I've been trying to get help continuously for almost four years. In that time I've been fobbed off, told i'm on waiting lists for therapy then discover they're lying. I get randomly discharged, or referrals from my GP ignored, even when I was in hospital thry discharged me suddenly and entirely from all services, without any treatment. Despite them all agreeing I need therapy (for the first 3 years anyway, they won't engage with me at all now).
They say they won't see me cos I missed 5 appointments, but I've only missed three and they didn't tell me about one of them. The other two I missed cos my friend cancelled on me at the last minute and I was not in a state I could leave the house on my own. I was suicidal for 5 days curled up in bed as my means to survive on the last occasion, desperately needed help but couldn't get there. When I explained this they just keep repeating "you have to show up to appointments" and blaming me. They refuse to see me at home, and their whole manner is of blame and annoyance. I feel like a worthless waste of space as it is, it feels like they want me to go away and kill myself.
I have tried getting in touch with head of services (all services for area), in one instance he arranged a psychologist to assess me, she was shocked how I'd been treated and said it was obvious I was suffering from the effects of trauma. I was put on a therapy waiting list for nine months, which turned out to be CAT which was highly unsuitable (because it assumed I was doing crazy **** which was making me feel bad, no chance to explore the nightmares from the past) - however the therapist said I was unsuitable for ALL forms of therapy. This is not true, I am now seeing a private therapist who actually listens and treats me like a human being. However this is time limited due to finances and obviously she can't provide more support than our weekly session anyway.
More recently I got in touch with the head of services again (March I think). He arranged for me to have a 'proper' assessment. Unfortunately his idea of a proper assessment was to get the head of the CMHT to do it, not a psychologist or someone who actually gives a damn. So it was just me and her, and as per usual she was a horrible bully, being all sweet to my face but point blank refusing to help, god knows what she was writing in her notes about me.
She refused to take me on or let me have a CPN (apparently she 'can't see the need' despite me struggling so much to do basic things and needing support alongside therapy). She said I wouldn't need to see a therapist as I'm seeing one privately (what a bitch! So she can refuse to let me see one on the grounds of being 'unsuitable', yet when I prove i'm suitable by getting on in therapy she says I don't need an NHS one!!! Evil, evil bitch!!) She also delayed me even meeting the NHS therapist last year cos they claimed I needed a CPN for support around therapy, however suddenly even though I'm going through intensive therapy I don't need one?!
If I ever point out their weird double standards or lies they've told, they claim they never said such a thing, or more usually they just speak loudly over me or even hang up the phone. When I try to be heard they say "stop shouting, i'm going to terminate the call now".
If I sound angry it's cos I have every ****ing right to be, four years of my life down the pan dealing with these abusive bullies. I want to hurt myself everytime I speak to them or think of them, trying to remain angry so I dont turn it on myself.
"I have a room for life at the home for the chronically groovy!" - Sgt Floyd Pepper
I don't think the CMHT hate you. Whether it's three or five appointments, it's still quite a lot to miss, though I do understand you have reasons for them. Because of the difficulties with engagement, there are often a lot of missed appointments, and CMHTs usually have quite strict policies to deal with this; it might be worth looking yours up as they're often available online.
It sounds like there's quite a lot of animosity between yourself and the CMHT at the moment, and I'm wondering if they are the best people to help you right now, or if another service might be of more use. There are always various mental health professionals outside of the CMHT.
Another option would be for your GP to formally refer you. What does your GP think of all of this?
It doesn't matter where you come from; it matters where you go.
No-one gets remembered for the things they didn't do.
We won't all be here this time next year,
so while you can take a picture of us.
We're definitely going to hell,
but we'll have all the best stories to tell.
My CPN used to tell me that if you missed several appointments then they would discharge you. She didn't agree with it because there are some people who struggle to leave the house due to their illness, but those are the rules. :/
I'm fine! Totally fine. I don't know why it's coming out all loud and squeaky, 'cause really, I'm fine!
Yes but if I cannot get to appointments cos I'm too unwell, what am I supposed to do? They refuse to see me at home, and the last appt. they told me about at such short notice I couldn't arrange anyone to go with me except the friend who had let me down the time before - he let me down again. And if I can get to the appt on my own then they're never seeing me when things are bad (also it's not safe to go on my own cos I find them so difficult I need someone to talk to afterwards).
