seven years and doesn’t ever show any signs of falling back to where she was.
Love her to bits and can only admire the determination and will power she’s shown to stay well despite losing her Father and Sister since she got herself sorted.
My Girlfriend had undiagnosed bipolar for many years and, somehow, during one of her episodes ended up in NZ where she was sectioned by the Police and then diagnosed.
When she returned here, despite her diagnosis, she wasn’t getting any help from her GP and was self medicating on prescription drugs and alcohol as she had been doing for the previous 15-20 years. We had to call 999 2-3 times when she returned from NZ as she was a danger to herself and others which got Police and Ambulance involved.
This is a very short summary of what went on, too much to detail here, but once in A&E she was sectioned for the first of three times. The level of care she got now means that she’s been stable for about seven years and doesn’t ever show any signs of falling back to where she was.
Love her to bits and can only admire the determination and will power she’s shown to stay well despite losing her Father and Sister since she got herself sorted.
You have my sympathy because I have been through this process with a relative and I have also dealt with it on a professional basis albeit not for some years.
The Police can detain someone under S.136 of the Mental Health Act but if I recall it is not a person in their own home and it has to be something they have witnessed in action that gives them grounds to do it. It's not something they like to do generally it's an emergency power.
Making contact with your local crisis team is a good option but that being said having met a number of mental health professionals over the years their bar for sectioning someone under the mental health act is significantly higher than I think most of the public would expect. I don't agree with it often but I have seen also that NHS mental health services are massively underfunded and they will try and use a lot of other options before ultimately sectioning someone.
The Police can detain someone under S.136 of the Mental Health Act but if I recall it is not a person in their own home and it has to be something they have witnessed in action that gives them grounds to do it. It's not something they like to do generally it's an emergency power.
Making contact with your local crisis team is a good option but that being said having met a number of mental health professionals over the years their bar for sectioning someone under the mental health act is significantly higher than I think most of the public would expect. I don't agree with it often but I have seen also that NHS mental health services are massively underfunded and they will try and use a lot of other options before ultimately sectioning someone.
Caddyshack said:
One thing I learned. There are different levels of sectioning. The higher level, for an older person, means they are then entitled to fully paid care home fees regardless of assets.
What you are referring to here is called Section 117 aftercare. Primarily this relates to anyone who has been on section 3 of the mental health act requiring aftercare. Not just older adults in care. Shnozz said:
B'stard Child said:
Approaches to social services so far have resulted in no progress towards getting actual help
Have the crisis team been engaged or just regular services? I witnessed a friend have a serious mental health crisis and she knew to call the crisis team who were very good over the phone, ultimately leading to a short stay in the psychiatric ward of the hospital.
Do you know who the nearest relative is?
Relatively little known or used, the role of the NR dates from the days when somebody 'commited' their relative into an asylum. This power is usually exercised by an Approved Mental Health Act Practitioner, usually a social worker, but the Nearest Relative retains the power to call a Mental Health Act assessment, make an application for admission and discharge their relative from hospital.
In my experience, a savvy NR making this call gives Social Services the kick up the arse they so often need and the application is made by an AMHP in the usual way.
Relatively little known or used, the role of the NR dates from the days when somebody 'commited' their relative into an asylum. This power is usually exercised by an Approved Mental Health Act Practitioner, usually a social worker, but the Nearest Relative retains the power to call a Mental Health Act assessment, make an application for admission and discharge their relative from hospital.
In my experience, a savvy NR making this call gives Social Services the kick up the arse they so often need and the application is made by an AMHP in the usual way.
oddman said:
Do you know who the nearest relative is?
Relatively little known or used, the role of the NR dates from the days when somebody 'commited' their relative into an asylum. This power is usually exercised by an Approved Mental Health Act Practitioner, usually a social worker, but the Nearest Relative retains the power to call a Mental Health Act assessment, make an application for admission and discharge their relative from hospital.
In my experience, a savvy NR making this call gives Social Services the kick up the arse they so often need and the application is made by an AMHP in the usual way.
