Help Mental health assessments - UK

[Defenestrator]

I'm completely new to all of this, so I'm wondering how this will go down and what the chances are of being sectioned (and avoiding that).
They know I'm suicidal, I also do not want to take antidepressants and I find it extremely difficult to fake not being anxious (shakes and involuntary movements that my GP picked up on and prescribed me diazepam for).


I mean, I don't even know if this is just a general assessment (the letter says 1.5 hours) or if it's an actual assessment under the mental health act - the literature they've sent me is completely vague.

 

[L-L]

Hey, I've recently had some experience with this which may be useful.

I was referred from a dermatologist to a clinical psychologist who in turn referred me to a psychiatrist and I had an assessment this week. I was really worried about the assessment, as like you I didn't want to be sectioned as it would have made matters a lot worse. I spoke to the clinical psychologist before the prior to the appointment and she was very honest and said that she didn't know what would happen.

At the assessment itself it was with a psychiatrist I had never met before and we spent about an hour chatting - or rather me answering his questions. I was very truthful the entire way through, even telling him that I have Soidum Nitrite and an enti-emetic and often think of using it, but that my brothers, relationships and guilt hold me back.

At the end, he asked me if I was willing to "come in for a few days". I was all like:


I made the argument that I would be under no more risk at home, because those binding factors are still there. We spoke about it a bit and eventually he relented. From what I've read/heard since the appointment, I think this was an attempt at getting me to self-refer or a "voluntary sectioning". It's much easier for them to get you to come in than it is to "forcibly" section you, as it were. This may be helped by the fact that I can present myself very well. Even though I always have the darkness and inner turmoil, most of the time I can hold my tears back and my anger in until I'm alone - so please don't take this as gospel.

After this, he recommended that I change to a new medication but after he couldn't answer my questions about the mode of actions, interactions and side effect profiles I asked him for a bit of time to research it. He followed up with me today and didn't have a lot more to say.

I don't know whether this is typical or helpful, but either way I hope you find some information useful. This is the first time I've spoken or written about it in detail, and it's actually nice to get it off my chest.

I hope your assessment goes well, and if you would like to bounce any more questions off somebody, feel free to ask.

 

[BPD Barbie]

It's massively dependent on the psychiatrist. I told mine I had a date set, told her the date etc. I'm incredibly transparent, she asked me if I wanted to be admitted, I said no, so we didn't. She's very aware of everything but that respect and trust she gives me makes me feel able to tell her everything.
But I've also met some before her than are total asses and I just told them what they wanted to hear. Most are good though and you can reason with them a lot of the time. How come you don't want to take antidepressants if you don't mind me asking?

 

[Defenestrator]

Hey, I've recently had some experience with this which may be useful.

I was referred from a dermatologist to a clinical psychologist who in turn referred me to a psychiatrist and I had an assessment this week. I was really worried about the assessment, as like you I didn't want to be sectioned as it would have made matters a lot worse. I spoke to the clinical psychologist before the prior to the appointment and she was very honest and said that she didn't know what would happen.

At the assessment itself it was with a psychiatrist I had never met before and we spent about an hour chatting - or rather me answering his questions. I was very truthful the entire way through, even telling him that I have Soidum Nitrite and an enti-emetic and often think of using it, but that my brothers, relationships and guilt hold me back.

At the end, he asked me if I was willing to "come in for a few days". I was all like:
View attachment 24959

I made the argument that I would be under no more risk at home, because those binding factors are still there. We spoke about it a bit and eventually he relented. From what I've read/heard since the appointment, I think this was an attempt at getting me to self-refer or a "voluntary sectioning". It's much easier for them to get you to come in than it is to "forcibly" section you, as it were. This may be helped by the fact that I can present myself very well. Even though I always have the darkness and inner turmoil, most of the time I can hold my tears back and my anger in until I'm alone - so please don't take this as gospel.

After this, he recommended that I change to a new medication but after he couldn't answer my questions about the mode of actions, interactions and side effect profiles I asked him for a bit of time to research it. He followed up with me today and didn't have a lot more to say.

