"Inconsistent and unhelpful support from the Home Treatment Team"

I took my father to A&E due to his presentation of low mood, anxiety and suicidal ideation. It was difficult to get my father to go to A&E to access the support he required and took great encouragement due to his anxiety despite him desperately wanting the support. At A&E, my father was referred to the Crisis Team for a medication review. Following this review, we began to receive intervention from the Hounslow Home Treatment Team who provided almost daily home visits.

Our initial home visit was with a Mental Health Nurse. Their attitude towards my father we found to be completely inappropriate, unprofessional and inexcusable. They made extremely unhelpful and inappropriate comments about my father’s situation and said that they felt  sorry for his daughters for having to deal with my father. My father is already struggling with thoughts of guilt of being a burden to others around him, and this comment alongside the general behaviour and attitude towards my father only further contributed to my father’s anxiety. My father was shaking after this interaction. When I and my father mentioned that the behaviour and comments were unhelpful they responded by saying they knew they were direct and they had gotten this feedback from other people before, but that’s the way they work. I am extremely concerned about his behaviour and these comments, as these are potentially triggering for individuals who are already experiencing a mental health crisis.

In the following visits, my father shared how despite trying the new medication suggested by the doctor, his anxiety is not improving and that he is struggling everyday, especially in the mornings, with chest pain, shaking hands, headaches, and pains elsewhere in the body. Several of the nurses who attended home visits suggested that my father should be prescribed  medication due to the severity of his anxiety. He was continuously told that his concerns and opinions would be passed on to the doctor in time for his next medication review. However, on the day of his next medication review, he was not prescribed any change in medication and the nurse who came to visit him on the evening after his medication review cited reasons of some medications being addictive.

We explained to the nurse that my father has previously taken similar medication in the past on a PRN basis. I showed the nurse a box of the medication issued from 2021 and my father still had 1 tablet remaining. Once the nurse had left, my father presented as severely anxious. He presented with laboured breathing, shaking and shared concerns of increased heart rate, headache -  like my head is in a vice -  and severe chest pains, due to the contradicting information regarding medication. It is as if he is given false hope during these visits, only for these moments of hope that he is clinging onto to be taken away.

We told the nurse that we would be making a complaint and that I would be speaking to the doctor the next morning. The doctor then arranged for my father to be prescribed the medication twice a day. They shared that my father should be on this medication due to the severity of his anxiety and that if this medication does not help, they will put my father back on an alternative as this helped my father previously but was stopped by his GP.

My father was feeling more optimistic as he was now being heard and being involved in his care. The medication was helpful in managing his anxiety. We asked for no home visits over the weekend as we had a guest staying over and my father did not want the guest to be aware of his anxiety. Without the visits and my father taking his medication, he was able to manage his anxiety well and he was starting to feel better.

Seeing the whole me

However, following this period, when the team returned for a home visit, the nurse once again said that my father should no longer be on the medication despite only taking it for a week, as it is addictive. My father shared that the doctor had specifically said that he should be on a specific dose each day, but he was only given a lower dose by the nurse who visited. They said that the team would bring more the next day but they only brought him 7 tablets. I then had to call the doctor the day after to ascertain whether my father was still prescribed the medication and the dosage he should be on. They shared that my father should still be on the higher dose. I shared my frustrations with the doctor on the call. They were apologetic and agreed to stopping home visits for a while due to the toll it was having on my father.

Being listened to

Involved in decisions

We felt frustrated that our concerns were not being heard. My father having to open up and share his mental health difficulties every day is a difficult process and leaves him feeling heavy. This exhausting process of reliving and recalling his difficulties everyday is made worse when following this, he is not provided the support discussed during these visits. There have been numerous occasions when I have been called by my father when I am at work, and when I have returned from work and he is in extreme distress due to his interactions with the crisis team. This is a service which is aimed at providing support to individuals experiencing a mental health crisis. Instead of providing supportive and empathetic care, they are making my father’s condition worse. A crisis team should be offering a more empathetic and supportive approach due to the level of risk presented by their patients.The team must be consistent with their guidance on what they tell their patients as this confusion can be triggering and distressing and further add to their difficulties in their moments of crisis.