Help - my son has a tribunal on Monday

Specific disabilities and conditions
1

Hi, I have posted about my 31 year old son previously when he was sectioned 10 days ago. He smashed next door’s front door and another neighbour’s car windows with a hammer. He is waiting for a diagnosis on autism and possibly bi-polar. He gets very angry and paranoid then shouts and swears at me but this time he went much further. He is on a Psychiatric Intensive Care Unit and does not think he is ill or did anything wrong. I get loads of texts of abuse blaming me, which is fine, but he is also very paranoid and angry with other patients and staff.

I found out yesterday that he has an advocate and lawyer and has a tribunal hearing on Monday. I know this is his right and do not have an issue with him taking this course as he clearly believes he should not be in there. However, I am really worried that he will win and be discharged. I have told his advocate and care coordinator (who agrees with me), that I do not think he has improved and should not be discharged. I do however think he should be moved to an acute ward in a hospital close to home, rather than 2 hours away. I have also said I am not prepared to have him home as I believe he is still a danger to himself and others. I then found out he can see his notes beforehand so he is going to be even angrier with me as he will not understand that I am trying to do what I think is best. However, I did not change what I said because it is what I believe.

The psychiatrist at the hospital has seen Jay twice - once on admission and the second time at the review meeting on Tuesday. He said he had seen a great improvement, which surprised us as we had seen none, and we tried to explain our concerns but were ignored.

My son has had issues with mood swings, social anxiety, etc for years but we have only realised in the last 2 years it could be due to autism. He used to drink 2 litres of vodka a week but then stopped that and started using cannabis. He does not take much and it does seem to clam him down. The psychiatrist basically said to my son “are you likley to do lose your temper and use a hammer again”, my son said no. He then said the issue was due to cannabis, even though we said he’d had this problems for years and how did this explain his multiple personalities, which he has had for years. No-one has engaged with us and included us in his assessment so do not know his full history. The doctor said he recommended my son be moved to an acute ward and possibly home within a few days. This has not happened yet and now we have found out about the tribunal.

I am so worried the tribunal will come to the same conclusion and he could be discharged on Monday because what on earth do I do then? I will not be able to cope with the anxiety of him having a meltdown and am already suffering from my own mental health issues. His care coordinator agrees with me and his advocate said some of the hospital staff also felt he was a risk as he still loses his temper and lashes out. My husband - my son’s stepdad - is an amazing person but we were beginning to have problems and I am worried the tension would be too much and cause problems between us.

I feel so guilty and am not attending the tribunal but I reallly hope they decide he should stay in hospital but be moved closer to home. Has anyone else had experience of a Tribunal?

2

Hi Tricia … given the time available … the Government’s own site on MH tribunials :

Apply to the Mental Health Tribunal: Overview - GOV.UK

MIND … on the same theme :
https://www.mind.org.uk/information-support/legal-rights/leaving-hospital/mental-health-tribunal/

3

HI Tricia,

I’m not surprised you are anxious and worried.

I’m afraid I don’t have personal experience of MH tribunals. However, the Mind information seems to indicate that the tribunal will look carefully at all the reports of those involved in your son’s treatment/care - so although the psychiatrist is the lead professional, they should consider information from the care co-ordinator and ward reports too.

You do not have to have your son home and I don’t think anyone in your position would want to take that risk, after the behaviour he demonstrated, his lack of accepting he did anything wrong and because he isn’t engaging with treatment.

People who are released from section usually need follow on support - hopefully that will be on an ordinary MH ward. If, they decide he doesn’t need hospital then he wont be released on to the streets - and finding a place for him, whether that is a hostel or whatever will take time.

Melly1

4

Thanks both.

We went to see my son yesterday and he was very angry with all the staff and shouting but eventually calmed down. He is convinced he is coming home Monday. I don’t know what the advocate said to him but because of his (undiagnosed) autism he tends to take things literally so would have just picked up on any mention of coming home. He struggles to see when he has done things wrong because in his head he was “protecting” himself or us.

I can’t go tomorrow as I am unable to drive and my husband is back at work. Also, I can’t face the anger he will direct at me if he doesn’t get discharged or, if he does he then finds out I will not have him home. Emotionally he is still a child and I am torn because I feel I should be there to comfort him but I know I will just get abuse.

I just keep breaking down all the time, feel anxious and unable to concentrate on anything. I am supposed to be going back to work tomorrow (but working from home) but not sure how I will cope. My manager does not understand as I told her I will try to work but feel as if any pressure put onto me will cause me to have a breakdown. She just said “Oh so does that mean you will not be able to come in to do the presentation to the board on Tuesday.”

I think I need to see my doctor and get some counselling as I can not deal with all this guilt and feelings of utter despair

5

Hi Tricia,

I think you should go and see your GP and explain how stressed and anxious you feel ( quite understandably,) and get him to write you off work for a bit longer. Definitely ask for counselling.

