Uk Nhs Therapy

[anthony]

Yer, that does suck.

I actually couldn't tell you the state of mental health care in Australia... as I am privately taken care off whenever I need it through veterans affairs. Our DVA is different to other countries, where they don't force you into some bulk building for veterans, and instead are all handled privately by any person you choose who deals with DVA funding.

Public mental health... no idea where a person would even go here. GP maybe, then referred to appropriate sources??? Never experienced it...

 

[Ladyhope Somerset]

In our area of the UK, it sounds like similar to yours Meadowsweet.

Referrals to Mental Health Services are seen by one or sometimes two members of the assessment team. They are a specifically experienced multi-disciplinary team of psychiatric nurses and social workers. They can refer you for CBT (NHS standard) and in our area this has been contracted out.

It depends on how honest you can be at your assessment, about your current situation and how your symptoms impact on your daily life and IMO, CBT would be a good place to start. If you develop a good rapport with the therapist then you will know if you have the necessary trust to do more specific work.

best wishes

Just my opinion

 

[Meadowsweet]

Im sorry to hear about your experience ptsd sufferer, hopefully it will be better in my area.

I am quite worried that he has referred me for EMDR. But, I've been looking up therapists who practise EMDR in my area and 3 out of 4 of them also use CBT. Of course the NHS might not use any of these particular therapists, but as it seems quite common for therapists to offer a range of therapy techniques, I'm hoping that whoever I'm referred to will be able to assess and offer whatever they feel is best for me.

 

[PTSD sufferer]

I hope you have better luck too Meadowsweet, and you won't know until you give it a good try, will you :) My area is very under resourced by the way...too many patients and not enough psychologists....so that probably is the reason for my specific case.

I am quite worried that he has referred me for EMDR. But, I've been looking up therapists who practise EMDR in my area and 3 out of 4 of them also use CBT.

Anthony corrected me on this too...so I'll pass on his message....

EMDR is a part of CBT. If you take a look at the link Anthony posted, there is an image at the bottom that explains that CBT (step 2 in particular) can involve EMDR. If there is no EMDR, then you are getting CTT (cognitive trauma therapy) not CBT (cogantive behavior therapy)...confusing I know...don't stress too much about the names of therapies until your therapist has had a chat with you and talked through a plan of action.

 

[maddog]

God, maybe I'm just triggered by anything this morning... or upset by anything at least... but all this talk of months on waiting lists, tick-a-box assessments by social workers, "take it or leave it" therapy non-choices and the complete helpless lack of control over your treatment choices that so many of you seem to have to deal with... it makes me feel sick. It appalls me, disgusts me, and many other words I won't use on a public forum.

And in the end it just makes me sad. Seems that public health care all over is in utter demise, and it's the people who need it so badly who suffer.

I am so so so very lucky, my tangling with our own mental health system has been comparatively minimal. The first professional I ever saw was our workplace psychologist and I went to see him almost as a desperate afterthought when I became convinced that I was going insane. In the midst of an escalating workplace crisis, I just thought "maybe this will help..." - and the rest is history. The likelihood that this person would be a random good fit for me, would possess the expertise, confidence and willingness to work with me on what turned out to be very very different issues from those with which I presented and would be able (within the confines of his workplace contract) to dedicate the time and duration of intervention to me, was obviously very, very low. And yet somehow it happened.

21 months later and he is the only psychologist I have ever seen, which suits me perfectly for now and the foreseeable future. He is brilliant, well matched to my personality and extremely holistic in his therapeutic approach. He is also willing to seek whatever training and professional development he/we identify as being potentially useful and is prepared to be open minded to anything that has a decent evidence base to support it... and all without my paying him a cent.

I have had the sobering reality of having to deal with 3 psychiatrists. The first arrangement was orchestrated by my workplace, paid for by them and did not require the usual process of referral by a GP or any appreciable time on a waiting list. I saw him for 5 sessions and am of the firm belief that the man is not only uselessly incompetent, but is also practicing fraudulently and should probably be reported to the relevant authorities for investigation of malpractice. Sheesh! Accepting only cash for his services is the first and least of many complaints I have about him. Thankfully T attended a session with me at my frantic insistence, was appalled and so infuriated that I thought he was going to take the guy apart in the middle of his surgery, and agreed with my assertion that I never return.

For someone who is almost obsessively anti the medical industry as a general rule, this was not very helpful to my future willingness to engage.

Psychiatrist no. 2 occurred in the almost conventional manner - I went to see my GP, asked for a referral and then, in a stroke of what is not uncommon luck if you're fortunate enough to fluke it, she identified a friend/former med school buddy of hers who she believed would be a good fit for me but who was unfortunately not taking on new patients at that time (this is a very very common situation with many medical specialists being full to capacity). So she rang her buddy, called in a favour and 2 weeks later I was in the psychiatrist's office.

This person, while much more professional, genuine and well-intentioned, wasn't a trauma specialist, didn't seem to have a lot of non-medication ideas (and the drugs she was prescribing were proving to be greatly ineffective) and charged the kind of mini fortune per session that I absolutely could not afford. The Medicare rebate was minimal and I was literally hundreds of dollars out of pocket each visit. My subsequent research revealed that this person was charging on average almost double what most other psychiatrists were charging, and I have absolutely no idea why. Let me assure you that the quality of her treatment did not reflect her insufferable price tag.

And so it was time to move on... again. After more toing and froing and uncertainty as to whether or not I even needed a psychiatrist (certainly not for therapeutic intervention, though T was addament that the extent of my instability at the time warranted a professional with the ability to facilitate a quick hospital admition to a private facility and drug intervention if needed) I was again unspeakably fortunate to discover that my boss at work (who is one of my greatest supporters) is a personal acquaintance of one of the so-called leading trauma specialists in the country. Phone calls were made, favours exchanged and there I was, less than a week later, sitting in his office.

