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Sometimes Crazy 21-02-2009 12:15 AM

The Mental Health Information Package.
Welcome to the Mental Health Information Package! This thread has been designed to help answer or give tips on most questions relating to mental health and mental health issues. There are quite a few sections, so feel free to skip to the appropiate post or read all the way through!

Talking to Mental Health professionals:Going into hospital:Medications and therapies:Where do I go for further information?:

Sometimes Crazy 21-02-2009 12:20 AM

How do I build up a relationship with my mental health professional?
Having a good relationship with your MH Professional really is a crucial element to making a successful recovery. The vast majority of people that have had a successful recovery believe that it was only able to happen when their relationship with their MH Professional was built. Of course, like a lot of other things, being able to build a relationship with your MH Professional isn’t as easy as me just typing this down! Having a positive working relationship with your MH Professional is reliant on a few main factors that can be built and worked upon in time.
Feeling comfortable: Having a good working relationship with your MH Professional lays mostly in the ‘bond’ between you both. You need to feel comfortable and safe around them. Finding a MH Professional that you feel comfortable with is a very good base foundation to build upon. If you don’t feel comfortable with them, chances are you will find it hard talking to them and opening up to tackle such sensitive topics. So take your time, chose wisely and try to find out what sort or person makes you feel comfortable, and which you think you may be able to work well with in given time. People have a good sense of judgement when it comes to knowing who they feel comfortable around and why, so if you don’t feel comfortable around them the first time you meet them, don’t be afraid to go ahead and find a different one that you do feel comfortable with.
Trust: To build a relationship with anyone, you will find that you need to hold some sense of trust in them (usually, this comes after feeling comfortable around that person). So trust is so important when it comes to making the time spent with your MH Professional a success. On your first visit, your MH Professional promises you your confidentiality; this is originally where the trust escalates from. Over time, your MH Professional will continuously prove him or herself trustworthy. Normally, it takes a fair few sessions with the MH Professional before the person even begins to feel able to open up to them. But don’t worry if trusting takes a little while longer to develop. MH Professionals are trained to be patient with people. And a good MH Professional will understand that some people are a little more cautious than others when it comes to knowing who they can put their trust into.
Commitment: If the other two pointers stated abvove have any chance in developing, time is needed! Commitment will give you the time needed to develop a positive working relationship. So it is important that you work with your MH Professional to figure out a schedule that will work best for you both and stick to it. If your MH Professional suggests a schedule that you think you wont be able to keep or arn't happy with, tell them about it. Work out an alternative. Time with your MH Professional is the key to being able to build up the layers from the foundation.
Up-front and understanding: A good MH Professional won’t pressure you into talking about anything you don’t feel able too. Being patient with you is in their job title, so they are willing to work with you at the pace you feel able to. But it is important to be up-front with them. If they suggest something that you don’t like the sound of, or say something that you don’t agree on, tell them! Instead of nodding and agreeing with something you don’t really agree with or understand, let them know about your concerns, or what you really feel about what they’ve just said. They won’t take offence. MH Professionals prefer you to confront them, rather than keeping what you really feel to yourself. After all, things aren’t going to work for you the best they could, if you don’t agree. By being up-front, this gives you both the added bonus of having the chance to talk about these things and find different approaches and ways in doing things that will work best for you.

Sometimes Crazy 21-02-2009 12:26 AM

How do I explain or open up about a difficult subject?

Sometimes, it is hard explaining something for the first time. Speech can seem incredibly scary when it comes to trying to explain something that’s been quite in depth within yourself for a while. But the kind involving your voice box isn’t the only type that can help explain things. Writing things down (amongst other things i.e. art) can also be used as a tool to out-let your thoughts and emotions, and sometimes, can be more clear than actually telling someone via verbal speech. In various situations, handing someone something you’ve pre-written can be a lot easier than it is to stand in front of them, look them in the eye and explain. Writing things down for someone has its advantages over verbal speech for both people. For them, it gives them time to take in what you’ve said to them, and for you, it gives you time to collect your thoughts and know exactly what you want to say to them. It gives you the chance to take your time while try to explain, so you tell them exactly what you wish to.