Also, it's not like I have regular appointments. I was re-referred by my GP back in February and didn't get an assessment until late May. They didn't think to actually let me know I had an appointment though... When I finally did see her in June, she said they wouldn't be taking me on or offering a CPN. She just said it was good I was seeing a therapist whilst also saying they think I'm unsuitable. She kept smiling whilst delivering her poison. I tried to explain that just by leaving the house I had to put a 'mask' on and explain things calmly so she'd never see the pain inside or believe me. So she said as a compromise she'd give me one more appt in a couple of weeks as I go up and down (well down and less down) so she could see a 'bad time' too. Then my friend let me down again. But she already said they'd not take me on, so it's nothing to do with missing appointments. I pointed out to her that I know people who NEVER show up to appts. and then get chased to hospital, so obviously missing appts. isn't an exclusion criteria! She refuses to tell me what's really going on.
"I have a room for life at the home for the chronically groovy!" - Sgt Floyd Pepper
I don't think there are any hidden messages in how the Cmht are treating you. They are over stretched as it is and can't afford to offer someone appointments if they aren't going to use them. Did you talk to her about not being able to leave the house without someone? Did you call them to let them know you wouldn't be coming when you missed the sessions?
And they DO hate me, or something weird is going on. Why have they messed me around for so long? I used to have a boyfriend who'd accompany me to appointments so I didn't miss any, but they still refused to engage with me (they don't like it when you say it back at them...)
Why promise me proper in-depth trauma-informed therapy then fob me off with CAT? Why give me appointments at all if they've already decided not to help? Why lie and say I'm on waiting lists when I'm not? And the constant rudeness and fobbing-off, annoyed manner they have is very upsetting.
@ Talaiporia - My GP has formally referred me, lots and lots over four years. They ignore them, or discharge me without doing anything.
What other services are there? Apart from IAPT of course who I'm deemed unsuitable/too high risk for (knowing a bit about CBT etc I'd agree.)
"I have a room for life at the home for the chronically groovy!" - Sgt Floyd Pepper
Yes I did explain in advance about not being able to leave the house. I also tried to make sure someone was there with me, and explained all this to them. Also i've only missed TWO appointments, both cos someone let me down!!!! They didn't tell me about the other one, it's so frighteneing they can use it against me when I have no way of stopping them. its so scary it reminds me of things in my life people can hurt me and i am powrless to stop them, they just blame me im not good enough and must die
"I have a room for life at the home for the chronically groovy!" - Sgt Floyd Pepper
They make you promise to do things you cant really do, if you try to explain you wont manage they just get cross and say things like "well if you refuse to engage we cant help you". So you have to convince yourself you can make it and then if it goes wrong they get even more cross, even though you tried to be realistic from the start.
When I was in my late teens/early twenties I went through all this and it was hell, they even got me exlcuded from homelessness services and things so I went through quite a lot without support. I'm trying to heal from it but they seem to relish picking open old wounds and making the nightmares happen again. Why can't they even act vaguely supportive? They assume you have lots of people who can drop everything and help, they don't understand that it's difficult to find someone who can spare a few hours on a weekday with 2 days notice.
"I have a room for life at the home for the chronically groovy!" - Sgt Floyd Pepper
Like Beckie says, it's a shame, but they're usually pretty strict about missed appointments. Ultimately if you've missed that many appointments, then you're probably not getting much out of them anyway. It also sounds like they have offered you alternatives that you've declined as unsuitable. Like Katie says; resources are stretched, and they can't keep pushing with people who won't/can't engage.
From what you've said it seems like you're so angry with them, that you'd not be able to have a working relationship anyway. I think it'd be worth going back to your GP and seeing what they think and what they suggest as a way forward.
It doesn't matter where you come from; it matters where you go.
No-one gets remembered for the things they didn't do.
We won't all be here this time next year,
so while you can take a picture of us.
We're definitely going to hell,
but we'll have all the best stories to tell.
Call them and tell you you need a different appointment when someone is available to go with you. Don't just not turn up. It looks like to don't care about their help making it seem your not engaging.
If you were willing to engage you would make an appointment that's more suitable for you.
The average,
well-adjusted adult
gets up at 7.30am feeling just plain terrible.
