Severely psychotic patient not being dealt with! Is this Legal?

Lost Dub

The situation as it stands is....My friends' parent is very ill. He has a brain injury that when not looked after with tablets sends his brain into overdrive and sets off his bi-polar disorder coupled with epileptic seizures. When this happens it he gets very high and mighty and thinks he's cured and this is the start of a few weeks of chaos for my friend as when he is not well, whatever brain injury he has give him the energy to stay awake for days on end.

I ask the question above because for 2 weeks now we have been trying to get him into a mental hospital and they don't want to know. This is the same situation that happens every time he is not well. He had his accident 36 or so years ago. Obviously she is the closest to him so she knows when this situation is starting as it takes about 3 days for the full madness of his actions to begin. So we ring his doctors to try get him into hospital and they literally fob her off saying she is a bit quick to get him into hospital.

It is a repeat of the same situation she had last year with him. Usually it takes a stay of about 6 months to get him well enough for a couple of years but, like last year, they let him out after 3 weeks, chaos ensues, then he ends up back for the 6 months. So now, in the middle of the chaos, he has been in A&E twice in 4 days for 2 more head injury's from falling from his epileptic seizures and tonight he made his way back home from the hospital.

Has anyone been in this position before that could lend some advice, please. He is going to end up dead from a fall if he isn't put back in hospital. Apparently all the doctors that deal with him are on holidays. It's really disgusting watching this going on.......My friend is practically on the verge of a breakdown and it's tough to watch when she is hitting a wall every time she tries to sort him out.

Thanks in advance

ABajaninCork

I really feel for your friend as I have personal experience of the situation.

The only thing that might work is getting Social Services involved. Not sure of the law here,but in the UK the social services DO have to power to section a patient for their own safety. As your friend's parent is known to the Mental Health services, he must have a social worker, surely? I would suggest ringing them and escalating the problem through to the top.

Make a nuisance of yourself with the doctors too, and be prepared to escalate all the way there too. It's BS that ALL of them are on leave. Surely there must be cover for acute cases? Get ringing, and refuse to go unless you speak to someone. Take note of the names and positions of people you've spoken to, and the time of the call. Tell everyone that the poor thing's been to A & E several times on account of his fits, and subsequent injuries.

Might it be an idea to get the TD involved??

Not much more you can do, I'm afraid, but to keep hammering on the doors until they open.

I wish your friend the best of luck. They're very lucky to have you looking out for them.

Lost Dub

Thanks for the reply, it really is a terrible situation for her. He gets an injection from a nurse that calls out to the house and he is ****ing her around too. He told her Monday that he would be calling to see her Dad on Tuesday, then rang her Tuesday morning to tell her that he was taking 2 days holidays and would see him Thursday, rang again Thursday to say he wasn't back till Friday, seen him Friday and gave him his injection and he was then ****ed out of the house by her father and tells her to have a nice weekend.

The police picked him up from her house last night and they said they couldn't bring him up to the hospital because they need a doctor to certify that he's not well and, unfortunately for him, only the doctors that know him well will know he's sick so since he has been dealing with it for so long he knows what to say to new doctors that meet him.

It's a very sad and heart-breaking situation for him as he is his own worst enemy. And his GP knows this but told her that he was sick of dealing with her family. It's like they're a hoping he might fall and die and they'll be throwing a party. It's disgusting

Procrastastudy

Your friend has availed of the services of a professional and in their judgement he's fit to be released. I would suggest being guided by that. I would suggest your friend takes the following action when dealing with the doctors:

Get names and ask to speak to the most senior person available.
Explain that you would like it in writing that he is fit to be released. (They wont comply but it might inspire someone to do some arse covering.)
+1 on the above. Just keep making a nuisance of yourself. Politely.

MagicSean

His GP sounds like a disgrace to be honest. Your friend should consider talking to another GP about the situation and seeing if they will be prepared to take him on.

ABajaninCork

Procrastastudy wrote: »

Your friend has availed of the services of a professional and in their judgement he's fit to be released. I would suggest being guided by that. I would suggest your friend takes the following action when dealing with the doctors:

Get names and ask to speak to the most senior person available.
Explain that you would like it in writing that he is fit to be released. (They wont comply but it might inspire someone to do some arse covering.)
+1 on the above. Just keep making a nuisance of yourself. Politely.

