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Self-harm: Parents' experiences

Mental health services for self-harm - hospital

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. 

Psychiatric hospital treatment
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.’ 
 

Staff at the unit where Sharon’s daughter was an inpatient were experienced in all areas, not just eating disorders.

Staff at the unit where Sharon’s daughter was an inpatient were experienced in all areas, not just eating disorders.

Age at interview: 37
Sex: Female
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But now she’s got people around her that are experienced in all, all the areas, not just, it’s not a specialist eating disorder unit. They’re there for everything. Obviously, no sharp objects are allowed and they’re, they’re very mindful of what the young people have access to and it’s, it’s talked about and there’s other people there that have got similar issues. She has individual therapy with a named nurse. She speaks to a psychiatrist as well, well he tries to speak to her. She’s [laughs] she’s not keen on chatting to him but we also have, we’ve started family therapy as well now. 
 

It was hard for Debbie to be apart from her daughter when she was admitted to a psychiatric hospital.

It was hard for Debbie to be apart from her daughter when she was admitted to a psychiatric hospital.

Age at interview: 37
Sex: Female
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I struggled. I found that really hard. We’d never been apart and none of, all my children kind of always been here. I don’t go anywhere really without them and she went into hospital on this Thursday evening and they took her in. Didn’t, I was in for the first interview bit of saying what was going on and then we was told to leave. We wasn’t shown where she was, her room, we didn’t know where she was sleeping and, from that point on, we wasn’t allowed back on the ward. We had to meet in a room out on reception. I visited every day. 

We got comments that I was jeopardising her recovery because I was visiting every day. They told my daughter that she needs to get out of her mother’s womb. She needs to separate herself. We would phone every night but I’d leave because it was quite a distance so I drove, travelled home, she’d worry because her OCD was related to keeping her family safe, she’d worry on the drive home that something bad was going to happen so I would have to phone when I got home, to make sure that I was okay. She’d then go to bed. We’d get comments. They would stop her using the phone. They would pretend that she wasn’t there so I couldn’t talk to her. I’d had meeting upon meeting with the hospital saying that, “I don’t understand what you’re doing because you don’t want to stigmatise mental health yet I feel that, as a profession, that’s what you’re doing because if took my daughter into a general hospital with a physical complaint, I’d be by her side. I wouldn’t be questioned. I wouldn’t be judged.” I said, “But I feel like I’m being judged here.” I said, “I’m here because I want to help my daughter recover.” I fought so hard to get help and now it’s as if I was handing my car over for a service and they would give it back to me when it was mended.

Yes.

And they said that they would have a look into it and do meetings. We wasn’t told. We had a ward round every week. They would phone us up. They was never phoning me. They always forgot to phone. I’d have to go in on the Tuesday and say, “What happened on the ward round?” When she came home on weekend leave, we got a great diary that we had to fill in, her mood, what she’d eaten, had she self-harmed, how she, her physical state, was she clean, did she wash? But yet, she was in hospital all week and I never got any of that. I never got told whether she’d eaten. Whether she was, got out of bed. Whether she went to the school. Whether she self-harmed. 

On one occasion, she was in hospital, she smuggled a blade in. She self-harmed in the toilet and nobody told me. Only, luckily, I’ve got a relationship with my daughter, she come out that night and said, “Mum, I need to tell you, I’ve self-harmed today.” And I asked them why they didn’t tell me and they said because of confidentiality. And I said, “This is my sixteen, fifteen.” Well, at the time she was fifteen, “This is my fifteen year old daughter. I need to know.” And they said, “You don’t need to know. We can only tell you if [your daughter] kind of lets us know.” At one point she tried to hang herself in her bedroom and I was downstairs and they didn’t tell me. So bad, bad, awful time, which has probably led me to kind of do this really.

Yes.

To highlight how important it is for parents to be involved, because…

And it isn’t just me. I’ve spoken to various families now that have had this problem with inpatient services. The only good thing from the hospital was they got her into a different department so we’re not under our local CAMHS any more. We go up to London and she’s under a service up there, which is thank goodness, that she got the funding and she’s getting the treatment she needs now.
 

Joanne didn’t think the local adolescent mental health unit was right for her daughter and hoped that she could be moved somewhere more suitable.

Joanne didn’t think the local adolescent mental health unit was right for her daughter and hoped that she could be moved somewhere more suitable.

