What is Mental health illness ! Part 2

How can the mental health system help?

Victorian institutions have slowly been closed down, to be replaced by care in the community. However, the large psychiatric hospital on the edge of town is a long-lasting and powerful image of the mental health system. It is now being overtaken by an image, drawn from news reports, of people with mental health problems, who are living in the community, being violent or homicidal. Both images are very misleading: the vast majority of people diagnosed as mentally ill are not violent and, for the small minority still needing hospital admission, psychiatric wards in general hospitals are taking the place of separate psychiatric hospitals.

If you are having problems, your first point of contact with the mental health system is likely to be your GP. Under the Government's Care Programme Approach, your GP should make an assessment of your needs and offer you appropriate treatment at the local surgery. This may be advice and information, a prescription for medication, and/or counselling. Your GP can also refer you to specialist mental health services, if necessary. You may be referred to a consultant psychiatrist attached to a hospital, or to the Community Mental Health Team (CMHT).


The Community Mental Health Team (CMHT)

CMHTs support people with mental health problems living in the community, and also their carers. The teams consist of social workers and health professionals, since the NHS and local authority can join forces to provide both community mental health care and community care services (see below). The team may include a community psychiatric nurse (CPN), a psychologist, an occupational therapist, a counsellor and a community support worker, as well as a social worker. One member of the team will be appointed as your care coordinator, to keep in regular contact with you.

Although NHS services are free, you may have to contribute to the cost of community care services, which are the responsibility of the local authority. This should be taken into account, as part of the initial assessment of your needs.


Community care services

A GP or hospital doctor can refer people separately for assessment for community care services. These include day centres, housing with care and support, help with employment, support groups, advocacy services, social clubs, befriending schemes and welfare rights advice. Some services are set up to respond to the needs of particular groups, such as women, or black and minority ethnic groups. There are also practical services available, in the form of laundry services, home helps and 'meals on wheels', should you need them.

Day hospitals are increasingly being replaced by day centres, which should provide recreation, therapy and rehabilitation, as well as helping people to feel less lonely and isolated. Drop-in centres and social clubs offer people the chance to stay in touch with others in a similar situation. For one-to-one support, there are schemes which put people in touch with volunteer befrienders.

Residential care

If you aren't able to cope on your own at home, there are other options. Hostels are short-term accommodation, with supervision, to help people until they can live more independently, while residential care homes offer a much higher level of input for people with severe mental health problems. Therapeutic communities are for short stays, and provide group or individual therapy as part of their rehabilitation programmes. Supported housing schemes enable people to live independently, in furnished accommodation, with the back-up of a mental health support worker.

Hospital treatment

Hospital can provide a place of asylum, offering shelter and protection. It can also supply an opportunity for the staff to assess people's needs and find the best way of helping them. Unfortunately, a stay in hospital can be distressing for some people. A hospital ward may offer little privacy, and it can be frightening to be with other people who are acting in a disturbed way.

Many people go into hospital on a voluntary basis, but there are between 25,000 and 30,000 compulsory admissions, each year, under the Mental Health Act 1983. It's very important that people in that situation should know their rights.

Crisis intervention

In a growing number of areas, there are special crisis intervention teams. These are able to support someone through a major crisis at home or in a residential crisis centre, without going into hospital.



What are the different treatments?

Users of health services are increasingly being consulted about treatments and conditions in NHS facilities and the decisions made about how health services are run and what they provide. Above all, they want to have more say in their own treatment. This means being properly informed about the undesirable effects of drugs, for example. It also means being offered choice: residential crisis centres as alternatives to hospital; talking treatments as an alternative or complement to drugs (as recommended by the National Institute for Health and Clinical Excellence – see Useful organisations). They want to be seen as individuals, not simply as passive patients.

