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When you are new to a caring role with someone who has a mental health issue (it may be a slow development, or it may come suddenly because of a psychotic episode, or it may be both) it is very hard to know how you should respond. When you are trying to find the service you think will help you, there are a number of ways in which health and social care services are organised.

It may also be that the person you are caring for has had some kind of mental breakdown or has had a relapse following treatment for an earlier episode, or has other new issues. You may have started a process involving your GP and you are getting some support. It may be a dramatic experience which may result in the person being arrested or being taken into hospital. In extreme cases there may be violence involved in the crisis which will result in the intervention of professionals carrying out ‘Sectioning’ or possibly involving the Police and probably treatment in a hospital A&E (Accident and Emergency) department. Alternatively you may have been a ‘carer’ for many years but are now faced with new challenges. 

​These are all difficult and anxious situations
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This section of the web site is designed to help you find the answers to some of the questions which are often asked at the beginning of an episode of mental illness (see also ‘Your Questions Answered‘ for help with particular issues). In all situations you may find the following information helpful in dealing with different organisations.

How Care Services are organised
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Primary Care
This is usually the first step you will take in accessing services. GP practices and hospitals are the main providers of National Health Service (NHS) services in the community. GP practices are the means for referring you to secondary care services described below and can tell you about other local services provided by the Private and Voluntary care sectors. If you are dealing with an emergency, hospital Accident & Emergency (A&E) care may be the best option providing immediate care where appointments are not required (but there may be lengthy waits).

Your GP practice will have doctors, nurses, and probably a pharmacist. These people will have a range of skills and the specialisms they have will be different in each GP practice because they are self-owned businesses. However there is a core range of services all GP practices have to deliver under the GP NHS contract. Apart from GP practices there are Chemists, Community Nurses, Opticians and other specialists who provide services in your community.
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If you have a problem with the person you care for, the GP is probably the best first step (but you will find that the knowledge and skills of GPs about mental illness is variable). If the problem needs specialist treatment the GP will refer you to secondary care, the next level of specialism. If you need help in a crisis there are mental health services you can contact directly (see Useful Contacts for Local mental health services) or use the A&E services in a hospital.

Secondary Care
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Community Care

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Local Mental Health teams
There are a number of people with different mental health clinical roles you may come across. Developing a good relationship with them will help you to support the person you care for in the best possible way:
  • Psychiatrist
  • Psychologist
  • Mental Health Nurse
  • Community Psychiatric Nurse (CPN)
  • Occupational Therapist (OT)
  • Peer Support Workers

They work within a process called the Care Programme Approach (CPA) which is explained on the Notts Healthcare Trust site

Mental Health Sectioning
One important aspect of mental health care is the systems which operate when a person is admitted to hospital for assessment or treatment because their illness has deteriorated. They are admitted under a Section of the Mental Health Act 1983 which determines how a number of actions including assessment and treatment are carried out while being kept in hospital.
The Mind web site is a good source of information about what sectioning is. The information is explained as if it is directed to the patient.

https://www.mind.org.uk/information-support/legal-rights/sectioning/about-sectioning/

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The Mind web site will take you through the questions below:

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• What does sectioning mean?
• When can I be sectioned?
• What do the different sections mean?
• Do I have to be sectioned to get treatment in hospital?
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  • Meetings & Events
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