Category Archives: MentalCapacity Advocates.

More mental health stuff…..

Standard

Some of the people who read my blog will already know, last year my grandson had a crisis in his mental health which was triggered by drugs, in his case a mixture of cocaine (cut with who knows what,) very high strength weed and we know not what else. He was extremely unwell and one year later slips in and out of different states of ok-ness and not ok-ness. He cannot settle anywhere for very long so he has become a serial transient which makes it more difficult for us to help him. His mother has bust a gut to sort out accommodation for him, but he reports back that it is always unsatisfactory and the places are full of “the dark side.” She has researched mental health services in depth and offered him various options of therapy none of which he tries. We flit from one idea to another already knowing he probably won`t do anything we suggest. He has taken himself off all medication and struggles a lot, to achieve a sense of normality in his life. We`re at an impasse and have sometimes come to blows, as a family, over how we should proceed from here. Mental health impacts not just on the person who is unwell, it impacts on their whole family. Services across the UK are sparse and certainly in our experience, not terribly helpful, so it is unsurprising that our homeless hostels and prisons are full of men and women who cannot find a way to `get better` and manage their symptoms, whatever they may be. Lots of people self-medicate with drink or drugs or both and for many this will work and for the rest it will exacerbate those very symptoms that trouble them the most.

I recently had an interesting conversation with the matron of Oleaster Psychiatric Hospital in Birmingham. A lovely, warm, engaging and compassionate man he said that most of the people who come into the hospital on a mental health section are young men who are often so high from street drugs, the hospital has to first manage their come down and then wait, often for weeks for individuals to have settled enough to begin to work with them in any kind of useful way.  He explained that many dealers are manufacturing new and increasingly stronger chemical highs usually in their own houses.  It is almost impossible for health staff to keep up with what new drugs are being designed or their chemical content, how they will affect the individual`s thoughts and behaviours and so it is inceasingly difficult to offer antidotes that will help.  It terrifies me, drugs terrify me, but legalising drugs would reduce the need for people who want to use drugs to have to approach dodgy dealers and would certainly be helpful to extremely vulnerable people like my grandson who are currently preyed upon by those who are pretending to be their friend. “The drugs are free, go on mate have some, you can pay me back when you next get your benefits.” Dealers rely on people running up huge debts of hundreds of pounds to ensure their money keeps on rolling in. The people they prey upon then are then coerced to commit crimes of various degrees of seriousness in order to get more money for more drugs.  It`s a horrible scenario.

Our family has sometimes begun to fragment under the weight of worry and there are very few services for families like us so we have to remain strong and hold each other. Oleaster run a family support group and when we visited it, there was only us and one other regular but it still helps to get other perspectives on the issues we are facing with our grandson. So I don`t know what the future holds for our beloved boy-man, it often seems rather bleak, we are certainly not in a sprint, we are in a marathon but I was heartened by the matron who said as we were leaving,  “Many people will go on to work out quite a lot for themselves simply by trial and error. So eventually they moderate the habits and behaviours that repeatedly make them unwell, unpopular, broke and unhappy, so take heart, the likelihood is that it will eventually pass.”

Medication time.

Standard

As many of you know by now, it`s not a secret, the young chap I wrote about in a previous blog is my grandson.

https://anightinwithnelly.wordpress.com/2018/09/02/mental-health-services-in-birmingham-are-woefully-lacking/

Since that time, he has returned to live at home.

From when he was first sectioned nearly four months ago, he has had a whole conglomerate of anti-psychotic drugs and mood enhancers, none of which have really improved his mood very much at all although he does have some better days from time to time. Drugs he has been prescribed and occasionally made to take without his consent include Risperidone, Depakote, Haloperidol which incidentally, he was given too high a dose of and this resulted in him being “wired” and unable to properly relax or sleep for about five days, Procyclidine, Lorazepam, Olanzapine, Propranolol, the list goes on. In spite of his family suggesting he is lucid and wishes to engage in talking therapies, so far our suggestions have not been accepted as a good way to go by the team “supporting” his recovery. They say that he is unable to attend talking therapies while he is being medicated.

Catch 22.

Our dear boy struggles a great deal with his condition. The anti-pyschotic medication sedates him to the point where he feels immobilised and despairing of ever getting better. He is fortunate though and tells us that some of the young people he met in hospital have no-one, no family loving them and helping them as they try to get through it. I can only imagine how lonely and isolating an experience this must be.

