"Brief periods of detention under section 2 of mental health act for assessment - are they beneficial or desirable "

About: Coventry And Warwickshire Partnership NHS Trust West Midlands Ambulance Service NHS Foundation Trust

(as the patient),

For several years I have been a mental health service user at Caludon Centre Coventry. The Caludon Centre is a mental health hospital located in Coventry West Midlands managed by the Coventry and Warwickshire Partnership Trust. I am prescribed psychotropic medication for bipolar affective disorder, post traumatic stress disorder and severe chronic anxiety related condition.

Prior to the easter period 2012 my treating consultant psychiatrist instructed me I was relapsing regards my mental health and developing hypomanic condition. They told me I must take my prescribed psychotropic medication compliantly as prescribed or I might find myself admitted to Caludon Centre for inpatient therapy. As they were to take 2 weeks annual leave over easter period they asked psychiatric colleagues to assess / monitor my mental health within the community setting during their annual leave to ensure I remained safe. I have good therapeutic relationship usually with my treating Consultant Psychiatrist.

Thus 4 members of Caludon Centre psychiatric staff visited me at home - 2 doctors and 2 social workers - I declined to speak with psychiatric staff fearful I might be hospitalised again compulsorily detained under section of mental health act.

The psychiatric team in my absence (after I had driven off away from my residential address) had instructed local police force to locate me due to their ongoing concern about stability of my mental health. Consequently shortly after I returned home and had gone to bed the police officers attended my residential address and as I did not answer front door forced entry into my home. Police found me drowsy in bed. I live alone. I had taken additional tablets, extra tablets from my usual prescribed psychotropic medication in an attempt to get to sleep together with some alcohol. The police officers arranged for me to be immediately transferred via ambulance to Accident and Emergency unit at University Hospital Coventry for further medical physical and mental health assessment. Later the same day a formal mental health act assessment resulted in my compulsory hospitalisation for further assessment within the Caludon Centre detained under section 2 of the mental health act. I remained hospitalised within Caludon Centre for less then 48 hours after which I was discharged - I was told to find my own way home where I would stay alone as I live on my own.

Several aspects of this admission concern me. I consider that the treating psychiatric staff could have managed my clinical case better.

1. I was hospitalised detained under section 2 of mental health act for less then 48 hours. This is the second occassion this has occurred to me whilst I have mental health service user with Coventry and Warwickshire Partnership Trust.

**** A detention under section of the mental health act should not be considered a trivial event as it has statuatory implications for patient concerned including that they are compulsorily hospitalised hence have limitations placed on their personal rights and freedom. Such a detention under mental health act section remains on my medical record for rest of my life and can have adverse employment or alternative social consequences. Information about sectioning procedure and detention will be included on my Criminal Records Bureau Disclosure under relevant information section should I request an enhanced CRB disclosure in future to gain voluntary or paid employment.

OR

b) I did not need to be detained in hospital at all under section 2 of mental health act - in short the psychiatric team detained me in hospital to avoid making a more detailed comprehensive risk assessment of risk I posed to myself or others - the psychiatric team were not qualified or experienced enough to make such a risk assessment or did not deem it relevant to do so for whatever reason. I add here that the week immediately post discharge from Caludon Centre was extremely chaotic for me. I found all of these visits traumatic and embarassing as my neighbours witnessed emergency services repeatedly visiting my residential address for no obvious reason. I now have to live in my community knowing that most of my neighbourhood know I am mentally deranged at times and this irritates me to extent I prefer to avoid direct contact with them.

2. My next of kin - mother - was not told by mental health team that I was to be discharged from inpatient mental health hospital care on day of discharge - hence it was a surprise to my next of kin to learn of my early discharge from hospital -in practical terms she did not have opportunity to make sure I arrived home safely on day of discharge via phoning me when I got home.

3. I was discharged without any discharge medication to take when got home or recommendations about what medication to take.

4. I was discharged without any discharge paperwork to take to my GP to recognise I had been admitted to Caludon Centre. My GP was not made aware by psychiatric team / hospital staff that I was mentally unwell and had been admitted to mental health hospital. Hence my GP was not in a position to arrange to provide additonal support to me post discharge from mental health hospital. I have very good GP who is supportive if made aware of situation patients find themselves in.

5. I was not given any written or verbal instructions regards follow up aftercare arrangements I should use post discharge to my recollection.

At discharge I knew my treating consultant psychiatrist would return from annual leave 12 days later and that I might speak with them then - otherwise I was not given any formal structured follow up plan to follow if I needed support regards my mental health. ****I receive support from local CMHT community mental health team however one of my support workers was also taking same 2 weeks annual leave easter break as my treating consultant and remainder of CMHT team were less easy to acccess due to easter bank holiday breaks. ****I receive additional support from a voluntary council funded charity however my usual healthcare support worker is off work due to longterm ill health issues and I had not met my new replacement worker before so did not feel inclined to attend charity facility for support if I was extremely distressed - I find it relatively difficult to trust and relate to new staff initially until I get to know them abit.

6.I was discharged without access to money that was suitable for use on local public transport that I could use to get home. I was admitted to hospital from home without any personal possessions (no mobile phone, shoes, change of clothes etc.

As a mental health service user with a longstanding history of mental ill health I question the purpose of brief admissions to mental health hospitals under sections of mental health act - compulsory detention in hospital against patients wishes or desire is traumatic and I found it stigmatising, degrading, and felt like a criminal - effectively punished for being in less then in perfect health - instructed in reality I was not able to make my own decisions or judgements as I was mentally unsound.

It would be advantangeous to me and probably other mental health users if mental health service providers placed more emphasis and gave more consideration to

a) purpose and desired therapeutic outcome of brief periods of detention for patients compulsorily hospitalised under mental health act sections - patients that do not want to be in hospital are less likely to comply with mental health teams proposed therapeutic regimes and may become anti - psychiatric in attitude if patient believes they have no human rights and are compelled to comply with mental health teams recommendations unquestionably

b) therapeutic plan for period post discharge from hospital as if patient is only hospitalised for brief perid their condition is likely to be similar to that present on admission - and possibly patient may be more distressed in view of forced admission. If patient lives alone than level of dysfunction that might occur in community post discharge is potentially greater as there are no persons available to limit such dysfunction

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Responses

Response from Chris Homer, Deputy Director of Experience, Coventry and Warwickshire Partnership NHS Trust

Thank you for your feedback about our services and we are very sorry to hear that your experience has not met your expectations. As you have also contacted the Trust directly and identified yourself to us we are able to look into the issues that you have raised in detail. Once this process has been completed we will update the response on this website and include any actions that we are taking. In order to maintain your confidentiality we will only be able to repond in general terms on this website. If there are specific areas to feedback to you we will do this directly.

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Response from Regional Head of Patient Experience, West Midlands Ambulance Service

Thank you for your feedback. Should you wish to contact the Patient Experience Team please do not hesitate to call 01384 246370

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Update posted by rightsawareness (the patient)

It would be helpful if Chris Homer finally submitted NHS trust's update as stated in response. I have not received reply to my patient opinion personally or via this website. Nearly 2 years have elapsed since Chris Homer agreed to update response on Patient Opinion website.