In some forms of therapy or depending on who you see, there may also be the option to express how you are feeling or things you may wish to talk about through artwork, drama/"acting it out", or some other way that your MH professional may suggest. You may even want to ask them if there is an alternative to talking that they think would help you. Professionals do understand that it can take some time to feel ready to open up about things you may have held back for a long time, and that it takes time to build up that trust. More than likely, they won't expect you to reveal many personal details in the initial assessment, for example. Everybody is different and the time it takes for them to trust is different and this will be taken into account as well.

Sometimes Crazy 21-02-2009 12:31 AM

What do I do in a mental health crisis?

A mental health crisis can mean different things for different people. For some, it will be feeling dangerous and at high risk of harming yourself or others. For others, it may be extreme and unbearable suicidal feelings. Others yet may experience pyschotic symptoms, or other things. No matter what you may be experiencing at the time, there are ways to help it.

Your first port of call if you're in immediate danger is likely to be calling your crisis team if you have one - you could also ring NHS Direct/24, depending on where you live, or go to your local A+E department and ask to see the on-duty pysch team there. If possible, don't be left alone while you are experiencing these feelings - try and make sure you have people around you until help arrives or until you can see somebody.

Time can seem to go on forever when you are feeling particularly bad, so try breaking your day up into little bite-size pieces you can handle and keeping busy, but not too much, for each piece. From 5 minute to hour long segments, it can help you to cope until you see somebody.

If you have a CMHT and it's in working hours, you may be able to call your key worker or whoever you see most regularly. If it's out of hours and a real emergency, you can see the on-duty psych team at A+E, or even ring the police if you are worried about the safety of yourself or of other people.

If you're under CAMHS and it's in working hours, you will probably know who to ring so as to get an appointment the next day. You're also likely to be able to see a duty psychiatrist at the weekend. As above, if it's out of hours and a real emergency, you can still go to A+E/police.

Sometimes Crazy 21-02-2009 12:35 AM

The importance of not using RYL to diagnose/as a substitute.

This information sticky is intended to be used for informational purposes only and is not suitable for diagnostic purposes. Here at RYL, we cannot diagnose you with a mental illness, as we are not professionals and we therefore cannot draw any accurate conclusions from the symptoms you may suffer with. Many symptoms can be interlinked, and this means that any diagnostic process could be complex and may involve more than one health care professional. We have written these sections to discuss aspects of mental health and the varying conditons to help those who have already been diagnosed, or those wishing to discuss this further with doctor or GP who, if neccesary, can accurately diagnose you. Recognising the symtoms of some disorders may be helpful when visiting the doctors in aiding them to see how your symptoms affect you. Our articles, personal experiences and understandings can help support you in understanding where difficulties exist in your personal life, and guide you in seeking appropriate, consistent diagnosis and therapy from trained professionals to enable you to make deep and lasting changes in your personal life.

Online peer support cannot be, nor is intended as, a substitute for face to face support by trained professionals. RecoverYourLife.com cannot be held responsible for any inaccurate information and reserves the right to withdraw this information without notice.

Sometimes Crazy 21-02-2009 12:39 AM

What circumstances mean I will get hospitalised?

For the most part, psychiatrists avoid admissions to a psychiatric hospital unless it is absolutely necessary. The first intervention during a crisis would usually be the home treatment team, sometimes referred to as the crisis team.

What constitutes as a crisis is quite individual and varies from person to person. For the most part, it is circumstances which lead to the safety of someone, or the safety of others, being pulled in to question. This would most commonly be suicidal ideation, which is where someone has thoughts and / or plans about killing themselves. It can also be a psychotic episode where someone cannot distinguish between the "real" world and delusions, or when someone is going through a manic episode which needs to be controlled, although these are not the only circumstances, just examples of a few.

As mentioned above, the first port of call is usually the home treatment team (HTT), the aim being to avoid hospital admission altogether. This is where a patient is seen in their own home by members of the HTT, who are usually Community Psychiatric Nurses (CPNs) and social workers. How often they visit is determined by them / the psychiatrist, although they usually visit at least once a day until the crisis is over, or a patient gets admitted to a psychiatric ward.

