Reply With QuoteWhich county are we talking about ?
A friend of mine needs any advice he can get on his ex-girlfriend and if there's anything that can be done for her.
She had to go and stay in hospital for a few months around five years ago, she's incredibly intelligent but pushed herself too hard doing some kind of advanced physics degree and became increasingly paranoid she wasn't doing enough and was going to fail (despite topping her class by a large margin and dragging them all along behind her). She went back to live with my friend, and seemed to be functioning again on anti-depressants, although their relationship had broken down. My friend rarely has any money and then lost his job, their flat was repossessed and his brother ended up giving her £3k to get started somewhere else. Six months down the line she had no job and wasn't on benefits and had no money left to pay the rent. My friend takes her back in (she had nowhere at all else to go) and she lived in his rented house. A couple of years down the line he moved into a new place and his mother paid to get the ex-girlfriend set up somewhere new. Six months down the line my friend had to go and rescue her as she's not had a job and hasn't claimed benefits.
It's now five years on from the initial stay in hospital and he's tried to get her to go to the doctor to get help, she's not well and isn't getting any better. He's also been doing an evening job on top of his 9-5 and could give it up if either she wasn't still living with him or would claim benefits. She refused to go to the doctor and she's really not capable of signing on. From what I know she spends all day in the house, often sat on the floor in the bedroom doing nothing. All this time my friend essentially hasn't been able to have a girlfriend. The parents of his ex- don't want anything to do with her (I'm not going to get started on that, the only time I've ever seen my friend angry was when he told me about it) so my friend really is on his own with her. Having failed to get her to get help, he gave her an ultimatum, she has to leave because he can no longer look after her. The only issue is he's not going to let her go if she has nowhere to go.
He asked her doctor to come over to the house the other day to see if anything could be done. The deadline for the ex- to move out is the end of the month but my friend knows she only has £70 in a savings account and nowhere to go or any means to make money. The doctor came over, the -ex claimed she was fine , has money and somewhere to stay in London where there are more job options. The doctor told my friend there was nothing she could do and my friend should let his ex- go and live in London. The problem is the -ex has no more than £70, has nowhere to stay in London and isn't currently capable of getting a job.
If you have any serious advice on what my friend can do I'd really appreciate hearing it please. He's one of the nicest people you could hope to meet but he's not going to kick her out if she has nowhere to go, has no money and isn't in a fit state to be chucked out. He's all she's had for at least the last five years and has set aside having a life so he can take care of her. He's talking to social services to find out if there's anything they can do but he's not hopeful they can help.
Which county are we talking about ?
Good luck everybody. Have a good one.
Social services?
I suspect he'll have to make her homeless before they do anything but the council have a duty to protect vulnerable adults.
The doctor should have been more helpful in the circumstances although most mental health "emergencies" are only classed as such if physical harm to the patient or others is imminent. Frankly, in your friends shoes, I'd call the Samaritans and I'd do it now. I can think of no better route to help.
Gray
EnglandOriginally Posted by seikopath
- - - Updated - - -
Thanks for this and you too, Jeremy.
I am a advocate for a secure mental health unit,
Try these http://www.mind.org.uk/about-us/local-minds/<<< I think this one is in London. We receive a lot of people who have had help and support from Mind to help them seek help at unit level.
This will not help but we see this pattern time and time again, as said before unless you are at risk to other's or yourself it's a no entry to a unit.
It could be a massive depressive episode but that would not be enough, this could soon manifest it'self into someone being at risk.
Also be mindful that if she is admitted on a voluntary basis it's the same as a section she just went in on her own accord.
Also if she is admitted it could possibly be well out of the area, so you may have to travel and visiting may be hard.
Best of luck.
Last edited by Fords; 20th October 2014 at 18:08.
COUNTY, not country.
Good luck everybody. Have a good one.