Last Wednesday, he was taken off the current anti-psychotic and also Lorazepam, which is a strong sedative, for a period of five days to “see how he would cope.” He has suffered withdrawal from Lorazepam, which is a highly addictive drug as well as whatever his brain is experiencing as it wakes up from the last round of anti-psychotics. He is managing with PRN medication (as and when needed) mostly Depakote which stops him from sleeping and Propranolol which is an anti-anxiety drug. He takes them in a fairly haphazard fashion and his greatest desire is not to take them at all. Unfortunately, he is still ill and becomes very anxious and `pacey` without them.

I fail to see how this treatment resembles anything like a recovery or as one of the women I supported some years ago recently said to me, “I got better IN SPITE OF mental health services, not because of.”  She is in her mid-sixties and has spent several years of her life in hospitals under a Section 3. It doesn’t bode well does it.  I hope one day we will be able to look back as a family on this time and laugh and say, “fuck me that was shit wasn`t it!”

The problem with mental health issues is that they don`t show and people can mask their symptoms sometimes for years living in a kind of hell and with no support or anyone to talk to. The effects and impact that mental health breakdown has on individuals and families is major and the episode my grandson experienced and is trying very hard to recover from, has fractured us as a family. We`ve cried, we`ve sometimes laughed at his idiosyncratic behaviours, we`ve disagreed with one another and argued, we have gradually concluded that heavy drugs do not really help, certainly not in his case. They contain the issue, they do not heal. We are hopeful that natural therapies, diet in particular; talking therapies, patience, innovative distraction ideas and plain old love, will get him through this.

If anyone reading my blog can make any suggestions as to a way forward, then do please feel free to comment. I`ll warmly respond to all comments.

What is Independent Mental Capacity Advocacy?

Standard
What is Independent Mental Capacity Advocacy?

A day in the life of an IMCA. (Independent Mental Capacity Advocate.)

Ever since I was a child I have awoken at around 5am. I get up with my little dog Alf, we have a cuppa and watch Jeremy Kyle. After my bath, Alfie and I have breakfast, go for a walk and then I drive to the top of my road, to work.

I work for Solihull Action through Advocacy as an Independent Mental Capacity Advocate or an IMCA for short. In the UK, IMCA`s have provided a statutory service since a court ruling in 2014 which has become known as The Cheshire West Case. The legislation arose because of an appeal relating to an individual`s liberty (Mr. P) who since 2009 had been cared for in a supported living situation. He received 24/7 one to one care to manage his idiosyncratic behaviours. He was learning disabled, never on his own and was not free to come and go.

The Court of Appeal stated that this was not a deprivation of liberty, but the judge, Baroness Hale did not agree. She said,

“If it would be a deprivation of my liberty to be obliged to live in a particular place, subject to constant monitoring and control, only allowed out with close supervision, and unable to move away without permission even if such an opportunity became available, then it must also be a deprivation of the liberty of a disabled person. The fact that my living arrangements are comfortable, and indeed make my life as enjoyable as it could possibly be, should make no difference. A gilded cage is still a cage.”

If a person is deprived of their liberty in the UK and requires an IMCA then the referral is called a DoLS or a Deprivation of Liberty Safeguarding.

There are many thousands of people across the UK in situations similar to Mr. P`s. They may have a learning disability, dementia, a brain injury or something else that affects their capacity. All of these people now have a statutory right to their own IMCA to represent them, give them a voice and, if they have no relatives or friends able to do so, make best interest recommendations on their behalf.

IMCA is a very challenging and responsible role. We are called in to safeguard extremely vulnerable individuals who do not have the capacity to make their own decisions, so we take it very seriously. A typical referral would be to visit someone either in hospital. or in a care home and talk to them, to the people around them, their friends and family and find out what they would want to happen if they were able to say. Sometimes the decisions are around accommodation, medical matters, money or care plans and reviews.

We write a report and in all cases of IMCA DoLS,  the report goes to someone called the Decision Maker, who authorises the DoLS and makes everything legal. We have to remain informed and up to date with the law so that we can confidently assist families when they are making tough decisions on behalf of their loved ones.

I absolutely love my job, it brings me huge satisfaction to know that I can help as far as possible to ensure that very vulnerable people are safe, happy, cared for and not being ripped off by any unscrupulous individuals, including sometimes I am sad to say, members of their own family.

If you would like to know more about IMCA, then please contact me on:

helen@solihulladvocacy.org.uk

or: 0121 706 4696