Relatives

This material is written to help Families and Carers of people admitted to St. Patrick's / St. Edmundsbury Hospitals, to understand the process of inpatient care.

Having a family member / friend admitted to inpatient care here in St. Patrick's can cause a variety of emotional reactions. There will be relief that help is at hand, but witnessing the psychological disruption to a loved one as a result of mental distress can be extremely stressful and difficult. The journey through the inpatient services here at St. Patrick's is filled not only with potential for recovery but also for growth and development in terms of your relationship with the person seeking inpatient care.

• What is a mental health problem and how can families help?
• Hospital admission procedures
• Communicating with the clinical team
• Hospital facilities of interest to relatives
• Treatment programmes

WHAT IS A MENTAL HEALTH PROBLEM AND HOW CAN FAMILIES HELP?
Just like physical illness, mental illness covers a wide range of symptoms. Most of us can identify with some of these to a lesser degree when we experience sadness, worry or apprehension. When symptoms become so severe however, as to disrupt everyday functioning, medical intervention is often needed. There are usually factors that contribute to developing mental health difficulties such as:

• Stress
• Physical ill-health
• Loneliness
• Alcohol and drug abuse
• When symptoms become so severe as to disrupt everyday functioning, then medical intervention is often needed

OFFERING SUPPORT
The best way to help someone in psychological distress is by offering a listening ear and conveying concern and understanding in a non-judgemental way. Openly discussing the problems a person with mental distress is experiencing without over-analysing them, and offering reassurance that things will improve, is usually all that's required.

Practical gestures of support, such as helping out with remembering to take medication, will acknowledge the significance of the illness. Research has shown that such support can positively influence the outcome of the illness, with fewer symptom relapses and hospitalisations, for the patient.

FAMILIES IN SUPPORT
Family members and carers can also learn to recognise the early warnings of relapse, and thus help avert a potential crisis, by encouraging the patient to seek prompt medical help. Relapse signs may be slightly different for each person, but can include symptoms like:

• Sleep disturbance
• Agitation and anxiety
• Difficulties with concentrating
• Mood changes
• Frustration and irritability
• Changes in behaviour that are out of character for the person

THE REMIT OF ST. PATRICK'S
St. Patrick's and St. Edmundsbury Hospitals offer specialised inpatient psychiatric care on two sites for approximately 300 patients. The remit of St. Patrick's is not only to alleviate the distress caused to people and their families due to mental health problems, but to research and deliver the most innovative therapies available. A multidisciplinary team of nursing staff, psychiatrists, social workers, occupational therapists, psychologists and other therapists will help the patient and their carers cope with and understand the symptoms and triggers of psychological distress.

HOSPITAL ADMISSION PROCEDURE
As a family member or carer you will have an important role during the admissions procedure as soon as your friend / relative has been referred for inpatient care. Having to come into hospital can be a very stressful experience for the person concerned, and just being with them to offer support is very comforting.

Accompanying the person to hospital can also facilitate initial contact you may wish to have with the hospital staff.

The admission itself consists of an interview and physical examination by the doctor on duty, who may or may not be subsequently involved in your friend / relative's care. The admitting doctor will usually invite you to describe your concerns, if your friend / relative will agree to this. As a policy we welcome information which may be of help in understanding your friend / relative's difficulties but the principle of confidentiality is important to us and it is best if any exchange of information between you and the hospital is open and transparent.

If it is inappropriate or distressing to the patient to involve a friend/relative in the first assessment, the duty doctor will indicate this and the treating team will be able to make contact with you at a later stage.

Your friend/relative will then be received on to their designated ward by the nurse on duty. It is standard procedure to ask patients to rest in their night clothes until reviewed by their treating Consultant. At St. Edmundsbury this is decided on a patient by patient basis. The duty nurse will also review the items packed for the stay in hospital and may need to place some of them into safe custody on behalf of your friend/relative.

COMMUNICATING WITH THE TEAM
Your friend / relative will be cared for by a multidisciplinary team which includes a:

• Consultant Psychiatrist
• Registrar in Psychiatry
• Allocated Ward Nurse
• Social Worker
• Clinical Psychologist
• Occupational Therapist
• Counsellor / Therapist
• Clinical Nurse Manager

The team members specialise in providing tailored care in accordance with the individual needs of the person. If considered appropriate, and with the consent of the patient, members of the team may meet or make contact with you to discuss your concerns and fears. The contact sheet at the end of this booklet will outline how formal contacts with the team may be made. Appointments with the treating Consultant are made through the Consultant's secretary, whilst the Registrar (Junior Hospital Doctor) is usually contactable via the hospital switchboard.

CALLING THE HOSPITAL
Families may wish to appoint a 'spokesperson' to liaise with the hospital as this will make communication more efficient. On occasion, if contact is made with the hospital which is unsolicited, staff may only be in a position to listen to your concerns without imparting information in return, as we do not wish to compromise the confidence and trust between the patient and hospital staff, as these are essential ingredients in the treatment process. If repeated calls are made without the consent of the patient, the patient is usually made aware of this to maintain confidentiality.

Around the time of the admission, the patient is asked to nominate a friend/relative with whom the hospital can speak on an ongoing basis. We would suggest that this person so nominated, should act as a spokesperson and inform other concerned family members/friends of the patient's progress. If a patient is not present at a family meeting, we may provide feedback to the person regarding discussions in their absence.

HOSPITAL SERVICES AND FACILITIES OF INTEREST TO RELATIVES
As a hospital we place great emphasis on preserving and repairing relationships between a person with an illness and their support network. Patients and families may require extra support if there has been undue stress or conflict during the course of an illness. As a hospital we are mindful of this and will make every effort to hear and address your concerns.

Support Groups have a valuable role to play in providing useful information about different forms of mental illness and their treatments. Patients may benefit greatly from hearing the experience of others, coping with similar problems. This may help them to see their problems as not being unique, and to understand the need for medication and to enable them to access advice and assistance with practical issues.

Voluntary groups such as Aware and Alcoholics Anonymous (AA) regularly use the hospital facilities and often conduct open, informative meetings on a variety of topics. The hospital reception or these bodies themselves will be able to proved details of forthcoming meetings. You can also click here to get contact details and meeting times.

The Hospital has a Patient Information Centre where printed material and electronic information is available in addition to self help literature for patients and their families. Other resource materials such as relaxation tapes , CD's and DVD's have been produced by the hospital staff and voluntary groups like Aware and are available for purchase in the St. Patrick's shop and in St. Edmundsbury Hospital.

The Day Care Service is a newly established facility which patients can access through consultants at St. Patrick's and St. Edmundsbury Hospitals. The team provides a co-ordinated set of individualised therapeutic services to individual patients. Day Care is for individuals who need more active/inclusive treatment than is typically available through an outpatient setting. It includes diagnostic and psychosocial interventions, and psychotherapy in a structured setting. Day Care is associated with recovery and the maintenance of wellbeing.