Call me Kate.
I have dyslexia so please excuse my poor spelling and sometimes poor understanding.
I just wanted to add that CAT is very much for trauma, I've just started it and it is very helpful. I would encourage you to go back and ask to be placed on the waiting list again. Also, it may not be delivered at the CMHT so you could end up with a different service that meets your needs better.
Ultimately if you've missed that many appointments, then you're probably not getting much out of them anyway.
I've missed TWO. They didn't tell me about the other(s). How can I show up if I don't know?
As for 'not getting much out of them' - they only ever offer 'assessment' appointments, i've not had any counselling, talking about stuff, ongoing appts. etc - at least not since 3 years ago when I had a CPN who came to my house every fortnight. (That was very helpful til she randomly discharged me... at a very low point when I'd just been in hospital for the first and only time.)
This time, they agreed to 'assess' me and on the first appt said they wouldnt take me on. Not sure what I was supposed to 'get' from that appointment? She wouldn't tell me why they wouldn't take me on and I was so frightened because of all the feelings jumbling round I semi-dissociated and it is hard to speak up for yourself at all then. It was all I could do to calmly leave and had to cry in the loo a bit before I'd calmed down enough to face my friend and walk home.
They have refused home visits (even for assessment; regular appointments with more than 2 days notice would be manageable even if I needed help getting there), refused to talk to me on the phone when I called to say I couldn't get in because I was in a really bad way. Also I know missing appointments as a result of being unwell isn't an exclusion criteria on it's own, and that others have home visits, but they won't explain what other criteria they are using to exclude me. I hate being lied to, if they do it by diagnosis or something why not just say so?
Quote:
Originally Posted by talaiporia
It also sounds like they have offered you alternatives that you've declined as unsuitable. Like Katie says; resources are stretched, and they can't keep pushing with people who won't/can't engage.
They are not 'pushing'. It is them who discharged me, or ignored referrals, repeatedly (for almost four years). With the CAT I only got an 'extended assessment' but I kept going (cos it was a regular time I was able to arrange a friend to walk there with me) even though I found it upsetting and it seemed to be missing the point. I was open and honest with the therapist. Even though it's horrible to be recounting, and remembering properly the stuff you've tried to repress to keep going, and then have the therapist say "I just can't understand what you're doing now that makes you feel so bad". Then I am left with the terrifying emotions and memories, trying to deal with them without being able to 'talk it through' like I can with the private therapist. I felt like I was being blamed for stuff that's happened to me and should suppress it all and 'be ok' cos that's what the therapist wants!
If they don't offer the kind of therapy I need I'd rather they said so, instead of making out it's me who's unsuitable 'for any type of therapy' (I quote). (Interestingly, this came up in private therapy yesterday, and she was appalled I'd been offered CAT, she said I was very analytical already and actually needed to be in touch with my emotions... the major theme coming up in therapy is that I constantly check and analyse myself and try to have appropriate reactions so as not to have people cross with me... feeling like I need to please everyone to be remotely 'acceptable' and still not 'good enough'... quite how too merge this with real life I don't know yet...)
The CMHT have offered me no other alternatives - in fact they only agreed to take me on/give me a CPN because of the therapy (which as mentioned was arranged after beginning to make a complaint). Once that was deemed unsuitable (by them; I would have kept trying even though it felt wrong) I got discharged althogether (this was last November). The therapist wrote in the discharge letter that I kept dissociating when talking about painful things; but she saw this as a problem rather than trying to engage - the private therapist will talk to me as at these times I say the most honest things and have insights from them as I 'come back' to myself. It just seems so weird as if an awful lot of the mental health team - even therapists - seem to have little idea how to talk to people in distress, in fact some even seem to have no interpersonal skills at all. I cannot imagine speaking to someone else the way they have spoken to me. And I have no training! (maybe struggling like this is a kind of training?!)
Quote:
Originally Posted by talaiporia
From what you've said it seems like you're so angry with them, that you'd not be able to have a working relationship anyway. I think it'd be worth going back to your GP and seeing what they think and what they suggest as a way forward.
