NHS mental health team referral rejected - can anyone shed some light?

I’ve always found it bizarre that I wanted to leave psychiatric hospital so I was sectioned whereas those who wanted to stay were usually discharged within days of being admitted

This happens all the time. Too complex for iAPT. Not complex enough for cmht. Rare to find a department offering psychotherapy to secondary care patients. Or just in depth 1-1s. Years ago you'd keep your patients and see them forever. Things changed.

This seems true from what I see. Some people are often threatening suicide and so are in crisis and getting seen. People who are really unwell don't request contact don't get seen but then relapse. Psychiatrists are an underused resource I think. If the focus was longer conversations with the psychiatrist I think people really unwell would build up trust and possibly relapse less often. I don't know what to suggest about those always threatening suicide. It's a complicated situation.

A couple of decades ago, you could be under mental health services when you were stable (i.e. 3-6 monthly check-ups) but these days are gone. NHS underfunding with the government trying to take it down to the absolute basic emergency only care i.e. privatisation through the back door, lack of staff (mass shortage of psychiatrists), increased demand/expectations... Quite how over-stretched GPs are expected to do the extra work is ridiculous (again government push to eradicate the NHS by making no qualified staff want to work in it as too stressful!). It's ashame as prevention is better than cure i.e. getting an earlier out-patient appointment rather than ending up being detained under the mental health act under police escort, but sadly despite the cost to the government of the latter plus the cost to the person's mental health due to a total relapse, does not seem to matter. It's the end of our beloved NHS:-(

OP, of you tell us what support from CMHT you want it might be easier to answer.

It’s something to aim for and plan for. On Radio 4 this morning they made the point that Mental Health makes up 20% of the burden of disease in the UK and the funding currently is not reflecting that at all. I feel people may agree to pay a bit for an insurance style top up system, if it meant there was adequate timely service

Provided by whom? Not only do services not have the budgets to provide this kind of care, the humans to do the jobs don't exist. It's very difficult to fill some MH roles and even if the NHS had unlimited budget to provide the kind of service you propose, they would struggle to find the people to do the work!

I'm stable at the moment, but when things get bad, they get really bad, and I want to be under some kind of MH care for when that happens again (sadly it’s probably a “when” not an “if”)

This isn't how NHS mental health services work. You can be referred if/when you become ill again but you can't be under services just in case.

It’s in the news today, such as on R4 Today…https://www.rcpsych.ac.uk/news-and-features/latest-news/detail/2026/02/18/uk-s-top-psychiatrist-raises-alarm-over-threat-posed-by-'silent-mental-health-pandemic'-to-patients--society-and-the-economy

Unfortunately as my experience and that of others on this thread shows, it’s also impossible to see a psychiatrist even in a crisis, so something is really, really wrong with the system. Politicians then wonder why people are claiming PIP and are off work - there is a cost to society for having people wait months for assessments as well… And like I said, there are no gatekeepers to seeing specialists in some countries, so it’s a choice, and a very short-sighted one.

NHS are useless with mental health in my experience other than putting you on medication. I was referred for talking therapies with my gp believing I have PTSD and was told that my case was ‘too complex’ to get help. I can’t afford private treatment so I’m just 🤷🏼‍♀️

My GP will not support continued care. They point blank refuse. So you have to start the whole process from scratch with the NHS.

The mental health service where I am doesn't exist. I don't tick the correct boxes even though my GP says I have a problem. She's been shocked at how I've been treated over the years.

It's an exercise in hoop jumping like a performing seal. If what they propose is completely inappropriate you are screwed.

Find the money.

Absolutely spot on response
This exactly

Around 20% of people have some form of mental health condition. If we regularly saw 20% of people rather than those in crisis the system would absolutely collapse and those who actively need help wouldnt get it.
The unfortunate reality is that those who don't generally actually need as high a level of support (personality disorders, anxiety etc) often request the most contact, and those who do need a higher level of input (schizophrenia/psychosis/severe depression etc) often dont seek out the support independently and are resistant to it. So on self reporting it would look like we aren't seeing those requesting support frequently, whilst in reality we are giving high regular levels of support to many who aren't actually wanting our input but do really need it.

France. It has an NHS (and a minimal private “top up” insurance system).

What is your home country and does it have a NHS or is medical care insurance-based?

I think it’s a bit outrageous that preventative psychiatric care doesn’t exist in this country. Other countries manage to provide it, so I don’t buy that it’s a luxury that a country can’t afford. It’s little wonder that we end up with mentally very ill people attacking others with knives if we wait until they are in crisis to then give them the very minimum we can get away with. Apparently there is to be a renewed focus on prevention in the NHS, I hope it encompasses mental health… We as a society pay for it in other ways if we are not going to provide psychiatric evaluations to people who need it. It’s not actually a big ask.
When my DC was acutely ill with OCD, I was told “this does qualify as an emergency, so we’ll put you on a waiting list for urgent care, and in the meantime, hide your knives.” Not only was it stupid advice regarding someone with OCD but it shows that emergencies are not even taken seriously - we waited for six months for a referral… It could have ruined his life, if we’d not had enough money to go private. Compared to my home country where you can see a psychiatrist whenever you want, I don’t get it, what is wrong with this country?
My other DC would benefit from preventative care too but again we’ll go private, even though we can’t really afford it.
Sorry OP, I think you deserve this care and am outraged for you too.

I will say I was lucky to have great cpn support and see a psychiatrist plus great consistent gp support about 18 yrs ago.
But no chance no sadly.

Even in a crisis you'll be lucky to get a referral accepted.
Passed from team to team for over 18 months with zero actual help.
Pp may say thats not a crisis and its not anymore but months of talking about how id end my life and at times doing things which were close plus very significant self harm which primary care saw and treated for months.
I am not at all surprised people complete suicide.

OP, if you could design your secondary care preventative support, what would it look like?

CMHTs are intervention focussed, so won’t offer ‘just incase’ monitoring. There just isn’t the resource.

If there is an intervention which needs to be completed by secondary care then maybe but other wise unless you’re under S117 or on clozapine it’ll pretty much be a no

I think the treatment pathway is that preventative and continuous care will be provided by the GP

There simply is no funding to see people are currently stable. Funding must go to those in crisis.

This is not the role of the NHS ,certainly not as things are at the moment

Im sure it varies by NHS trust a bit but my experience of the mental health services was strange in parts. Reading this thread it’s answered a big why - I’ve got a serious condition with medication GP can’t prescribe without secondary care input and yet I’ve seen no one (not GP, not CMHT) for years now.

I did find them pretty awful tbh when I was in acute care (not inpatient). They did things like threaten to come and get me when I “missed” an appointment (which they cancelled at my previous appt!!), I wasn’t a danger to others or to myself. Work wasn’t part of the problem but i was told by more than one medical person it would be a good idea to quit my job and go on benefits - I had a very secure, well paid job and was being paid in full while I was unwell. My condition is cyclical and before meds I was triaged for talking therapy during a “well” couple of weeks and told I wasn’t ill enough and didn’t I know there were people who actually need help.

I didn’t get myself sorted until I scraped the money together to see someone privately, and my (very good) GP then prescribed on their instruction. The psychiatrist also worked for NHS in that trust and wasn’t surprised by my experience (although found it appalling).

I look after myself rigorously now to avoid having to go through the NHS experience again - their advice re my job would have been so, so destructive if I’d followed it.