More mental health problems

[Graye]

I know there is someone contributing here who is a current or ex pyschaitric nurse and I also know there are plenty of people with good avice to give so I wonder if someone could come up with some suggestions for a friend of ours, please?

He is lovely, kind and caring chap, although probably not 100% stable himself but his girlfriend is now giving him serious problems. He has turned to us for advice and I honestly don't know what to suggest. I can't communicate directly with his girlfriend herself as she apparently has an ongoing close "relationship" with my OH's first wife despite this lady having died eight years ago, long before I met OH. She totally ignores me, as if I just don't exist, so I can't speak to her at all. She has had mental health problems before and has been committed at some point, a state of affairs her "boyfriend" is desperate to avoid again. I'll refer to him as R and her as N to make this easier.

N has always been "hard work" but R has been fantastic at caring for her. As far as I can see she couldn't care less about him one way or another. She has now apparently stripped her flat of furniture except for her bed, a sofa and one pan and sits and drinks all day, refuses to eat, wash or shower, etc. She is about 40 years old but her teeth are now falling out, she looks like a bag lady and weighs about six stones. He sometimes persuades her to his own home where he cooks her a meal but he says he is now frightened of her as she becomes abusive and violent. R is beside himself with concern for her but is worried she will be "locked up" again. I'm not sure that this is likely under current regulations but I would love to give him some assistance somehow. The only way forward I can imagine is via Social Services but I'm not sure what action they woud take if N doesn't contact them herself. R is not at all assertive but will probably do whatever is best for N, once he knows what the possibilities are Does anyone have any ideas please? She DOES have family who seem to have abandoned her, also a 20 year old daughter who has disappeared back to Majorca (she was brought up by her grandparents there from around 4 years old when N couldn't cope and was with committed, was returned to N at 14 and generally led her a merry dance until she went back). I don't think Social Services were involved with the daughter's return as there was no supervision whatsoever and I don't see her being interested in the slightest about what is happening to her mother now.

AS you can see, it's a total mess! I have no ideas on mental health issues - I would just like to help R, who is a sweet gently soul in absolute torment about this. I suspect their relationship as such is long over but he still feels a lot of responsibility for her, if for no other reason than that she has no one else!

[invisiblepiper]

Hello Graye - I'm afraid she needs professional attention - and by the sound of her displayed symptoms . she will need to be admitted to a psychiatric unit. She has become a danger to herself - and if very violent outbursts are common - a danger to others.
Try to persuade your friend to get help for her.
Not an easy position to be in.

[Graye]

Thanks, invisiblepiper. Do you know if he should approach her doctor, social services, etc for this? I think he's concerned she will lose her flat (I suspect it's a council flat) and find himself even more liable for her if she is taken into some sort of unit and becomes homeless on release.

I agree she needs some sort of professional help as he certainly isn't equipped himself to do anything more for her. But it's new territory for us and we have no idea where to point him and what might happen. I must admit this has put my problems into perspective a little!

[Green Aura]

Hi Graye

I'm an ex psyche nurse and agree totally with IP - it sounds as though she's way beyond help from friends or family. Her GP should be able to initiate any help required so you should persuade R that's his first place to seek advice.

It's likely that he's worried she'll reject him if he gets in professional help (and I'm afraid that in the first instance that's highly likely) but if he cares for her he needs to put that aside.

It's also highly likely that care has moved on and improved since her last time in hospital so although she may well be sectioned at first, if she improves quickly she won't necessarily have to stay in long-term.

For all concerned, it would be best for her to get help quickly.

[mrsflibble]

I hope very much that she gets the hel;p she needs, and that it's not too hard for your friend to secure that help.
much luck, they're in my thoughts.

[Millymollymandy]

It does sound like she needs to be hospitalised first before her mental health issues are addressed. If she's down to 6 stone and her teeth are falling out from not eating she needs medical help and very fast, not to mention that the drinking sounds like a big problem too.

I wouldn't have a clue what you do either but I hope you can all help her soon.

[invisiblepiper]

Hi Graye - if you are in the Uk at present - it should be her GP who is approached - just as Green Aura has said. The sooner the better for her chances of a recovery.The local council should also be clearly notified if she is sectioned - there is a time limit to retaining her flat - social services for that one. Depends very much on the local authority.
I hope things go well.

[Rosendula]

Good luck Graye. The advice already given sounds like very good advice to me. If your friend takes the advice, at least he will have you there with kettle and sympathy if it turns out to be a trying time for him. It might actually turn out to be a big relief for him, with this being the most difficult part. It must be awful to have to consider 'sending' someone for care they need but don't want, but once she's in things will improve for both of them.

[pumpy]

Hi Graye, i'm not sure that N can be given any sort of help, without her own consent. Afriend of mine (a few years ago now), was in a similar situation & i managed to get help for her, which she hated me for initially. Nowadays we are good friends. Can N be made to do anything without affecting her 'ooman rights'? Her G.P. has to be the starting point for R to approach. Maybe N is on medication for depression? ( or similar), how about arranging a home visit from a counsellor. It's a very difficult situation, but N needs to acknowledge that there is a problem, before any treatment can be successful.

