I have come on here in a desperate bid to try and find help in preventing Social Services from removing my nieces 7 month old baby girl from her. She suffers with bipolar and has done so for about 13 years. Last year in January she was sectioned a short time after having her medication completely stopped due to a long period of depression. She was pregnant at the time she was sectioned and so SS were tipped off and have been on her back ever since. She is a loving caring mother and her baby girl is in perfect health. My niece has been receiving constant support from her mum and dad but this unfortunately has gone against her showing ,in their eyes, that she is unable to care for her daughter on her own. My niece is understandably very depressed and I think almost suicidal with everything that is happening around her. She is on 300mg a day of quetiapine and has been so since she was sectioned over 14 months ago. She has been very down ever since then and I feel her medication is keeping her at rock bottom and needs adjusting which her consultant is unwilling to do. My question is does a depressive period go on for as long as this because it seems to me that something must be done to try and put her in a better place mentally. Has anyone been on this medication and had any other medication taken alongside of to improve the depression. Having researched the drug it would seem to suppress dopamine and serotonin which give us our pleasurable feelings, no wonder she is depressed. I know it's also to suppress any manic bouts but it seems to be like using a sledge hammer to bang a drawing pin in! Anyway would appreciate any one's comments or experiences. Thanks for reading this. By the way the father also has mental issues and has limited access so is of no real help with the situation.
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Just to clarify, she is taking quetiapine but is at home? Quetiapine can be used as an antipsychotic and also a mood stabiliser, it does however sound as if this medication isn't working for her. The usual treatment for bipolar would be a mood stabiliser to try and prevent depressive and manic episodes, as you probably know. Not all antidepressants work for everyone and it sounds like she's given them a good try. I guess from a SS point of view/psychiatry point of view a) changing medication is a worry as it may have a positive/negative effect but this could take some time b) if medication is changed she could go manic or become more depressed...both of which may be a child (and mum) at risk. It's a tricky situation but I don't see why if her parents are supportive they can't become legal guardians (in this case) whilst mum gets better. Does your niece have an advocate? They are extremely helpful and very good with knowing the ins/outs. Also, have you tried sitting with your niece and writing a list of all her worries and concerns?
Sorry, I don't know if that's helpful at all...I'm just on a break but will have another look later.
Thank you Vix for your quick reply as wasn't really expecting a response so soon. I can fully understand your concern with problems associated with changing her medication in the present situation. The problem is she is not showing or saying she is able to care for her child in the way that the SS are happy about. When asked she say's she wants to keep her baby but needs help. She has problems leaving the house etc but breast feeds and cares for her daughter in such a loving way. The SS wont let her parents have an SGO with the baby as they say their loyalties would be compromised as needing to care for her mother as well and my niece would only have limited access 6 times a year! It's all like something from a Stalinist state, SS have such power it's frightening. My niece has great difficulty expressing how she feels other than being really sad and finding nothing pleasurable although smiles at her baby a lot. I tried taken her to a hypnotherapist a couple of days back but without any positive outcome unfortunately. She seems to have lost all hope and it's so heart breaking to see. Can anything be done to make SS take a backward step and give her a chance to get better?
meant to add that she is staying in her own flat with constant support from the family 24/7. The court has ruled that she is not allowed to go home to her parents with her baby as this constitutes a change of guardianship and would require a court order. What a load of ridiculous tosh!
Hi. Really sorry to hear about your situation. We are also being 'watched' by Child Protection and Social Services due to my mental health and unresolved postnatal psychosis/depression. I have BPD and unfortunately Social services do seem to see long term mental health problems as a 'significant risk' and certainly where I live Social services have their agenda, whilst the adult mental health team, have their own. However, depending on where you live, your niece could be fortunate in that due to her baby's age she may be able to be referred to a 'mother and baby unit' until her depression and medication can be stabilised. She would get the support and help to care for herself and be in an environment where she can prove that she is capable of looking after her baby. I spent several months in a unit after my second child. There are usually doctors, psychiatrists, therapists nursery nurses and a social worker involved in the team so she would also have a care package established before being discharged. Otherwise, it is really a case for the family to build up evidence of how the baby will be 'protected' whist in your nieces care. I guess if courts are already involved, your niece could perhaps benefit from an advocate who specialises in mental health- have a look at Mind's website. As far as quetiapine goes, it was fairly good for me and stopped lots of the irrational thoughts and suicidal thinking, but it is quite strong and can cause lots of drowsiness and stop you feeling anything so it takes a while to get the balance right. I had quetiapine in combination with an antidepressant which could be an option your niece may be able to request. Sorry I can't be more positive but I wanted to be honest with you. Hopefully Mind will be able to signpost you to other supportive agencies. Good luck x
Thank you for your advice. We looked into the mother and baby unit situation but was advised that she would really only be considered for these units if she was having a psychotic episode, which she isn't. Because of the nature of the patients condition being admitted to these units they can be fairly noisy and disruptive environments and this is not really a suitable stable place for my niece to go to. I should add that I have not had any direct experience of these units and I am only going on hearsay which may well be incorrect. I would be very interested to hear of anyone's personnel experience regarding this. I have taken numerous videos of them together to show what a loving caring mother she is but it makes not a jot of difference because she has been assessed by an expert!!! I would hate to think how much money is being wasted by the establishment in trying to destroy the life of a lovely mother and her beautiful daughter. I am sure this sort of draconian and cruel treatment doesn't exist in the third world but only in our so called civilised society. Sorry if I sound angry but just come from another three hour family meeting with social services and my nieces CPN, both of whom are about 25 and fresh out of Uni and are only able to answer with pre prepared and text book answers that avoid really answering anything. Blah!
