Nearest Relative and Sectioning

Cazcat

Cazcat

Well-known member
Moderator
Joined
Sep 12, 2013
Messages
2,425
#1
My Husband suffers episodes of psychosis. Last year he had a crisis whilst we were away on holiday in another area of the UK and I feel that we were both let down by the MH service in that area and that my safety was compromised along with the safety of the general public. I am also unhappy with his treatment by the service. I have suffered with PTSD as a result of my experiences and now my head is starting to clear I can see things much more objectively. I am writing to the service in question about our experience in the hope they can improve things for others. I hope we are never in this situation again, but I would like to know if theres anything else I could have done as his nearest relative to improve the situation, for future reference if needed.

He became unwell sudenly, he had been drinking which exacerbated things and I think complicated things somewhat too. His psychiatrist had stopped his antipsychotics 2 months prior to this and he had seemed to be managing well.

He thought that he had a mission to kill certain people and threatened to kill me if I stood in his way. He was aggitated and agressive and ranting about his plans and I didn't feel safe. We were in a public place in the early hours of the morning and the police were called. I explained his history to them and asked them to organise an emergency assessment for him. They detained him and took him first to the psych ward where they were told to take him to A&E. He was too agitated and aggressive to manage in a&e so was then taken to the police cells to wait for assessment which took place later that day. I was phoned by a police officer to warn me not to be alone with him as he had been making continued threats to harm me whilst he had been there.

I managed to track down the team that were going to assess him and fill them in on his history. I also gave them the contact details forhis local mh team although neither of the CPNs who work with us were in work that day. The CPN I spoke to said that based on what I had told them he was taking a full team out to see him with view to sectioning. A few hours later I recieved a call to say that the assessment had found no signs of psychosis and that I needed to go and collect him from the police station. They told me he just had a nasty temper and had been drunk. I was shocked, I know my husband, and I knew he was completely out of character and not well. I had not seen him since the police detained him at which point he was treatening to kill me. I said that I didnt feel safe collecting him and asked if someone from the team would be available to facilitate as I was scared and still felt he was unwell. I was told no there were no signs he was unwell and that the MH team were no longer involved. I was advised to meet him in the police station where there were people arround. On arival I was told that there was no public access to the police station and I should wait in the carpark.

Although my husband was calmer he remained erratic and agitated and I was scared for my safetey and that of others. The CPN who was pressent for his assessment phoned that evening to ask if I still thought he was unwell. I said I did then my husband took my phone off me and refused to let me speak to him again, despite himbringing back again. I managed to get him home to the other end of the country over the next couple of days and got his CPN to review him. His assessment was that he was very poorly and he was concerned that if someone looked at him wrong he would smack them. It also became apparent that he was hallucinating frequently. My husband agreed to restart the antipsychotics and things improved.

You could say that because he didn't harm anyone the emergency assessment that he didn't need sectioning was correct. On the other hand I didn't feel safe and think there was a real risk of him hurting someone else. He has now admitted to me and his CPN that he agrees there was a real risk of him hurting someone during this time. He is very good at hiding his symptoms, his CPN aknowledges this and I did explain this to the team that assessed him. I feel like I wasn't listened to by the team assessing him, and that if they had admitted him for a few days his symptoms would have become clear, medication could have been restarted and the risk managed better.

I now know that the nearest relative can apply for a section 4 for 72 hour assessment, but am unsure if this would be the case as 2 Drs had already assessed him as not needing a section. I can find information on nearest relative appealing against a section but not the other way arround. Please understand that this would be an absolute last resort, and I hope never to need to go down this route. I don't want my husband sectioned, but I don't want to end up in this situation again, where I feel so vulnerable.
 
C

Coast2

Well-known member
Joined
Oct 9, 2016
Messages
1,235
Location
UK
#2
Goodness, what an awful situation to be in. The MH team acted terribly badly, youbcould have been seriously injured, or worse.

I think you should complain, the department sounds totally inexperienced and incompetent.

I really hope that things are improving now for both you and your husband.
 
BorderlineDownunder

BorderlineDownunder

Well-known member
Joined
Nov 23, 2015
Messages
17,146
#3
My Husband suffers episodes of psychosis. Last year he had a crisis whilst we were away on holiday in another area of the UK and I feel that we were both let down by the MH service in that area and that my safety was compromised along with the safety of the general public. I am also unhappy with his treatment by the service. I have suffered with PTSD as a result of my experiences and now my head is starting to clear I can see things much more objectively. I am writing to the service in question about our experience in the hope they can improve things for others. I hope we are never in this situation again, but I would like to know if theres anything else I could have done as his nearest relative to improve the situation, for future reference if needed.

He became unwell sudenly, he had been drinking which exacerbated things and I think complicated things somewhat too. His psychiatrist had stopped his antipsychotics 2 months prior to this and he had seemed to be managing well.

