Looking for insight into the NHS Mental Health system

[Mike_in_London]

Hi my sister was recently diagnosed with Paranoid Schizophrenia and is being held under section 3 of the mental health act.
She is 43 but has lived with my parents all her life. She suffered from ME in her youth and never managed to get a job and lost many of her friends.
For the last 5-6 years her mental health issues really became an issue. Despite my parents asking for help for her with their GP and writing letters to them, they said as she was an adult and not seeking help that there was nothing they could do.

To cut a long story short, her mental health really suffered in the past year with COVID. It seemed to only accelerate and validate the conspiracies, and the sense that 'evil' was everywhere. I tried to engage with her to request help, took her on a walk once a week to talk about stuff and get her exercise. She gradually stopped doing anything to help my parents, stopped going out, stopped personal care and after an incident which ended with the Police being called, she eventually stopped eating and drinking.

At this point she was taken to hospital, still refused to accept anything was wrong or eat and was sectioned. This was a relief in one sense as the lack of engagement from services up to then had undoubtedly meant her condition had become critical and there is now a very long road ahead.
After a stint being assessed, she was moved to another hospital and then last week was moved to section 3 which I understood to be a treatment phase. I spoke to the independent assessor who said she had severe psychosis, she could be held for 6 months and everyone agreed she should not be sent back home.
I should point out that both my parents are elderly, vulnerable and struggling with health issues of their own. Despite them being heartbroken that their daughter had to be taken to hospital, they understood that they were not able to cope or care for her with such issues and that she needed care for her future.

The next day after assessment, my parents had a call from the hospital saying that they needed my parents to sign that she wouldn't been coming home. They refused this as they couldn't see why they should if she hasn't even begun any treatment to see if there could be an improvement.. In truth they are still coming to terms with the change and it was handled quite insensitively. They were told later that day that she was being moved again to another hospital by taxi.

Up to this time my sister had been totally calm and although tired from medication had not seemed distressed or angry. This changed today when my parents phoned her to hear her crying, telling them that she had been told she wouldn't be going home, would need to get a flat and a job to pay for it. She also said that she is scared of the other patients there who appear boisterous and angry. She is hiding away from them.

I'm desperate to know what to do for the best. My parents are distressed and considering taking her back which solves nothing.
I'll try and speak to a consultant there but it seems hard to get information out of these people. Is it really the case that nobody wants to help them and they look for a way to kick them out without offering any regular treatment for a length of time? What would the options be and how can I protect my parents by ensuring they don't feel they have to take her back in when they can't cope.

Long post I know but if you have been able to follow it and have any experience as a carer or worker in the system I'd love to hear from you.

[bowlingbun]

You seem to have had a lot of mixed messages. Do you know where your sister is currently, the name of her consultant, or social worker?
I really don't understand why your parents are expected to sign anything at all?

Tell us more about your parents. How old are they, and what are their health issues?
How much support do they need from you?

[Melly1]

Mike,
you might find the Mind website helpful. There is information on Section 3 https://www.mind.org.uk/information-sup ... ectioning/ and they have helplines too.

Melly1

[Londonbound]

if your sister has been officially sectioned then she may be entitled to a mental health advocate to represent her and make sure she is treated fairly.

An IMHA Independent Mental Health Advocate, contact your local advocacy scheme, I don't know if you have visited the hospital, there might be posters about advocacy.

Otherwise try contacting PALS, Patient Advice and Liaison, all Mental health trusts should have a PALS.

The Hospital should be helping you and your Relatives (unpaid carers) they cannot reveal confidential details but can advise guide and help relatives with the complications of Mental Illness.

That your sister is not going home, will have to get a flat and a job, unlikely, your sister may not be able to hold down a job, but Benefits will be available to help.

Your parents sound like they have a lot on their plate and should not be subject to the stress of all this, do they want your sister home, can they manage caring for her? probably not.