Medication

By far the most common type of treatment is prescription medication, given by a GP or psychiatrist. Depending on the diagnosis, there are a variety of drugs commonly used. Different types of medication can be used to help someone calm down, or to help them sleep (minor tranquillisers or sleeping pills), to lift depression (antidepressants), or control disturbing thoughts (antipsychotics). The great advantage of drugs is that they can help people to keep going. Millions go to work each day, or look after their children, while taking them. Without drugs they might have lost their jobs or been separated from their families. However, these drugs don't 'cure' mental distress. Medication can relieve the symptoms of mental distress, but the underlying problems often remain. Drugs can also have side effects that may make people feel worse rather than better. They can also be addictive, or cause physical damage if taken in too high a dose. Therefore, they need to be used with caution.

Talking treatments

Talking treatments, sometimes in combination with medication, can be very successful in helping people deal with mental distress. Professionally qualified therapists and counsellors are specially trained to help people to a better understanding of themselves, and to overcome difficulties in their lives. There is a wide variety of talking treatments, and they may be available on the NHS (through GP surgeries or hospitals) or privately.

GPs often employ counsellors, who are trained to listen, and who may see you once or twice a week. They can help you deal with specific issues, such as bereavement, or to find strategies for managing your life better. Longer-term psychotherapy, individual or in groups, helps you understand the origins of your problems in the past and to bring about change in the present. Your GP can also refer you to a psychologist who can provide cognitive behaviour therapy. This is a short-term treatment, which has been actively promoted by the NHS in recent years. It can help you to identify and change unhelpful patterns of thinking and behaving. (See Useful organisations and Further reading.)

Electroconvulsive therapy (ECT)

ECT is a controversial medical treatment for mental illness. It involves passing an electric current through the brain, under anaesthesia, to produce a seizure similar to a fit, with the aim of relieving severe depression. ECT can cause unwanted side effects in some people, including drowsiness, confusion, memory loss, headaches and nausea.

For further information please visit....

http://www.mind.org.uk/index.htm

Hi clare
The list of help is great, There is however a problem for those that do not wish to accept help or their issues stop them wanting help.
The only way this can be over ruled is if The person is a danger to themselves or others. This makes it very difficult for a carer of someone with mental health issues. My daughter was assessed as needing support from the mental health team but won't accept it due to her issues and they are quite happy to say on one hand she needs lots of support but leave her without that support if she declines it. This is frustrating as someone with a broken arm would not be asked if it was ok for medical staff to fix it, they would go ahead as they know it needs done, This should also stand for any medical help.
Take care
kathy

I totally agree with you Kathy especially with Mental health, they have to realise that you`re might not understand the support she needs, as you saya broken arm we all know needs to be put in plaster, you can`t see with mental until you work with the person concered, How many people with mental health dissabilities beleive they don`t have a problem.

Hi Tony
Thanks for your reply. Iam also trained in mental health as well as other disabilities and illness. I do know what support my daughter needs but as you say its difficult as some people don't understand they need help. Iam not the one to help my daughter anymore than Iam doing as her dependancy on me will not help her to move on!
Yet her issues with regards to other people and people she doesn't know stops her being able to accept other help.
Unfortunately a professional carer as a mum does not enable me to help in a professional way with my daughter because of the mother daughter connection if you know what I mean!!
Take care
kathy

My wife jill had a terrible time at work when she was 18. She had always been a happy somewhat niave girl for her age. Her boss, the owner of a string of chemist shops, started having affairs with three other shop assistants at the same time. (not with her I might add) As he had put it to one of the other girls, "Jill's not that kind of girl" The problems arose when each girl in turn poured out their problems to her. Each one in complete confidence you understand? This all became too much for her and she had a nervous breakdown over it all. She saw her GP but couldn't explain to him as he was a friend of the chemist as were all the Doctors and medical staff.
So she just bottled it all up. She couldn't even tell her parents, or so she thought, as they wouldn't have believed her. Everyone thought this man was so wonderful in that small town.
Her problems just got worse so the GP sent her to Mental Hospital suggesting that she should have ECT Theropy!! Of course this only made her worse as she didn't need such radical treatment at all!! Just someone to talk to and tell of her fears. What a shame. All it did was to cause her to forget most of her childhood and leave her with depression for the rest of her life.
When I met her, she was 23 and had suffered two nervous breakdowns. We had both been "dragged" to a dance by our respective friends and fell for each other at once. Well, I did anyway. Jill took a little longer I wanted to run a mile when she told me of her past history, but I was well and truly hooked by then. We got married eighteen months later, had three children and I became self employed as I couldn't keep having time off to help her through the bad times. She had two more nervous breakdowns during these years and life was hell on wheels trying to juggle Caring and work and children alla at once. Anyway, we survived and now have five grandchildren.
In 2006 Jill had a series of TIAs, mini strokes. She went quite potty for a few months and was assesed by the mental health team and put on Paranzopine ?? (or something sounding similar) to bring her down to earth. Then eventually put on Trazodone to help the depression. She had been on Maprotiline for 36 years untill the NHS decided that it was unsafe! Also Valium and Dalmane to help her sleep. The Dalmane she is still prescribed.

