Psychosis (young people)

Getting help in a crisis

Many people had only received help when their psychosis had reached crisis point – i.e. they felt unable to cope or control things. This could be because they had not sought help earlier, or because although they had tried to access help, adequate support was not given. Some had already been receiving support for low mood, anxiety or depression when they first experienced psychosis and felt that it was only when they had reached crisis point that proper help for their psychosis was offered. 
 
Getting help in a crisis typically involved some or all of the following services:
  • A&E
  • Emergency services
  • CMHT crisis team
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Some people had periods where they were regularly accessing a crisis team, going to A&E or calling emergency services and helplines.
Accessing Emergency services
 
Most people we spoke to had contacted the emergency services in relation to their psychosis at some point. Police or paramedics could be called on by the young person in need of help, or by others. Becky had been arrested for breach of the peace, and for her own safety. Crisis teams, within Mental Health Services, can also work with emergency services and sometimes take a person to A&E, or offer them community support, depending on the situation. People often had good things to say about those who worked for the emergency services and spoke about the importance of staff being “patient” and “human”.
But there could also be misunderstandings which could make people reluctant to call out of hours services for help. After she had been discharged from CAMHS, Sam heard voices telling her to hurt others and called 111 for help. She then went to A&E but the 111 operator informed the police who, concerned she might hurt someone, nearly forced entry to her house (luckily a neighbour said she was out). If out of hours had known more about her history they would have known that she has never acted on the voices she hears. 
 
Going to A & E
 
Psychosis can be a very distressing and often frightening experience and can get worse very quickly or with little warning. Some people said they heard “bullying” voices telling them they were “useless” or should harm themselves or that they were in danger and should harm others. A few of the people we spoke to had delusions and paranoia or false memories that made them act out of character, which other people could find upsetting. 
 
In some situations friends and family had brought the young person to A&E when they were acting out of character, but at other times the young person had gone there themselves because they were concerned for their own safety: Nikki, for example, had gone to A&E because she felt unable to keep herself safe. When Sam was waiting to be transferred from CAMHS to Early Intervention Services  there was no “out of hours” support for her because of a gap in services and she found herself regularly going to A&E. 
 
Some people had to wait a long time at A&E to be seen, or felt they were not taken seriously. Lucy, Ruby and Nikki who experienced depression, low mood and severe anxiety attended A&E several times after having taken an overdose or because they were self-harming but had been sent home. Nikki said she had been to A&E 20 times, desperate for help, before she was eventually admitted. 
 
Being in A&E and experiencing psychosis could be a strange experience. When Luke was having delusions and hadn’t slept for 72 hours his dad took him to A&E. He said he was “flying high” and was going around the beds putting his hands on people’s heads and saying, “you are healed”.
Being assessed in a crisis
 
Where people had reached a crisis point during their first experience of psychosis there could be a difficult period of assessment where medical professionals sought to understand what was happening and to decide what treatment and support was appropriate. When Luke first saw a psychiatrist he felt that the process was just a ‘tick box’ exercise and that nothing would come of the assessment.

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