Sister having mental health crisis I'm not sure what to do
Discussion
My sister has had mental health issues last few years blast 6 months its really ramped up, and last 2 weeks its been really bad and I just dont know what to do or who to get more help from, she calls the samaritans. She started drinking which she never used to before, she signed off work, she is on medication, she tells me she just wants to die or be sectioned. I went to see her today and she cant even get out of bed she just cries, the doc just increases meds, I worry she will end her life. She is a nurse and I fear if we get her sectioned that will be the end of that if she gets better. I just dont know what to do now, I feel she needs to go somewhere like a retreat or be in patient and get help, but where ?
BenEK9 said:
does she live alone? she might not say it but just someone being in the same house is a huge help, even if they do nothing but be present.
Yeah lives alone, Im a few hundred miles away, my other sister lives closes by and she has stayed at my other sister place for a few days but then she gets taxi home, she might be ok for a day or so then its back to same. I drove up to my ill sisters today she wouldn't let me in but I had a key so went in, she just wanted me to go, flat was a state, she was a state, just crying in bed. I spoke to local mental health crisis team but they couldn't offer much help. markiii said:
What meds is she on? Alcahol with SSRIS sends me bats
t spiraling if I have more than a couple ?
I dont know the meds she on but something beginning with F I think, she also menopausal, they have significantly increased her dose, but she just seems to be in downward spiral she cant get out of and I fear its only a matter of time until she does something stupid. I've told her to come back with me to my place but she won't. When I was at her flat she just screamed at me to go, I've tried to talk to her but nothing helps.t spiraling if I have more than a couple ?Getting her sectioned might be only option for her own safety, but then I know that will be most likely be her nursing career gone if she gets better. I want to get her help, I feel she does need to be admitted somewhere but I don't want to get her sectioned if I can avoid it.
Thanks
I have written and deleted so many replies as I am trying to keep this as practical as possible based on my own similar experience with my wife who is also a nurse. You may have already done some of this but here goes…
- your sister has said she wants to die - take this seriously. You need to understand if she has any plans or the means to follow through… Think about what you can reasonably do to reduce the risk, for example if it’s an OD - what medication does she have, how much of it and can you take control of it. GP’s can reduce the issue quantity to reduce the risk, so speak to them if this is a concern ie she gets issued 1 week at a time rather than 4 weeks worth. The crisis team can also review what she has stock piled and rationalise it.
- Tell the crisis team everything you know, feel or fear and don’t dilute any of it. If you don’t think she is safe or you cannot keep her safe, be absolutely clear about it and explain why. They don’t know your sister so won’t pick up on the little warning signs you see. They also have limited resources so you need to ensure your sister is there priority. Her living alone, not having a nearby support network along with desire and possibly intent to harm herself should bump her up the risk scoring. Don’t overcommit how much support you can give, as this can reduce what they offer your sister.
- I am going to be honest here and say I found the effectiveness of the crisis team generally to be poor, which you have started to describe. I found I had to be very direct (different to being rude) with them otherwise they just dithered about and spoke in vague terms. I would confirm what was going to be done and by when and hold them to account to those things each contact, but always finish with a ‘thank you’ as you need them on side.
- if your sister will allow you or someone else to be her advocate when speaking with MH services and GP, this can provide a tangible improvement in outcome. If she will not agree, MH & GP will still take your opinions on board so make sure to communicate your concerns with them still.
- MH wards can be quite stressful, volatile places and not always the right place for treatment or recovery, so some of the perceived reluctance of the crisis teams to progress a formal admission is for this reason.
- Being admitted voluntarily is preferable for a few reasons so encourage it, but do not fear a section. Being sectioned does not mean she cannot be a nurse.
This next bit is more about you - this is going to be physically and emotionally exhausting for you all, so make sure you build and get help from yours and her support network soon. You need to be realistic about what you can do, which is likely going to cause a lot of internal conflict. The crisis team is actually there to support you too, so do ask them how they support you and anyone else supporting your sister.
Genuinely thinking of you and the BumFluff family - your sister is unlikely to see it now but there is a light ahead.
