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Mental health services for self-harm – community
Some people who self-harm may need to be supported by their local Child and Adolescent Mental Health Service (CAMHS). CAMHS is a service for young...
Occasionally, young people who self-harm may be admitted to a psychiatric unit or adolescent unit if they are thought to be at high risk of self-harm. We spoke to parents and carers who were able to tell us about their experience of this.
Several parents talked about the time when their child was an inpatient in a psychiatric hospital. In some cases, as for Jim, the young person had an eating disorder which needed to be treated in hospital. Visiting was difficult for parents when the hospital was a long way away, especially when there were other children in the family. Alexis’s daughter went to a mental hospital that was ‘like a hotel. I know it cost a lot of money but it was full of quite caring people, lots of lovely staff, psychiatrists, psychologists, CBT [cognitive behaviour therapy] sessions.’ She was discharged after three months because the Primary Care Trust could not fund her after she was 18 years old. Alexis was glad, because she saw people who had been inpatients for years, and thought ‘you’ve got to be able to cope with life out here, in the real world.’
Some parents had reservations about the inpatient units. The hospital Ann’s daughter was transferred to was very different from her local one. Ann said it was very good with patients, but ‘with the family it was abysmal. No communication at all, so we went from being involved every Monday morning on the ward-round locally and asking for our opinions and what our thoughts were and being open, to no family involvement, other than family therapy. And the family therapy could be quite destructive and then you’re just left to go on your way. ‘You’ve had your hour, thank you. Off you go”. Parents were anxious that their children might learn different ways of self-harm from other patients. Ann’s daughter made a serious suicide attempt while an inpatient but Ann didn’t hold the hospital responsible. ‘If someone is determined to do something, even in hospital where somebody is on a watch, they will do it’, she told us.
Young people are occasionally treated as day patients and go home overnight. Erica was very pleased that this was the case for her daughter, because she could be with her in the evenings and get to know her better.
Sometimes the young person didn’t want to be admitted to hospital. Charles said that when his son was being assessed for admission he ‘knew very well that if this happened he couldn’t come with the family to France, which he likes and enjoys, and I think we were planning to go skiing. And so he managed to persuade those people that he wasn’t a candidate for hospital, for inpatient treatment or hospitalisation.’ Although Fiona’s son realised he needed help and said the staff were ‘very good to him’, Fiona told us that ‘he said he wasn’t sure about the medicine and also that he didn’t really want to be there, and the more days he spent there he didn’t want to be in there. He wanted to go visiting there when he was unwell, but he didn’t want to stay in. He said because there were people in there that were in a lot worse circumstances than he was.’ Alexis’s daughter, on the other hand, was keen to be admitted. Some parents were reluctant for their children to become inpatients (see Anna above). Jo said she was afraid that if her daughter was admitted she wouldn’t be able to take care of her. Others were pleased. Liz told us, ‘We needed some time with me not on at her about what she was eating or not eating and our relationship was tricky so I was very glad that she was admitted.’ As Liz says, sometimes it can be good for the young person and their family to be apart for a while.
Sometimes, if young people are at serious risk of self-harm and not willing to have treatment they may be admitted to hospital under a section of the Mental Health Act. This means that they have no choice about being admitted in order to give them the treatment they need. Some people call this ‘being sectioned’. Philip and Mary’s son was suddenly admitted under a section when he wouldn’t promise not to kill himself, although he was allowed to leave hospital a few days later. Ann described the time when her daughter was admitted compulsorily as a ‘horrible experience’. However Jim was relieved when his daughter was put under a section because it meant that the police had a legal duty to return her to the hospital when she refused to go back.
Some people who self-harm may need to be supported by their local Child and Adolescent Mental Health Service (CAMHS). CAMHS is a service for young...
Difficulty in relationships within families may sometimes contribute to self-harm. However, in general, families are seen as a very important part of trying to help...