Tag: CMHT

Moving Community Mental Health Team In Pursuit of Help

Moving across borders within the NHS is somewhat like going on a pilgrimage for treatment. Before you go you are promised that things are brighter on the other side: more resources, more funding and more staff. My voyage -from an area which didn’t have a pot to put pessimism in as far as mental health services are concerned- was tough. The new team didn’t pick my case up for over a month. The team I had moved from, clearly glad to see the back of me, didn’t send any notes over at all. They probably burnt them all in a bonfire to celebrate my departure. Frustratingly this means I haven’t received the findings from the psychological assessment which I waited six months to complete. Three hours of shaking and crying and no one seems to have bothered writing it up. Ho hum.

One thing I have discovered about moving is that community teams like to do their own thing. They trust their psychologists and their psychiatrists, so even if you come brandishing a 100 page assessment they will likely still want to conduct their own. I’m in a bigger team now, so thankfully the waiting times are shorter. I’ve also, for the first time since leaving CAMHS nearly a year ago, been granted a community psychiatric nurse- something that a staffing crisis caused short supply of in my original county.

So I have a community psychiatric nurse, or CPN. A CPN’s job is to work with you towards recovery or towards getting some form of therapy.  They know about medications and, hopefully, all the symptoms you experience. They are generally very useful people to have on your side.

When… Let’s call her *Sue… Turned up she had no knowledge of my background. No transfer notes and no discharge summaries- she didn’t even know that I had been out of children’s services and inpatient for six months. Nevertheless I was very glad to see her, with visits every fortnight and her specialism in mental health rather than social work she is the first mental health professional I’ve had regular appointments with since inpatient.

Being in a bigger NHS trust certainly has it’s benefits as there are more support groups and, though still not many, a lot more resources. Coming out of the first meeting with Sue I had a psychiatry and psychology referral- something which took an age to get in my old trust. Over the last few weeks I have been trying to get to know her as my CPN and tentatively hoping that the support won’t fall to pieces beneath me- a process I am too familiar with.

Obviously it is a drastic decision, one that is pretty hard to research, but if you are in a rural area and a smaller trust it might be worth looking into moving to a bigger area. You are playing with fire as if the area is too big and not split into separate teams the service might be swamped with high demand. It’s also worth remembering that you can ask for a referral to a suitable consultant anywhere in the country through your GP. If you live in or near a city I have found that they tend to have better resources with and without the involvement of NHS mental health services. Some have excellent services a like crisis cafes and support groups. Our NHS mental health resources are a postcode lottery, it needs to change.

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For The Mental Health Team Teach Me So.

When she picked up my call two days later I was covered in glue from trying to stick the jagged shards of myself back into an almost human-like form. I’d been rebuffed by people I trusted, dramatically shortened said list of trusted people and shattered into a thousand pieces.

Why?!

A meeting had taken place which I had not been invited to. It was about my care, the roles of the professionals around me (which I am forever being told I misinterpret) and setting goals for my recovery. Why couldn’t I be involved in this? What did they not want me to hear? They tell me to be responsible for my recovery but give no opportunities for me to do so.  The summary I got from my co-ordinator involved the words ‘responsibility’ and ‘independence’ many times. According to CAMHS I had these skills in abundance- have they vanished?! Did I never have them?! This lack of communication and influx of mixed messages is what they laughingly refer to as person centred care. Let’s summarise:

So far the community mental health team have taught me:

  • I should phone them more often.
  • But if I do I’m being dependent.
  • If I try not to be dependent I’m not being proactive.
  • If people do the wrong thing and hurt me I should have ‘taken responsibility’.
  • If I do ‘take responsibility’ then I should be more cooperative and trust.
  • If I give them trust they will break it.
  • If I didn’t reply to emails I’d be non-compliant.
  • If I send practical emails I’m breaching boundaries and being inappropriate.
  • Despite being a full time resident in my body I am not a professional.
  • Meetings are for professionals.
  • Professionals will make decisions in meetings I don’t know about.
  • I am not being proactive because I’m not making decisions I don’t know I have to make

Basically the only message I am getting loud and clear is that I am a dung beetle to the service. However this analogy does suggest something about the service itself…

I’m so confused, I don’t know what to do because every move I make is wrong.

CMHT- what do you want from me??

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(They close for two weeks over Christmas… Ho Ho.. Huh?)

Facing Giants

After the saga that was my ‘peer mentoring’ (dis)appointment I didn’t do too great. On the day I posted my blog I ended up being semi-dragged into the walk in at the Community Mental Health Team office. I expected the worst, “WHY ARE YOU WASTING OUR TIME?!”, and all the other phrases I have become accustomed to.

But it didn’t come. I took one of my support workers and just talked for a bit. I expressed my concerns about having a care co-ordinator who is under the illusion that I am just a disobediant child and how everything felt very hopeless. It was the CPN from the previous meeting and she listened carefully and said she would take it to the Multi Disciplinary Team again the following day.

My phone eventually rang mid afternoon on Friday. I was told that a change of Care Co-Ordinator had been granted and my CCO was now the CPN I had seen as a walk-in. I was over the moon, this CPN had understood me so much better. I cried with relief.

My first appointment with… (time to think of a pseudonym)… Esther… was this afternoon and it went really well. We played the facade of ‘who sits where’ that always comes with a patient and worker entering one of those small white room for the first time; our positions yet to be molded by therapeutic routine. I took the high backed seat nearest the door and hoped dearly that my choice wouldn’t be psychoanalysed. We talked about my moods and how they are erratic and the ‘base work’ that needs to be done whilst I am on the enormous waiting list for therapy. Things like emotional understanding, trigger recognition, crisis prevention and so on. Generally the aim is that I will feel better for a bit before therapy churns everything up again but I should be able to deal with it. We didn’t pick up anything heavy other than the very background details of my trauma. Esther noted down a few of my questions so that she can ask the psychology team. She also reiterated that she will be having supervision from the psychologists following our sessions to make sure she is doing the right things to help me. Again with the complex case stuff: cringe.

It might be my ‘exaggerated moods’ but I feel super happy. Like everything is going to turn out fine. The lions den wasn’t as scary as I feared. The lion has been replaced by Esther the domesticated moggy!

I felt this picture fitted well. Mél and Noodle properly met each other for the first time yesterday. Of course at first I took err on the side of caution- holding Noods back, just in case. Both girls were amazingly brave. Soon Noodle was stretched out with her head on my knee, Mél perching in her ball pocketed between her back legs and stomach. They were both looking up at the TV and the scene was too adorable to not capture. It made me think about my CMHT situation and how sometimes the scariest situations can go smoothly. I’m not complaining that the end of this story is anti-climatic. I don’t think I could have taken another plot twist!