I'd second what has been said. The doctor should have been more help, perhaps push for a different doc from the practice. It's very hard to persuade someone if they don't want help but maybe your friend could accompany the girl to some kind of counciling session - a short course should be available through the GP . Sadly one has to demand these services in some practices but a gradual hand over to professional services might work. The Samaritans is a good idea as could be the mental health charity 'Mind'. Your friend might also push social services as he seems to be acting as carer - again a way into the system.
People with mental health problems who can intelectualise away their situation and difficulties are hard to help but by no means uncommon.
edit. just read Ford's reply - good advice.
Last edited by Dentsmithy; 20th October 2014 at 18:17.
Whoops! Dorset.
Thanks for this - and to Dentsmithy - I've sent on the link.
Something came out of the doctor's visit that my friend and I had thought likely, his ex- described the last hospital as like a concentration camp. It sounds like her fear of going into hospital again is far greater than that of having nowhere to live or sleeping rough.
try dorset first point 0845 310 6843
http://lifeyouwant.org.uk/service/dorset-first-point/
have a look at rethink.org under local services
also bridport/ dorchester cmht ( community mental health teams ) will provide useful points of contact
also worth contacting the local council housing service and ask if any agencies provide floating support specialising for those with mental health issues.
Good luck everybody. Have a good one.
Thanks for this, all passed on.
I'm afraid the mental health provisions in Dorset go from good to shit, depending on where your based in the county.
And as for the Doc's there are a fair few GP's who I wouldn't have treat me.
Shelter have an office in Bournemouth and can give housing advice.
The following should be read alongside all the good advice above...
If your friend can help his ex-gf (perhaps using the advice in the thread so far) without continuing to make his life a misery then that would be fine but it sounds like he has already tried. It sounds clear from what you say that the situation has gone beyond what he can possibly cope with.
Thus the current situation has to end by whatever means are feasible. Ideally this would be a managed handover to professionals but, as observed above, this is unlikely to happen until it's (almost) too late. If she can't be persuaded to cooperate then the situation has to be forced by your friend.
I have had friends in a similar situation to your friend and I am sorry to say that the only workable solution was to cut off the ill person. It is ruthless, painful, harsh, but in the end there was no other way out of it (at least in the experiences of those I know well).
DO NOT hand out ultimatums unless you (your friend) are deadly serious about following them through.
Do help your friend make a plan of action that he will stick to. The plan should have an end point after which, one way or another, the ex-gf will no longer be his responsibility.
DO then hand out an ultimatum and then carry it through when your friend has done all he can practicably do according to his plan.
The GP should ideally have been more helpful but nevertheless gave good advice (sadly!): Letting her go to live in London is a practicable way out for your friend. The fact that she has no more than £70 and nowhere to stay in London can no longer be your friend's problem. If the professionals will not take over in a managed way then she simply has to be left to her own devices, no matter how sad and harsh this might seem. Your friend's own wellbeing depends on distancing himself from her, one way or another.
Unless, as I say above, the professionals will step in now, then this is what he is going to have to do. It sounds like his current life is intolerable. He has to recover it for himself. She will not cooperate (she is incapable of doing so). And so, logically speaking, he must take whatever action he needs to protect himself.
And this has not in fact helped her! Your friend's kindness has allowed her to become dependent on him and to continue in her denial of reality. She has to be forced, one way or another, to face reality on her own. She should no longer be your friend's responsibility.
If they will, great. If not (which is likely), your friend must still act in his own best interests. Supporting an ex-gf in this state is not in his own best interests (and in the longer term, which has already been reached by the sounds of it, it's not in her best interests either).
Last edited by markrlondon; 20th October 2014 at 22:21. Reason: Added text
As mentioned, it is very difficult when someone intellectualises their situation as the GP won't see any risk; however, seeing as she has been admitted previously should have convinced the GP to make a referral to the local CMHT given her long standing inability to fend for herself. Getting her to attend for assessment would be the next battle.
Personally I would contact the local Community Mental Health Team and ask to speak with the duty worker, and if your friend can't spare the time during the day, the Out Of Hours Mental Health Team, and have a discussion with them.
