Does anyone in the UK actually get help from the mental health services?

November 1, 2007 at 6:11 am 15 comments

Here’s a comment from Alison, which was originally in response to an earlier post of mine, called 90 Days. I’m quoting it in full, because it highlights the difficulty that I and others seem to have getting anywhere (hope you don’t mind me doing this Alison):

Reading your story is a little like my own. I too have suffered with periods of depression and self harm for a number of years, focussing on the past 4 years which resulted in time off work and endless appointments with my GP. I was referred to someone at the GP surgery who have two visits sent me to a CPN, I waited about 4 months for an appointment with this woman! I saw her twice and was discharged, I too do a good impression of often hiding how I really am, it would seem when I see these people they think I am perfectly normal!

She told me I could self refer and in the new year of 2007 after being back at work about 6 week I realised I was not coping and telephoned her, she asked me to keep a mood diary for a month and phone her back. During that time I had several bouts of wanting to die but did what she asked and called her back. She made me an appointment for the following week, she asked me to see my GP to go back on antidepressants and I did the next day, I was given Mirtazapine.

Days after starting this I went into rapid cycling and knowing the signs I went back to my GP and told him, I felt uncomfortable in the appointment as he had a student with him and when he asked me if I was suicidal I said yes but that I would not act on it. 3 hours later in my lunch break I nearly walked in front of a police car. I went back to work and spend the rest of the afternoon in a daze. My closest friend begged me to go to the hospital but I refused and kept repeating I would be fine.

The next morning a Friday {March 9th a day I won’t forget} on the way to work I couldn’t get the thoughts out of my head that I needed to end the hell I was living in, I went to work dazed and confused and it was during a call {I worked in the council call centre} with a customer that I exploded and lost my temper not only with the customer on the phone but with a manager. The tears came and I walked or rather ran from the building ringing my GP surgery to see someone I needed help and now.

I was chased by the department manager who encouraged me to talk to her and I explained how I was feeling, she drove me to the doctors. My GP seeing the state I was in telephoned the Crisis Team and later that afternoon I was visited by two CPN’s who both mentioned Bipolar. I have suspected I was Bipolar for around 3 years but I didn’t want to admit I was ill. On that day the biggest break through I made was telling my mother what I was feeling, it was the first time I admitted what I was thinking and whilst she has given me some support I still don’t open up and tell her everything.

I was referred to a Psychiatrist {a trainee} who I saw 6 weeks later. I felt patronised and he told me I was Bipolar only because I had read about it on the internet! He was rude and ignorant and didn’t listen to me or anything I mentioned. I left determined to go Private but my friend said she would come with me to my next appointment 12 weeks later. That too was useless he told me I had Bipolar traits but would need to discuss me with the consultant and see me in 8 weeks.

8 weeks turned into 12 and that was 2 weeks ago and I saw someone else, who didn’t seem to know anything about what had gone on and gave me the option of seeing them again or being discharged! I choose to be discharged and am thinking of going back to the CPN who I found partly helpful this year.

I resigned from my job in August after the pressure to return and now I just feel in limbo, no definite diagnosis and no suitable medication. I am and have been sinking into depression again the past few weeks, reluctant to go on AD’s because I hate the way they make the mood swings worse but at the same time I am scared to hit the low points again.

There is not a day goes by I don’t think of death and ways to end how I feel like you I also think the last thing I would do again would cry for help especially when help is usually a waste of space.

Well that’s my story, sorry to bore you!

And then there’s this interesting post, from Fighting The Urge:

The CMHT rang me earlier, they’re not sure if I fit their referral criteria as they are not sure that I am suffering from a “severe and enduring mental illness”.

I told them that my GP wants me to be referred. They said that they cannot accept all GP referrals. I then said that I wasn’t initially referred by my GP, I was initially referred by the duty psych at UCH because I attended A&E. They said that said duty psych refers a lot to ease their conscience.

I asked what would happen now… they said they didn’t know but they would be in touch, but in the meantime to keep the appointment with my GP on Friday and to keep taking my medication.

I said I wasn’t on any medication because my GP wanting me to be assessed by the CMHT and get their opinion before re-prescribing anything.

They said that if I wasn’t taking any medications then I couldn’t be that ill and therefore didn’t require CMHT intervention. I put phone down.

*Slams head against wall*

Ruth

PS. Someone found this site yesterday by searching for “depression cmht cpn” – please don’t use the above post as any indication for yourself!