The strokes left her totaly dependant on me as her carer. I had to pack up my thriving Decorating business, a job that I loved to look after her 24/7.
We lost everything. Home, business and eventually bankrupt in 2007.

Mental illness is invisible to others. They dont understand. People say stupid ignorent things in an attempt to "help" Even my own eldest son is no help at all, saying "I dont know how you put up with Mums behaviour, I'd have kicked her into touch years ago!" Hopeless.

Anyway, rant over it's late, Thanks for listening

Pete

Pete
Thanks for sharing you`re story with us, it is totally amazing how much of that I can relate to, it not take many allterations to make that our story, my daughter really struggles with her mums condition as well, but she did really well stepping in last week when I was taken to hospital.

Tony, you dont no how good it feels to have someone like you who understands totaly what We've been through. I made a silly mistake last Saturday, by going out to a gig on my own and leaving her on her own at home. Albeit with a good neigbour on standby. When I got home late at midnight (the gig went on and on!) she was in a terrible state, terrified that something had happened to me. I've been in the dog house ever since! She had the phone next to her but couldn't remember how to use it! I shant be leaving her alone again at night.
I'm glad your daughter was able to help you both. Were very lucky to have daughters, both my sons are too busy with their own lives to help out. I love our Wendy dearly, she has her own business but would drop everything to help us out.

Bless you mate

Pete

Hi pete and Tony,
I understand completely
I think unless you understand the issues carers have, you cannot begin to imagine what the caring role consists of. The emotional turmoil and also the strain it puts on all of us. sometimes we are thrown into isolation because others DO NOT understand. Its hard to find some ME time and even though we may be lucky enough to have some space we are thrown in to the other emotional feelings of guilt for wanting space and worry about the ones we do care for. All our roles as carers are very difficult and complex.
This site however allows us to be with people that understand, so big thankyou to clare.
Take care
kathy

Hi Kathy and thanks for your kind words. It sounds as if you know excactly how me and Tony feel. Me time? Whats that? I have to sneak onto my lap top as Jill is jealous of it!!

Have a great Christmas everyone! Better times for us in 2009, lets hope.

Pete x

You are both totally right Kathy and Pete, my wifes jealousy is not as bad now as it was, If I read a newspaper I was either eyeing up the models or haveing an affair, but most people do not have any understanding of how caring for a mental health disability can really destroy the sufferer the carer and the family.
Clare has done a wonderful job giving us this place, because I can`t post these things on other forums.

Thank you all for your kind words of thanks for the group... but they are not needed...
My aim in this group was not only to help others, but to help me..

As I'm sure you all know, been a carer can sometimes be very lonely, even when you have, your loves ones around you... finding someone who truly understands what you are going through .... the stress, worry, and even, I hate to say it, but I'm sure we have all felt it 'Resentment'... is a rare thing.
And unfortunately, my strong pillar of strength I was having to appear to be, for my hubby's & kids sake, was starting to crack, with not been able to talk to anyone....
So infact I owe you all a BIG THANK YOU.... you are what makes this group what it is, and YOU are what has help me feel like Me again..

THANK YOU

hugs Clare x