Needless to say I'm pretty underwhelmed and after several months of mostly weekly sessions (very rare with psychiatrists in this country from what I gather) I am still wondering what it is that this person can/has contributed to my recovery at all. But for now I am prepared to keep him on the treatment team as an insurance policy more than anything else.

All of that longwinded personal jibber simply to say that I am still trying to come to terms with just how fortunate I have been in contrast to so so many of you, and all through good luck and not good management on my part. And with conditions surrounding mental health funding, in this country at least, seemingly going from bad to worse, it does make me fear for the state of the future.

Wishing there was a way we could all find the treatment we deserve - it's a long and difficult enough journey anyway without mere access to it being so almost impossible at times.

Maddog

 

[Oberons Wife]

mmm, it's very sad, the 'going around in circles' and 'hitting your head against a brick wall' required before you find the therapy you need.
I do wonder if there are loads of people training as Doctors, because their parents are Doctors and it's expected, but not actually appropriate to the individuals personality. There are afterall plenty of horrible ones out there,.... so it's brilliant to hear of some good ones. :)

 

[Blondie362]

I first visited my GP I realised that my childhood onwards had really started to catch up with me mentally and went to see my GP, I was then referred for an assessment at the CBT clinic, diagnosed with CPTSD and had to wait over a year to get in to see a therapist, I had therapy for 15 months then she left and had to wait to restart with another CBT therapist, I now have a care coordinator/support worker and have seen a psychiatrist who prescribed further meds and is really good, although the wait time was horrendous, I now have a team of three now who meet to discuss my case and where to go next and what options are available.

I recently had a discussion about EMDR, but my therapist has decided that this probably isn't for me as I seem to hold onto to trauma's and can't process them as I should be doing, so is now looking at another avenue of therapy, if you can get the team behind you, thats half the battle- also having a supportive GP is crucial.

MH help in the UK isn't well funded and the waiting times are long, but if you can get the right team behind you, it really can help , I know certain area's in the Uk are worse than others, I have been lucky but we do need more money for MH sector in the NHS.

 

[Meadowsweet]

I thought I'd come back to this thread, because I think I've found some answers to the questions I was asking almost a year ago. Also, because there are others who seem to be having difficulty with the NHS.

As I mentioned in the first post, I went to my GP in September 2011, she refferred me to the MH team for assessment.

In some ways it is my fault for not revealing a long list of trauma at the initial assessment. But, during the assessment he asked me about my symptoms at that time, not about my history. So I only spoke about symptoms from one trauma.

So I was referred to a tier 1 therapist. She is experienced in CBT and trauma focussed CBT. And she is strictly limited to no more than 20 sessions. The first 3/4 of those sessions are used for further assessment, for her to get to know further details of the person and to build trust.

In the next couple of sessions my dissociation became apparent. When we did re-living, childhood stuff became apparent. Then she was off sick and I coped by dissociating and seperating. So by the time she got back, there were 12 sessions left, and she felt my trauma was too complex to be treated in that time, and the risk of destabilisation was too high.

what happens in the UK if the therapy youre offered isnt effective? and...do you get offered a limited number of sessions and then get told to get on with it? or are you assessed again at the end of the initial treatment?

So in answer to these questions: yes, there are a limited number of sessions. You are re-assessed at regular intervals to see if the treatment is having an effect. But, if the therapist is not able to treat you in that time, it is probelematic.

I was given a choice to be referred to tier 2 MH. There I would be re-assessed in light of my additional needs (dissociation etc). Then, I would be prioritised - or as I'm not a danger to myself or anyone else, I would be de-prioritised. And I could expect the wait to be at least 12 months. Then there is no guarantee that therapy wouldn't be limited (as currently NHS is trying to cut services).

Thankfully, my therapist was helpful as she personally gathered details of other options (charities) that might suit me. So I've chosen this way.

The other thing that is worth mentioning, is that if I had some therapy, but then felt it necessary, I could go back to my GP and be referred again for a full 20 sessions at tier 1. If this was the case, my therapist would still have my notes, and we could get into therapy in session 1.

 

[Ice_Fire]

This is problematic, as you know, me and the NHS aren't seeing eye to eye at the moment. Right now, I'm stuck not being even able to get a referral to get a CPN, or get onto any level one services. I think I'm going to have to stick with Mind and just forget the NHS...

After meeting a CPN (one off) and being assessed, I've not had a squeak out of them, despite making numerous trips back to me GP. The two areas; my GP's surgery and the mental health team don't seem to be communicating with eachother?!

Rang the mental health access team earlier...so, whether I'll get any further now remains to be seen.

 

[amethist]

Keep on at them Ice_Fire.

I yelled and kicked at doors to get my husband looked at properly in the beginning, and then kicked off when the first lot from the Mental health team turned round and said they knew nothing about PTSD. The guy he has now did not know much, but took time to find out and understand as best he could.

For your own sake, dont let them fob you off.

 

[Ice_Fire]

Thanks Amethist. I've just found this leaflet online (am I allowed to post the link, it's an NHS publication?) and it says: 'If you have symptoms of PTSD, your GP will normally refer you to a
specialist clinic where a psychological assessment will be undertaken
by a psychologist or psychiatrist. A diagnosis depends on your symptoms meeting specific criteria'

This publication is from my area, so...wondering whether to ring the access team back on Monday, or go back to my GP and quote that at them and see what they say?

I hate admitting it, but I just can't deal with it all on my own. :(

 

[amethist]

Do both Ice_Fire.

If you can avoid it I would not go to A&E unless you are in full blown melt down. The crisis teams are less than useless unless you are a danger to yourself. They will pack you home with meds and a letter for your GP.

Though it could be a way into the system.