How much detail is too much?

[itsmymess]

I had a 2hr in depth assessment with an NHS mental health service. I was asked very sensitive and probing questions as you would expect abs I did my best to answer honestly. I was told the assessment would be discussed with the team and my GP would be informed of the outcome as to whether I'd be accepted for their service

Today I received a copy of an 8 page letter to my GP detailing everything that we was discussed, much of it quoting my words - private information I'd disclosed about childhood, the kinds of details I'd had therapy for. I don't believe any of this was important for the GP know. The language was accusatory - she "denied" that she was a smoker - that implies I lied? She asked me do you smoke and I said no, I don't smoke.

I feel completely duped and let down by the service. (Who by the way won't see me anyway as don't meet their threshold).

Is there guidance on the depth of information that should be shared? . Surely the presenting issue, summary of the assessment and conclusion should have sufficed. I actually feel quite traumatised and suicidal about this.
What can I do about it?
I want to complain as surely this sharing went way beyond. I thought I was disclosing in a 'confidential' discussion for the purpose of them assessing whether they will prescribe me a medication that by GP won't.
So stressed

So I'm being ridiculous clearly

I’m bumping this as I don’t know the answer.

But have you been diagnosed with a specific condition, I am not asking you to reveal your diagnosis and why do you think a certain medication is for you ?

It sounds like a difficult time OP and it must have been upsetting unexpectedly seeing details of sensitive topics shown back to you and feeling let down with the service. I have had similar and during times of anxiety or stress have felt very exposed and embarrassed but it is not personal.

However what I will say of it is of comfort is that the language such as 'the patient denies' is bog standard wording for stating that they asked you and you said no. It doesn't imply or mean the person hearing it believes you are, just that you have literally said you don't. It's not a loaded statement, just archaic medical terminology.

The detailed letter to your GP is also standard practice, your GP is your primary care provider and all copies of any medical testing or nhs consultation you have goes back to them in this way. Your GP will always be privy to your medical records and any and all letters shared about you and you generally consent to this when signing up at a GP surgery or using NHS services. You can opt out of receiving copies of your notes and letters cc'd to you if you like though, your GP surgery or hospital can action this on request.

Although it may not seem it I would think it is a good thing that clearly time was taken to review your conversation, proper notes taken and considerations given etc. They are there to try and help, as is your GP who will not be judging what they are reading as they read similar often I am sure. However if you feel a line was crossed re: specific inclusions of personal details then certainly write to the hospitals PALS about this and they can direct you to the right pathway. Ultimately you do not deserve to be feeling this way and it will be useful feedback even if they have acted within the rules.

Unfortunately the NHS for all its perks is a beurocratic nightmare re: thresholds and clinical eligibility. You have the right to a second opinion and can exercise this but don't give up. Go back to your GP to discuss what's happened and how you are currently feeling.

What is the GP's rationale for not prescribing a specific medication? Presumably there must be a medical reason it isn't suitable for use but there are other options which may be suitable?

Thank you for listening.

(The medication but isnt hugely relevant here as my concern - my care is just being moved from private to NHS due to insurance running out and the particular drug is prescribed in the first instance by 2ndry care rather than GP. The service have concluded and advised my GP to change the medication I am taking to something a GP can prescribe directly
rather than take over my care)

Strange that 'to deny' something in any other context has a different meaning.

I totally agree with you, OP. I understand what has happened though - from my own experience.

Basically, when you're in an assessment and/or seeing a psychiatrist, the details DO all go to your GP. When you're actively in therapy, the detail of the discussions are all kept confidential.

The problem is that none of this is explained upfront and we all assume that 'therapy rules' apply across the board. It really takes away from the feeling of 'safety' we deserve to have when we're fragile.

Agree with PP about the wording piece. It's jarring but standard.

No comment to make on the assessment, but I do agree that if a person 'denies' something, it means the questioner believes a statement to be true. It could have been worded much better. 'The person is a non smoker' would be clearer and less controversial. It might be common
medical parlance, but the word 'deny' comes loaded with connotations.

Thank you.

It's incredible how much words can distress. what must seem like casual irrelevances to the professionals who write these letters are devastating descriptions of my actual lived experience. How do they decide what to cherry-pick from the notes to include? There was no quote of me saying that my private doctor was shit at his job and I know I used those words!

Btw, I have a new iPad and the keyboard is a different size and layout hence all the typos 🤣

The language was accusatory - she "denied" that she was a smoker - that implies I lied? She asked me do you smoke and I said no, I don't smoke.

It's fairly standard and to another HCP won't imply that you lied, just that the GP asked if you smoked and you said no. I work in mental health and I also hate it though- so what if we all know it means that, we should also all know that to most people it really does sound like an accusation of dishonesty. Language absolutely does matter. I also hate the lack of care taken to explicitly inform people of what happens to information they give, who it will be shared with and when.

TLDR: no one thinks you're a liar, but you are absolutely right about the impact of the words used as standard