To be upset about being discharged?(19 Posts)
So I've been with secondary mental health services for nearly a decade. I have a cpn who I see regularly (about every 2/3 weeks) and appointments about 3 times a year with a consultant psychiatrist. I'm on three different medications and have been hospitalised and sectioned in the past. I still get a lot of paranoia, psychosis and I need more sleep than it is possible to live a normal life around. I'm piling on weight with my medications (I've gone from a size 10 to a size 16/18 in less than a year) and I have to live with my parents or else I wouldn't cope with day to day tasks.
Anyway, my cpn has told me I'm going on a cbt based course and then she will be discharging me back to my gp.
I know I should be happy that she clearly thinks I'm stable, but I don't feel stable and I'm really upset that she seems to think I'll not improve from this. If I relapse I will have to either be treated by my gp (and GPs don't like touching the types of meds I'm on as they are complex) or go back on the waiting list with the pot luck of what team I'll end up with rather than the excellent people I have now. If I do have a serious relapse it has taken me 48 hours in the past to go from wobbly to in hospital.
Aibu to be terrified?
YANBU but there just isn't money available for mental health services. At least not in my area.
I OD'd spent a week in a coma and 9 days in a mental hospital last July. I was discharged by the cpn October.
Touch wood I'm stable but I just have depression
boring I know psychosis is harder too manage.
I know, I feel awful for taking up resources for so long, but it must be cheaper to have a cpn spend an hour with me every couple of weeks than to have me go back to being in and out of hospital and all the emergency services involvement etc.
I understand why it is happening, I'm just really scared
I hope you are feeling better now xx
Entirely normal practice now. They tend to talk about the "recovery model" and are loath to have anyone under services long-term. MH services where I am started mass discharging people about a year ago, so that anyone who was not extremely suicidal or actively psychotic was sent back to GP. I was discharged several times over the course of a year - with one of the discharges, I was given instructions to tell my GP to re-refer me to them in four months' time for a review appointment. It's (ahem) insane but they can't do anything else, given their resources. I was at one point referred up the chain (IAPT -> CMHT psychology -> specialist psychotherapy) for therapy several times. When the specialist psychotherapy also said that they couldn't meet my needs, I was discharged. Unfortunately the risk of relapse isn't considered to be as important as the urgent needs of someone who is currently ill.
So, "recovery model" is supposed to be, as far as I can make out, acknowledging that people can live a fulfilling life even without full symptom remission, and that people should be facilitated in doing that - so recovery doesn't just refer to full clinical recovery, but also to recovery in a more personal sense that can include using peer support, accessing things outside the mental health framework, etc. It's supposed to mean that for the individual, the focus should not just be on pharmacological and psychological "treatments", but on a whole-life basis.
They use the acronym CHIME, meaning Connectedness, Hope and optimism, Identity, Meaning and Empowerment. In many areas, trusts have set up Recovery Colleges, which offer services that are complementary to mental health services - peer support and mentoring, groups run by people with experience of mental health services, tools to help manage recovery, assistance in returning to activities that help people live meaningful lives, and such.
In practice, this seems to mean withdrawing CMHT support, refusing people psychological treatment and ongoing monitoring of psychiatric drugs, getting people to accept that they won't necessarily make a full clinical recovery (so much for hope), and getting people to use the cheaper "Recovery College" services in place of professional treatment.
In my area, the Recovery College was, entirely coincidentally apparently, set up at the same time as the mass discharges were happening, and my CPN told me all about it and how wonderful it was just before they discharged me. I was encouraged to play up certain problems I was having, as the service was in a pilot stage and had yet to be rolled out to people with all types of mental health problem.
I used the Recovery College services; of course I did, because there was nothing else. But the whole time, it was emphasised that this was not therapy, not a replacement for mental health care. But for all the people who had been discharged, it was a direct replacement. And the concepts of "peer mentoring" and "peer-led groups" seem to be a way of getting mentally ill people to work for free (after a while working for the service, a token few are taken on as paid employees, but apparently it's good for people to work for free as peer workers, because it aids their own recovery).
Secondary mental health services are needed by more people each year, and get less funding each year, so what else are they to do? But the recovery model is used as a cover for the mass discharges of people who need help. As far as I can work out, it originated in service user and survivor groups and their desire to take control of or acknowledge their primacy in their own lives, but it's been hijacked.
And I believe we are the unfortunate people who have to bear the consequences of this. I was discharged before I was ready, re-referred, discharged, re-referred, discharged - I can't help feeling that I'd have got to the point I'm at now (happy, well, and out of mental health services) if I'd had consistent care throughout the time I was unwell, as you need too.
I'm fine fluffy thank you, for what it's worth my friend has bi-polar and I don't think the mental health team have any intention of discharging her.
I don't know if it's the same your end but in my district a gp can refer you back too the cpn/crisis team within 48 hours.
Both my friend and my girlfriend are on 'urgent' waiting lists of three months to see a psychiatrist. It's a nightmare.
See when I was under my CPN if I needed to see a shrink via her it was still a six week wait
It boils my piss one of my sisters best friends killed himself waiting for one of those appointments.
The thing is, I'm pretty sure if I wasn't with secondary services and rocked up to my gp with just the symptoms I have now, in a 'stable' period, they would give me an urgent referral. Psychosis makes people nervous.
I can just see a lifetime of waiting lists ahead of me.
I was in a hospital in the north east. One women I was in with had bipolar and she's still under as an outpatient. She gets her meds through injection though so don't know if that makes a difference.
It seems too massively differ by region.
Ooh I've been in hospital in the north east - I was in cherry Knowle. Lovely grounds. Horrible place but at least there were individual rooms.
But I was in there in 2010 I think. A while ago anyway.
Im bipolar and was diagnosed at 18 im now 34 and have only spent 3 years of that time purely under a gp although he was actually a great gp and asked me to book a double appointment once a month to keep a check on me he was fabulous and it was the most stable period I had. Could u ask your gp for regular check ups. Currently see cpn every 6-8 weeks and consultant once a month (as im pregnant) if I wasn't pregnant Id see him every 4 months and there is not any talk of discharge they seem happy to just keep me ticking over. Could you look into something like life coaching privately ive heard it's quite good x
Ps. Cherry knowles has shut down and been refurbished into a new hospital I was there a year ago and had outstanding care
Like Pp said, there are no resources. I went to Gp time and time again with severe anxiety, depression, self harm etc but when I eventually got referred, I was told that I wasn't suitable for CBT so basically they couldn't do anything. I was sobbing but they just said that if you aren't suitable for CBT there is nothing available.
Tbh cherry Knowle could have been lovely, I was in no fit state to be making judgements then I 'escaped' (told them I was going to Sunderland but just caught the bus home instead and rang up to say I wasn't coming back until the next day when I had a Dr appointment with my cpn there and I refused to stay in hospital any more. Looking back I was still in a massive mixed episode but I was no longer an actual risk so didn't need to be in that place pacing up and down and developing conspiracy theories, I could do that at home)
I've never been DH has too visit his exes sister. I was in Westpark at Darlington. The care was iffy. I felt the more vulnerable patients seemed too suffer.
I had a couple of run ins with one of the nurses. A patient was moved wards he didn't know where he was and I swear too god she smirked as he was moved. Some other staff were fab so it wasn't all bad.
Plus I met now DH so pleased I went now.
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