Attempts to contact the family have been unsuccessfulRelatively little known or used, the role of the NR dates from the days when somebody 'commited' their relative into an asylum. This power is usually exercised by an Approved Mental Health Act Practitioner, usually a social worker, but the Nearest Relative retains the power to call a Mental Health Act assessment, make an application for admission and discharge their relative from hospital.
In my experience, a savvy NR making this call gives Social Services the kick up the arse they so often need and the application is made by an AMHP in the usual way.
DFNorfolk said:
This is a very short summary of what went on, too much to detail here, but once in A&E she was sectioned for the first of three times. The level of care she got now means that she s been stable for about seven years and doesn t ever show any signs of falling back to where she was.
Love her to bits and can only admire the determination and will power she s shown to stay well despite losing her Father and Sister since she got herself sorted.
I know I'm going O/T but you need to recognise your own part to play in her recovery/maintenance. It's easier for her when she's got love and support.Love her to bits and can only admire the determination and will power she s shown to stay well despite losing her Father and Sister since she got herself sorted.
A very good friend of mine had undiagnosed bipolar. It's one of those things that in retrospect I think about old times and wonder why I never realised, but then remember his own family didn't realise either. When it was diagnosed it was thankfully mild and he was controlling it well with medication as well as the basics of getting enough sleep, doing plenty of exercise, no booze and so on. But then they tried him on some new meds, he got depressed and his bipolar went off on a tangent. The one saving grace was that his manic episode took him into a hospital to speak to a friend who worked there, where an incredibly observent on-duty doctor spotted that he wasn't right, started the process and by the end of the day he was in a secure ward at another hospital.
He's controlling it well again, but his (lovely, and stable) family really helps him along.
Been involved in MHA detentions many times, although not in the last 8 years or so and in Scotland, so the Act is slightly different; but hopefully this will be helpful.
Although the advice you have been given so far is well meaning, most of it is incorrect. For example, SW and Crisis Teams will not take a referral directly from a family member, friend, concerned citizen etc.
As it is a health issue, the gateway into the Psychiatric Services is the person's GP, who can make an urgent referral to the local Community Mental Health Team, or an emergency referral, usually to the local Crisis Team if one exists. The standard for an emergency referral is being seen on the same day, the standard for urgent referral is 72 hours, (again this may have changed since I was involved, AND may be different outside Scotland.
The other route into the Psychiatric Service is via the Police, who can refer directly by bringing someone they believe to be a danger to themselves or others to a "place of safety", usually an inpatient assessment unit.
Obviously, if the person is violently attacking someone because they have psychotic beliefs, or is about to jump from a window ledge, trying to speak to a GP is inappropriate....the response is to phone 999, just as you would do in any scenario whether mental illness is suspected/known or not. This is why MH workers will give that advice in these type of scenarios rather than involve themselves.
The problem that any concerned friend may have is that the person they are worried about will have very little insight into the fact they are unwell and will likely refuse to contact a GP; this will be compounded by the fact that the GP will often be reluctant to intervene on a friend/relatives/concerned citizens say so. The irony with this is that Psychiatric Services acknowledge the importance of early intervention, but the reality is that episodes of unwellness usually rumble on with the person unwilling to see the GP, the GP unwilling to see a patient that doesn't want to be seen, and the person falling below the threshold of emergency Police involvement.
The person who stated earlier in the thread that it is now more difficult for someone to be detained than it used to be is unfortunately correct, there are many more "safeguards" for the patient than in the previous Mental Health Act; in my experience this simply does them a disservice by allowing them to remain unwell for longer and deteriorate.
I should have said upstream a GP can detain someone under the MHA in their surgery; this is less common than it used to be most will refer to Psychiatry, and in this scenario the boat can be missed.
If I was the OP I would attempt to get their friend to go to their GP, even under a spurious reason as a way of getting the ball rolling.....unless Police involvement is appropriate, but as I say this would really be for the same type of reason as you would phone them for anyone.
Hope that helps, apologies if things are different proceduraly now.
Although the advice you have been given so far is well meaning, most of it is incorrect. For example, SW and Crisis Teams will not take a referral directly from a family member, friend, concerned citizen etc.