He thought that he had a mission to kill certain people and threatened to kill me if I stood in his way. He was aggitated and agressive and ranting about his plans and I didn't feel safe. We were in a public place in the early hours of the morning and the police were called. I explained his history to them and asked them to organise an emergency assessment for him. They detained him and took him first to the psych ward where they were told to take him to A&E. He was too agitated and aggressive to manage in a&e so was then taken to the police cells to wait for assessment which took place later that day. I was phoned by a police officer to warn me not to be alone with him as he had been making continued threats to harm me whilst he had been there.

I managed to track down the team that were going to assess him and fill them in on his history. I also gave them the contact details forhis local mh team although neither of the CPNs who work with us were in work that day. The CPN I spoke to said that based on what I had told them he was taking a full team out to see him with view to sectioning. A few hours later I recieved a call to say that the assessment had found no signs of psychosis and that I needed to go and collect him from the police station. They told me he just had a nasty temper and had been drunk. I was shocked, I know my husband, and I knew he was completely out of character and not well. I had not seen him since the police detained him at which point he was treatening to kill me. I said that I didnt feel safe collecting him and asked if someone from the team would be available to facilitate as I was scared and still felt he was unwell. I was told no there were no signs he was unwell and that the MH team were no longer involved. I was advised to meet him in the police station where there were people arround. On arival I was told that there was no public access to the police station and I should wait in the carpark.

Although my husband was calmer he remained erratic and agitated and I was scared for my safetey and that of others. The CPN who was pressent for his assessment phoned that evening to ask if I still thought he was unwell. I said I did then my husband took my phone off me and refused to let me speak to him again, despite himbringing back again. I managed to get him home to the other end of the country over the next couple of days and got his CPN to review him. His assessment was that he was very poorly and he was concerned that if someone looked at him wrong he would smack them. It also became apparent that he was hallucinating frequently. My husband agreed to restart the antipsychotics and things improved.

You could say that because he didn't harm anyone the emergency assessment that he didn't need sectioning was correct. On the other hand I didn't feel safe and think there was a real risk of him hurting someone else. He has now admitted to me and his CPN that he agrees there was a real risk of him hurting someone during this time. He is very good at hiding his symptoms, his CPN aknowledges this and I did explain this to the team that assessed him. I feel like I wasn't listened to by the team assessing him, and that if they had admitted him for a few days his symptoms would have become clear, medication could have been restarted and the risk managed better.

I now know that the nearest relative can apply for a section 4 for 72 hour assessment, but am unsure if this would be the case as 2 Drs had already assessed him as not needing a section. I can find information on nearest relative appealing against a section but not the other way arround. Please understand that this would be an absolute last resort, and I hope never to need to go down this route. I don't want my husband sectioned, but I don't want to end up in this situation again, where I feel so vulnerable.
The situation, the alcohol, and the hour, had him written off as a Drunk.

One of the best ways to avoid a repeat is to not be out drinking with him till the wee hours of the morning because the Services see people all weekend who get hammered and lose it in public and have limited sympathy I'm afraid.

I'm sure this wasn't Your Particular Circumstance but that's probably what it LOOKED like.

Sober him up and he wont need sectioning.

Were they right? did he become OK once he sobered up again?
 
Cazcat

Cazcat

Well-known member
Moderator
Joined
Sep 12, 2013
Messages
2,425
#4
Coast, thank you I am in the process of complaining. He is well again now thanks and back in work.

Borderline, I think you are right that this is what they thought. I don't drink and its very rare for my husband to have more than a couple. So getting drunk is a very rare event. He was sober before they assessed him, but no he wasn't OK by them. He was erratic, aggressive, susspicious, and halucinating, all of which lasted a couple of weeks untill the antipsychotics got back into his system? The thing is he is very good at keeping the lid on things during assessments, his own CPN who saw him a few days later knows this and also knows him well enough to pick up how poorly he was. He was the one who got his antipsychotics restarted, which got things back under control again. I suppose if he hadn't got drunk and told me he was going to kill me, and had just been thinking it instead, then maybe I would have felt safer dispite his erratic and aggressive behaviour, and agree with the decision not to section him....
 
Cazcat

Cazcat

Well-known member
Moderator
Joined
Sep 12, 2013
Messages
2,425
#5
Hmmm, maybe the docs who did the assessment were right that there was no risk once he was sober, and it was just me that felt vulnerable and at risk. Obviously it would be wrong to section him just to make me feel safer. I would have felt better if they had said, yes he seems poorly but we don't think he needs sectioning. The fact they said there were no signs of psychosis when I could clearly see that there were worried me. Also if he had been assessed in a hospital setting and I could have been with him for a while there before he was discharged I think I would have felt safer. The other thing that makes me think they were not sure was the follow up phonecalls in the evening to try to find out how things were and if I still thought he was poorly. Its just he wouldn't let me talk to them then, so if there had been a problem it would have been too late by then.
 