But the mental health services are responsible for her treatment and aftercare when leaving hospital, they cannot just send her home with zero help and support.

https://www.nhs.uk/conditions/social-ca ... aftercare/

[Mike_in_London]

You seem to have had a lot of mixed messages. Do you know where your sister is currently, the name of her consultant, or social worker?
I really don't understand why your parents are expected to sign anything at all?

Tell us more about your parents. How old are they, and what are their health issues?
How much support do they need from you?

Thanks for the reply. Yes I know where she has been moved to. Nobody from the hospital she has moved to has been in contact with the nearest relative (my dad due to his age and the fact she was living with them). We don't know the consultant or her social worker.
My mum has heart failure, is on oxygen 24/7 and is living/sleeping in the lounge. My Dad has survived Cancer twice, has diabetes and cataracts and has limited mobility. They are independent but are having some limited social services care since my sister was admitted. I did get safeguarding involved for them since they were not able to cope.

I will be contacting the hospital today to try and get details and find out what is going on. I understand that the services are stretched and that with the pandemic as well things are difficult however I can't understand why you would tell an unwell patient that she won't ever be going home and upset them instead of working on a treatment plan with them. Especially a patient you should know has been refused food in the past and tried other self harm.

[Mike_in_London]

if your sister has been officially sectioned then she may be entitled to a mental health advocate to represent her and make sure she is treated fairly.

An IMHA Independent Mental Health Advocate, contact your local advocacy scheme, I don't know if you have visited the hospital, there might be posters about advocacy.

Otherwise try contacting PALS, Patient Advice and Liaison, all Mental health trusts should have a PALS.

The Hospital should be helping you and your Relatives (unpaid carers) they cannot reveal confidential details but can advise guide and help relatives with the complications of Mental Illness.

That your sister is not going home, will have to get a flat and a job, unlikely, your sister may not be able to hold down a job, but Benefits will be available to help.

Your parents sound like they have a lot on their plate and should not be subject to the stress of all this, do they want your sister home, can they manage caring for her? probably not.

But the mental health services are responsible for her treatment and aftercare when leaving hospital, they cannot just send her home with zero help and support.

https://www.nhs.uk/conditions/social-ca ... aftercare/

Thanks for the reply. I totally agree with your reply. It's very unlikely that my sister could survive completely independently in her current state and without support. She would likely self-harm.
The inference so far is this support financial and otherwise will have to come from family. Not getting much in the way of commitment to helping her out. This could just be a rhetoric from a tired and worn out consultant but I need to find out for myself.
My parents are just unable to do any more than they already have. They need to look after themselves and each other in the time they have left.and my sister needs a sustainable direction. I don't want her sent back to them in her current state. They cannot care for her and she does not look after herself or them.

PALS have been very good to date - they helped me locate and collect belongings that had been left behind when my sister was moved about.

I can see that the road ahead is going to be a massive drain on all of us that have already been dealing with it for several years.I hoped getting services involved may lead to a brighter future but it;s turning in a very stressful and emotional one.

[Mike_in_London]

Mike,
you might find the Mind website helpful. There is information on Section 3 https://www.mind.org.uk/information-sup ... ectioning/ and they have helplines too.

Melly1

Thanks, I have spoken to Mind in the past. I will revisit once I have spoken to the Consultant who is involved in my sisters care.

[Londonbound]

I have been in and out of mental health services for over 30 years.

In my area they used to do a scheme called supported Housing, i think it was called.

A charity owns a big house and rents out rooms to anyone vulnerable e.g Mentally ill, physical health issues, homelessness or just old age.

They employ full time staff there to help the residents, someone stays at night in case of emergency's.

The occupants do little jobs, cleaning cooking etc just to help.

The rent was expensive but the Council paid as vulnerable people were getting a good safe place to live saving the council money.

It was called supported housing or half way housing but it is housing with support built in, you are not just getting a crummy bedsit.

I don't know if this still exists or is available but this is what your sister needs, accommodation with support built in.

So this is what your sister needs when she is let out, hopefully feeling better and also getting the right support from the Community Mental Health team for the severely mentally ill living in the community.