The HTT can help a patient manage their medication, especially if that is an area of difficulty during a crisis. If someone is at risk of overdosing, the HTT can bring over medication for that one day and help that person to take their medication.

If it is decided that the HTT is not able to work with the patient and / or no progress is made then usually an admission a psychiatric ward is required. If an admission to hospital was deemed necessary, and the person was refusing, then they would be sectioned under the mental health act, which is further explained in another section of this sticky.

If the patient agreed to go into hospital, then it is what is referred to as a "voluntary" or informal admission and they are free to discharge themselves at any point. However, if their condition deteriorates and they insist on being discharged, they can be sectioned to prevent them from leaving. Again, there is more on this in another section of the sticky along with information on what psychiatric hospitals are like day to day.

Sometimes Crazy 21-02-2009 12:44 AM

What happens when I get onto the ward?

If you get admitted, usually the first thing that happens is a doctor will see you and take your blood pressure, pulse, possibly weigh you and have a quick chat about you're feeling. He will also intially set your level of observation which normally are as follows:-

Level Three are general fifteen minute/half hourly obs, you are free to do as you wish on the ward.

Level Two is around five or ten minute obs, you can pretty much do as you want but a nurse will come and find you every ten minutes or so.

Level One observations are also known as 1:1. This is where a nurse has to be with you 24/7, even in the toilet/shower (although if you get a nice nurse she will allow you to half close the door as long as you keep talking). You would only be put on 1 to 1 obs if the doctor thinks you are considerable risk of self harming or attempting suicide.

Then a nurse will most likely go through your bag (with you there) and take an inventory of what you have and show you around the ward and where you will be sleeping.

Sleeping arrangements depend on the hospital. Older psychiatric hospitals will have a female dormitory one end of the ward and a male dorm at the other end. Bed spaces are separated by curtains and they may be one or two single bedrooms for the more vulerable patients (suicidal, pregnant, young etc). There will also be toilets and a bathroom, again seperated by sex.

Newer psychiatric hospitals have single bedrooms, mostly en suite.

You will be expected to eat your meals in the dining room with the rest of the patients. The food is cook chill and there's not a great choice, usually two different main courses and one vegetarian.

There are usually medication times at 9am, 1pm, 6pm and 10pm. You may not have to take medication at all of these times. If you need PRN inbetween these times you can ask a nurse to give it to you. At meds time, patients will line up by the clinic and the nurse will dispense medications in a little cup and watch you take them. The queue can get quite long, so try to get to the line quickly!

Sometimes Crazy 21-02-2009 12:47 AM

How can I cope when I leave hospital?

Leaving such a secure and monitored enviroment such as hospital can be difficult to get used to. If you have been in hospital for some time, or depending on your circumstances, you may have had day or weekend releases which will give you an idea of how you feel when you leave hospital for good. Although you are likely to feel vulnerable and fragile for the first few days, there are some ways to help.

Plan some activities to do at home before you leave the ward, but nothing too strenuous. The structure and order of being in hospital can feel very secure, so try and plan activities or get a routine in place for when you get home. Simple things like getting a bedtime routine worked out, or times for meals and snacks, depending on your circumstances, can make a big difference.

Take advantage of any help and support you're offered. Home visits, helplines, they all come in useful and are there if you need them. Telling the professionals involved in your care that you're not coping so well can be difficult, so try writing down these feelings and what's happening on a day to day basis. This will also give them a good idea of what's going on for you. Spending time with friends and family can also help ease any feelings of loneliness, though don't overwork yourself. RYL will always be here for you too.

Journalling and expressing yourself can be a great benefit. Anything creative, such as drawing, writing, painting, taking pictures, etc. can be very therapeutic. It will also be a great basis to discuss any problems you're having with the people involved in your care, although personal expressions can be private if you wish them to be.

General self care will be very important too. Trying to eat healthily and regularly, gentle exercise, getting plenty of sleep and doing your best to wash and get dressed will go a long way to helping your over-all feelings.

Sometimes Crazy 21-02-2009 12:53 AM

What are the differences between sections?