I don't know whether this is typical or helpful, but either way I hope you find some information useful. This is the first time I've spoken or written about it in detail, and it's actually nice to get it off my chest.

I hope your assessment goes well, and if you would like to bounce any more questions off somebody, feel free to ask.

Thanks, that was really helpful - I think I should give any therapy they offer a chance as I've not had it before and I've heard it can really help some people. Maybe I'm not a completely lost cause(?) but I am also scared of being too honest with them and it all going to shit and being turned into a monged out zombie on drugs they force you to take.

 

[BPD Barbie]

Thanks, that was really helpful - I think I should give any therapy they offer a chance as I've not had it before and I've heard it can really help some people. Maybe I'm not a completely lost cause(?) but I am also scared of being too honest with them and it all going to shit and being turned into a monged out zombie on drugs they force you to take.

Drugs can be useful. I take an absolute cocktail and I still can function, don't feel wasted etc. They can really help, it just depends what they want you to take. There are many options so if you started drug A and didn't like how it made you feel, you could try drug C or D or E. There are loads out there.

 

[Defenestrator]

Drugs can be useful. I take an absolute cocktail and I still can function, don't feel wasted etc. They can really help, it just depends what they want you to take. There are many options so if you started drug A and didn't like how it made you feel, you could try drug C or D or E. There are loads out there.

My main fear is them causing a psychotic episode. I have a family history of mental illness and my brother went full on psychotic on them a couple times, we have a couple things in common like not being able to smoke weed without going full on paranoid so I really am worried they'll actually make me worse.

 

[L-L]

Thanks, that was really helpful - I think I should give any therapy they offer a chance as I've not had it before and I've heard it can really help some people. Maybe I'm not a completely lost cause(?) but I am also scared of being too honest with them and it all going to shit and being turned into a monged out zombie on drugs they force you to take.

I'd agree with you in terms of the therapy - if it's none invasive what's the worst that can happen?

If you're happy to share, we can talk about what the most honest thing is and think it through together? If you'd rather not, I understand. I would say, however, that part of what @BPD Barbie said is true - I think it depends hugely on the psychiatrist. There was a member on here who ended up going from Manchester to Durham because a psychiatrist insisted upon it.


With regards to the pills, I wouldn't necessarily sorry about them turning you into a zombie, so to speak. Most of the time, if you do get side effects and discuss them I'd imagine any rational and competent practitioner would recommend another one - there are so many different classes of drugs and loads of different drugs within those classes.

If you're completely against medication, each to their own, but @Sensei wrote a really good thread on the benefits of herbs and supplements that a lot of users have been grateful for - I'll link it below.

https://sanctioned-suicide.net/thre...-actually-not-new-age-shit-and-placebo.26847/

Just realised you both beat me in replying. I now feel like the old dude who is slow on his phone.

 

[BPD Barbie]

My main fear is them causing a psychotic episode. I have a family history of mental illness and my brother went full on psychotic on them a couple times, we have a couple things in common like not being able to smoke weed without going full on paranoid so I really am worried they'll actually make me worse.

That's understandable. You could always discuss this with your mental health team and they can advise you further. But if you're considering ctb, then can things get worse? Hopefully you manage to come to a conclusion. Don't worry about the assessment, it'll be fine

 

[Defenestrator]

That's understandable. You could always discuss this with your mental health team and they can advise you further. But if you're considering ctb, then can things get worse? Hopefully you manage to come to a conclusion. Don't worry about the assessment, it'll be fine

That's true, I guess I'm worried it might stop me from being able to CTB? I'm still on the fence half the time; sometimes I really want to end it and other times I wonder wtf is wrong with me.

I'd agree with you in terms of the therapy - if it's none invasive what's the worst that can happen?

If you're happy to share, we can talk about what the most honest thing is and think it through together? If you'd rather not, I understand. I would say, however, that part of what @BPD Barbie said is true - I think it depends hugely on the psychiatrist. There was a member on here who ended up going from Manchester to Durham because a psychiatrist insisted upon it.