I totally understand how divided you feel but in his current state it isn’t safe for you or the neighbours for him to come home. Imagine how terrible you’d feel if he came home and hurt you or someone else. A more reasonable frame of mind, I’m sure he’d be very upset too.

He doesn’t sound ready to discharged, if those responsible for his care want to release him then they need to be accountable for ensuring he is supported and he and everyone else are safe.

If he shouting and angry, I can’t see him being totally discharged, as this proves he loses control even when not on cannabis ( just as you said.)

Sending you (((hugs))) and cyber support.

Melly1

6

Thanks Melly1, he has been lovely all day then started up another rant and said he had hit someone (not sure if this is true). He was then good again. His mood swings are terrible and I am not convinced the medication he is on is helping, which I have raised, as he never had these so frequently before. My GP is on tomorrow and she knows my son well so I will see her. I am seeing Occupational Health on 16th so think I will be best to get signed off until I see her. I saw her last year when I was signed off for work related stress and she is very supportive.

I am grateful that my son did not injure anyone but it could be so different next time and that is what I need to focus on. He also smashed up some stuff in our garden, which he can’t remember doing, so I feel fortunate that I was asleep. He is such a lovely, gentle and caring boy normally but these personalities seem to have “taken over”.

My friend is coming to keep me company tomorrow - her daughter has been sectioned in the past - so I will have some support as I just need to get through the day until I know what the decision is. I will let you know how it goes but, in the meantime, thanks both for your help.

7

Well what an awful day. The Tribunal did not go ahead as the Psychiatrist rang me at 9am to say he was going to discharge my son and what did I think. I told him I did not think he should be and read out the threatening texts my son had been writing about the staff this morning and also that I could not cope having him home. He said well I can’t keep him here so he can come home today unless he agreed to stay as an informal patient. I said I did not think he would agree to that so he said there was nothing to stop my son leaving.

I asked him to let my son know I wanted him to stay for a few days because I needed to sort out some support as felt he would take that better. We were also in a strong position to get him moved much closer to home. Psychiatrist said he would ring me to let me know what my son said. Well no phone call at all but a load of texts from my son saying I hear you don’t want me home, why is that? Obviously, because he does not think anything is wrong, the fact he could leave in his eyes confirmed that. I was getting text after text and so were my siblings. I ended up having a panic attack so spoke to the mental health team at my GP and been signed off work again.

I spoke to my son’s care coordinator who was “gobsmacked” as he was then on his way to the tribunal (2 hour drive) and had not been told anything. He totally agreed with me and said he was concerned about mine and other’s safety if Jay came home. He spoke to the local hospital and said they had a bed as they had a patient who lived in the town my son is in.

Eventually my son calmed down as he was allowed out for a walk on his own, which he loves as he loves nature. He has agreed to go to the local hospital and was told he would be going at 9.30pm. At the moment I am still waiting for him to let me know if he is going tonight but as it is so late I am not convinced it will be tonight.

My family and friends are in shock and can’t believe this has happened. As they have been getting texts they also realise what state he has been in. His personalities are stronger than ever, his mood swings are all over the place and he is still paranoid about people. We have been excluded from any information about my son and his treatment, completely ignored, not asked about his history and not had the gradual discharge we were promised. Acute ward and then home leave leading to coming home once support was in place. The doctor said “oh that’s ok he will be reviewed after 48 hours of being home” and I replied great he could have injured/killed someone by then.

I intend to write a letter of complaint about everything that has gone on the past 2 weeks and his actions today have had a massive impact on the relationship between me and my son. I am also going to complain because, as my son was having a tribunal, he should have been seen by an independent doctor. That was my last hope that someone else would see him and realise my son is ill, but we were denied that. Also because he made the decision before the tribunal my son’s care coordinator who knows him well was also unable to give his point of view. This was also denied last week as his review because she had not been told one was being held.

Sorry to go on but I am really angry and frustrated now as I thought my son my finally get some help after 2 years of trying and feel we have really been let down.

8

Trisha.
I’m not surprised you are angry and shocked and even more stressed.

The psychiatrist has not acted professionally nor followed procedure. He has failed your son and your family and is taking advantage of the fact that in his eyes it was ok for your son to return home, devolving him off responsibility. I would definitely be putting in a formal complaint. I sincerely hope the care co-ordinator puts in a complaint too. I hope he gets more effective treatment at the local hospital. Oh dear.

Melly1

PS there is info here about making a complaint Making complaints | Carers UK
and here https://www.mind.org.uk/information-support/legal-rights/complaining-about-health-and-social-care/how-to-make-a-complaint/#.XXdiUm5FxEY

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Thank you Melly1. My son finally got moved to our local hospital at 1.30am today. I had a few nasty texts this morning and them some nice one’s but nothing since. I had a phone call when I was out from him saying he wanted to come home but when I rang back he was out “on leave”. I text him but still nothing so am now going to go up and see him. I am rather nervous but I need to make sure he is ok.

I will be making a complaint without any hesitation as I am appalled by the treatment of the situation.