Before someone can be sectioned, they have to be assessed by either an approved mental health professional (formerly referred to as ASW), section 12 approved doctors (doctors who have specialist knowledge of mental illnesses and have been trained in the mental health act), other doctors, registered mental health nurses (RMNs) and the police, depending on the type of section.

Section 2 is for assessment of your mental illness and lasts for up to 28 days, but it cannot be renewed when it expires (but can be transferred to a section 3 if needed). It can be enforced after an assessment with an approved mental health professional and two doctors (one of whom being a section 12 doctor unless in an emergency). The assessment can be carried out anywhere, but most commonly happens in a hospital, police station or the patient's home.

You will be placed under the section 2 if you are refusing to go to hospital, and it is agreed that you need to be detained in the interest of your own health, safety or the protection of others. The section effectively takes place once the person is transported to hospital, and patients can be given medication against their will as this falls under the category of assessment (the assessment is the response to treatment).

Family members can also request that a person be assessed for detention under a section 2.

You can appeal your section any time within the first 14 days of detention and have a mental health review tribunal (MHRT), or you can appeal to the managers of the hospital at any time. Either of these can lift your section, as can your psychiatrist at any time. A period of leave from the hospital can be granted by the psychiatrist.

Section 3 is for treatment of your mental illness and lasts up to 6 months before it can be renewed. You can be placed directly on a section 3 without having been on a section 2, in the same ways outlined above. This section can be renewed for another 6 months, and subsequent renewals after that last for 1 year.

If your nearest relative (which does not have to be your next of kin) objects to your detention under a section 3, you will be detained under section 2 and your nearest relative taken to court to be removed, and social services take over the role of nearest relative.

During the first three months of the section 3 you can be treated and medicated against your will, even with injections and antipsychotics and in some cases even electroconvulsive therapy (ECT)- (in emergencies or if the treatment is authorised by the mental health act comissioners panel). After three months, you must consent to treatment. If you do not, an independent doctor must confirm that the patient can still be treated against their will if it remains in their best interests.

You can only apply for a mental health review tribunal (MHRT) once during the period of the detention until it is renewed, but you can appeal to the hospital managers at any time. As above, your psychiatrist can also lift the section at any time. A period of leave from the hospital can be granted by the psychiatrist.

Section 4 is used in emergencies where a second doctor cannot be found to detain a person under section 2. It lasts for up to 72 hours and is implemented by one doctor and an approved mental health worker. Once the patient is in hospital, a psychiatrist or another doctor will make a recommendation and the section 4 be converted to a section 2.

Section 5 (2) is the holding power a doctor has. They can use it to prevent a voluntary (informal) patientS leaving the hospital, in a psychiatric ward or a general medical ward. It lasts for 72 hours and can either be recinded or recommendations can be made to implement a section 2 or 3. Treatment can be given under common law.

Section 5 (4) is the holding power a nurse has to prevent a voluntary (informal) patient from leaving. This lasts for six hours and is often converted to a section 5 (2) upon assessment by a doctor.

Section 135 is a magistrates order. If a person thought to be mentally ill by a an approved mental health worker is denying them entry to their house, this will allow entry into the house in order to carry out an assessment. The section allows police the right to enter into a house and take the person to a place of safety, usually a psychiatric hospital or the police station where they can be assessed.

Section 136 is a simlar order to a section 135 and lasts for up to 72 hours. It allows the police to take a person they believe to be mentally disordered to a place of safety, usually a psychiatric hospital or the police station where they can be assessed. Treatment can be given under common law.

Sometimes Crazy 21-02-2009 12:59 AM

Different kinds of medications

A list of types of medication can be found here on the Main Site - clicky.

A more indepth look at different medications will be added to the Main Site shortly, so watch this space!

Sometimes Crazy 23-02-2009 12:30 AM

Counselling, DBT, CBT and more.

The Main Site also holds a wide range of articles and information on different kinds of therapies you may hear mentioned or be spoken to about. While the professionals involved in your care will be able to explain the therapy suggested in greater detail, these articles will proved you with a good idea of your options.


More articles on a vast array of other therapies and terms used will be added shortly, so again watch this space!

Sometimes Crazy 23-02-2009 12:36 AM

Useful links and resources.

