Yesterday I was called to an ’emergency’. Well, as I don’t operate strictly in a crisis setting, it was more to act as a gatekeeper to the ‘real’ emergency services.
In essence, did Mr A need to come into hospital? It wasn’t a formal assessment – more like a pre-assessment and an attempt to establish levels of risk.
Mr A was homeless. Not ‘street’ homeless but as near as possible to that as could be. He had been evicted from one hostel following allegedly ‘disturbing’ behaviour. He had been moved by the Housing Department of different council to another hostel in our area where he had been for a few days, and was due to move to a more permanent place (a bedsit) but it was again in a different local authority.
The housing officer was concerned about him. She was concerned about how he would manage in a more independent setting as he felt that the hostels had been providing more informal support. So she called us to see if Mr A needed to come into hospital.
Mr A appeared unwell. It would, of course, be wrong as well as unlawful to use the Mental Health Act to solve housing issues. Mr A was unwell enough to need support though.
He was agitated but I’d also be agitated if I had strange people trooping in to see me when I didn’t know where I was going to be spending the night. There was no way he could be said to lack capacity, at least from the history and interaction that I had access to.
So what to do?
I told the housing officer that we couldn’t refer for a compulsory admission as Mr A did not warrant it. Yes, he probably needed to see a doctor and could definitely benefit, possibly most of all, from some kind of care coordination, someone to help him and guide him to tie some of the pieces of his life together, possibly some medication – but not compulsory admission to hospital.
But I felt a bit empty on my way home. It’s likely that Mr A moved to a different area overnight. I don’t know if he would have got into the taxi to take him or not (he was fairly adamant that he wouldn’t when I left), but I think it’s one of those situations that might be on its way to deteriorate.
The housing officer will contact us later to tell us where he is, and we can contact the local team there to try and ask them to make contact. I think its unlikely that he’ll want anyone related to Mental Health to go and see him. Already when I told him (and it was the first thing I did ) that I work in a Mental Health team he became visibly more anxious (again, understandably – he has had a string of compulsory hospital stays in the past).
I have a feeling things will get worse for him before they can get better – and that is frustrating.
Sometimes, I just want to -do- something, but have to walk away. I think those are always the hardest situations and those are the people that sometimes I think about when I’m going to sleep at night.
I know I shouldn’t. I’ve been given and have given out the advice a million times about not taking work home with you – but I suppose there must be a way to stop thinking without stopping caring.