Wednesday, August 20, 2008


September 2003

If you have been following our story in order this is quite a jump forward in time, but the subject of having a loved one detained under a section of the Mental Health Act is one that has been discussed recently, but not in depth. This was our experience.

It was a Sunday morning. I awoke earlier than usual, not having slept very well after being woken during the night by Mr Man repeatedly banging his head on the pillow in an attempt to get the voices to stop. He had been discharged from hospital five months earlier, but the medication he was taking seemed to have less and less effect on his symptoms as time went on. It had been decided some months previously that Mr Man would be admitted into hospital to start treatment of Clozaril, but he was still on the waiting list for “the Clozaril bed”.

Despite a growing history of self harm, suicide attempts, and psychosis, Mr Man still had no Care Plan in place, no CPN, and no Care Co-ordinator. We “coped” alone. Earlier that week the strain had become too much for me and I had resorted to alcohol, just to experience one night without the worry and the emotional pain of watching Mr Man suffer. Not being a regular drinker, when I wanted to repeat the experience two days later I realised I wasn’t coping.

Without a support system in place, when I realised how bad the voices were getting I didn’t know what else to do except call the usual “out of hours” Doctors surgery. I explained that Mr Man was waiting to be admitted for treatment with Clozaril, but that in the mean time his condition was deteriorating quite badly. The Doctor agreed that I should bring him in to be seen.

The problem was that although Mr Man had previously agreed to go into hospital to start his treatment of Clozaril, whilst waiting to be admitted his symptoms had deteriorated to the point that now he was confused as to whether he was really ill or not. Mr Man refused to get up. To begin with I thought this was merely part of the ongoing problem I had with getting Mr Man to do anything, because of the negative symptoms of his Schizophrenia. I called the surgery to explain. I was sure that the Doctor wouldn’t understand and would think I was wasting his time; after all, that was the response I was used to from Psychiatrists and Psychiatric Nurses, so I didn’t expect much from a GP, but he suggested I try again. Mr Man still wouldn’t get up, but this time it became clear to me that it was because he didn’t want to be seen by a Doctor, rather than just not wanting to get up. This worried me even more because I knew from experience that once Mr Man had lost the insight that he was ill his delusions would take hold and there would be no reasoning with him. I called the surgery again to cancel the appointment. I was embarrassed that I had called the surgery for an appointment and now Mr Man was refusing to go, and I felt so helpless. The Doctor must have discerned the anxiety in my voice and he threw me a line.

“Are you saying he is refusing to be seen by a Doctor?” Something in the tone of his voice told me what he was thinking.
“Yes” I replied.
“Are you concerned that he could be a danger to himself?” he asked.
“Yes” I replied, and I went on to explain that that was why I was so worried; because the voices were worsening and they often tell him to harm himself.

I was so relieved and so grateful when he said he would arrange a home visit for Mr Man to be assessed. Mr Man was a bit sulky with me about that, but once the Doctor arrived he agreed to go down stairs to be seen by him. After discussing his symptoms with him, the Doctor asked Mr Man if he would go into hospital voluntarily, but he refused. The Doctor asked me if I agreed that Mr Man needed to go into hospital, and I did, so arrangements were made for a Psychiatrist and a Social Worker to attend.

Mr Mans mother visited us that day, which had been pre-arranged earlier in the week. She was obviously confused by the presence of strangers in our home, so I took her into the kitchen and explained what was happening. She was overcome with emotion at the thought of her son being taken into hospital against his will, but for me – as someone who had needed to hide knives and blades, and constantly reassure Mr Man that he doesn’t have to slice himself open when the voices tell him to, and that no harm will come to him or me for not doing it – having him “sectioned” seemed far less traumatic than the thought of his condition deteriorating further.

The lesser of two evils?

"Sectioned Lady" by Philippa King

The whole process was very drawn out with much waiting around, firstly for the appropriate people to attend and then for an ambulance to take Mr Man to the hospital, which wasn’t really necessary but apparently required by law. From the time I called the surgery to the time Mr Man was finally admitted took about 12 hours. During that time Mr Man was anxious but quiet. He didn’t argue, and he didn’t struggle. He was resolute that he didn’t want to go to hospital, but he seemed to have resigned himself to the fact that he would have to. The Social Worker was very chatty and friendly, and even managed to get a smile out of Mr Man a couple of times. There was no drama, and apart from that edgy feeling of expectation when you’re waiting for something to happen, the day was quite boring. I was relieved when the day was over and Mr Man was safely on the ward, although leaving him on the ward was never easy for me. I could never quite decide which was the lesser of the two evils.

I’m not sure if I had Mr Man admitted for his own safety or my own sanity, but it prevented him from having to wait many more months before starting his treatment of Clozaril – the first medication to really make a marked improvement on his symptoms.