Are You Worried About Someone s Mental Health Factsheet Signs that someone might need help We all experience stressful events from to time that can change our normal behaviour. This can include things like a relative dying, losing a job or a relationship ending. We may feel stressed, angry or sad, which are all natural responses but will probably only be temporary. Sometimes changes in behaviour can suggest that someone is developing a mental illness. Typically, a mental illness rarely comes out of the blue. You may be the best judge when someone you know is behaving differently. You may notice a change in behaviour over a short period of time or over a number of months. Common changes to look out for are: Becoming anxious, irritable or confrontational Changes in mood Showing thoughts of suicide or self harm Sleeping too much or too little Preferring not to be around other people Seeming less able to cope with work or studies Difficulty concentrating or with memory If someone is developing psychosis or a psychotic illness, you may see more noticeable changes. Psychosis is a medical term that describes hearing or seeing things, or holding unusual beliefs that other people do not. Changes can include: Being preoccupied with unusual new ideas or odd beliefs Becoming overly suspicious and paranoid such as thinking people are talking about them Believing that friends or family members want to do them harm Thinking that the TV is talking to them Believing they are on a special mission or have special powers Not communicating with anyone or refusing to leave their room for days Difficulty concentrating or with memory Finding it more difficult to complete personal tasks such as washing or dressing or preparing food You can find more information about psychosis at rethink.org. Top 2. First Steps You can try and help your friend, relative or loved one by encouraging them to seek help from a doctor like a General Practitioner (GP). You can get more information on visiting the GP in our ‘What to expect from your GP’ factsheet available from rethink.org. You can also get a hard copy by calling us on 0300 5000 927. Your friend, relative or loved one might not want to visit their GP for different reasons. They may not feel they are unwell or think that a GP wouldn’t be able to help them. They may realise they need help but feel too embarrassed or ashamed to talk to a doctor. It may help to: Imagine how you would feel in your friend, relative or loved one’s situation. Remember that they might feel sensitive, anxious, frightened or confused. Remember they may feel you are ‘getting at them’. Be calm, sympathetic and tactful. Raise the subject when you are both relaxed and have time. You could suggest that: Stress, anxiety or other symptoms seem to be making it difficult for them to cope as well as usual, and that a doctor could help. You can go along with them to an appointment to support them. Many mental health problems can be easily treated. They might be worried they will have to go to hospital, but this is usually unlikely if they get treatment. GP notes are confidential. This means that information they share with the doctor can’t be passed onto anyone else unless they agree to it. It may be helpful to read our factsheets ‘Dealing with unusual thoughts and behaviours’ and ‘Supporting someone with a mental illness’ which you can download from our website at rethink.org. Top 3. How to ask for help The person you know may refuse to see a doctor. If so, you can try and ask for help yourself. Writing to the GP If you know the details of their GP, you can write a letter to them. Explain the reasons for your concerns clearly and try to stick to facts and examples. Keeping a diary might help. You could make a list of concerns. For example: My daughter has left college because she believes all the staff are talking about her. My son does not come out of his room except to get food. My wife has started self-harming and takes a lot of time off work at the moment. Evidence of any changes in behaviour might also be useful. For example, your friend or loved one may have sent you an email, letter or text that seems odd or distressing. You should also explain to the GP if there is a history of mental illness in the family. The GP might invite you to make an appointment to discuss your letter. Or, you could make an appointment yourself. Once again, the doctor will appreciate factual statements about what has happened, rather than opinions or vague descriptions. Sometimes GPs may contact your friend, relative or loved one to invite them for a check up or they may agree to do a home visit. Contacting the Community Mental Health Team (CMHT) A Community Mental Health Team (CMHT) is made up of professionals like psychiatrists, psychologists and community psychiatric nurses (CPNs). Usually your friend, relative or loved one will need a referral to get help from the CMHT. A referral is when someone passes their details to a team or service so that they can make an appointment to see them. GPs can refer someone to a CMHT. Sometimes local CMHTs will also accept self referrals or referrals from friends and family. You can usually check this on the local mental health trust website or we could try to check this for you. Even if you cannot refer your loved one to the CMHT, you may still like to write to them explaining your concerns. However, the CMHT may say they cannot get involved. If the CMHT already supports your loved one, then it should be easier for you to share your concerns. Contacting the Early Intervention Team Early intervention teams treat and support people between 14 and 35 years old, who are experiencing psychosis for the first time. If someone has psychosis and does not get treatment for a long time, they are more likely to develop longer-term problems. This can include becoming unwell again or having problems with relationships or being able to work or study.1 This makes it important to try and get medical help for someone if you think they are developing psychosis or a psychotic