Regular readers will know my own story, which starts off with me walking into A+E with cuts on my arm and the acute mental health team refusing to see me. I found little help from the psychiatrist I saw, being prescribed citalopram by my GP and ending up in hospital after severing a tendon in my wrist. And currently being pretty much back where I was in January, waiting to see another psychiatrist.

So is there anyone in the UK who does find that the mental health services work at all? Why are these services so useless? I mean, most first-world mental health services are underfunded and understaffed, but they still seem to offer at least some help within a reasonable timeframe. In the UK it seems like these services are just there to scoop people up when they’re making a public enough fuss. Anyone who doesn’t actually have a knife pressed against their own, or someone else’s throat, is presented with delays, refusals and apathy.

Has it always been like this, or have things got worse? How many people die through lack of treatment and care?

Looking at MIND‘s website, (MIND describes itself as “the leading mental health charity in England and Wales”), I see their current list of campaigns includes access to justice, “Ecotherapy – the green agenda for mental health”, independent living, a campaign against budget cuts, improved access to talking therapies. All important issues, but where’s the outrage about what seems to be the actively hostile stance of the mental health system towards would-be service users?

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Eek Sleep / Work

15 Comments Add your own

  • 1. Anodyne  |  November 1, 2007 at 9:36 am

    Unfortunately you have to cause trouble to get help from the mental health services. If you’re quite and passive and controllable, they couldn’t give a shit if you kill yourself. It’s more important to be a raving delusional loon, taking your clothes off in the street or setting fire to things – then you’ll definitely get the help you need.

    Telling the mental health services you have had thoughts of killing someone else always gets you moved to the top of the list.

    Sad but true, like everything else in this world. You have to work the system.

  • 2. Gabriel...  |  November 1, 2007 at 9:55 am

    How come you never quote my responses? Should I be trying harder? I know I can use more words if that’d help.

    “Unfortunately you have to cause trouble to get help from the mental health services.”

    Not true on this side of the ocean. Just walk into a local Canadian Mental Health Association and say something along the lines of “I need help, eh.” It can be hard, but they don’t make it difficult.

    “Ecotherapy – the green agenda for mental health”

    Dude, seriously, if a Mental Health organization sees a need to place the environmental movement before, or as an addition to serving the mentally diseased and chronically fucked up it needs to have its funding revoked. I would much rather see an organization dedicated to first housing the mentally ill and making sure they have enough to eat and get the respect they deserve from employers and Society in general while, secondly, shooting polar bears or selling cigarettes to children rather than saving a tree and planting a manic depressive. Priorities.

  • 3. experimental chimp  |  November 1, 2007 at 10:32 am

    Anodyne: Have you actually done this? What happens next? Since my problems don’t involve running naked down the street, setting fire to things or wanting to harm others, isn’t this going to lead to a) inaccurate diagnosis and b) ineffective therapies (whether psycho- or pharmaco-)? And once the fabricated crisis of clothing-removal, object burning or outwardly-directed violence has passed, won’t the mental health service’s response just revert to the standard apathy?

    What I – and others – want and need isn’t any intervention at all. It’s the appropriate intervention and follow-up delivered in a reasonable amount of time.

    So yeah, working the system might get me some help, but probably not the right help. (And I haven’t just been sitting around – I’ve been actively pushing for a psychiatric re-evaluation, because I was stuck with the borderline label by the first one I saw. Even so, it’s taken 5 or 6 months.)

  • 4. experimental chimp  |  November 1, 2007 at 11:00 am

    Gabriel: When I do a post about the beneficial properties of Kelp, yours will be the first response I quote.

    The ecotherapy thing actually seems to be about walking in nice, green places being therapeutic. They did run a week long campaign about it and seem to think that access to green spaces should be a human rights issue. So possibly their time and money could have been better employed…

  • 5. Gabriel...  |  November 1, 2007 at 1:32 pm

    People just don’t seem to understand how important Kelp is… you should totally write a post about Kelp.

  • 6. Alison  |  November 1, 2007 at 5:01 pm

    No worries with quoting the comments I posted, there are so many people like us out there the more than come forward and tell there story the better. I printed off the NICE guidelines earlier and I am going to spend the weekend going through them, right now I feel like walking into my GP’s surgery and screaming for help, proper help, someone to listen and someone to understand what is wrong!

    I read with interest people’s posts on forums I use from Canada and the USA, it’s like a different world, they seem to get help and access so quick and easy, I guess it what comes from paying for your healthcare.

    I am trying to save to go private the The Priory in Preston, 1st appointment £180 every appointment after than £90 – well that was the price six months ago. The more I think about it though the more I tell myself I have contributed and paid taxes and national insurance why the hell should I go private!