Age at interview: 44
Sex: Female
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What sort of treatment is she having now? She’s in. 

She’s in hospital.

An inpatient.

She’s on a waiting list again to receive DBT therapy [dialectical behaviour therapy*].

Oh yeah.

But the problem is, she needs to go to London for that and she’s not safe enough because she’s suicidal so she’s on a section three now so, at the moment, it is just a case of we’ve just got to get her safe enough to be able to travel. We’ve also looked at moving her to a more therapeutic hospital and there is one that we’ve got in mind, subject to funding, which we hope but it is the last chance sort of hospital and they do give a hundred per cent success rate and it is more therapeutic. It is not, where she is at the moment, you’ve got all types of mental illness and it’s just not the right place for her.

It’s just like a holding place I think now. She’s beyond help for there. The psychologist that she is supposed to see is a man, which due to circumstances doesn’t help so I know that you can’t pick and choose but it just doesn’t help that she just does not want to talk to him.

Understandably because of her issues with men.

And what about the other therapeutic hospital. Do you think that’s a possibility?

Yes, we’re hoping. It’s, yes, she can’t be moved yet because she’s not safe and very, very suicidal, is always trying to run out as soon as the doors are opened.

Yes.

But they have said that they would take her even on a section three but her mental health has got to be a lot better than what it is now because what we’ve got is she’s disassociating and she’s thinking that she’s dead and that she’s not here so she’s in the depths of depression and this is one of the effects of this depression and that is what we’ve got to treat before we can make her get properly better.

* This is a form of therapy (using individual and group work) that helps the young person to learn skills to manage their emotions, cope with distress and improve their relationships. DBT helps the young person see that their suicidal and other unhelpful behaviours are part of their way of coping with problems and encourages them to develop more helpful behaviours and solutions.
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. 
 

Liz was angry that her daughter was allowed a pair of scissors when staff knew she was at risk of self-harm.

Liz was angry that her daughter was allowed a pair of scissors when staff knew she was at risk of self-harm.

Age at interview: 52
Sex: Female
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And, while she was in the adolescent inpatient unit, she still managed to cut herself. They knew that she was a self-harm risk and they allowed her scissors because she was doing cross-stitch and she did a lot of cross-stitch at that time to try and relax and to distract and they allowed her scissors and she cut herself. Not very badly but, when she first went in she was on twenty four hour watch, so we went from being on twenty four hour watch with somebody outside her room to being allowed a pair of scissors and I was deeply, deeply angry about that. Because, obviously I was looking for someone to blame and I thought I could have done a better job quite honestly. At the very least, I wouldn’t have allowed her a pair of scissors.
 

It was ‘devastating’ when Wendy’s daughter was placed under a mental health section. Wendy thinks the drugs she was prescribed ‘induced a psychotic episode.’

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It was ‘devastating’ when Wendy’s daughter was placed under a mental health section. Wendy thinks the drugs she was prescribed ‘induced a psychotic episode.’

Age at interview: 64
Sex: Female
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So she was in in hospital then, that time for three and a half months but they messed about with her really badly with all kinds of different drugs and my belief is they induced a psychotic episode through the drugs and they sectioned her, which was absolutely devastating, because I honestly believed the whole time there was, [sighs] I can’t say there was nothing wrong, but I think they tried to put a label on her and that she had mental health issues. Maybe she does, I, depression is a mental health issue. Self-harming is a mental health issue but, you know, to be in a psychiatric hospital with stuff that you wouldn’t want to know about for a young girl was, so yeah, I mean I don’t know what more I can say really but that’s, she’s out of hospital. 
 

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 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.
 

Hospital staff were ‘quite amazing’ when Erica’s daughter had a crisis.

Hospital staff were ‘quite amazing’ when Erica’s daughter had a crisis.

Age at interview: 48
Sex: Female
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I was on the phone to the hospital and I think, with hindsight, they were very good keeping those strict boundaries because they was saying, “We can’t have her here tonight. She has to be with you. She has to be at home. She has to learn that she’s at home.”

Yeah.

But they were they were quite amazing because they rang me up every fifteen minutes and then they rang me up every half hour throughout the night, checking how things were going, telling me what to do and yeah. Her sister, my daughter’s sister, my other daughter, who was two years older, and so she was sixteen at the time. She was amazing too because she could have freaked out but she didn’t so we took it in turns staying physically very close to her and her sister was saying, “Look, it’s fine. I’m here. We’re here. She’s not coming to get you. We’re keeping you safe.” Yeah [sighs].