With regards to the pills, I wouldn't necessarily sorry about them turning you into a zombie, so to speak. Most of the time, if you do get side effects and discuss them I'd imagine any rational and competent practitioner would recommend another one - there are so many different classes of drugs and loads of different drugs within those classes.

If you're completely against medication, each to their own, but @Sensei wrote a really good thread on the benefits of herbs and supplements that a lot of users have been grateful for - I'll link it below.

https://sanctioned-suicide.net/thre...-actually-not-new-age-shit-and-placebo.26847/

Just realised you both beat me in replying. I now feel like the old dude who is slow on his phone.

How did they end up moving from Manchester to Durham?

 

[BPD Barbie]

That's true, I guess I'm worried it might stop me from being able to CTB? I'm still on the fence half the time; sometimes I really want to end it and other times I wonder wtf is wrong with me.

Well, why do you want to ctb in the first place? If you're back and forward on the idea, I'd 100% recommend exhausting other means of help first. There are herbal and natural routes you can try, good old fashioned therapy like CBT and CBT, mindfulness etc. Remember, it really is OK to not be ok. It's nothing to be ashamed of.

 

[Defenestrator]

Well, why do you want to ctb in the first place? If you're back and forward on the idea, I'd 100% recommend exhausting other means of help first. There are herbal and natural routes you can try, good old fashioned therapy like CBT and CBT, mindfulness etc. Remember, it really is OK to not be ok. It's nothing to be ashamed of.

It's a lot of things, involving bereavement and the usual shit life throws at you. I keep wondering if I am mentally ill or not to be honest, it's odd.

 

[BPD Barbie]

It's a lot of things, involving bereavement and the usual shit life throws at you. I keep wondering if I am mentally ill or not to be honest, it's odd.

Well, you don't have to necessarily be mentally ill to want to ctb. Everyone has their own reasoning why they want to and each one is just as valid. Sorry that life has thrown you enough shit that you've ended up here. But it's a good place, lovely community. Keep us updated on how the assessment goes

 

[L-L]

How did they end up moving from Manchester to Durham?

I'm assuming ambulance. If I remember correctly, he was released 72 hours later and it wasn't the best experience for him, but he had his phone with him the whole time etc.

 

[Defenestrator]

I'm assuming ambulance. If I remember correctly, he was released 72 hours later and it wasn't the best experience for him, but he had his phone with him the whole time etc.

Yeah, my experience with the police/ambulance and hospital (in particular) was pretty fucking traumatic too. I get these people mean well and want to help but, my god, do they really go about it lol.

 

[SinisterKid]

He was moved to Durham because there were no beds available anywhere else near Manchester. Thats the mental health service for you in the UK right now.

To be sectioned these days, you need to do actual harm to someone or something. Being a danger to yourself is unlikely to result in a compulsory section. Crisis teams and Community Mental Health teams step in to try and keep you outside of wards because resources are scarce.

Just remember, these are pseudo sciences you are dealing with, not exact sciences. There are standard assessment procedures they must follow, forget their name. They use those traits to form a care plan and build a medication regime. But its guesswork for the most part. It helps some, hinders others. But go to it with a open mind and I hope you have a good experience of the system and it helps you.

 

[Jean4]

He was moved to Durham because there were no beds available anywhere else near Manchester. Thats the mental health service for you in the UK right now.

To be sectioned these days, you need to do actual harm to someone or something. Being a danger to yourself is unlikely to result in a compulsory section. Crisis teams and Community Mental Health teams step in to try and keep you outside of wards because resources are scarce.

Just remember, these are pseudo sciences you are dealing with, not exact sciences. There are standard assessment procedures they must follow, forget their name. They use those traits to form a care plan and build a medication regime. But its guesswork for the most part. It helps some, hinders others. But go to it with a open mind and I hope you have a good experience of the system and it helps you.

Same bed problem in the USA.

Also, mental health professionals can admit someone without consent (it's called a 2PC). 2 licensed professionals (Doctor, Psychiatrist, Social Worker) fills out a form saying they think the person should be admitted and why.