    The only thing I did that was out of sorts for me was lose my temper with a 10 year old and I pushed him to the ground, said little shit had abused and harassed me for years. That was in June and even know I sit and wonder how the hell I stopped myself from doing him more harm at the time.

  • 7. Gabriel...  |  November 1, 2007 at 5:16 pm

    Health care, even for the Mental people, is totally free in Canada. If it were anymore freer my Lithium would come wrapped in dollar bills. The comparison is something worth exploring… I’ve been meaning to use my reporting powers for good, maybe this would be a good cause. Health Canada v. The NHS Mental Health Service: This One’s For All The Kelp.

  • 8. Ad  |  November 4, 2007 at 6:05 pm

    Hi Ruth, it’s true the mental health system in th UK is pretty dire.

    It sounds like Canada’s syatem is to ours what dutch public transport is to ours, but he fact that another country can do something well doesn’t seem to matter a jot here (you’d think the authorities could just benchmark a country where their systems work). Unfortunately we know it’s not just the mental health side of the NHS that’s in trouble, so it may not get better for some time. I think it’s a shame that we shoud have to go private, but the government is effectively pushing stealth privatisation in areas like this – unless there’s a big change in publicity for, or results from, these types of services. In that context, it’s understandable that there’s so much research into alternative forms of therapy because the government wants a cheaper way to treat the growing numbers of mentally ill (this could be a good thing as much as bad, but who knows). I don’t recall the statistic for ‘cost to the UK economy from time off through stress or depression’ but it’s pretty substantial I’m sure.

    The green agenda does seem a bit rich from ‘Mind’, but part of the research is aimed at the underlying causes of the (apparent) increase in mental health problems which can’t be a bad thing. IBut mental health is a difficult area for definitve study since the causes and effects vary across individuals and cultures and the factors involved are so numerous.

    These days you only tend to see the catchy/mass appeal headline (or politically motivated ones!). So you’re more likely to read ‘walks in the park can make you happier’ rather than – ‘the underlying combination of exercise and nature can offer a mental, physical and emotional workout for all round catharsis’!

    But I find the most interesting ideas are the ones that are a bit ‘out there’, afterall, you don’t have to believe in something to benefit – it can be interesting or enlightening simply to learn what other people think or believe. Most would agree that religions offer wisdom, whether you believe in God (or any particular religion) or not.

    Ecotherapy/ecopsychology seems to have some interesting theories about mental health problems and what we’re doing wrong to suffer from them (if anything!) But although I found the mind study interesting, I haven’t got to the bottom of this area of study yet. However, I suspect some of the more interesting theories, like the idea that watching sunrise/sunset can be beneficial, will seem too ‘new agey’ for some – but worth a browse, if only to reconfirm your position as a sceptic!

    P.S. Nice blog – such a good idea, you should get paid by the NHS as a consultant to help them sort it out. Tried emailing their marketing or PR department? you could threaten them with bad PR if they don’t pay you attention – but I imagine their quite used to it.

  • 9. Ade  |  November 6, 2007 at 1:41 pm

    I don’t understand why the system is so useless here. But I’ll tell you the solution I discovered: make a formal complaint. All the mental health Trusts have procedures for this; or write to someone senior in the Trust. After nine months of waiting and being postponed and shuffled around the services etc., within ONE WEEK of sending the letter I was offered an appointment which was actually even kept by the specialist involved, with a follow-up appointment already scheduled for a month’s time. Amazing!

  • 10. Ruth  |  November 10, 2007 at 5:38 pm

    I don’t know why the mental health services are useless. I just know that I’m fed up with them. Next week I have a joint meeting with a community psych, a CPN, my GP, me and possibly my Mum (for moral support)… I just hope they don’t turn me away again!

    Thanks for visiting my blog though, it’s always nice to knwo people are reading.

    Ruth

  • 11. exactscience  |  November 10, 2007 at 7:48 pm

    I seem to be a contrarian.

    In 03 when this all started in terms of getting health services involved I was marched to a GP by a friend and spoke with him, firstly about not sleeping and eating to break into it gently then about self harm. My arm was a mess of scratches but nothing too damaging, I was 17 and about to turn 18 in two months. I was referred to the Adolescent Deliberate Self Harm Service and met with a nurse therapist fortnightly and a consultant psychiatrist monthly, I was put on an anti-depressant as well. Lets skip over the suicide attempts – that was mainly because I was being an arguementative prick in therapy.