I have had a lovely man on the phone today from ACS saying he is chasing my carer’s assessment and arranging for my son to have a needs assessment (even though my son doesn’t think he has any). I actually feel like someone cares at last so pray we begin to make some progress.

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Hi Trisha,
glad that he has been moved to the local hospital but what awful time to be moving.

Hope the visit goes well - keep strong though. Use his breakdown as the catalyst for change - a new start for both of you.

Glad the chap from ACS (what does that stand for?) is being proactive.

Keep us updated. We are here when you need us.

Melly1

11

This is beginning to sound like a soap opera!!

I went to the hospital and Jay was not back so I went looking for him. Couldn’t find him and phone switched off. Went back to the ward and the doctor asked to see me. We had a long chat and she asked about how I felt and what had led up to the section. She assumed the section had run it’s cause and they forgot to put him under a section 3, which is why he was informal. I briefly explained what happened and she said from chatting with Jay that morning she felt he needed to be sectioned as he had no idea what he had done was wrong. I almost cried with relief that finally someone agreed with and listened to me.

Anyway after Jay had been gone for 5 and half hours panic began to set in. I was in a quandary as to whether to call the police as I knew if he was just happy in his own world it would really upset him as he had done nothing wrong. On the other hand I was terrified he had done something to himself and every minute I did not call them was precious. Luckily the phone rang and it was Jay. He had had a lovely time walking a mile to town and buying glitter, cigars, 2 ties, socks, a necklace, a hat and a lighter. He even managed to get a bus back - never would have dreamt he would do that. He was angry because they had not given him his mobile charger so it was flat so he could not let me know where he was.

Anyway we went up to see him and had a walk then he showed us all his stuff. I spoke to the nurse about his charger and it was a misunderstanding so that was sorted. He was so happy and chatty and did not mention coming home, he just wanted his charger.

What a day but, despite all the worry, I do feel that we have moved further forward with the team in one day than in the 10 days he was at Norwich.

PS. ACS = Adult Community Services or Social Services in the old days.

12

Trisha,
Lots of us live our own soap operas, too.

It sounds like finally you and your son are getting more support. The psychiatrist sounds interested and is getting to grips with the whole picture.

Keeping everything crossed for you.

Melly1

13

I know I’m a little late but I’ve worked in psychiatric wards so may be of some help.

Do make a complaint, that was improper care - but it’s not clear what kind of ward he was on? If it was high/medium security then if he is presenting calmly then it wouldn’t be appropriate to keep him. If it was just another acute ward in another area then that psychiatrist was discharging too early. Patient are suppose to be kept for 72 hours minimum to observe behaviour and discharging after that is considered poor practice.

If he is in an acute ward now, then rest assured they will follow procedure. If you run into an issue where he is threatening to leave, if the staff feel he can be sectioned they will call the external doctors to place a section on him. If they don’t feel he could be sectioned, then it’s likely he can’t. Sectioning is about capacity, my partner was showing psychotic symptoms but had too much awareness so couldn’t be sectioned. They can’t just section because he was violent, sectioning is about capacity, people can be self harming etc and not be sectioned because they are capable and able individuals.

His medication will not work that quickly, it takes 4-6 weeks to notice any difference in symptoms and that is just difference. Also, medication is like halfothe battle, the rest is therapy for any condition. But his medication will help a little, if it helps more that’s great!

I’m glad you are taking to the ward staff, now he is on an acute ward he should be having ward rounds which you will be invited to. If you want you can just let them know you want to attend any ward rounds.

I will say, if you are worried about your safety and his safety and when he is discharged you don’t feel he has improved enough for being at home with you (whivh is possible, beds are in high demand and you do have to be presenting in a certain way to have a bed, horrible as that sounds it’s just reality) you have the right to refuse to have him home.

I know that’s probably so hard to even consider, you want to protect him. Can you really take care and support him if you aren’t able to take care of yourself first? You need to ask them to find him housing as a vulnerable adult because you are refusing to have him home for safety reasons. It could actyally be better for him to be in supported accommodation becausr it takes pressure off your relationship.

Obviously you don’t have too, and I know I’d massively struggle to do that. I hate when my partner has to go to a ward, I can’t imagine with it being your son!

I wish you the best to you and your son. Its such a challenging process and I hope he gets the help he needs

14

Thanks both,

My son was on a PICU ward but was still confused and did not think smashing someone’s car with a hammer was wrong, which made me concerned he would do it again. His care coordinator and other nurses on the ward did not think he should be discharged but, because it did not go to the Tribunal they were not given a chance to speak.

I spoke to the Psychiatrist at Ipswich today and he said my son was obviously very unwell and should never have been discharged from Norwich and apologised to me, although not his fault. They are going to section him again today but have not been able to do it yet because he went wondering off for a few hours again. He also said he should really be on a PICU ward but there is no room so they will be able to manage him on the acute ward. There is no way I am going to have him sent away again, although I know I will have to fight that. I know until he is sectioned he can leave so need it done asap.