[invisiblepiper]

Up to a point Pumpy - but sadly, one diagnosis of psychotic - as opposed to neurotic - behaviour, is the lack of awareness in the sufferer that anything is wrong. This often leads to terrible harm to the individual and possibly those around them.
That is why , in the UK, if someone is displaying a severe psychotic mental disorder ( danger to self or others) - they can be 'sectioned' on the agreement of two doctors.
Sometimes folk just don't know they need help.
Your friend was lucky to have you.

[JulieSherris]

Hi Graye, part of the problem in a situation like this, is that she really needs to WANT the help for any long term benefits...
It doesn't sound like she wants the help at the moment, although once in treatment & on medication, some people will realise what they 'used' to be like & THEN the big changes happen.

However, a lot of time, other folks still think that they know best & will go along with treament & medication - then they return home, forget to take said medication & start once again, on the slippery road downhill.

If this lady has already had dealings with the system, it should be quite easy to get her the attention she needs - but the GP is the first port of call, unless she has retained a care worker from previous psychiatric dealings. (In which case it's THEM that are being negligent here)

Your friend will need to have a rather solid backbone - he'll be blamed for interfering, for having her life tipped upside down & all that goes with it.... he needs to firm & VERY strong. It might be an idea to try & learn a few of the latest 'buzzwords' too - sounds crazy, I know, but sometimes things happen quicker if you know the correct & latest teachings in the psych world.

This lady does sound like she needs to be sectioned, for her own health, if nothing else - you just have to find the right doctor that concurs & hope it's a long term road for treatment & not just the 72 hour observation period
As for her housing requirements, it might be that she could need some form of monitored living - that would be established by the folks treating her & they should be responsible for letting the council/landlord know what's happening with her flat & under no circumstances should your friend put himself forward as a home giver!
If he does this, it absolves the local authorities of responsibilty & quite often it doesn't work - he'll find himself making a rod for his own back - like I said, he'll need to be strong & FORCE the local medical & mental teams to get on this lady's case to go forward with plans for a future - the authorities are not allowed to release someone from a section order unless the patient has somewhere safe to go to - if there's nowhere safe, then they must provide it themselves.... and hopefully a monitored accommodation would be the best way forward for all concerned.

OOooo... first thing on a Sunday morning & you got quite a ramble out of me!!

Hope everything works ok, for ALL of you - your friend will need support just as much as anyone else - good luck.

[Graye]

Not much happened on this for a week or so as we couldn't persuade R to act. N had a couple of "good" days and he said she would be OK. As I said before, he isn't exactly stable himself and a good day for her would be that she managed to eat a sandwich, not wreck anything and stay sober! I tried to explain that she should really still be taking her medication (apparently she was originally diagnosed as schizophrenic when she was sectioned previously) and that she needed help but he said she would be OK and was worse when she took tablets.
Yesterday he phoned me to ask about something on freecycle - a gas cooker - and how to apply for it. When I had explained the contact methods he said that N was convinced there were presences in her flat and had ripped up all the carpets, taken out all her light bulbs, cut straight through the cables on all her electrical appliances even though they were plugged in (including here electric heating system), also the TV aerial and was probably about to do the same to her gas cooker as this was the only way the presences could now be getting in. As she lives in a multi-occupancy building and I had visions of them all going up in flames I must admit I panicked, called the police and an emergency social services number, explained the situation and asked if they felt they ought to be doing something. The end result is that N was carted off, I suspect sectioned again and is now in hospital being treated. Of course R is furious and thinks she would not have done anything "silly", but I think there was really no option but for me to call for help as he couldn't bring himself to do it, also what she had already been up to seemed reasonably "silly" to me!

Thanks for the input and hopefully she will soon be set back on a road to recovery. Once he has recovered from his rage I expect R will be on the phone for help with sorting out her flat rent, etc. That will then be a whole different story...

[Green Aura]

You did absolutely the right thing, Graye, and when R calms down he'll realise that.

Actually even if he doesn't that won't alter the fact that you've acted correctly.

Tough decision, well made.

[invisiblepiper]

You absolutely did the correct thing Graye - the symptoms you describe are those of paranoid schizophrenia. This is a condition which can be lived with when under control - and can also take 'normal' or lucid periods when she seems fine. She will always need monitoring.
You may well have saved her life - and those in her building from serious harm. That doesn't sound 'silly' to me.

[Graye]

Thanks for those comments, it really helps as I was beginning to feel a bit like a pariah!

When I first had the conversation with R on Friday morning I asked OH what he thought and he said "Well you COULD just keep well out of it and keep R happy. Or you could read in the papers that a block of 16 flats in the centre of of a popular seaside town had a gas explosion on a Bank Holiday..." Not much choice there really!

R hasn't been able to see N yet but has apparently reconciled himself to the fact that she really does need serious help now. He admitted she had not seen doctors or social workers for several years, she even refused to keep a dental appointment he worked very hard to get for her a couple of months ago.

He has agreed to go out metal detecting and for a picnic with us on the beach next week so I hope we can just make it a normal day out so that he sees how far from "normal" his existence with N has been. I'm hoping her social workers/health visitors will give him some help with being firmer with her once she is out (they've told him it will be at least 30 days I believe). He has found enough cash in her flat to pay her rent for a couple of months and agrees that there is no way she can move in with him. So we will just have to see how it goes I suppose...