I'm a Mental Health Nurse but work in a completely different speciality, and a different country/laws, but personally I would be making contact with Statutory services first. The CMHT/Out of Hours teams are the best way to do that, and take their lead on Third Sector Agency assistance. It's getting close to becoming an emergency if he has asked her to leave at the end of the month and she has no way of supporting herself. She might not be detainable, but without proper assessment, who knows. However this has to be tempered against her right not to seek/enter in to treatment provided she has capacity to do so.
Tricky one, but hats off to your friend and his family for looking after her for so long.
Best wishes.
Excellent advice especially last post, unfortunately many GP's don't have expertise in these areas.
I work as a GP. I'm reluctant to side track this thread particularly as it obviously deals with such difficult circumstances, but would those criticising the GP please consider what was actually written in the OP.
"It's now five years on from the initial stay in hospital and he's tried to get her to go to the doctor to get help, she's not well and isn't getting any better"
"She refused to go to the doctor"
"He asked her doctor to come over to the house the other day to see if anything could be done"
"The doctor came over, the -ex claimed she was fine , has money and somewhere to stay in London where there are more job options. The doctor told my friend there was nothing she could do and my friend should let his ex- go and live in London."
Returning on topic I doubt that I can give any more useful advice than has already been given. Investigating what services are locally available (there is huge variation region to region and even sometimes postcode to postcode) and then signposting his ex girlfriend to them would seem all that anyone could do in his circumstances. It may be important to consider if withdrawing his support could actually be the only way to break the current impasse, but obviously this would need dealt with sensitively and with great compassion. His mental health could be at some risk if things don't change and your role may be as much to give him friendship and support as the "answer", as unfortunately it may prove almost impossible to find an answer which will sort this out easily.
Wow. Well done to your friend and his family for being supportive, emotionally, physically and financially, for so long.
I firmly believe in appropriate medication and cognitive behaviour therapy, However this situation goes way past that. This person may benefit from intensive inpatient care.
Unfortunately, to access this, your friend may have to push her out from the "safe place" both his flat and his close friendship provides. In doing this, your friend is NOT failing her, she needs professional help.
Your friend deserves to get his life back, as harsh as it sounds, this won't happen while she is in it. I don't mean block her out entirely, as she will need friendship and compassion. But his role needs to change, simply for self preservation and his own wellbeing.
Dave
Last edited by dforgrieve; 21st October 2014 at 00:00.
My friend is working through a few options right now. He is still working all day and all evening so finding the time is causing a few problems but he's trying to get something sorted.
CMHT called him back earlier but he missed the call (because he was on his evening job) although when he spoke to someone there earlier they didn't seem hopeful. He already tried MIND but they could do no more than offer some advice. He's going to try to contact his and her old doctor to see if he can help in any way.
The main problem seems to be that while she's living with him no one seems able to do anything, at least until she's left his care. But can or will she seek help if she thinks her previous time in hospital was so bad?
I think he's just at the point now where it's not doing her any good continuing as she is. He's tried and he feels there's nothing more he can do for her other than keep a roof over her head and keep her fed. It just seems nuts he has to make her go and just hope someone helps her then, despite her being scared of seeking help rather than someone being able to do something now. She literally has nothing but some clothes and a rucksack. Her parents have been told what's going on but have so far declined to contact my friend. She has no friends, no money to speak of, nowhere to go.
Thank you for all the suggestions, I've passed them on and my friend really appreciates it.
I agree!
I know I said this already but worrying about whether or not she will seek help simply must cease to be your friend's responsibility. For his own wellbeing (and ultimately her wellbeing too) he really needs to cut her loose and leave her to it.
Yes, it is heartbreakingly sad. Ideally it really wouldn't be that way round and yet that's how it seems to be.
I wonder if they have simply given up. On the face of it, it seems incredible that parents could give up on their child but when they have tried everything then there is nothing more they can do.
Good luck to your friend in getting his life back.
They haven't been involved at all, they cut her loose when she became ill and have left my friend to look after her. Their reasoning is unbelievable too. Like I said, when he told me about it is the only time I've ever seen him angry.
