They are not able to gain co-operation with what they have to offer, nor have confidence in any commitment to a future engagement, nor do they have confidence about the future abilities of sufferer to seek care. They are unwilling or they believe they do not see, for themselves, sufficient grounds to step in exert their authority as professionals in the secondary mental health service - that is they are not able or willing to use the powers of the Mental Health Act.
What to do ? You also are out of touch, less aware what is going on in the head of the family sufferer, are less approached by them, less able to persuade or even to support the family sufferer sufficiently.
You are not being given any permission by them to bring in other people.
It's a job for the professionals.
How do you approach, and inform Them, so that they can, and will, be able to intervene.
Crucially, document your observational items and any comments from others who have been in the position to observe. Write them down, copy them, and be able to present them. Add, that the information is not for disclosure to the sufferer as coming from you, you are entitled not to be exposed to nor receive recrimination - but is for assistance in an assessment of the degree of expression of continuing illness in the sufferer, and its impact on the sufferer.
Hearsay evidence is acceptable here - not to be set aside as in Courts - but to be evaluated, tested in the light and support of other separate obsevations.
The professional staff to intervene have to be able to establish illness, and a sufficient degree of illness.
Where there has been illness before, the first is usually detectable at interview, but the second cannot always be evaluate at interview and requires supporting information. [ hence the exculpatory ...' not sufficiently ill as I saw them' ... I didn't ask elsewhere, and didn't know at the time about ... this or that ... if I had ... well it would have been different ... sorry. ]
In two respects, you want to help to demonstrate by observations, that of the family sufferer ... a.
that they are in sufficient personal neglect.
b.
that they are so ill in this particular kind of mental illness: that this is going to continue
It may well be that the pointers are to the kind of illness that has been already established, and what is happening now, has happened before
These two respects satisfy the conditions for regaining authority through implementing detention through the Mental Health Act
What has been observed is active illness of a nature ...... that is ... schizophrenia
.... and the neglect is of a degree that, continuing, endangers the health of the person { it might also or separately endanger other people ]
a:- this is describing the things that the family sufferer has said and done that point to the illness being active. In observational terms i.e not ' is paranoid ' ... or 'is high' or 'low' but ... said this ....were seen to be doing this ... did this ... or, is not doing this as should be expected ordinarily.
Now, document the observations you have recorded, to all the the people who are going to act.
[ .... If your family member is wandering 'at large' and ill in public, it may be that the police will evoke temporary holding powers - a MHAct 136 Order for removal to a 'Place of Safety' for temporary care and examination - still usually a designated police statione.g. Redruth in Cornwall
The desk officer will be in charge and will decide whether or not to ask for an 'Appropriate Adult' - it can be you, so butt in and ask to be it, - but usually already they like to get the modern equivalent of the old Approved Social Worker - they are now called 'Approved Mental Health Professional' [ AMHP ] a person to watch over what's going on.
The duty Approved Mental Health Professional will likely be called in. The police doctor [ often insufficiently experienced ] decides about a level [ degree ] of illness, and whether fit for detention.
Both AMHP and Doctor may, are likely, to try for an informal removal - quicker and less documentation, less trouble .... 'do you want to go on a section or will you go in informally ?? Mental Health Act section 3 - a Treatment Order carried an aftercare commitment on LA Social Services and NHS - informal admission did not [ see Inquiry Dale; Holiday ]
The may succeed in getting the sufferer removed as an 'informal patient.
You don't want this - it rules out a subsequent Mental Health Act Community Treatment Order, and probably becomes yet another revolving door person }
I have never tried or heard this, but I can't see why some family worried about their ill person who is wandering ill, should not send a photiograph to the Place of Safety Police station asking to be contacted if ill member is taken there. ... ]
The professional people to receive your documentation will be
:- (i) the community mental health team ( secretary if no one else - they can't dodge make sure they pass it on - and file anmd date it - don't lose it who will have some kind of social worker in the team. Try and speak with them
(ii) the Consultant Psychiatrist for the area [ they will be the persons to invoke the Mental Health Act ] be available to speak with them.
(iii) the Approved Mental Health {Social] Worker - the modern New Act equivalent - that is the Local Authority approved [ now the Approved Mental Health Professional , I think AMHP's ; used to be Approved Social Worker; ASW ]and appointed representative who puts detention under the Mental health Act into effect if they are satisfied the condtions are met: they have to speak with the nearest relative
I recommend you speak directly to the Local Authority Social Services personnel approved to use the Mental Health Act - don't be put off by them saying it's a matter for anybody else - this is to inform them and give them your contact. Emphasise again the information you have/are documenting to them, and document it to them is for the particular purpose and not to be disclosed as coming from you. Give them the name and contact of any other possible source of information about the current state of X.
(iv) The GP of patient - if this the same one you get an appointment for yourself, and deliver your observations, copy placing them in writing with the GP.
Why is Mental Health Act detention now often the better way.
Because, after detention in this way, and only after detention in this way, through the Mental Health Act, does the next, new way, of keeping authority to intervene in the future, obtain: the move to the Community Treatment Order [ CTO there are about 1600 in place most of whom seem to be wrogly so; little attention being paid to providing an aftercare routine and programme of activities in the community; they seem to be apllied solely to ensure continuing medication - alright, but totally insufficient for aftercare. ]. CTO's cannot be apllied to people who have been 'persuaded' to enter 'informally'
Community supervision cannot be ensured for the future without this on-going authority.
If some one who has their liberties lessened in this way without justification - i.e. that it is done to convey service 'betterness' then an individual who does not receive betterness because resources are not put in in place [ occupation activity for personal support ] may be able to seek redress for lack of resources [ Under the Convention on Human Rights - denial of need to a 'life' ]
The above is written against the background of the frustrating and heartbreaking experience of some families, who have felt unhelped or impeded in their attempts to bring a change to the life of their family member, at an acute stage in the illness.
Many are self critical of the need for Mental Health act detention - the stigma of 'sectioning' for the future, the blame addressed to the involved family, by others .. was that necessary . the recrimination if even with sectioning intervention ... it did not turn out right.
The stigma comes from the public exhibition of illness behaviour: and from there not being in place, the resources to deal with aftercare.
The one can be curtailed and prevented; the other can be campaigned about. If you 'come out' .
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