a mental health act assessment.
i work with a young man who i believe is in the prodromal stage of a psychotic illness, his behaviour has been worrying me for some time now so today i put the wheels in motion for a MH assessment. it was the first one i have ever been involved in and it was an interesting experience. i always imagined them to be quite a formal process with lots of professionals making an already poorly service user feel disempowered and controlled. it was not like that at all, the Approved Mental Health Professional is a very experienced social worker and she was incredibly compassionate and warm to the young lad, the Psychiatrist knew the young lad from a short stay on an inpatient unit and the GP was also very kind and layed back, i was probably the most twitchy one there.
this young man is thought disordered and quite confused at times, over the last few days i have noticed he has begun to get very depressed and i am wondering if this is the negative symptoms starting to show through. The service user has expressed suicdal ideation over the last few days and as he is in thehigh risk bracket for suicide this alarmed me: he is a young man, unemployed, no social contacts, no family support, in the early stages of psychosis and has recently (less than seven days ago) been discharged from a stay on an inaptient unit where he refused medication and refused to engage in any structured activity. he has also been known to be quite impulsive and that concerned me.
i felt like i was carrying this masive weight on my shoulders of a complex risky young man and i was unsure of how risky he was. the AMHP decided that there were not grounds for section as when we were all there he managed to hold things together and denied any of the unusual things he had been telling me or the ideas of suicide he had been expressing.
when i came into this job i promised myself i would avoid sending people to locked wards unless really necerssary and maybe i was a bit hasty today - i am not sure- but i really wanted for him to go to a locked ward where he would be compelled to take an anti psychotic, thats something else i disagreed with before you see, medication, i felt was probably not the answer but i am learning fast that sometimes when everything else is tried the meds are a necersary process.
however we have come up with a robust plan, i will see the young man every day to give him his meds ad someone from the Home treatment team would see him in the afternoon and he would be reviewed next week to see if there had been an improvement or a decline. i am really hoping that things will improve.he also had to agree to start taking medication in the community which he did do
i feel a bit guilty that maybe i wasted everyones time today however the burden of the decision got too much for me and it was great that i had three experienced people to see the service user and to help with the decison.
so what started as a seriously anxiety provoking day ended with amore calm me and a service user who will get the best support we can possibly offer. (fingers crossed)