Ah, I see. It would be interesting to know what sort of history there was there between parents and child but I imagine it would be rather academic now anyway. Very sad.
Still loads of stigma about mental health no matter what people say.
People are ok with someone on a surgical ward, loads of sympathy and all the right words, soon as you mention it's a mental health unit, there eye's react first then they lose there speech, it's like someone having a small stroke in front of you for about 5 seconds.
Unless she tells someone herself she has feeling of ending it all, trying to get immediate help will not work. Meds take weeks to kick in.
Right one important question too ask ..............Is she sleeping I know it sounds daft but sleep deprivation is what will take control and push her over the edge of a major depressive episode. she could well be planing something/on a countdown for when the time comes to leave your friends safety.
Has she ever spoken of ending it all, ever. has she used words not in context of a general conversation about the future to describe such feelings, like, I Can't go on, it's all too much,
Dose she see a future for herself.
Is she neglecting herself.
Lack of interest in anything.
Is she eating/drinking.
Has she used substances other than what's prescribed, if prescribed is she taking them correctly, has she overdosed on them.
She may well intellectualise her feelings, but her body and general attitude will start showing signs.
One last shot.
Take her to A&E ask them to take a look, get an assessment from the duty MHN, is there weight loss, loss of interest, confusion, delirium, if he has to intellectualise it for her take her under the pretence of a urine infection if he has to, these can cause similar symptoms. Is he is fearful she will take her own life when she has to leave.
To get any help nowadays you have to go the whole nine yards, and a bit more.
Not saying anything to anyone, just thinking out-loud, it's almost like you have to be Suicidal and have thoughts of harming yourself and the possibility of harming others directly or indirectly with an attempt, like jumping of a motorway bridge into on coming traffic. before you are listened to.
As to the unit being like a concentration camp, ours was in a building that was 110 years old up to seven years ago it had curtains separating patients, the noise at night can be bad, people with all kinds of mental illness thrown together, a lot of disturbances some very frighting, some requiring removal to our most secure unit. Our's was rebuilt and it's like a premier inn, own room's en suit, air conditioned, lot's of activity's, good food, an excellent environment for treating someone.
Look they are not nice places, but she will get help there and links to other outside agency's like the CMHT and others who might just help her deal with this and get her back on her feet.
Last edited by Fords; 21st October 2014 at 07:53.
I don't really know if she's said anything about being suicidal. She isn't really neglecting herself, she is aware she's totally reliant on my friend and refuses to let him buy her clothes and he almost has to make her have her hair cut. So she tends to wear threadbare clothes. She eats and drinks but when she had alcohol one time I was there (and she was a bit more socialble) she made no sense, as if she'd argued herself out of the sentence she was saying before she'd finished it. I think she stays in the house and probably watches TV in the day but goes upstairs to sit on the floor by the window in the bedroom as it gets dark. I have no idea if she sleeps but when I've been over there she sits by the window in the bedroom well after it gets dark and doesn't tend to appear again in the morning before 11 or so. I haven't a clue if she's sleeping.
I think the conclusion my friend is coming to is that there's little he can do to help her now if she's just about articulate enough to tell someone she's fine and has somewhere to go and means to support herself. The next step is to work out how best to make people aware of what's going on if she's so determined not to seek help. Or is unable to.
Last edited by Foxy100; 21st October 2014 at 09:30.
Let me preface this by stating I’m not a mental health professional and if I've said anything incorrect below then please point it out.
Nevertheless, I have had exposure to those suffering with mental health problems like these in the past.
Imagine two sliding scales:
1). Physical health: Slides all the way from the peak of physical fitness at one end of the scale to death at the other end
2). Mental health: Slides all the way from a happy, fully functioning and well-integrated member of society at one end of the scale to someone with a barely functioning mind who is a danger to themselves and, potentially, others at the other end
At the moment, your friend’s ex seems to be at a reasonable point on the physical scale. I don’t believe you’ve mentioned malnutrition or anything like self-harming.