Doesn't work that way I'm afraid. With mental health patients, costs vs target no. of in-patients is key. Very often, such patients are given the bare minimum of treatment, and sent on their merry way, in the (vain) hope that they'll continue to take their medication. Of course, if the patient is severely ill, there's zero chance of that happening. It is only if patient has violent or homicidal/suicidal tendencies that they are sectioned.

You see, severely (mentally) ill patients have no insight into their illness. Often, they believe there's nothing wrong with them, and will refuse to take the medication. Or they might believe the medical profession and/or family are trying to poison or kill them and refuse to co-operate with the care plan.

Either way, this poor man sounds as though he is a danger to himself and others and should be sectioned. Whether that happens or not is sadly another story.

liquoriceall

To the best of my knowledge a medical professional & family member have to section a patient so has your friend offered to sign the papers? He will be eligible for tribunal after a specific period of time if she goes this route

behan29

The gentleman in question can be sectioned in the Garda station by a member of the family and a doctor, ie, caredoc, he should be under a section for 24 or 48 hours, the gentleman would be involuntary. If they cannot section him in a Garda station they may bring him to the local casualty to rule out a organic cause, ie cause of confusion. A casualty doctor and a member of the family should be able to section the gentleman the mental health services would be from the op s post be well aware of the gentleman, they will have old notes etc etc. Dr on holiday etc will not be a good enough excuse not to section a man if they are at risk. Sorry for your trouble s op.

Strawberry Fields

http://www.stpatrickshosp.ie/

Have you tried this place at the back of Jameses, as far as I know it's the best one.

WildRosie

godeas16 wrote: »

http://www.stpatrickshosp.ie/

Have you tried this place at the back of Jameses, as far as I know it's the best one.

St Pat's is good but the man would really need private health insurance with a high level of cover or else lots of cash to cover a six month stay there.

OP this is a really difficult situation for your friend. It might be wise for her to identify a new GP, preferably one with an interest in mental health if possible. They may be more prepared to consider facilitating an involuntary admission.

If all his doctors are away (which sounds a bit unlikely) there will be a team covering for them. Find out who the consultant is and look to speak to him/her. If they aren't available ask for the specialist registrar. There will be someone responsible for his care in the absence of his own team. Could the CPN who gave him his depot be of any help? I know that you said he wasn't great last week but it sounds like he's the only person from his team that has seen him. Could he give the medical team an idea of how bad things are?

I don't think you've said if he's willing to consider a voluntary admission - even if he is I understand that it's still difficult to get a bed. Does he have an outpatients appointment coming up soon? Would he go to an appointment if your friend could get one? In the short term I think a new GP will probably be their best shot.

Strawberry Fields

WildRosie wrote: »

St Pat's is good but the man would really need private health insurance with a high level of cover .

Agreed but I'm amazed someone with such a severe condition doesn't have health insurance. You wouldn't need that high a plan.
Even if on welfare, your health is paramount.

ABajaninCork

godeas16 wrote: »

Agreed but I'm amazed someone with such a severe condition doesn't have health insurance. You wouldn't need that high a plan.
Even if on welfare, your health is paramount.

Quite. But if you're on Welfare, perhaps health insurance is something that might be difficult to afford...

WildRosie

godeas16 wrote: »

Agreed but I'm amazed someone with such a severe condition doesn't have health insurance. You wouldn't need that high a plan.
Even if on welfare, your health is paramount.

I wouldn't be amazed at all to be honest. The bipolar mind isn't always logial. If he had private health insurance then he would have most likely been treated privately before, therefore there would be no problem getting admitted to Pat's or John of God's now. If he wants voluntary admission to a private hospital he's been treated in before it's just a matter of ringing the consultant's secretary.

If he's being treated privately there will be a team covering and again the secretary can coordinate this and would also be able to advise on procedures for involuntary admission.

Re the levels of cover, many plans only have 100 days of inpatient psych cover per year. You need to move up to the higher plans to get 180 days. If you're in for longer than your level of cover pays for you're looking at €450-€500 per day in those hospitals and I know SJOG look for €16k upfront if you don't have health insurance.

ABajaninCork

I think it's fairly safe to assume the OP's friend does not have health cover as he presented himself to the A & E who refused to deal. Therefore the discussion about St Pat's SJOG is probably moot.