What a day!
I would say it was typical of a Friday, but even by Friday standards today was hectic.
It started with the usual supervision call with Alwyn. Nothing so unusual. After this we had the morning huddle meeting, so far so good.
It was as the meeting ended things started going wrong. First the internet went down for around half an hour. Looking online on my phone it appears it was an issue beyond just our house, but it meant I was not able to access the system to check any patient’s phone numbers to start my daily calls.
While I was waiting for the internet to come back on, and contemplating having to go to the office to see whether it worked there, I received a call from one of the intensive support nurses. One of their patient’s had becoming increasingly depressed and distressed following a bereavement, and had begun harming themselves and running away from the home. The support staff no longer felt they could keep them safe, so asked us to complete a mental health act assessment.
To be admitted to hospital for your mental health, toy either have to agree to come into hospital, or else be detained under the Mental Health Act, commonly known as being sectioned.
This is not something to take lightly, but some people, because of their mental health, pose such a risk to their own health and safety, or might pose a risk to other people, so that they need admitting to hospital whether they agree or not.
In this case, the risks the patient posed to himself were clear, and on the surface he actually agreed to come into hospital. I decided to use the mental health act instead as I do not feel he actually understands what admission to hospital means, and it is important to have capacity to agree to an admission to hospital, and for this patient I felt he did not.
The process to detain someone in hospital is not just a decision for myself. After I have reached the conclusion he needed admission, I have to arrange for someone called an Approved Mental Health Professional (AMHP, pronounced amp), usually a specially trained social worker, to come and give their opinion on whether to admit the patient to hospital. They will bring with them a second opinion doctor who is independent of me, and all three of us need to agree to the admission for it to take place.
Unfortunately I could not wait at the home to find out whether the AMHP and second doctor agreed with me. By this point, I had received several more phone calls, one for another possible mental health act assessment, as well as several people increasingly struggling with their mental health. It felt like I was answering a constant stream of calls for the rest of the afternoon, while I tried to write up my notes for the first assessment in between each call.
Fortunately, I work with an amazing team of people who were able to help out assessing the patients and then coming to me for advice, which certainly removed some of the time pressures from me, and by moving a couple of less urgent calls to next week it was not much past five when I finished.
Sarah had had an equally busy day. We had initially planned to go for a walk this evening and possible order fish and chips for dinner, but we quickly gave in and ordered our traditional Domino’s pizza (let’s be honest, it did not take long to decide, and we only have one more Friday in this house if all goes to plan).
After the excitement of today, I am probably going to read a little more of Dune this evening, and might see what Friday night TV has to offer. Tomorrow we have another trip to the recycling centre planned, hopefully this will be the last, and with more glorious weather this weekend, I might try and spend an hour or two outside as well!