However, it’s clear that she is at bad point on the mental scale.
I can understand those who’ve recommended that your friend cuts the girl loose. By the sounds of things he has done far more for her than anyone could’ve reasonably expected him to. Making her leave may also bring about her hospitalisation (and treatment) more quickly.
The risk on the flip-side is that letting her fend for herself (and potentially fail at doing so) could not only worsen her point on the mental health scale, but see a corresponding drop on the physical scale (potentially even to a tragic outcome). This is certainly a concern if she is as intelligent as you say she is and is capable of staying out of the hands of the mental health services.
That said, hospitalisation and treatment is the only means by which the girl can be helped.
So how to make this happen?
She doesn’t trust or like the thought of the mental health services or the mental health hospitals, yet it doesn’t appear that it would be a straightforward matter for her to be committed (e.g. the GP visit to the home you recounted) - so treatment will need to come at her own request.
One possible way to bring this about might be termed a non-pressurised “baby steps” approach:
A). First, open her up to the possibility that she isn’t well by arranging a visit (and then series of visits) to your friend’s home by a mental health specialist – these should be an opportunity for her to talk to someone (a "simple chat") in an environment she feels comfortable and safe in, not to actively treat her;
B). If these visits prove productive, it may be possible to encourage her to visit a mental health unit – even if just for an hour or so to look around. This is more likely to happen if she knows your friend will be in attendance and trusts that the visit is only to check the place out;
C). Again, if this proves to be successful, it may be possible to encourage her to visit such a unit for a longer period of time (e.g. overnight / weekend), with your friend staying for an hour or so at the start and agreeing to pick her up afterwards;
D). The ultimate goal would be for her to decide to stay in a mental health unit for a longer period of time in order for her to receive the treatment she clearly needs (with regular visits by your friend).
In summary, then, if she can’t be committed she needs to decide of her own accord that she needs help.
For this to happen she not only needs to open-up to the possibility that she isn’t well, but to break down her fear of the mental health services and build her trust in them bit by bit.
I realise that I’ve gone on a bit here and your friend might have tried what I've written above already – but I hope that some of what I’ve written may be of use to you and to him and I wish you both the best.
Last edited by CamCG; 21st October 2014 at 12:59.
I'm passing on all suggestions so thank you.
If she's incapable of signing on, a claim for ESA should be made on mental health grounds. Potentially PIP also.
ESA/housing benefit should be in line as it gives more scope for a move to potentially supported accommodation depending on the levels of help that can be accessed for her.
In Dorset also consider speaking with the very nice folk at Bounemouth Churches Housing Association. They do a great deal of work with single homeless across the spectrum of needs and have huge knowledge of what can and cant be done, even if theyre not in a position to offer accommodation - check out their website first.
http://www.bcha.org.uk/health-and-ho...al-health.aspx
Mind might be worth a call http://www.mind.org.uk/information-support/
If it was me, without a home, without a job, without any money, without any family support and with only one friend in the world I think I'd be terrified of what the future held.
There are two major issues to address, firstly somehow keeping a roof over her head and secondly accessing the right sort of assessment and care she needs to help her back onto her feet.
My friend was involved in a very similar situation a few years back, also in Dorset coincidentally. We only started to get anywhere once we consulted the MP, Annette Brooke, and I'd suggest that if your friend has tried all of the relevant agencies and feels he is being passed around from one place to another, then his local MP should have the skills and contacts to unblock the system.
I hope this is useful.
Last edited by catch21; 22nd October 2014 at 07:41.
Good call
Good luck everybody. Have a good one.
Me too. And I think my friend is now worried that since he's given her a deadline she might just go one day while he's at work, before he's managed to find someone who can give her some help.
Thank you everyone for the suggestions, I've passed them on to my friend who is very grateful.
A very good suggestion. A letter from your MP to the PCT (copied to the GP and Director of Public Health) will get noticed and dealt with. Stress the 'prevention' aspect to stop things escalating. It might seem overkill but sometimes you have to fight for these solutions.
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