Need advice from a psyc nurse in western australia specifically.

Will'smum · Nov 9, 2004

Hi Barb, Don't know if you've been able to sort anything out or not but my suggestion is that you get onto the community health nurse that is looking after your sister on an outpatient basis and stress the issues that you have. They may be able to intervene and help your parents out a bit.

Hope that helps. :o

bulletproofbarb · Nov 9, 2004

I did eventually get onto them. Apparently, she refused social services so they can't do anything. Meanwhile, she still rings the local police department complaining about anything she doesn't like. The nice thing was, the reply was from her doc as well. Nice people, hard job.

I told my mother that I had contacted them and she told me that many years ago, a psych registrar told her my sister had a personality disorder but mum refused to believe it. She only just told me this, so she feels because she denied it all along she now has to live with the burden. :crying2: She really believes this. She said it to me. I can't tell her otherwise. She thinks it's her fault for not doing something earlier. My heart breaks, I cry when I think about it. My poor mum. I don't know why she has only just mentioned it and kept it a secret all these years. I can't imagine what she has gone through. She did say my sister had recently been started on risperidone.

My mother is 71. She grew up in Egypt during the war. I wonder if her upbringing has made her feel like this.

I just wish the social services could have more power. How can someone with a personality disorder, who is listed as a nuisance caller to the police, has been charged with asaulting a nurse ect have the ability to make their own choices. She needs help but isn't getting it because she refuses. If I refused to pay my mortgage taxes ect, no one would say "thats okey, you don't have to, just keep on going as you are."

At her lowest, she used to ring my mother to put out her garbage bin for the weekly collection because she couldn't do it. But, according to bloomin social services, she is coping okey because she says she is! :uhoh3:

Will'smum · Nov 10, 2004

I am sorry to hear about your mum. I know this won't help but she is definaitely not alone in the way she feels. Many relies of mental health patients feel lost, alone and somehow responsible for what is happening. have you suggested that she seek counselling? ARAFMI is a group that is for relatives of mentally ill and in the area that I work they are piloting a carer support network for people exactly like your mum as they have identified such a huge need. Let me know how you go

:rolleyes:

StuPer · Nov 18, 2004

Hello,

I did'nt reply to this earlier because a) I'm in NSW not WA & b) You seemed very angry and I felt it would have been difficult to try and explain some of the issues in mental health.

The first thing I should say is that a diagnosis of a personality disorder by a psych registrar does'nt mean its cast in stone.. and being treated with Risperidone suggests something more serious, unless its for behavioural management, and even then its not really the appropriate medication.

The next thing I should say is about mental health ethics, the authorities generally only have the power to detain someone against their will if they present a risk to themselves or others (as in physical violence) and then only because of a diagnosed mental illness. If your sister HAS got a personality disorder, this is considered to be a learn't behaviour as a result of personal trauma or a dis-functional coping strategy. While you may not be interested in diagnosis, it is important, if she does have a personality disorder, there is nothing really medications or case managment can achieve unless your sister is willing to participate. If she is, there is a very good therapy called Dialectic Behavioural Therapy which has been shown to be very effective in certain personality disorders.

As I said before the use of Risperdone suggests something more serious, such as a psychosis, in which case their should be active case management, and information should have been made available to the family to understand a) what the illness is b) any signs and symptoms & c) what to do about it if these signs and symptoms do manifest themselves (mental health contact details etc.)

Finally your mother probably has not had anything to do with the reason why your sister is the way she is, I'm reaching in saying this, but if you and your brother do not behave in the same way as your sister it is unlikely to have been as a result of upbringing.

I know this is not going to help with the situation at your mothers, but I hope it has helped you see some of the complications in mental health, your also expressing some of your frustration at being so far away and unable to do anything directly. Is there anyone you know close to your mothers who can go and advocate on their behalf to the mental health service? and what Will'smum suggested is very good, there are a number of organisations for families of those with mental health problems.

regards StuPer

bulletproofbarb · Nov 19, 2004

My mum went to Arafmi years ago. She has never really had any good support. I think if my mum were to pull out, then something would be done. But because she is always there, at the expense of her own health, then social services don't give a damn.