- your sister has said she wants to die - take this seriously. You need to understand if she has any plans or the means to follow through… Think about what you can reasonably do to reduce the risk, for example if it’s an OD - what medication does she have, how much of it and can you take control of it. GP’s can reduce the issue quantity to reduce the risk, so speak to them if this is a concern ie she gets issued 1 week at a time rather than 4 weeks worth. The crisis team can also review what she has stock piled and rationalise it.
- Tell the crisis team everything you know, feel or fear and don’t dilute any of it. If you don’t think she is safe or you cannot keep her safe, be absolutely clear about it and explain why. They don’t know your sister so won’t pick up on the little warning signs you see. They also have limited resources so you need to ensure your sister is there priority. Her living alone, not having a nearby support network along with desire and possibly intent to harm herself should bump her up the risk scoring. Don’t overcommit how much support you can give, as this can reduce what they offer your sister.
- I am going to be honest here and say I found the effectiveness of the crisis team generally to be poor, which you have started to describe. I found I had to be very direct (different to being rude) with them otherwise they just dithered about and spoke in vague terms. I would confirm what was going to be done and by when and hold them to account to those things each contact, but always finish with a ‘thank you’ as you need them on side.
- if your sister will allow you or someone else to be her advocate when speaking with MH services and GP, this can provide a tangible improvement in outcome. If she will not agree, MH & GP will still take your opinions on board so make sure to communicate your concerns with them still.
- MH wards can be quite stressful, volatile places and not always the right place for treatment or recovery, so some of the perceived reluctance of the crisis teams to progress a formal admission is for this reason.
- Being admitted voluntarily is preferable for a few reasons so encourage it, but do not fear a section. Being sectioned does not mean she cannot be a nurse.
This next bit is more about you - this is going to be physically and emotionally exhausting for you all, so make sure you build and get help from yours and her support network soon. You need to be realistic about what you can do, which is likely going to cause a lot of internal conflict. The crisis team is actually there to support you too, so do ask them how they support you and anyone else supporting your sister.
Genuinely thinking of you and the BumFluff family - your sister is unlikely to see it now but there is a light ahead.
M22s said:
- your sister has said she wants to die - take this seriously. You need to understand if she has any plans or the means to follow through Think about what you can reasonably do to reduce the risk, for example if it s an OD - what medication does she have, how much of it and can you take control of it. GP s can reduce the issue quantity to reduce the risk, so speak to them if this is a concern ie she gets issued 1 week at a time rather than 4 weeks worth. The crisis team can also review what she has stock piled and rationalise it.
Also, try not to say things like "you're not going to do anything stupid are you" as she's less likely to answer honestly. If you're asking try to be direct and ask if she wants to kill herself and if she's made plans. Not easy and feels wrong but "I want to die" is less serious than "I want to kill myself" or "I'm making plans to kill myself" so the distinction is important.(I'm not a MH professional but have had some training as part of my role.)
Please call the GP in the morning. Usually it’s difficult to discuss a patient without their consent but in this instance, capacity is doubtful (intoxication, refusal to engage) and there is a threat to life. You may need to push this point a little to get though triage. Express your concerns re suicidality and her living conditions.
It may/will trigger a rapid response from a home treatment team who can assess and treat/refer/section as necessary.
It may/will trigger a rapid response from a home treatment team who can assess and treat/refer/section as necessary.
M22s said:
I have written and deleted so many replies as I am trying to keep this as practical as possible based on my own similar experience with my wife who is also a nurse. You may have already done some of this but here goes
- your sister has said she wants to die - take this seriously. You need to understand if she has any plans or the means to follow through Think about what you can reasonably do to reduce the risk, for example if it s an OD - what medication does she have, how much of it and can you take control of it. GP s can reduce the issue quantity to reduce the risk, so speak to them if this is a concern ie she gets issued 1 week at a time rather than 4 weeks worth. The crisis team can also review what she has stock piled and rationalise it.