 

[terry_a_davis]

To be sectioned these days, you need to do actual harm to someone or something. Being a danger to yourself is unlikely to result in a compulsory section.

I got sectioned for being a danger to myself.

 

[Polly]

I'm completely new to all of this, so I'm wondering how this will go down and what the chances are of being sectioned (and avoiding that).
They know I'm suicidal, I also do not want to take antidepressants and I find it extremely difficult to fake not being anxious (shakes and involuntary movements that my GP picked up on and prescribed me diazepam for).


I mean, I don't even know if this is just a general assessment (the letter says 1.5 hours) or if it's an actual assessment under the mental health act - the literature they've sent me is completely vague.

So I am not a doctor nor di I even play one on tv. So ignore this advice if it does not sit well with you.

I would be very hesitant to give any detailed info on where you stand in the ctb scale. I find folks are far more interested in keeping you breathing than your quality of life. Try to give them as few reasons as possible to interfere.

a while back I hada very very good psychiatrist who was fought to keep me off the heavy duty antidepressants. He did prescribe me Wellbutrin. It has the quickest effect and the fewest side effects. And if need be it can keep your shrink happy because at least they've given you *sime* drug.

Take a long time before you trust anyone with sensitive info. There are somegood ones out there but they are few and far between.

 

[Defenestrator]

I got sectioned for being a danger to myself.

Thanks for bumping this up again as some shit has gone down since I made this thread.

I had made a request to my psychiatrist for a particular antidepressant that is not often prescribed for depression in the UK (Bupropion, known as Wellbutrin in the US) and she was totally fine with it, she said she'd send it through to my doctor's surgery and warned that most GPs are loathed to prescribe it these days as it's off label (that and I think most of them are fucking thick as pigshit when it comes to how these drugs function in our bodies, but that's besides the point.)

So I called the doctors yesterday about it and they asked me to come in and see a doctor that afternoon - I went in and it was another locum () and he said that that a gp had replied to my psychiatrist's request with a no, that they won't prescribe it. He then proceeded to show me my psychiatrist's reply stating to prescribe me 7 days of escitalopram instead then.
I emphatically told him no, I won't take that. So he just gave me some more diazepam to get over the weekend. My mum's getting pissed about it (at them) because of how it's affecting me and that it's completely unnecessary. So she's asked for the psychiatrist to call her on Monday.

I've told her, I'll take the antidepressant I've requested and nothing else. They talk all this bollocks about allowing the patient to decide their care, it's all bollocks.

I'm annoyed.

 

[Ghost2211]

Yeah I don't know why anyone thinks removing our freedoms would make us any less suicidal. If anything hospitalization would push me over the edge as soon as I got out. The system isn't to help us it is to contain us.

 

[Defenestrator]

Also, the psychiatrist said she'd be fine with me taking bupropion as my prognosis is very poor without ADs... so where does this end? Me being hosptalised? Oh yeah, that's fucking cost effective; it's over three thousand pounds a week to keep someone in a psychiatric ward. These people are fucking stupid.

 

[terry_a_davis]

^ it's retarded that a locum gp has denied the psychiatrist requested prescription, the psychiatrist should be the 1 giving the script not the gp, it's a daft way to do things.

 

[Defenestrator]

^ it's retarded that a locum gp has denied the psychiatrist requested prescription, the psychiatrist should be the 1 giving the script not the gp, it's a daft way to do things.

I'm trying not to focus on it right now as I can't do anything about it and it's a waste of energy, energy I don't have a great deal of right now.
Come Monday though, the shit is gonna hit the rotation if nothing gets sorted.

 

[Polly]

^ it's retarded that a locum gp has denied the psychiatrist requested prescription, the psychiatrist should be the 1 giving the script not the gp, it's a daft way to do things.

A very good point to bring up. You've been prescribed by an expert. SInce you agree with their decision their option should overrule.

