Working with GPs and Psychiatric Consultants
For many carers the GP (general practitioner) is the first port of call when seeking help for the person they care for. A GP can...
Carers of people with mental health problems come into contact with different hospitals departments. If people with mental health problems are very unwell and considered a danger to themselves or others they will be admitted to an NHS psychiatric hospital. Admission can be voluntary or compulsory through being ‘sectioned’ under the Mental Health Act. The law says that the view of the nearest relative should be considered when a person is admitted to a psychiatric ward. It is also possible to have private health insurance and use private psychiatric hospitals.
Hospital outpatient departments are used by those who need treatment but don’t need to be admitted to a psychiatric ward. Some carers we spoke to had to take their relative to an Accident and Emergency department after serious injuries or suicide attempts.
Many carers said that, when people are very unwell, they are safest and best looked after in hospital. These carers thought it important to work together with medical staff. Some said they trusted the expertise of the hospital staff and were relieved to have some responsibility taken off them.
Other carers, however, didn’t think people could really get better in psychiatric wards. Some said that people who were in psychiatric hospitals long-term were ‘just locked away’ with very little to do. One woman asked ‘how can you have so many people sitting around smoking and watching TV – do they think it is worth sectioning people for that?’ And she wondered’ ‘how does that equip you for when you leave?’
People also said that hospital care seemed mostly to involve medication, and that there was not enough psychotherapy or activities to occupy patients, or spiritual care.
Some carers worried about the safety in psychiatric wards. One person’s elderly aunt, who had dementia, had been sexually abused by another patient. Based on her own experiences, another carer felt her father wasn’t safe in hospital.
Some talked about a lack of resources in mental health services, which meant that wards were understaffed, or unqualified personnel were used to save money. Carers had sympathy with hospital staff because of their demanding jobs, including ‘being shouted at’ and the ‘risk of being beaten up’. They also mentioned the long shifts and ‘poor pay for nurses’. But they also felt that hospitals should take their duty of care seriously, and not hide behind ‘restricted resources’. For example, some said the food in hospital didn’t suit people’s diet and was unhealthy. Since ‘healthy eating is not rocket science,’ hospital food could be made more nutritious and culturally appropriate.
People also talked about neglect, such as their loved ones not being changed or fed as often as they needed, their medication being wrong or left untouched, people getting dehydrated as well as a lack of privacy and dignity.
People with mental health problems sometimes need hospital treatment for physical conditions and are sometimes moved between general wards and psychiatric wards. Some carers reported a lack of communication between different wards or between hospitals, which sometimes meant people missed out on treatments, or were not seen as ‘whole persons’. Lack of communication between services meant carers often knew more about the situation that the professionals involved.
Many carers talked about how general hospitals wards ‘did a good job clinically’ but didn’t have the resources to look after people with mental health problems. One man even commented: ‘If you ever get sick, don’t go to hospital, they are dangerous places!’ Some therefore felt they needed to be involved in hospital care to make sure their loved ones were safe and treated well. One carer thought her father wouldn’t have survived had it not been for her nursing background.
While in hospital for observation after suffering a seizure, another carer’s husband (who had dementia) did not get out of bed for a week, and couldn’t stand up when he came home. Since then, both have been housebound because of his immobility.
For many carers the GP (general practitioner) is the first port of call when seeking help for the person they care for. A GP can...
Many people with mental health problems and their carers are helped by services in the community instead of - or in addition to - doctors...