I can't believe what the IAPT assessment 'professional' has just said to me!

[Ikeatears]

Long story involving Home Treatment Team, hospital admission, psychiatrist appointments, psychologist appointment etc. over the last few months. Diagnosis of depression and anxiety. Finally discharged from HTT 3 weeks ago to IAPT (therapy service) during a multi-disciplinary team meeting.
IAPT 'lost' me in the their system and only because I phoned yesterday, they allocated me a triage appointment this morning.
I arrived 10 minutes early and waited nearly half an hour (assessor said she'd got my appointment time wrong - all fine, it happens)
She rushed me through the process, at one point telling me we needed to be quick because she as seeing someone else in 7 minutes! Argued with me that there was no way I would get stage 3 (trauma therapy) until I had done 6 weeks of stage 2 (CBT - self help therapy first) despite the fact that two consultants and my HHT nurse all agreed that I needed more than stage 2.
I was very polite but pointed out that maybe the fact my IAPT appointment had been lost was why there was nowhere to say what these health professionals had recommended.
Anyway, the whole thing felt very rushed and she was not in the least empathetic. I disclosed that I felt I needed more than CBT due to historical abuse. She then suddenly decided I was stage 3 after all. All well and good and I was remaining calm and polite throughout but felt very stressed and a little upset and how rushed I felt. She then asked me how the abuse affected me (the whole abuse conversation lasted about a minute).
I felt put on the spot and didn't particularly want to confide in her but I had to in order to access the therapy. I told her it has had a very negative affect on my sex life (very true). She then looked at me in disbelief and said, " What? Even though you've had three children?"
WTF!! So I can't be affected by childhood sexual abuse or teenage rape because I have children?? I was so astounded I just muttered "yes"
It felt like she was disbelieving me and making me out to be a liar. I am so pleased I stayed calm and polite but I really wanted to let rip.
Got my stage 3 referral though...

[NellWilsonsWhiteHair]

That's awful. Really impressed by how you handled it, and glad you got the referral you needed. But so sorry you had to deal with her.

[Ikeatears]

The whole thing was horrendous, she slagged off the HTT, told me I should have contacted them at the beginning so I could have 6 weeks therapy then been referred to HTT then back to them for stage 3. Yeah, because when I wanted to drive my car into a wall I needed half an hour of CBT a week not crisis intervention! I'm more angry than upset now. What if I had been one of the many people who can't advocate for themselves?

[unweavedrainbow]

I'm currently undergoing Stage 3 trauma therapy for childhood sexual abuse/neglect and awaiting a diagnosis of DID. I'm somewhat concerned that you've been referred from HTT to IAPT. They're quite far apart on the "seriousness" scale. It's likely that the IAPT lady behaved the way she did as HTT and hospitalisation and so on are quite far out of her remit-round here they're not even part of the CMHT! I presume that the psych that you saw as part of the HTT as ruled out any of the more serious trauma based conditions such dissociative disorders, complex PTSD, BPD? If not, do you think any of them apply? Was your breakdown trauma related? If so, make sure your psychologist is aware of your history as trauma therapy can bring up some really nasty stuff which can be really difficult to sit with. I remember that you're on quetiapine, is that still right? Are you still seeing your psych? I hope you get some more support soon. CBT is definitely not the right treatment for complex trauma

[Ikeatears]

Thanks Rainbow, that's interesting, I'll try and address your points:
In my trust, HTT, IAPT and other agencies meet once a week for a multi-disciplinary team meeting.
I had to have been discharged from home treatment before IAPT would accept me.
I was discharged the day after the mdtm and the HTT said I had been accepted by IAPT for stage 3 therapy.
The IAPT lady made it abundantly clear to me (with her wonderful bedside manner) that I certainly wasn't the only one to have been passed to them from HTT and that she was sick of them promising things when it's nothing to do with them (her words). I tried to explain that her IAPT colleague had been in the MDTM with the HTT representative when my case was discussed and they had together agreed that I was suitable for stage 3. She said they wouldn't make an exception for me just because the HTT said so but that wasn't the case!
I've seen a full report from the psychiatrist and he diagnosed depression and anxiety and suicide ideation with no evidence of psychosis. He believes that failure to come to terms with past trauma (there is more than just abuse) and difficult extended family dynamics are possibly at the root of my depression and recommended psychological therapy alongside my mirtazapine and quetiapine (he states this is to augment the effects of the anti-d and is NOT being used as an antipsychotic - lowish dose of 100mg)
I was then seen by the HTT psychologist who wrote a recommendation which was used in the MDTM.
I do believe that if the correct process had been followed I wouldn't have had to attend triage.
In answer to the cause of my breakdown, I don't know. I had very mild symptoms for a few moths but within a week and a half on fluoxetine, I experienced serious anxiety and suicidal/self harm thoughts - I don't think this is a coincidence. I have had milder periods of depression and anxiety over the last 20 years but nothing on this scale and nothing requiring crisis intervention.
I do feel ready to tackle the underlying problems, I have tried for years to get help but have never been 'bad' enough. It's sad that you need to hit rock bottom sometimes before the help is available.
I'm not still seeing th psychiatrist because he is part of the HTT and I have been discharged from them. This is only really an issue because my GP is rubbish so I'm not getting any advice about my medication at the moment but once I am back in work, hopefully January, I intend to change GPs so hopefully I will get someone more competent.
Sorry, that was an essay!
How are you finding the trauma counselling? Do you think it's helping? I'm prepared to maybe feel worse before I feel better.

[Ikeatears]

The more I think about this, the more inappropriate I feel she was. Dh is livid that she spoke to me like that. My friend just couldn't believe it and it was all I could to stop her phoning up to complain on my behalf.

[Rosenwyn1985]

I would definitely phone and complain. Or certainly to discuss the issues at least! After a traumatic second recent childbirth I'm having by awful time. Have been sent to iapt, stage three straight away, one to one therapy with a diagnosis of complex trauma (a type of ptsd) associated with my abusive childhood. I've been a bit taken aback at how sudden this has come on but apparently it's common with adults of a similar history. You disassociate so well that it's only years later it comes up to the surface. Push for proper care, the lady I'm with is brilliant. I hope you get the support you need. It's hard explaining to someone how you feel when you've got kids. They don't always understand but she really should have done!

[Ikeatears]

Thanks, I've got a few complaints I need to make once I feel ready to process everything that's happened. I really didn't believe this could happen to me. I knew I'd had some periods of depression but they were nothing compared to this time. It feels like I've been hit by a bus both emotionally and physically, although it's getting much, much better.
I hope it's helping for you.