illness. Getting help sooner rather than later can: Improve how quickly and how much a person recovers Reduce the likelihood of becoming unwell again or admission to hospital Reduce time lost from work, school or college Reduce stress on family and friends Usually your friend, relative or loved one will need a referral to get help from the early intervention team. A referral is when someone passes their details to a team or service so that they can make an appointment to see them. GPs can refer someone to this sort of team. Sometimes early intervention teams will also accept self referrals or referrals from friends and family. You can usually check this on the local mental health trust website or we could try to check this for you. Even if you cannot refer your loved one, you may still like to write to them explaining your concerns. However, the early intervention team may say they cannot get involved. The National Institute for Health and Care Excellence (NICE) recommends that everyone experiencing psychosis for the first time is offered a referral to a CMHT or early intervention service.2 It might be worth pointing this out to the doctor if the person you know is experiencing symptoms of psychosis. You can find more information about Community Mental Health Teams and early intervention teams at rethink.org. Or call 0300 5000 927 and ask for a copy to be sent to you. Things to remember It can be useful to give a doctor information on your friend, relative or loved one’s health as they may decide to seek help later on. This might help shape the questions the doctor might ask them. Sometimes when family or friends share concerns about the person they care for, professionals may share this information directly with this person. This can have an understandable impact on relationships and trust. When sharing concerns verbally or in writing, you could request that any information you share is kept confidential and used as sensitively as possible. You could explain that this is necessary to protect your relationship. Some doctors believe that listening to the concerns of others may breach their duty of confidentiality. This is not true, and the duty of confidentiality does not prevent a doctor listening to your concerns.3 A doctor or mental health team will need permission from your friend, relative or loved one to share their personal information with you. If not, you can still share concerns. However, professionals will be limited in what they can tell you, including what they will do with your information. You may not know which GP surgery your relative is registered with. If you ask a surgery if they are a patient there, the surgery will not be able to tell you unless your relative has given them permission to share information. Top 4. Asking for help outside the NHS Voluntary services/ organisations If your friend, relative or loved one doesn’t want to get help from a doctor, you can check if there are any voluntary services in the area. Sometimes people are more open to getting help from this sort of service. A voluntary service, like a local charity, may feel less ‘clinical’ than a GP surgery. Although voluntary services can provide some treatments such as talking therapies, they can’t give medical help. But sometimes staff from voluntary organisations have day to day contact with NHS mental health services. They could let mental health services know that someone is unwell and needs assessment. Mental health services might add extra weight to information from voluntary services. Social services You can ask social services to carry out a ‘community care assessment’ of your friend, relative or loved one. Community care means getting help from the Local Authority for social care needs, like having support in the home or getting out of the house. Social services have a legal duty to carry out a ‘community care assessment’ under the NHS and Community Care Act 1990. This means that if you ask for your friend, relative or loved one to be assessed, they must carry this out by law. The assessment will usually be carried out by a social worker, or other people working for the Local Authority social services department. Under section 47(3) of the NHS and Community Care Act, the local authority should invite health services to help a person who may be in need of health services. This can include social services contacting the local Community Mental Health Team (CMHT) and asking them to assess the person you know. You can find out more information on community care at rethink.org. Top 5. Common problems From our experience, most doctors or other professionals in NHS services expect the person who is unwell to approach them directly. This can be a tricky barrier as you cannot force someone to get help even if they are clearly unwell. Doctors should take on board and listen to your concerns. In some cases they may try to arrange a home visit so that your friend or relative can be assessed. If the doctor seems unsympathetic you could try asking at reception if any of the doctors have special experience in working with people with mental health problems, and try contacting them. Even if a doctor or other health professional has agreed to make contact with your loved one, they cannot be forced to accept treatment unless they are detained or ‘sectioned’ under the Mental Health Act. If your loved one has become very unwell, you may wish to explore the options in our ‘Getting Help in a Crisis’ factsheet available from rethink.org. 6. Getting help for yourself Trying to get help for someone who is unwell can be stressful. Carer support services and groups offer a vital source of support for many carers across the UK. They can provide an opportunity to meet others to share mutual support, information and advice. You could also ask your local council’s social services department for a ‘carer’s assessment’. Someone would then assess you to see if you need services, which could include respite care.
Posted on: Fri, 15 Nov 2013 11:47:22 +0000
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