I can list the numerous diagnosis she has had in the past. This is the reason I am no longer interested.

First, it was OCD, then depression, then schitzophrenia, then aspergers syndrome.

In the past she has been on Epilim, Lithium, some antidepressants I don't know the names of now resperidone. She also used to have that injection - can't remember what it is called. She had ECT at one stage. She has been to behavioural therapy and also to living skills and then she decides she doesn't want to go because (and she said this) "those people are all druggies and lowlifes (?sp). I'm too good to be with them"

She has taken numerous overdoses and as soom as she takes them, she turns up to the ED and tells them.

It's comeplete rubbish. No one really knows do they. After all, how many diagnosis and variety of medications can a person go through? (I have no psych training)

I know what will happen. This merry go round will continue until my parents pass away and then she'll end up on the streets or something.

My brother nor I will take her in. He has 2 small children and is already concerned for them when she is around. I've been strangled by her and verblly abused for the last 20 years. I can't cope with it.

She should be in a home with other people, not locked up, but in a supervied accomodation where she eats proper meals, takes her medication and is given some responsibility for something like maybe shopping and made to shower more frquently as well!

Anyway, thanks for your response. I have just bout give up. The social services say the same thing "she is allowed to make her own decisions and they also said it is up to her if she takes her medication or not."

On the point of upbringing, we had a very good family life with a few of the usual problems all families experience. Nothing huge, maybe the occassional sibling fight. Parents never fought but did get angry at eachother occassionally. However, my mother feels bad when my sister is awful to me and my brother as mum stated " we did more for her than for you two". Of course, me and my brother knew that but didn't really care (except for a few situations), but I think that is why my mum feels bad as well. Thats also why in the past (when we were teenagers) both me and my brother used to call her the spoilt brat when she was "ill"

StuPer · Nov 22, 2004

Hello again Barb,

Thanks for explaining the background, and your right, if I was in your position I'd be pulling my hair out in frustration (if I had any ). It sounds as though your sister has been too and through a number of psychiatrists and GP's, and no-one has been able to resolve a) a definative diagnosis b) and effective treatment plan.

There is research (so a psychiatrist told me) to show that a single patient seen by 100 psychiatrists will get 80 different diagnosis. While that is a sad indictment of psychiatry, it is also an indication of the difficulty inherant in mental health... unlike other medical disiplines, who can do investigative surgery or order tests, we cannot open up the brain and say... 'ahhh thats it'... so most mental health presentations are a trial and error in terms of diagnosis and treatment. You normally think you have a presentation tied down, but often additional information or changes in the individual's behaviour introduce doubt.

Sorry to carry-on, but again I hope to show why services particuarily in mental health can sometimes appear very ineffective. The last thing is that from looking at the situation you describe, your sister probably does have a personality disorder, as I have seen a number of people with similar story and its normally because they present in crisis, either having taken an o/d, or self harming/threatening self harm. This is of course extremely distressing for the family, but also for the clinical team.

For many years people suffering with personality disorders were considered untreatable, and this stems from learn't behaviour part of the presentation. Unless the person themselves sees a need to change they cannot be made too... or forced into homes/hostels etc. the only time legally a MHS can get involved is in crisis, when therre is a risk of harm to self or others. We simply cannot make anyone do anything outside these boundaries, so if your sister will not participate, then the MHS is powerless.

On the other hand if she is willing to take part in a treatment regime then the DBT I mentioned before is definately the way to go.