- Tell the crisis team everything you know, feel or fear and don t dilute any of it. If you don t think she is safe or you cannot keep her safe, be absolutely clear about it and explain why. They don t know your sister so won t pick up on the little warning signs you see. They also have limited resources so you need to ensure your sister is there priority. Her living alone, not having a nearby support network along with desire and possibly intent to harm herself should bump her up the risk scoring. Don t overcommit how much support you can give, as this can reduce what they offer your sister.
- I am going to be honest here and say I found the effectiveness of the crisis team generally to be poor, which you have started to describe. I found I had to be very direct (different to being rude) with them otherwise they just dithered about and spoke in vague terms. I would confirm what was going to be done and by when and hold them to account to those things each contact, but always finish with a thank you as you need them on side.
- if your sister will allow you or someone else to be her advocate when speaking with MH services and GP, this can provide a tangible improvement in outcome. If she will not agree, MH & GP will still take your opinions on board so make sure to communicate your concerns with them still.
- MH wards can be quite stressful, volatile places and not always the right place for treatment or recovery, so some of the perceived reluctance of the crisis teams to progress a formal admission is for this reason.
- Being admitted voluntarily is preferable for a few reasons so encourage it, but do not fear a section. Being sectioned does not mean she cannot be a nurse.
This next bit is more about you - this is going to be physically and emotionally exhausting for you all, so make sure you build and get help from yours and her support network soon. You need to be realistic about what you can do, which is likely going to cause a lot of internal conflict. The crisis team is actually there to support you too, so do ask them how they support you and anyone else supporting your sister.
Genuinely thinking of you and the BumFluff family - your sister is unlikely to see it now but there is a light ahead.
This ,don't rely on Gp and the drugs they hand out, - your sister has said she wants to die - take this seriously. You need to understand if she has any plans or the means to follow through Think about what you can reasonably do to reduce the risk, for example if it s an OD - what medication does she have, how much of it and can you take control of it. GP s can reduce the issue quantity to reduce the risk, so speak to them if this is a concern ie she gets issued 1 week at a time rather than 4 weeks worth. The crisis team can also review what she has stock piled and rationalise it.
- Tell the crisis team everything you know, feel or fear and don t dilute any of it. If you don t think she is safe or you cannot keep her safe, be absolutely clear about it and explain why. They don t know your sister so won t pick up on the little warning signs you see. They also have limited resources so you need to ensure your sister is there priority. Her living alone, not having a nearby support network along with desire and possibly intent to harm herself should bump her up the risk scoring. Don t overcommit how much support you can give, as this can reduce what they offer your sister.
- I am going to be honest here and say I found the effectiveness of the crisis team generally to be poor, which you have started to describe. I found I had to be very direct (different to being rude) with them otherwise they just dithered about and spoke in vague terms. I would confirm what was going to be done and by when and hold them to account to those things each contact, but always finish with a thank you as you need them on side.
- if your sister will allow you or someone else to be her advocate when speaking with MH services and GP, this can provide a tangible improvement in outcome. If she will not agree, MH & GP will still take your opinions on board so make sure to communicate your concerns with them still.
- MH wards can be quite stressful, volatile places and not always the right place for treatment or recovery, so some of the perceived reluctance of the crisis teams to progress a formal admission is for this reason.
- Being admitted voluntarily is preferable for a few reasons so encourage it, but do not fear a section. Being sectioned does not mean she cannot be a nurse.
This next bit is more about you - this is going to be physically and emotionally exhausting for you all, so make sure you build and get help from yours and her support network soon. You need to be realistic about what you can do, which is likely going to cause a lot of internal conflict. The crisis team is actually there to support you too, so do ask them how they support you and anyone else supporting your sister.
Genuinely thinking of you and the BumFluff family - your sister is unlikely to see it now but there is a light ahead.
TLDR sectioning maybe for the best and doesn’t immediately mean your sister can’t continue to work as a nurse.
I’ve been through the sectioning process with both my father, who was sectioned due to dementia, and also my girlfriend, who has bipolar, but neither were in the same place as your sister OP but similar?
