Mental Health Teams Ignore Family Concerns and Fail to Detain Masking Patients

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Some (not all) survivors of severe mental illnesses like schizophrenia and bipolar disorder can learn to mask their symptoms when assessed by healthcare professionals.

This is not just a coping skill consequence of paranoia or distrust; it is a survival defence to avoid the necessary interventions formed to help them when in crisis. This masking exacerbates the survivor's symptoms as help goes unused and the condition heightens.

I’ve seen this happen with two close family relatives of mine. To protect their privacy, I have de-identified said family members and will only refer to them as "Family Member X" and "Family Member Y" in this article.

*A Note on Tone and Context (added in 2026): I wrote this essay in 2025 while actively dealing with the systemic failures detailed. As an autistic person and writer, I have blunt communication. Some may find my critique of the current mental healthcare system somewhat accusatory, but I can only detail what I have witnessed. My only aim in this essay is to advocate for survivors of severe mental illness and the loved ones of the survivors with honesty and compassion.

(The following accounts throughout this essay are a record of behaviour we, the family members, have witnessed and are not intended to be derogatory or judgemental towards severe mental illness survivors or their symptoms.)

We, the family, witness these survivors in the midst of a suspected psychotic episode. They’ll accuse strangers on the street of muttering disparaging things at them; they’ll open windows and shout weird onomatopoeic sounds to the public; they'll jump on cars or smash windows. A blatant display of their deteriorating mental health which is abundantly obvious to those who interact with them daily, those being their friends and family.

However, they, the healthcare professionals, come across a different person. They visit the survivors for a limited time slot and "assess" their condition. Due to the survivors masking their symptoms and answering questions in a coherent, engaged and lucid manner during that brief time slot, the fundamental reality of their condition is entirely missed.

When questioned about their mental state by the healthcare professionals, the survivors in false sincerity answer, "No, I don’t intend to harm myself," or "No, I don’t hear or see things that aren’t there."

All of a sudden, the family concerns, the emails, the calls and the reports made are thrown out and dismissed in favour of a brief, masked denial.

"Family Member X has literally told me they want to 'end their life' multiple times.

"What are you talking about Family Member X has said 'no, they don't.' Why are you believing that? If you were paranoid and had distrust in everyone, would you readily admit to strangers sent to assess you, ‘Oh yes, I do intend to harm myself. And I do hear things that aren’t there.’ No, you wouldn’t. Please use discernment and common sense." I passionately state down the phone to a mental health professional.

"Family Member X wouldn’t have been able to mask their condition for an hour." The professional retorts.

"Yes, you could. If you’ve been undiagnosed for so long and coping with such a condition with no help or recognition for two decades," I say.

"Also, there is family history of diagnosed severe mental conditions such as schizophrenia. Do you not take that into consideration?"

The professional falls silent at these common-sense statements.

Since I was a child, for over 20 years, Family Member X would accuse people on the street of calling them derogatory names. They would start arguments with anyone who let out a sigh or sneeze their way, misconstruing it as malicious.

In anguish, at home, Family Member X would talk to themself incessantly, go on about conspiracies and accuse people of being "Badmind." They would open the windows and doors and make weird noises to passersby. Their moods would switch from rage to despair every few minutes.

Now, I, as an adult, have tried desperately to get Family Member X the mental help they desperately need.

Yet, the NHS mental health systems fail continuously. They instead rank a brief assessment interview under the Mental Health Act by healthcare professionals who only know Family Member X for an hour, over decades of lived experience and ever growing concerns from their family members (and even some professionals in other fields such as social care workers). This is unfair to Family Member X as they continuously experience their untreated symptoms.

The other family member I aforementioned, Family Member Y, has a diagnosis of schizophrenia and gets sectioned every year without fail. This has been the status quo for over 10 years. To note, rather than the mental healthcare professionals fulfilling their Duty of Care part during assessments and actually considering loved ones concerns and reports, said family member only gets sectioned after committing crimes when in crisis or disturbing the public to a point that requires police to intervene. This is unfair to Family Member Y and is completely preventable.

The professionals will see Family Member Y on Monday after reports from family or friends, they will conduct their assessment, and because the Family Member Y engaged, "I feel fine," they will dismiss any further concerns. The next day, said family member is being arrested for disturbing the public and is sectioned there and then.

This illustrates that the only way for the current mental health system to validate the severe mental illness is through public disturbance or criminal act, not clinical assessment. This needs to urgently change.

Family Member Y has been sectioned every single year for over 10 years straight, usually through arrests as Mental Health Act (MHA) assessments fail.

Last year, 2024, the mental health team themselves confessed they were failing Family Member Y and, as a result, they prolonged their in-patient sectioning for Family Member Y in 2024. Stating they needed to "evaluate how they have been failing them for so long, evident by yearly repeated sections and their condition seemingly not being managed or improving." That’s their own admission of systemic inadequacy.

Nonetheless, this type of systemic failure to safeguard is at the hands of police, too. Though yes, they have been able to section said Family Member Y year in and year out, I remember one hot night in July 2022 when police were called in absolute dire urgency as Family Member Y's presentation was particularly threatening and hostile to others.

The police dispatch said they would send officers out. Two or three hours later, we see a police car drive by the house slowly with no sirens or lights on, presumably on patrol. We frantically call back to ask why no one has turned up. Their response, "no officers available."

A bold faced lie. It took contacting the crisis team, who then had to contact the police, to finally get this family member the medical and mental health attention they needed. To put it bluntly, it's inexcusable and clearly concrete a negligent pattern. A family's concern is dismissed constantly. Why wouldn't loved ones' concerns be paramount in social and mental healthcare service intervention?

It’s no wonder why the suicide rate has increased in recent years, with over 5000 reported in 2024, according to The Samaritans website. Survivors of not recieving the help because of systemic incompetence.

Those who are meant to protect fail to do so because the system that trains the professionals fails to take into account for high-level masking presentation.

Professionals are urged to make critical decisions in an insufficient single hour timeframe. High-level masking is victorious in this timeframe despite the belief to the contrary. I have two family members who are absolute proof of this. That is lived experience, and lived experience is vital.

Here’s how it goes: healthcare professionals conduct an insufficient Mental Health Act assessment where sufferers mask highly. They believe the masking and dismiss any family concerns. The survivor either goes on experiencing their psychosis and/or manic symptoms or is detained at a later date because the crisis results in public disturbance where must police intervene.

We need reform now. We, the loved ones who are much more intimately aware of these episodes, demand the immediate prioritisation of family lived experiences and evidence.

Things must change! We need a system that recognises that survivors of severe mental illness can, at times, mask right when they need urgent help the most. We need a system that prioritises and takes multiple family members' concerns on board. We need a system that is well-informed by experience rather than just relying on textbook analysis.

I am working on writing a UK Government Petition for this exact matter. I will include the link in this article once it’s up. Update: Link to the petition is at the bottom of this piece.

Update on the UK Government Petition as of January 2026: I wrote a petition on 15th November 2025 but in January 2026, it was rejected as they accepted another petition with the same aims a few days prior.

Here’s a link to that petition by Davis: https://petition.parliament.uk/petitions/750399