The GP doesn't know what to do - he can't understand why they won't help me. The primary care option is bsically the IAPT place, but they won't take me on for being a 'complex case', needing different kind of therapy than they offer (and for longer). I was hoping they might reconsider for things like mindfulness as I'm seeing a private therapist for the serious stuff but not sure. Also I don't know how well I'd be able to engage with that kind of thing precisely because of the problems I have, it all depends if it's a 'good day' or a 'bad day'. It just feels like they (secondary services) won't/don't provide what I need, yet primary care services say I'm too unwell for them. Everything leads back to the CMHT who say 'computer says no'.
I think being angry at them is a step forward. The alternative is reinforcing how I feel deep inside which is that I'm not worth as much as others so why should anyone care? And that I'm just not good enough to do life properly or be happy, i'm not ill or struggling just a stupid useless failure and they won't help cos I'm a hopeless case.
But I think to myself: if they treated a friend of mine like this how would I feel about it? Would it mean they were worthless or that we have an inadequate system? And as for the interpersonal rudeness and unwillingness to be honest, that does not come down to funding so the people doing it are, frankly, wrong to treat people like that.
You are right I probably should give up trying to get help from them. I'm just so frightened cos the private therapy could stop any time if the person paying decides so. The CMHT feels like constantly going back to an abusive relationship. Trapped, powerless, but needing something from them. It's awful and so confusing when things are getting worse and you know you should probably ask for help before it gets worse, but there's no-one to ask, and you can't tell if you're being pessimistic cos your depressed or if it really isnt worth contacting them.
I might sound like I'm being strong but inside I feel very very alone and not strong.
"I have a room for life at the home for the chronically groovy!" - Sgt Floyd Pepper
If you were willing to engage you would make an appointment that's more suitable for you.
I didn't know until the last minute that my friend wasn't coming with me. I have said this upthread.
When I phoned to say I couldn't make it, I explained I was in a bad way and suggested we could have the appointment over the phone, although not the same as face to face as I was 'in the middle of it' I could articulate what's going on inside better than when I had put the 'going outside' face on. She refused this suggestion.
Also when they offer appointments you tend to get a letter just a day or two before (but dated earlier) and if you call to rearrange it they get cross. I get frightened and this 'eager to please' thing takes over, this is also why I can easily be bullied into saying I can do things I cannot - I could tell them in advance I need a home visit but if they point blank refuse or hint I'm not trying hard enough then I get scared and agree to whatever they want. What else can I do?
It's also very hard in a better patch to remember quite how bad things are in a bad patch... and they jump on board with this thinking and when the crash comes it's so much worse because you were encouraged to believe you wouldn't feel that bad again. I tried to break the "I'm fiiiine and will never feel bad again!"/"Argh must die" cycle when I was younger, but it seems that the way they act encourages it... and other dodgy thought/feeling patterns.
It's very upsetting to hear all this "not willing to engage" stuff because as I said it's been four years... I have 'engaged' and they kept discharging me. I asked for help when I could manage better to jump through their hoops. I have been honest and feel like I've bared my soul only to have it trampled over by them.
"I have a room for life at the home for the chronically groovy!" - Sgt Floyd Pepper
I wondered have you actually asked for an explanation as to why you keep getting discharged from them?
They give different reasons, which don't make sense. For example the therapist wrote (in a letter i'm not supposed to have seen - thanks GP!) that I felt let down by services so my GP shouldn't refer me again. She wrote this in my discharge letter. However, in reality the only time I've mentioned this, I made it very clear that it was in the past in a different area that I felt let down (I had been excluded for having a BPD diagnosis that was informally and inapropriately made). I said I knew things were different now and I was in a different area with different professionals who I was eager to work with, but had just mentioned in passing the fear and shame and aloneness I'd felt previously cos I still have intrusive memories of that time and things that happened (police cells etc.)
I have also said I know that services are overstretched so I'd rather they just said "we only take on people with psychosis" or "we don't offer the kind of therapy you need" than fob me off with excuses that don't make sense. Especially, as I mentioned, when I try to understand or ask questions to get to the bottom of it and she talks over me.
Last edited by earthbound_misfit : 10-07-2014 at 02:26 PM.
"I have a room for life at the home for the chronically groovy!" - Sgt Floyd Pepper
I just wanted to add that CAT is very much for trauma, I've just started it and it is very helpful. I would encourage you to go back and ask to be placed on the waiting list again. Also, it may not be delivered at the CMHT so you could end up with a different service that meets your needs better.