    Skip ahead two and a half years of depressions and manias and I realise I really need help. I go to my GP about anxiety and self harm, he suggest I see a uni counsellor and come back and see him in a month, three months later after the counsellor recommends referral to a psych I am in his office and he is being a prick about me wanting referral, turns out it was a tough guy act to get me ready for assessment. A month after that I have my assessment, get a bipolar diagnosis. I see my psych fortnightly, a CPN monthly and since September a self harm development worker.

    What I will say is that trying to contact them psych and CPN because Barb – the self harm worker is ace – is pretty tough. In my experience thy are far from useless, not incredibly helpful – my CPN is dire, but better than nothing and it never felt like a battle against the system, just my own fears and paranoias. I wish more people could say the same as me – the mental health team was easy to access.

  • 12. Brian  |  December 1, 2007 at 12:02 pm

    I’ve had many years experience of how UK society should not treat people with mental health problems.

    Lack of empathy, lack of support being told theres ‘nothing wrong with you’ being told to go away. these are apparently the professionals of the service to.

    I am a quiet and submissive person who has struggled for the best part of his adult life with mental health issues. Yes I was forgotton about and abandend byt the state when I was 19. Im now 35 and I have nothing but haterd for the powers that be.

    Every day is like hell for me. and what do i get support wise over the last 15 years.

    ‘6 councilling sessons a year later’ beta blockers for 10 years then moved onto anti depressents.

    Not proper assessment. I even had to read my notes on the computer screen to know I was suffering from ‘agrophobia’ No one said.

    Being depressed with no hope is the norm for me and I’m sure more than me in the UK are in the same boat. I was supposed to go back to my gp for a assessment for medication but you know what why bother. why don’t they just prescribe you a shovel and tell you to start digging.

  • 13. my sad alter ego  |  April 3, 2008 at 10:15 am

    I think that in a lot of socialized health care countries, mental health care is set up to deal with the psychotic only. Everything else, including suicidality, is considered something like cosmetic surgery.

  • 14. jan  |  July 25, 2008 at 9:04 pm

    I too have had bad experiences with cpns have seen 4 different ones. they are too concerned with filling in their tick boxes to listen. i have been judged lied about have witnesses to prove this then referred to mind who said they don’t judge and help people without prejudice of prior experiences. what a lie the cmht telephoned them with a load of lies someone i hadn’t even seen and i was told by mind if they saw me get in my car they would call the police. Been scarred by cmht and mind chinese whispers and all untrue. also looked at my medical notes at doctors you can do this for free. the copy of the letters from the cpn are different to the doctors it says “highlighted paragraphs omitted from patients copy” how can u trust them they don’t care at all only cause trouble with inaccuracies. I am left with no help or support and labelled nuisance bt doctor i too feel suicidal and if someone could find a way out it would be good.

  • 15. experimental chimp  |  July 25, 2008 at 9:48 pm

    jan: I’m sorry you’ve had such a bad experience. This post is kind of old and things have changed a bit for me in the meantime.

    It’s hard to tell what’s going on with Mind and their threat to call the police if you got in your car. The only circumstances I could think of for this to happen would be if they thought that you would be a danger to yourself or others if you were driving. Maybe this wasn’t the case, but if it was, they probably had your best interests at heart. I haven’t had any contact with Mind myself, but I haven’t heard anything bad about them. Maybe you could give them another try?

    Under data protection laws, doctors and other medical people can withhold notes from patients if they feel that seeing the notes would be harmful to the patient. And there are circumstances in which this is justified. I don’t know if that’s the case for you. At least your doctor let you see these notes when you were there.

    Mental health services do sometimes suck. And when you’re ill it’s easy to perceive them as worse than they are. You haven’t given many details, but it seems to me that you have three potential sources of support – Mind, the CMHT and your GP. You’ve obviously had bad experiences with all of them, but you could try to re-establish a working relationship with them. They don’t have to take your side to be helpful, especially if you work out what you want from them in advance and communicate it.

    If you think your GP just isn’t very good, it’s fairly easy to change to another one in most places (London is probably the exception here). What I’d recommend if you want my advice, is to go to see your GP (or a new one) and explain how you feel and what you want, being as specific as you can. You obviously want to feel better, but ultimately it’s up to you to go after the help you need to accomplish this. Re-establishing contact with your GP and finding out what they can offer would be the first step.

    Anyway, I hope you feel better whatever you decide to do.

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Hi, I'm James. I'm a 26 year old guy from England with bipolar disorder (currently well controlled). I also have a circadian rhythm sleep disorder (not so well controlled). This blog has charted my journey from mental illness, through diagnosis and, recently, into recovery. It's not always easy, but then, what is?

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