From my personal experience a m&b unit wasn't particularly noisy as any moms experiencing/displaying psychotic behaviours were isolated temporarily if thought to be 'a danger' or disturbing for other moms..Everyone had their one bedrooms, shared lounge, large garden, nursery, kitchen etc. All areas staffed. I don't know their criteria for admission now but it could be worth contacting one directly for your own peace of mind and explaining your nieces situation. Your niece could try asking social services if they could help with an admission again proving she understands her own mental state but is actively seeking help (appearing to be cooperative with baby priority, is what as want to see- it was seen as positive and a protective). Hope you have some good luck soon (hug) x
Really glad you have found this forum, and I'm so sorry to hear of the difficulties you and your niece are having with social services. You mentioned that both the CPN and SS seemed young and inexperienced at the family meeting. I wonder whether you could ask for your niece's case to be reviewed by a more senior AMHP - (Approved Mental Health Practitioner) these workers are often social workers who are integrated into a community mental health team and have higher levels of training in dealing with complex cases.
As others have mentioned, I'd definitely advise contacting an independent mental health advocate who can bridge the gap between you as a family and the legal system. Here's the link from Mind mind.org.uk/mental_health_a...
Does your niece have access visits witho her baby at the moment? It would be worth asking if these could be supported by a clinical psychologist who specialises in parent-infant attachment, as what she will need at the moment is professionals who can support this bond and help to redevelop her confidence in nurturing, playing with and interacting with her baby. I'm so sad for you that the services have seemed punitive rather than supportive. I know you must feel very helpless at the moment, but really hope that through some advocacy you are able to refocus the professionals on doing all they can to support your niece and promote her recovery.
Take good care of yourself too, you might even find it helpful to chat to your GP about any carers services/befriending that is available to you as the whole situation must be very stressful.
Thank you all for your wonderful support and helpful comments, it means a lot to be able to communicate with people who have an understanding of these types of situation. Regarding an independent mental health advocate, I did get in touch with 'Mind' and a very nice young girl came to see my niece and spoke to her. She also spoke to me independently and explained she cannot advise but only provide a voice for my niece which is completely understandable. The problem is that throughout this whole process my niece is coming across as being 'frozen in the headlights' and totally unable to make a decision about almost anything. She will say 'I want to keep my baby ( she obviously say's her name) but I know I can't. Anyone that represents her whether it be a solicitor or 'Mind' representative can then only convey that negative message onwards. When I challenge her CPN on her not being able to make a sound response because of her current mental state she just say's( the CPN) that she has been seen by a psychiatrist who pronounced her capable of making her own judgements. I seriously question this and from what I can find on the internet her mental capacity to be able to make pressurised decisions is being severely compromised by her medication and perhaps suffering from postpartum depression. There's very little that a family member can do when up against so called experts. My niece has completely lost her confidence in her own ability to cope as a consequence of being under this constant barrage of negativity and the near certainty of losing her little girl. Having spoken to her CPN yesterday I got the very strong impression that budgetary constraints at present are preventing my niece from getting access to quality help, this wasn't said but only what I sensed. It does seem to be a lottery postcode situation. I will definitely look into the ' AMHP ' options but pretty certain I will be blocked. I won't give up. Many thanks again to everyone on here for your help.
I am so sorry to hear about your neice's troubles and I wanted to offer a few thoughts to you.