I was glad that they decided that she would be at home in the evening because by the time she was discharged, which was about three months later from the hospital, it meant that I knew who she was.

When I took her home. If I had left her there as an inpatient, I would have probably seen her once a day during visiting hours, seen her there during therapy, because we had family therapy, but I wouldn’t have really known who she was.
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.

Mental Health Act ‘Section’
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.
 

Mary doesn’t think her son has trusted anyone since being compulsorily admitted. She says he is terrified of being put back on a locked ward.

Mary doesn’t think her son has trusted anyone since being compulsorily admitted. She says he is terrified of being put back on a locked ward.

Age at interview: 62
Sex: Female
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And can you say a bit about your experience of professional help so how did it first start and what sort of things have you had and what have you felt about it?

I think there have been quite a lot of problems. My son is a bright lad and he can argue the hind leg off a donkey. It is very, very difficult to interact with him and get the results you want, let’s put it that way. He’s had he had very unfortunate experiences at university because he went to the university counsellor and said he was having difficulty coping and at about the third session he had with him, he mentioned his suicidal ideation and the counsellor just freaked out and called in the local mental health team and because my son who, is also very literal minded, he was asked to promise not to kill himself and said, quite reasonably, “How can I promise that? I cannot give my word never to kill myself.” And they sectioned him and he was put in an ambulance and driven sixty miles away, because there wasn’t a place locally for him. He didn’t know where he was. He suffers terribly from car sickness and ended up on a locked ward and was, not surprisingly, totally freaked out.

And I don’t think he’s trusted anybody since. He was simply released into our custody and, in fact, after a week, went back to university because all the other professionals were sort of saying, “Well, you know, he just needs to get some treatment.” And he’s not been wildly cooperative ever since because he hasn’t, just hasn’t, he’s terrified of being put back on a locked ward.
 

Ann’s daughter was kept in hospital under a Mental Health Act section. Ann later realised it was to keep her daughter safe, but worried that it would go on her daughter’s records.

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Ann’s daughter was kept in hospital under a Mental Health Act section. Ann later realised it was to keep her daughter safe, but worried that it would go on her daughter’s records.

Age at interview: 47
Sex: Female
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I wonder if you could talk about what it was like to have your daughter sectioned under the mental health act.

It was horrible. At the time I thought they they’d only done it because they didn’t know what else to do with her because her behaviours were so erratic, her thoughts were so irrational and she was just so hell bent on hurting herself, if not killing herself. And they’d warned us that they were thinking of taking this step, how did we feel about it? 

And, actually, because her dad is next of kin, well, I looked on it as it was his responsibility and if he agreed to it that was that was him and I wasn’t happy with him, you know, for, I I couldn’t see at the time that it was in her best interest. All that I knew was that if she was under section she’d be under constant supervision, even to the point of going to the bathroom. She wasn’t allowed in the bathroom on her own and for somebody who is such a private person, that was a real big issue and she got into all sorts of trouble with her body systems because of it. She wouldn’t drink because she didn’t want to go to the loo, you know. Her food, you know, she wouldn’t eat because she didn’t want to go to the loo. 

And it was as though people didn’t know her and they didn’t realise how that would affect her because they didn’t know her and I did. I couldn’t see at the time that it was there to try and keep her safe. 

I think she’s been sectioned three times and the worst of experience of it was I’ve actually seen her being pinned down by about six members of staff and, to this day, I don’t think she should have been sectioned at that time. I think her medication had a lot to do with her behaviours at that particular episode and she was put in the psychiatric intensive care unit and I don’t think you can even describe what one of those places is like unless you’ve been in one yourself. 

She was transferred to the other hospital under section and then the other hospital forgot to lift the section. At the end of the term they forgot to submit the paperwork so she was actually under section for about three months longer than what she should have been, which has obviously gone on her record, and it does have implications for the future. I mean for travel and things like that, you know. There’s things that you have to declare. 

Do you want to say a bit more about that?

I don’t know much about it.

Right. Okay.

It depends what country you’re going to but you do have to declare for some countries.

Whether you’ve been held under the mental health or you’ve got a history of psychiatric problems.

Right. 

So we weren’t impressed when we found out that they forgot to lift the section, forgotten to submit the paperwork. Never mind [laughs].

Last reviewed December 2017.
 

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