BorderlineDownunder

BorderlineDownunder

Well-known member
Joined
Nov 23, 2015
Messages
17,146
#6
Hmmm, maybe the docs who did the assessment were right that there was no risk once he was sober, and it was just me that felt vulnerable and at risk. Obviously it would be wrong to section him just to make me feel safer. I would have felt better if they had said, yes he seems poorly but we don't think he needs sectioning. The fact they said there were no signs of psychosis when I could clearly see that there were worried me. Also if he had been assessed in a hospital setting and I could have been with him for a while there before he was discharged I think I would have felt safer. The other thing that makes me think they were not sure was the follow up phonecalls in the evening to try to find out how things were and if I still thought he was poorly. Its just he wouldn't let me talk to them then, so if there had been a problem it would have been too late by then.
I feel very badly for you, it must hurt terribly to watch someone you love suffer this way.

But your story does emphasise the Absolute Importance of Self Care for the MI, by which I mean a decent amount of sleep, avoiding alcohol etc.

Quite probably if youd had a nice quiet meal then gone home, the Episode would not have been triggered.

I'm just learning about all this stuff for myself btw, no judgment here.

Its like we Cant Cope with Triggers (as I'm sure you know) so the No. 1. priority needs to be Removing the Triggers.

Staying up at night and drinking, is clearly a Trigger.

Its sad we cant just lead lives where we can live in a way we can do what we want without Major Fallout, but its the same for a Paraplegic.

We are mentally challenged and have to be extremely vigilant about our own self care as No One will do it for us. :(

I hope hes better now and you've managed to put this away as a Learning Experience.

No harm was done, in the long run, thankfully.

BDU
 
Cazcat

Cazcat

Well-known member
Moderator
Joined
Sep 12, 2013
Messages
2,425
#7
Selfcare is definately paramount. Unfortunately my husband thought he was 'better' and could go back to 'normal'. He was working long hours, and not looking after himself well for the 6 months prior to this, he'd also suffered a berievement. I was worried but he kept telling me he was coping ok, and he did seem to be until it all fell apart. His psychiatrist had stopped his antipsychotics as he was doing so well. What I didnt realise was that he was missing his CPN appointments due to work commitments. I wish I'd contacted his CPN when I was first concerned, but didn't want to go behind his back when he kept telling me he was ok and he did seem to be stressed but coping, until he very clearly wasn't. I think it would have come to a head at some point looking back. Part of me wonders if he needed a crisis to learn what selfcare is needed long term, but it was bloody horrible for us both.

Thankfully he is loads better now, back at work in a less stressful part time job. Now my PTSD is resolved I can start to think about what happened clearly for the first time. We are working jointly with our CPNs now to look at prevention of future crises, so you are right hopefully we can learn from this and move forward better prepared for the future.
 
BorderlineDownunder

BorderlineDownunder

Well-known member
Joined
Nov 23, 2015
Messages
17,146
#8
Selfcare is definately paramount. Unfortunately my husband thought he was 'better' and could go back to 'normal'. He was working long hours, and not looking after himself well for the 6 months prior to this, he'd also suffered a berievement. I was worried but he kept telling me he was coping ok, and he did seem to be until it all fell apart. His psychiatrist had stopped his antipsychotics as he was doing so well. What I didnt realise was that he was missing his CPN appointments due to work commitments. I wish I'd contacted his CPN when I was first concerned, but didn't want to go behind his back when he kept telling me he was ok and he did seem to be stressed but coping, until he very clearly wasn't. I think it would have come to a head at some point looking back. Part of me wonders if he needed a crisis to learn what selfcare is needed long term, but it was bloody horrible for us both.

Thankfully he is loads better now, back at work in a less stressful part time job. Now my PTSD is resolved I can start to think about what happened clearly for the first time. We are working jointly with our CPNs now to look at prevention of future crises, so you are right hopefully we can learn from this and move forward better prepared for the future.

sometimes, you need to go behind their backs.

Especially with Mental Illness, as you've just experienced the meds started working, he began to feel better, so decides to stop them. And then all hell breaks loose. :(

Why his psychiatrist fell for this old BS is beyond me. They should know better. People with MI need special treatment and monitoring, and this "i was feeling better so I stopped" shite is so familiar and common the Psych has really raised some ??? for me but every pancake has 2 sides I suppose.

anyway I'm glad you've got through it all, learnt a lot from the sounds of things, and hes hopefully frightened himself so badly there wont be a repeat.

I don't mean hopefully, but you know what I mean. This may have been a very valuable lesson for All Concerned including the Psychiatrist.

Hes lucky hes got you, you are the best asset in his battle.

BDU
 
Last edited:
Cazcat

Cazcat

Well-known member
Moderator
Joined
Sep 12, 2013
Messages
2,425
#9
He's under an early intervention in psychosis team and I believe it was his psychiatrist instigated stopping the meds to see how he got on. The CPN said to me after he should have been monitoring him closely, but he kept missing appointments, which I didn't know. One of the CPNs from his team told me that some people can end up medication free even after a couple of episodes of psychosis. I think the psychiarist wanted to see if he could manage med free.