The first relates to your neice's medication regime. I took quetiapine at 300mg but in conjunction with lamotrigine. There was a clinical trial about this combination for depression. I was not part of this trial but have to say that in comparison in was more effective than quetiapine alone. The trial was based in Oxford I believe. Your neice is entitled to a second opinion and for me that is where my life changed. I do not know where you are based but Professor Geddes and Goodwin in Oxford are experts in bipolar. Services will often view the risk of mania more than the risk of depression but in your neice's instance the risk of depression is she could loose her child and if she has capacity she should have choice about her medication and the risks associated with an antidepressant which may in any case be ameliorated with a mood stabiliser. Lithium has a good evidence base for treatment resistant depression. Look at NICE guidelines - she is entitled to this treatment which includes psychological treatment.
Second yes social workers have huge power and the focus will be that the welfare of the child is paramount and the concern about impact of attachment issues at a critical stage of development which could have longer term consequences. Decision making withstanding court scrutiny has to be defensible. Typically a family based approach is taken in children's services and this approach should extend to child protection so you are entitled to have this open discussion with senior childcare social workers. It can be off putting when people in such significant roles appear inexperienced but sometimes these workers are more thorough and knowledgable and can be senior in their role based on capability. Share your fears with them social workers are human and are doing what they genuinely believe is in the best interests of the child. By no means I am saying they always get it right but to resolve issues you need some confidence in the relationship and an open dialogue.
The other thing is for your neice she is in this awful paradox where she feels she has to be better to keep her child but doesn't feel herself and can't make this happen. The more she piles on the pressure to be better and a good mum the more critical she is of herself and the worse she feels. This circularity will not benefit her mental health and bring relief from her depression. Its not easy to find a different mindset. I don't know whether mindfulness may be helpful for her to focus on the present. I think there is a self help module on mental health foundation?
CMHT's typically have a mother and baby expert and this would be better than an AMHP as they usually have very good working relationship with C&F and up to date knowledge of relevant processes, legislation and support.
Your neice is very lucky to have such strong support in the family and remember that if care is being given to her by virtue of her mental health then you/her parents are entitled to a carers assessment.
If you are unsure about capacity ask to see documented evidence in relation to test of capacity as outlined in The Mental Capacity Act.
I hope this information is received in the way intended to inform and equip and not that I do not recognise the powerlessness and distress you all must be feeling right now in this situation.
Oh and if budgetary constraints are relevant pressure from GP if its health related particularly as the GP's now commission mental health service rather than PCT's. Letters from MP also goes down well with service deficit issue.
it's difficult for me to put into words the comfort and support I am getting from so many people on this forum, thank you all so very much, its really gets to me and I feel very emotional I have to say. I am only an uncle but yes we are a very close knit and loving family and having to contend with something like this is very very difficult. We accept that my niece is not capable of supporting her baby on her own, at least not in her current mental state. The best outcome we feel is for my niece to be living with her Mum and Dad and her baby in their home but this won't be considered by social services. Her parents are to be reassessed for an SGO having been rejected on the first one because of a conflict of loyalties between the baby and their daughter. My niece would only be allowed access six times a year. They are not considering any outcome that would include my niece staying with her baby. One of my other nieces, my sisters daughter, is being assessed for an SGO and looking likely to pass the assessment but they are only really doing it to avoid the adoption route which would lose baby from the family group completely. There has been some very helpful advice given on this forum and I will be following up some of the suggestions. The final Court hearing won't be until early August so will keep battling away. .Many heartfelt thanks to you all.
Wishing you all the best with this situation. My concern was not to polarise yourself from services even if you have different views as the power in their role would in this instance make your position vulnerable in opposing outcomes. Its clear from what you say its not an easy situation to understand and by working with services as you have been to find solutions the hope is that the worst case scenario can be avoided. I hope so much you are able to support your neice to access the mental health care she needs. Take care.
I have had a severe psychotic episode before that lasted for 3 months and a couple of mild episodes and have been diagnosed with bipolar. I must say that 300mg quetipine does sound like a low dose to me. I take 600mg usually and increase that to 800mg during stressful periods. 300mg would be too low to keep me stable and I'd have trouble being a good parent to my kids on this dose. I know this because I have tried to be on this dose before and I found it too difficult to manage. Hope this has helped.
I had my children removed by Social Services due to undiagnosed PP which was seen as a Personality Disorder. It took five months for me to get them back after a Judge ordered a Psychiatric Evaluation which proved the children were not at risk of significant harm from me. Please get in touch for more advice....
Agree with most answers. Please don't feel that any one decision from authorities is final. Keep asking different professionals until you get the situation you want, even if this case goes against you initially. Literally, do not give up, search out more and more second opinions and supporting facts. Keep going, I've been through this, things can change like you would not believe.
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