It wasn't me who stopped the CAT - it was them. They actually presented it to me as "an extended assessment to see which kind of therapy would be suitable", but all the worksheets were CAT ones and afterwards they admitted she was a CAT therapist (but still felt she could say I was unsuitable for all therapies). Thus they would not take me back - the therapist even said my GP shouldn't refer me again.
Anyway... I am very interested that you find CAT helpful for trauma. I had heard this before so was keen to get on with it, but the process seemed utterly unsuitable. I wonder if the therapist wasn't very good? (Although she seemed like a nice person.)
The thing I found difficult is that it seems to be about looking at why you behave a certain way and the thought processess and historic events that lie behind it. So for example certain things might trigger bad feelings so you respond by self-harming. So you need to work out where those feelings are really coming from and adjust your response. Thing is, I have spent years doing this myself. So I am pretty good at saying "I am feeling this cos of x,y,and z," and as more memories and insights happen I piece it together. I don't respond by doing anything, apart from self-comfort eg. making tea, and telling myself the feelings will pass (this is very hard when in the middle of it as I'm sure you know!)
However, it doesn't stop the feelings being crippling. Sure, I'm not being dragged to A&E or self-harming, but being curled in a duvet drinking tea is also not compatible with living and causes genuine problems that feed depression - eg. missing out on things I'd like to do, or friends finding it hard to be around me when I am 'shaky' (the ones that don't mind are truly awesome), or being unable to hold down a job. One of my friends described me as "the most pro-active depressed person I know" and another pointed out I am actually very good at 'talking myself up', I just have this mass of pain from the past I need to go through with support.
I felt like I needed to address (and still identify a lot) of the feelings, sort of deal with them and lay them to rest. But CAT seemed to be about addressing behavoirs that follow the feelings. It's like they don't care how dreadful you feel or how crippling that is as long as you don't bother anybody. I don't do anything crazy, I just hurt alone and cope as best I can, but would like not to hurt so much.
ETA: As mentioned in earlier post, the CAT therapist actually said "I just can't understand what you're doing now that makes you feel so bad". She just didn't seem to understand that the feelings pop up as if from nowhere (esp. in nightmares and first thing in the morning) not related to any conscious action of mine.
How does this compare to your experience? (If you don't mind me asking, sorry I know it's very personal).
Last edited by earthbound_misfit : 10-07-2014 at 02:42 PM.
"I have a room for life at the home for the chronically groovy!" - Sgt Floyd Pepper
I can't quite concentrate on reading all of your replies, but I just wanted to say my heart absolutely goes out to you. The system is rubbish and unfair and inconsistent. It makes me so angry to see people like you ignored and being made to suffer and not have the quality of life you deserve, whilst others are given all the support they could ask for, bounce in and out of hospital using up the precious resources of a stretched service, do nothing to actually help themselves and all the while are loving the drama and attention.
I was discharged for missing one appointment (years ago), because it was an assessment and I was living on a pile of bags under my desk, didn't think I was a real human and didn't know how to leave the house. Sometimes mental health services are idiots and discharge the people most in need. I found out later that it's actually a responsibility thing (?) if they're not "treating" you they wont have you on their books encase you become ill, they don't want to be "responsible".
I also had an issue with referrals, but mine was being a hot potato and referred to about 6 different departments before someone decided to actually meet me. I'm not sure if it's because I'm a human and they're looking to treat a pile of bits, or if there's something in my notes that scares them off. Probably the latter.
I will tell you this: if they have made a mistake with discharging you, they will not tell you. They never admit to their mistakes. You will get a very good sounding explanation that doesn't actually make sense in the circumstances.
I hate it when therapists think there is something you or doing, or a way that you are acting that's giving you depression, anxiety, or intrusive thoughts. It's like saying "you're doing this to yourself", you think anyone would CHOOSE this? Sometimes I'm on top of the world, other times I'm down in hell, I have the EXACT same thoughts only they way I feel is different.
I hope you get in touch with PALS and keep complaining, because they are probably scared to deal with you because of your past complaints and are hoping you will just go away, which means that unfortunately the only way you will get help is by kicking up a fuss. Self fulfilling prophesy.
I may be lost in the chasm between my goals and reality, but I'm floating gently across on a cloud.