Your concern for your mother is well founded, if personality disorder is the problem, then it is likely your sister will 'up the ante', if she feels she is'nt getting what she wants from the family and/or the MHS. This could result in further o/d, self harm or violence towards the property or people (you mentioned she's tried to strangle you). The difficulty is that your mum sees an unwell daughter, rather than someone who is manipulating the situation to get the attention she feels she needs. As long as this goes on I doubt your sister will feel the need to change. My heart goes out to you and your family, and I hope that some resolution can be found, maybe with your presence at home things can be achieved.

regards StuPer

dllewellyn · Dec 29, 2004

Hello

Ive just joined the chat room so only read your request today. So sorry to hear about your sisters problems, I am a psych nurse working in Perth. Are you aware that Perth has an Internationally renowned Personality disorder program based at Royal Perth Hospital The program is called CHANGES hope this helps

bulletproofbarb · Jan 2, 2005

I'm back from the UK. (Thank crunchie :) ) and haven't seen my sister for over a year.

Well, like i said in my last post, she was started on Respirodone (?sp) and well, she is a completely different person...I'm sure it's the new drug. Also, she has now met a guy from the respite house she was sent to a few years ago. Not sure how the caught up, but he is really nice. He has a borderline personality disorder, takes medication and is a real nice guy. He also tells my sister what is appropriate and what isn't...she listens to him. I know she doesn't take the medication 100% of the time, but he makes her take it.

It is hard to explain, but it is like my sister is alive after being dead for over 20 years. I am so happy for her. I feel bad about the things I said before over the years and the anger I had at it all. I get teary thinking about it.

I hope she stays the way she is. This year, she put up christmas decorations for mum and dad. She has never ever even helped before, even when we were kids. She actually opened her christmas presents this year. Many years, she would leave them for months on end.

She went out on new years eve for the first time ever to a party with her partner. They are living together now.

She sounds alive when she talks, she looks alive when you look at her, she walks with a skip in her step. She smiles, she takes pride i herself. You know, I hope she stays like that forever.

Only down thing. My dad offers her alcohol. I told him off, said it made her ill which it does. She completely flips out when she drinks. Is abusive ect, out of the blue, no one expects it. He told me not to stir up trouble when i said "i hope you don't offer XXX wine". I feel like pouring all his booze down the sink. I told him so as well. He has mild dementia... drinks to much. Forgets to buy stuff when he goes shopping, never forgets to go to the booze shop. If he loved her like he says, he wouldn't buy her alcohol. He makes me mad!! :angryfire

Anyway, she only had half a glass on Christmas day, and didn't drink it because she didn't like it so mum took it away and told her not to drink and explained why in a nice way.

I don't drink, I have epilepsy. He doesn't try to shove it down me, because i say "no" but my sister, she says yes, but I still think that is a decision she doesn't have the understanding to make.

Anyway, I wanted to tell you all as you replied. My sister is in the Fremantle catchment area so I don't think she can access the RPH services. Good hospital, thats where I worked before I left, hoping to go back.

talaxandra · Jan 2, 2005

Barb, so glad to read that you have your sister back :) Happy New Year (and welcome home!)

Brigid · Jan 3, 2005

Hello Barb

So glad to see you'r sister is doing well now and I dearly hope she keeps well.

For what it's worth for the future (in case you should ever need to find her help again) it's always useful to organise a 'professionals meeting' where everyone involved with her conduct disordered behaviour (Social services / Disability team / Police / Last school nurse / Doctor / Psychiatrist / Psychologist & the family can pool their concerns to inform some sort of action plan.

Once everyones views are formally on paper, a designated 'agency ownership' should follow some form of 'official' assessment.

Interested Party · Jan 3, 2005

Hi Barb

Read this thread for the first time. I am glad that your sister is doing well. I am sure, I can hear the sighs of relief from psych nurses out there, I sure did. Sounds like 'Love is in the air'. However, can I suggest that you get online, hosp library etc and perhaps read about personality disorders and it's definition and about DBT (Dialectical Behaviour Therapy). It will give you a better understanding about your sister. This is a good time to do this because you are not upset about the whole situation presently.