With my father the GP needed a kick up the arse as he didn’t understand the aggression my father was displaying to my mother which was resulting in her having to barricade herself in a separate room to stop him getting at her. However having spoken quite clearly with the nurse who regularly visited my mother for her own health “issues” social service support was offered which resulted in him being sectioned a few weeks later. He passed about 18 months later on a secure dementia and he couldn’t have been given better care and support from the Team working on the unit.
With my girlfriend she had suffered with undiagnosed bipolar for 10-15 years, and tried to self medicate with alcohol and prescription drugs, and regularly spoke of wanting to commit suicide. I never witnessed her make an overt attempt to end her life but she put herself in very dangerous situations regularly.
During one serious bipolar incident she went missing at Heathrow for 2-3 days, and still doesn’t know what went on whilst there, but she ran up £’000s of debt with a fly now pay later company. She somehow managed to get to NZ where she was finally diagnosed and started treatment for bipolar.
When she eventually returned to the UK the local mental health team didn’t think she had bipolar so she wasn’t treated for this initially. Things then got really bad for her and resulted in the Police sectioning her three times. Eventually she then got the help she needed and now lives a balanced life and has been sober for over seven years, proper proud of her I am!
In short whilst sectioning may feel like a big step it may well be the best one and the one that offers a way forward for her and the nursing aspect could well be sorted later. Be prepared to take on some challenges that will leave you drained at the time but, from personal experience, hopefully give you both a much more positive outcome.
I’ve been through the sectioning process with both my father, who was sectioned due to dementia, and also my girlfriend, who has bipolar, but neither were in the same place as your sister OP but similar?
With my father the GP needed a kick up the arse as he didn’t understand the aggression my father was displaying to my mother which was resulting in her having to barricade herself in a separate room to stop him getting at her. However having spoken quite clearly with the nurse who regularly visited my mother for her own health “issues” social service support was offered which resulted in him being sectioned a few weeks later. He passed about 18 months later on a secure dementia and he couldn’t have been given better care and support from the Team working on the unit.
With my girlfriend she had suffered with undiagnosed bipolar for 10-15 years, and tried to self medicate with alcohol and prescription drugs, and regularly spoke of wanting to commit suicide. I never witnessed her make an overt attempt to end her life but she put herself in very dangerous situations regularly.
During one serious bipolar incident she went missing at Heathrow for 2-3 days, and still doesn’t know what went on whilst there, but she ran up £’000s of debt with a fly now pay later company. She somehow managed to get to NZ where she was finally diagnosed and started treatment for bipolar.
When she eventually returned to the UK the local mental health team didn’t think she had bipolar so she wasn’t treated for this initially. Things then got really bad for her and resulted in the Police sectioning her three times. Eventually she then got the help she needed and now lives a balanced life and has been sober for over seven years, proper proud of her I am!
In short whilst sectioning may feel like a big step it may well be the best one and the one that offers a way forward for her and the nursing aspect could well be sorted later. Be prepared to take on some challenges that will leave you drained at the time but, from personal experience, hopefully give you both a much more positive outcome.
BumFLuff said:
She was sectioned this morning, I tried my best but couldn't do anymore.
Reading through, it is all you could do, and like others have said, probably the best thing and from a safety point of view, definitely for everyone involved. You might be feeling it as wrong now, but if it makes a difference you will be given yourself a pat on the back.
Can happen to any of us anytime, having a breakdown or being in your position, you can't deal with it yourself.
I appreciate it may not feel like it now, but this is a good outcome. As well as keeping her safe, they can offer so much more support during an admission than on the community - medication changes, therapeutic support etc.
I have been through similar a number of times with my wife and am happy to share my experiences and what to expect if of any value to you - just drop me a PM.
I’ll be honest and say there is still some difficult times ahead but I am hopeful she starts to come back out the other side soon.
I have been through similar a number of times with my wife and am happy to share my experiences and what to expect if of any value to you - just drop me a PM.
I’ll be honest and say there is still some difficult times ahead but I am hopeful she starts to come back out the other side soon.
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