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Discharge from hospital

My beautiful clever 23 year old daughter has recently had a diagnosis of schizoaffective disorder bi polar type. Two months, three hospitals and two treatment orders later she has just been discharged home. 

Things are ok but I feel that her follow up is lacking.

We had a private psych that we lost confidence in. We had a very positive experience in the last public hospital she was transferred to under a treatment order. However she has been discharged with 30 days worth of meds and a recommendation that she find a new psych and sees her GP.

That's it, I was astonished that there is no outpatient follow up  and or at least facilitation of a new psych.

Our GP has referred her to a private psych practice where "they will asses whether to accept her but cannot see her at least until August 7" This seems too long as the hospital have started her on a low dose of a mood stabiliser with no instructions to increase. She was desperate to leave hospital but is now very emotional, very bored (and I have returned to work reduced hours). She is very smart and is negotiating a return to work in a few weeks but I feel we have no guidance around her mental health. I have read that rebound depression is common after discharge but I am also aware that part of it could be her hormonal cycle. Also she is suddenly complaining about the drowsy effects of her meds where over the last two months she has been having very high doses of all and they didn't seem to slow her down. So many questions, sorry.

Thanks for all advice. Thank you Rockpool.

Mon0497

12 REPLIES 12

Re: Discharge from hospital

Hello there @Mon0497 and welcome to the boards. I sometimes pop over to the carers forum if I see something that compels me to reply (I usually lurk over on the Lived Experience forum). I saw your post and thought I might reply.

You see, I have the diagnosis as your daughter and can really relate to how she feels post discharge. I always feel flustered, bored, restless and very depressed. If I am not careful, I can spend all day in bed and fall into that trap. I know the medications can make you feel flat and drowsy. I am lucky that I take a combination of medications with one of my antipsychotics also being a mood stabiliser and they seem to work okay.

A key is to find a new psych which is appropriate as soon as you can. I know and understand there may be a wait as most good psychs have a waiting period for new patients. If this psych works out, it could make the world of difference to your daughter. I wish there was a rotten tomatoes website for MDs and specialists like psychs, so you could read reviews and see what others like/dislike about them. It'd certainly make life so much easier.

I've recently had a manic episode where I crashed afterwards and now I am trying hard to stay in the world. I am using a good psych, GP and also a good psychologist which can 'teach' emotion regulation. 

I remember how scary and troublesome hospitals can be, especially on involuntary treatment orders, having been there more times than I care to admit. I just wanted to let you know that although I have some rough times sometimes, my life is a lot less chaotic than it once was and that is a good thing. It does get better. I am currently studying and looking to go onto uni to study social work and then (hopefully) gain employment in the mental health field. That was something people thought was impossible not too long ago. I just wanted to say recovery is achievable.

 

Re: Discharge from hospital

Thank you @Queenie

its lovely to hear your experience of living with your diagnosis. As this has been my daughters first admission it’s been exhilarating and terrifying having her home from hospital. It feels like we are learning to walk all over again, trying to figure out what is safe and what isn’t. I am so happy to hear you are studying and you will be such an asset in the mental health services profession. Thank you for your insight into how my daughter may be feeling. It makes a lot of sense after her long hospitalisation. Best wishes and I may draw on your knowledge again in the future if I may. 

Re: Discharge from hospital

Hi @Mon0497,

 

Your story is unfortunately not uncommon.  Our loved ones go into hospital, appear to be stable and are released without support.  It can be very scary for both carer's and patients.  Finding support as quickly as possible is critical.  We are fortunate that our son is  a teenager and under the care of the Child Adolescent Mental Health Service, however this will not always be the case.  Use the web to research mental health support resources and carers resources in your area.  You do not have to follow this up on your own.  In our experience, the GP is supportive, but not an expert in serious mental health matters.  He can provide scripts, but not much psychological assistance.  Take care

Re: Discharge from hospital

Thanks Boo13,

It is very frustrating I am still waiting to hear back from a private psych clinic (three days now, me ringing every day) to see if they will accept her!!!! What does that even mean? 

Rang the hospital this morning and asked about where my daughter's discharge summary is? Apparently pysch patients don't get one. (only their GP's ). I feel emabrrassed that as nurse of thirty five years I did not realise this until now. All of my other patients receive a rundown of their hospital stay, adult, maternity, paediatric. Does anyone know why Mental Health Patients don't? Thanks for everyone's replies. 

Re: Discharge from hospital

What state are you in @Mon0497 there will.be documented policy on this.

Re: Discharge from hospital

Hi Darcy, 

 

we are in Victoria, haven't looked into any policies actually as this all so new for us but I feel like I do need to follow up some things.

thanks

Re: Discharge from hospital

Re: Discharge from hospital

HI @Darcy

I have had a quick read, it states that after an inpatient stay documentation of the discharge plan should include

  • "Discharge has been formalised in writing with a discharge summary and follow up actions clearly indicated to relevant providers."

It's interestiing that only service providers get a written discharge summary, I feel that is excluding Mental Health Clients. Do you know if this is different elsewhere in Australia?

 I feel a few other steps of the process has been missed and although I could be "projecting my distress" at the moment there are many, many things that could have been done better for my daughter over the last two months, including her discharge. Thank you for following up for me.

Re: Discharge from hospital

@Mon0497  I am not familiar with the Vic Mental Health Act nor do I know what variations there are between states. 

 

There are avenues for complaint or "clarification" if you feel that things were not done right. 

 

 

https://www.betterhealth.vic.gov.au/health/ServicesAndSupport/mental-health-laws-and-your-rights

 

 

 

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