I say at the start .Until you know what the family is getting itself into, until you are told in detail what it will be that you will have to do for a lifetime, until you are told what services the professional mental health service in your locality will have to offer, you should not take on the care of your family member suffering from schizophrenia, in your own home.
Learn the Language, the different Teams.
Admission services - beds - may well be uncertainly connected with Community Teams. The basic community team - the one that first responded is the Community Mental Health Team. [ see caring journey ]
There are Assertive Outreach Teams - to reach those hard to keep in contact; Home treatment teams - an uncertain practice - chiefly to keep patients out of hospital care - no beds ; Crisis Resolution Teams - to respond to immediate requirements - it helps to just be there - but then what ? [ not evenings and weekends ?? ] - if you are lucky - a Rehabilitaion and Recovery team for aftercare in residual illness - the most likely outcome - connected to activities etc.
Part of the requirement for a community care service is a variety of domestic alternatives
- supported homes, day centres, sheltered flats, hostels with associated routine and aactivities -- where the professional team is in contact, in charge, and accountable.
Unless you are clear that there is some outside interest that your family member will take up on a regular committed engagement during the week, that the supporting professional team will see as part of their commitment to arrange and support that, and if not successful, that they will intervene with alternative domestic placement and an outside routine
don't allow the decision that they will be living with you to be made in the first days.
When you are told everything - be hard about this - then , up to you.
You must get a working diagnosis as early as possible, so that you can prepare yourself for the range of prospects in store for any possibity of your commitment to family care at home.
You absolutely must ask for a Carer Assessment at the earliest contact with the Mental health Team, and request - demand that this is read into and taken into account at the Needs Assessment - the first stage before a Care Plan - the second CPA stage - [ which they must do as the first stage of the Care Programme Approach ] is made for the family member.You should state in your Carer Assessment that you will not be able to carry on caring unless there is, in the plan, somethimg for your family member to be doing outside the family, on three spread session during the week, so that these breaks allow you to get a life of your own
If not deliverable at once in the CARE PLAN - it may be said your family member is not ready for that, make absolutely sure - look at the CARE PLAN, that it is there in the CARE PLAN, as an undertaking , so that at REVIEW, you can bring it up again, and again I'm afraid likely. But then you go to complaint and write to the Chief Executive of the Trust requesting a SERVICE DEFICIENCY FORM is made out, and Stated as an UNMET NEED for you.P>
Otherwise you will be into those with a distressing level of burden of care
There will be a Carer Support Worker service in your Mental Health Trust [ ask the Community Mental Health Team at once for their contact number ] area and you should invite them to give you advice immediately, about what aftercare support there is in your area, before you have the family member home.
They will know the reality in local aftercare delivery - day centre based occupational and educational activities, supported housing, supported flats - from their conversations with other carers before you.
They will put you in touch with carer groups and/or other carers who have been longer in your position, to enlighten you
on what to expect from the aftercare NHS services in your area.
If you wait
, options will already be closed off for you.If you are stuck and frustrated try PALS the mental health team has the tel, no.
Ask at once for - the team will know how you get this - and get a Carer Assessment - make sure it is read by your local mental health team - so that you can be sure your views and the reality of your caring circumstance are recorded by them before they close down their plan for your family member
How to behave to someone with schizophrenia
This how one letter writer described Home Treatment in care in the community " throwing people back on their own resources regardless of whether they have any, or not. "
That is also my personal experience of 'Home Treatment'. It is offered because 'they' have removed 'beds' so that there is no way back.
*** New !!!
Mental Health Trust Services which do not have a Rehabilitation and Recovery service have a Service Deficiency.
Where staff see such a deficency they have a Service Deficiency Form to make out. That it is a clinical need - for aftercare - means this should go to the local NHS Managers and Commissioners so that they register the Deficiency, accept it or deny it, and plan to deal with the Unmet Need.
When the Form does not go in, managers, and NHS specialist secondary mental health services nationally can continue to be in denial - how were we to know this - no clinician told us that this was a basic clinical need
Nor did any family carer !
What is it
that carers must do.
Request, in writing to the local Team clinical lead, copied to the local Mental Health Trust Chief Executive, that there is an unmet need in the local Service for continued aftercare and treatment for those with schizophrenia, and that a Service deficiency Form is made out officially.
A proper NHS Service Carers of and about people in this predicament will represent the concern at a Mental Health Trust Carer Advisory committeees
Mental Health Trusts need to have their own ,Trust Carer Committee made up of
representative carers from the catchment area,
representatives of the Community Mental Health Teams,
the lead manager of the local Carer Support Worker service to carers of serious mental ilnesses i.e. those served by Mental Health Trusts,
the lead Mental Health Trust Social Worker,
and a Trust senior nurse manager.
The Committee
to be administered by the Mental HealthTrust,
the Chair to be the Social Work lead
the Trust Social Work office to provide the Secretariat to the Committee.
The Minutes to go to the Trust Chief Executive and to the Team clinical managers
Get your self on a serious mental health carers committee - the representative body in your area - now - later you will be too tired and resigned: find someone else in the same position and both go along. You fight better with a companion who is in the same boat, both prepared with what you want and need -to fight for the same things that your family sufferer needs.