Psychosis - can anyone help, please?

[StarFish_1502]

My son was last discharged from hospital in September 2013 under a Community Treatment Order, which meant he received monthly injections of antipsychotic medication for 6 months.

Since the CTO ended he has received no medication - if he's not compelled to take it he refuses it - and we have jogged along uneventfully till last week. Psychotic symptoms started last Friday; chanting, shouting, and not responding to conversation.

On top of this my mum is forever asking me to go and see her or she gets bored and lonely.

I've left messages for his CPN but have had no reply. The 'Emergency' team has a recorded message to ring 111 (!) or go to A&E, which he won't, and as he is a foot taller and several stone heavier than me I'm not able to insist.

I've considered just leaving him to it. He is unthreatening although we are sick of the chanting, especially as my other son has to get up for work. When we've had similar situations in the past I've contacted his CPN but no-one has intervened and my son
eventually escalates to going out and damaging property, at which point he gets arrested and sectioned.

I am so fed up that the services won't step in until he reaches crisis point, not least because prolonged episodes of psychosis are considered to make a person more untreatable. Has anyone ever found a successful way to get help in such a situation?

[jenny lucas]

Starfish, I'm sorry no one's spotted your post yet - wonder if you could post on one of the more general threads just to get more visibility? Maybe mods could do so?

I can't give any experience about your situation, but I do want to offer you my sympathy in such a difficult and frustrating situation.

I hope that there is some way to break the 'deadlock' you are experiencing, so your son can get the meds he clearly needs, even though his mental state is such that he is currently unable to recognise that need. It's so dreadful when our children are ill and troubled and I do feel for you in your situation.

Kindest wishes, Jenny.

[bowlingbun]

I'm really sorry, I don't know anything about mental health. However I know quite a lot about being a carer. When did you last ask Social Services for a Carers Assessment? Maybe they have a way of helping you?

[StarFish_1502]

Bowlingbun, thankyou so much for your reply. The mental health service has come through at last and they are sending a team tomorrow to assess my son and try to get him admitted informally for treatment. Seems they are staggering under the weight of work, hence the delay.

Re a carer's assessment: I have had one but it was before mum came on the scene. If she starts to need my help more I will let SS know I have extra responsibilities.

[Frito]

I saw your post earlier but this is the first opportunity I've had to reply, and now I see that wheels are thankfully in motion. So good luck!

[ladybird]

Starfish, a slightly mangled reply as I'm very tired. I do have some experience of the MH services and especially the "ring 111 in a crisis or go to A&E - they HAVE to see you", what a crock.
But thinking about your son, does he live with you? If so, MH will drag their heels as much as they possibly can as there is family involved, kind of pass the buck with responsibility. I'm also wondering about the Carer's Assessment, certainly not a guarantee to getting any services but if you were to say you cannot care for your son anymore, it may jolt them into action and come up with a proper plan to break this cycle. If he refuses to take meds, then he needs to understand that there is a consequence to that, he gets ill, he gets out of control, he gets sectioned. Does he have a social worker of his own? He certainly should have, and they should be working alongside the team to come up with workable solutions.

Terribly hard though it is, you might need to consider withdrawing the level of support you are providing in order for him to get the level of service he needs. Experience has showed me that while MH know there are family closely involved, especially if the person affected lives within that family group, they do very little - if anything. If there is no practical family support, such as living accommodation and somebody to deal with things until a crisis occurs, they will have to do more than they are now.

Maybe something to think about? Bearing in mind I don't know your exact situation, these are just suggestions. I really hope it goes well, good luck and keep us posted please?

[Mezz]

When I had a similar situation I took my husband to the GP and persisted until I got help, it took 3 visits my brother in law stepped in and put pressure on the GP as we have a family history of bipolar resulting in a tragic end so with this knowledge and my husbands history they had to do something. I think its appalling how we have to reach crisis point or even beyond that to get help meanwhile relationships and careers are being ruined. Has no one heard the saying prevention is better than cure????? mental health seems to get no priory at all which is appalling.

How are things have you managed to get help?

[jenny lucas]

Jayne, grimly,. the entire NHS is predicated on NOT being 'preventitive' in almost any section of health (with the exception of the few cancer screening programmes that exist, and perhaps a few other areas I don't know about).

Basically, the NHS is a 'break-fix' model of healthcare, and because of acutely chronic underfunding (as against needs) we are almost right down to systemic and endemic 'firefighting'.

That means the patient who shouts 'Fire!!!' loudest and longest gets the attention. It's a ruthless situation......

[StarFish_1502]

Dear everyone

Thankyou so much for your replies. Your support really means a lot.

I must eat my words about the CMHT - they did come through for us in the end, and when they finally got going they did things pretty quickly, like locating a bed and a doctor, and informing the police (that my son is known to). I'm guessing he has a big red flag on his record from previous incidents.

CMHT sent two people to see him Thursday but he had gone out, so the doctor called Friday morning. My son refused to be admitted informally and stormed off but the doctor was satisfied that he merits a Section 3. I am now waiting for the duty Social Worker to come up with a plan to implement it and just hope she gets to him before he's arrested for breaking something. I do feel for these guys as my son makes their job very difficult .

....

Ladybird, I take on board all you have written (no detectable mangling and I appreciate you doing it when you were so tired). The cycle is dictated by the legal prohibition on forcing treatment unless the patient is a risk to self or others. Unfortunately the very things done in a situation that has reached 'risk' (for example, getting locked in a police cell) also do tremendous extra damage to the patient's mental health.

My son seems to have no insight when he is unwell and the cause/effect of illness/sectioning is lost on him; he just feels he's unjustifiably persecuted.

He has had a council flat for several years but it becomes unmanageable for him when he's ill. He spends his money on trinkets that chime with his delusions and has nothing left for food, electric or gas. The place gets filthy and he can no longer tolerate noisy neighbours and barking dogs. He actually thrives when he stays with me and is good company when he's well.

Will post an update when I know the outcome.

[Stephanie_1502]

Glad things seem to be on the way to being resolved. Must be the week for it; my son has just announced to the SW that we are trying to poison him!! Fun weekend here we come