Royal College of Psychiatrists
NHS Mental Health Library
How to give support [BBC]
Mind Factsheets
Young Minds
Mental Health foundation
Mental health first aid
No panic
Mental Help

How to get help for your mental illness (UK)

My head hurts (UK) - For young people with mental health problems and their parents, where to get help and information on illnesses and treatments.

Mental health guide - Information about a variety of mental health problems.

Positive steps for mental health

Mental Health Care - Information for people who care for someone with mental health problems.

Sometimes Crazy 23-02-2009 12:56 AM

Main Site articles.

A few of the articles we thought relative to the topics raised in this thread are listed below - however we encourage you to check back on the Main Site regularly for anything updated and see what else we have to offer!

Going to the doctors - explaining what will happen when if you see a doctor about a particular thing. This covers depression, self harm and eating disorders currently.

What happens when I see a psychiatrist for the first time? - this deals with various issues and questions you may have when taking the step to reach out for professional help, and outlines what happens.

What to take and what not to take to psychiatric hospital - does exactly what it says on the tin!

A personal experience of psychiatric hospital - one person's perspective on what it was like to be inpatient.

Sometimes Crazy 23-02-2009 12:59 AM

The importance of talking to professionals

No matter what kind of mental health professional(s) you are seeing, their aim for you, all point in the same direction. For them to be able to provide you with the correct support and working on steps towards recovery with you! But for this to be able to work, it is crucial for you to co-operate and communicate with them. Understandably, this can be difficult for many people.
Talking to and communicating with your MH Professional does nothing but contribute towards a healthier life for you. You have them by your side and they will help you in any way they can. By talking to them, this gives them insight as to what is needed to help you. They will be able to understand your needs much better and can work forth from there onwards with you to help take positive steps.
By talking to your mental health professional, this gives you the chance to explore your thoughts and make sense of your feelings. This can ultimately help to highlight how these can influence behaviours and how they can also be connected to your mood state, and eventually, leading you to realise and work out with your MH Professional what is needed to help change these un-healthy ways of life.
But talking to them doesn’t just help them to understand your needs and help you to realise what is needed to be worked on for better mental health. Talking can also help a huge amount with confidence. As I said at the end of the first paragraph, many people find it difficult when it comes to communicating with people. Sometimes, it is self-confidence that it pointing completely southwards. Or they feel that what they have to say isn’t of any importance. MH Professionals like to listen to you. They will always listen to you and what you have to say is of importance to them. After a while, this self-confidence can grow whilst seeing them, causing communication with people to be a lot better, not just within the relationship between your MH Professional and you, but communication in the outside world too. This can help a wonderfully huge amount when it comes to taking more control of your life.
It is also important that you talk to your MH Professional about your diagnosis. This really does help towards recovery, because it gives you the chance to understand what is wrong with you. Sometimes, it is difficult to talk about your diagnosis outside of your appointment with your MH Professional, so talking about your diagnosis with them helps you come to terms with what you have been struggling with and can evidently help you understand what can help you or is needed to over come these struggles.
Another importance of communication with them is contacting. Just as important as it is for them to have ways to contact you, it is also vital that you always have some way of contacting your MH Professional for any reason, be it in crisis, discussing medication, moving appointments or just letting off a bit of steam. Discuss with them ways to contact them outside of your appointments. Depending on what MH Professional you are seeing sometimes varies on the different ways you are able to contact them on. Some will give you their personal mobile phone work number which you can either call or text them on in their working hours. When they hand this number out to you, they will discuss with you the times that the phone is switched on, so don’t worry about having to play ‘guessing games’ of when they will receive your call or reply back to your text. Some MH Professionals have an email address that you could contact them on also. I personally have found this a great help to me for discussing things I don’t feel able to tell face-to-face, or for moving appointments and the most help of all, for having just a general outlet for times when I feel out of control and confused. An alternative for emailing is to send your MH Professional a letter at their clinic, if it’s a ‘less urgent’ situation. If you can’t reach your MH Professional via work phone, clinic/surgery phone or email, don’t be afraid to contact the clinic/surgery where they are. The receptionist will always leave your MH Professional a message and they will always call you back.

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