(Note that if I didn't agree with the expert decision I'd argue thst my go knew me best. I'm all about results. )

 

[Flippy]

Wow you have been through a lot again :-( just my view on the likelihood of being sectioned, from seeing a friend in a deeply agitated state for months and clearly suffering psychosis and grandiose beliefs I worked out that in my area at least it must be extremely difficult to get sectioned. It took months of her being in a complete state before they reluctantly agreed to admit her to a psychiatric ward. Their reason was that she "wasn't engaging with mental health services." I mean how can you expect someone who has no idea how unwell she is to engage with people she thinks are manipulating and bullying her.

I'm sorry that your GP didn't prescribe the meds you hoped for. Usually it's the psychiatrist who makes those decisions and the GP follows through with it. I'm glad that you have some diazepam to help in the meantime. I was offered the possibility of some lorazepam and some sleep meds, but I didn't really care by that point and still don't, it turned out they had no one to prescribe it anyway. Was I fitting end to a crap appointment I guess.

 

[Defenestrator]

Wow you have been through a lot again :-( just my view on the likelihood of being sectioned, from seeing a friend in a deeply agitated state for months and clearly suffering psychosis and grandiose beliefs I worked out that in my area at least it must be extremely difficult to get sectioned. It took months of her being in a complete state before they reluctantly agreed to admit her to a psychiatric ward. Their reason was that she "wasn't engaging with mental health services." I mean how can you expect someone who has no idea how unwell she is to engage with people she thinks are manipulating and bullying her.

I'm sorry that your GP didn't prescribe the meds you hoped for. Usually it's the psychiatrist who makes those decisions and the GP follows through with it. I'm glad that you have some diazepam to help in the meantime. I was offered the possibility of some lorazepam and some sleep meds, but I didn't really care by that point and still don't, it turned out they had no one to prescribe it anyway. Was I fitting end to a crap appointment I guess.

I think it's the danger part - was she actively suicidal or homicidal? If they think you're going to rapidly deteriorate into that area they kind of have to do something. It's either that or they leave you to it and you do kill yourself; then at the inquest it comes to light that the patient asked for medication and you refused it? Yeaaaaah, not looking good. I genuinely think these box-tickers are idiots.

 

[Flippy]

I think it's the danger part - was she actively suicidal or homicidal? If they think you're going to rapidly deteriorate into that area they kind of have to do something. It's either that or they leave you to it and you do kill yourself; then at the inquest it comes to light that the patient asked for medication and you refused it? Yeaaaaah, not looking good. I genuinely think these box-tickers are idiots.

She had expressed that she had plans to jump from a high place. I won't say where to keep things anonymous. She had explicitly told them several times. She was really grandiose when the crisis team came to see her. She was telling them to eff off and was expressing some very confused ideas about reality and the future. And all they kept saying was that she is refusing to engage or accept treatment. I might be naive but I thought those would be the exact circumstances that would necessitate a section order! It is crazy and the are seeming more and more like bunch of box ticking idiots.

 

[Defenestrator]

She had expressed that she had plans to jump from a high place. I won't say where to keep things anonymous. She had explicitly told them several times. She was really grandiose when the crisis team came to see her. She was telling them to eff off and was expressing some very confused ideas about reality and the future. And all they kept saying was that she is refusing to engage or accept treatment. I might be naive but I thought those would be the exact circumstances that would necessitate a section order! It is crazy and the are seeming more and more like bunch of box ticking idiots.

Yeah, that's the truly crazy part in all of this - I get that there aren't enough beds but there are people struggling out there who really do belong in hospital yet they bother people who DO have capacity. Stupid.

 

[Reallyreallyreally]

It's a lot of things, involving bereavement and the usual shit life throws at you. I keep wondering if I am mentally ill or not to be honest, it's odd.

Not in the UK but I am in therapy and the main goal is to increase my stability and resilience so I can employ better coping skills than CTB. I've been halfway there since 1989 and I was born in 80 so I can't advise what works in the long run but personally I'd recommend giving it a go. I feel pretty good when I'm not sitting at the bus stop so if it's possible to feel better then might as well try. I'm trying and sometimes it works.