As it is a health issue, the gateway into the Psychiatric Services is the person's GP, who can make an urgent referral to the local Community Mental Health Team, or an emergency referral, usually to the local Crisis Team if one exists. The standard for an emergency referral is being seen on the same day, the standard for urgent referral is 72 hours, (again this may have changed since I was involved, AND may be different outside Scotland.
The other route into the Psychiatric Service is via the Police, who can refer directly by bringing someone they believe to be a danger to themselves or others to a "place of safety", usually an inpatient assessment unit.
Obviously, if the person is violently attacking someone because they have psychotic beliefs, or is about to jump from a window ledge, trying to speak to a GP is inappropriate....the response is to phone 999, just as you would do in any scenario whether mental illness is suspected/known or not. This is why MH workers will give that advice in these type of scenarios rather than involve themselves.
The problem that any concerned friend may have is that the person they are worried about will have very little insight into the fact they are unwell and will likely refuse to contact a GP; this will be compounded by the fact that the GP will often be reluctant to intervene on a friend/relatives/concerned citizens say so. The irony with this is that Psychiatric Services acknowledge the importance of early intervention, but the reality is that episodes of unwellness usually rumble on with the person unwilling to see the GP, the GP unwilling to see a patient that doesn't want to be seen, and the person falling below the threshold of emergency Police involvement.
The person who stated earlier in the thread that it is now more difficult for someone to be detained than it used to be is unfortunately correct, there are many more "safeguards" for the patient than in the previous Mental Health Act; in my experience this simply does them a disservice by allowing them to remain unwell for longer and deteriorate.
I should have said upstream a GP can detain someone under the MHA in their surgery; this is less common than it used to be most will refer to Psychiatry, and in this scenario the boat can be missed.
If I was the OP I would attempt to get their friend to go to their GP, even under a spurious reason as a way of getting the ball rolling.....unless Police involvement is appropriate, but as I say this would really be for the same type of reason as you would phone them for anyone.
Hope that helps, apologies if things are different proceduraly now.
Anastie said:
Caddyshack said:
One thing I learned. There are different levels of sectioning. The higher level, for an older person, means they are then entitled to fully paid care home fees regardless of assets.
What you are referring to here is called Section 117 aftercare. Primarily this relates to anyone who has been on section 3 of the mental health act requiring aftercare. Not just older adults in care. B'stard Child said:
To a certain extent by reason of his house being a semi he's a danger to the neighbours
Just reading between the lines, is this a case of self neglect? As in living in squalor rather than likely to self harm?? In which case environmental health might be the way forwards, but there may be little they can do if they have capacity.
Bill said:
B'stard Child said:
To a certain extent by reason of his house being a semi he's a danger to the neighbours
Just reading between the lines, is this a case of self neglect? As in living in squalor rather than likely to self harm?? In which case environmental health might be the way forwards, but there may be little they can do if they have capacity.
This issue is poor judgement - lets call it "clouded" - leading self neglect and to a situation where actions are being taken that are unsafe and put him at risk as well as the property and as a result potentially the neighbours property.
phumy said:
Anastie said:
Caddyshack said:
One thing I learned. There are different levels of sectioning. The higher level, for an older person, means they are then entitled to fully paid care home fees regardless of assets.
What you are referring to here is called Section 117 aftercare. Primarily this relates to anyone who has been on section 3 of the mental health act requiring aftercare. Not just older adults in care. Derry Rhumba said:
<snip>
If I was the OP I would attempt to get their friend to go to their GP, even under a spurious reason as a way of getting the ball rolling.....unless Police involvement is appropriate, but as I say this would really be for the same type of reason as you would phone them for anyone.
<snip>.
In England rather than Scotland - attempting to get him to go to his GP might have been possible 6 months ago but not now unfortunately - he hasn't left the house in 4 months.If I was the OP I would attempt to get their friend to go to their GP, even under a spurious reason as a way of getting the ball rolling.....unless Police involvement is appropriate, but as I say this would really be for the same type of reason as you would phone them for anyone.
<snip>.
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