Health Anxiety clogging up A&E

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Im really pleased that finally someone within the NHS has come out and said this.

Having been treated myself in A&E, in the corridor (outside triage) due to lack of cubicles, I was genuinely shocked at the amount of patients that attended who shouldn’t have been there. I’m not talking about those that were genuinely ill and couldn’t see the GP and had no other choice but the ones that were clearly anxious about their health and symptoms that didn’t warrant an A&E visit. They were all sent on their way but it still was time that was taken away from those patients that genuinely needed help. I wonder what the answer is to this, because something has to change.

Health anxiety not emergencies clogging-up A&E

CTB app has a high level of satisfaction from users.

I don’t think any of my posts have suggested that people should be grateful for crumbs or that I’m blaming patients
I’ve reiterated several times that the significant issues with the way that things wrong I can see from your previous post at your tarring all services with the same brush from your poor experience

you reference people being under qualified or not qualified enough without knowing anything about their qualifications - people cannot work a CBT therapist without being qualified and completing the training. Naturally, some therapist will be better than others, but nobody is under qualified.

there’s often an expectation in mental health therapist have to know absolutely everything and be able to treat absolutely everything however that’s just not the reality.

we also get requests for people to see a therapist who trained to help with autism but with a team of 6 CBT therapist the chances of finding that slim

we of course put people forward for training, we have people in champion roles and we link him with all of the services in the area so we can support clients as best as we can, but it’s just not an offering that is always available should it be to some degree yes but again that’s not the therapist fault. We have clients who want clinicians who are trained to understand living with a number of health conditions - Crohn’s diabetes, cancer, COPD respiratory conditions, digestive conditions, pain conditions, brain conditions, variety of learning difficulties want a therapist who’s experienced homelessness, even requests for therapist who lived similar difficult experiences as them but that’s just never going to happen not just in the mental health but all realms of health

It’s not the services fault, it is the way that we are funded, somebody has quite accurately referenced that previously we used to create a budget and send them to the ICB where is now you win tender by saying where you’re going cut spending

It does! I referenced in an a previous post that sometimes clients don’t want what’s being offered to them despite the fact that the evidence tells us this is the most effective treatment for them - they already have a belief that it won’t work so why they don’t do it or decline

Mental health services were originally for people with mental illnesses. Everyone else used to be managed by GPs. The expansion in demand from mental health services has been enormous, and those with serious mental illnesses as a result, get less services than they used to.

CBT is not necessarily that great if you are ND .

No those with serious mental illness could not access the treatment they should have so serious and non GP treatable illnesses have been left to get a whole lot worse.

And for some it is. We have tons of clients who are ND who it works great for

Yep and it’s shit for others so a generic shoe horning towards CBT and young people not having good quality assessments with experienced professionals as regards the correct type of treatment necessary is likely to be a)causing a huge waste of money and b) damaging as it was for my son.

People with serious mental illness used to see a psychiatrist much more easily. If you were psychotic or manic, you did used to get far more services.

I think some people are unrealistic as well. The NHS could never afford to fund tear long therapy for everyone who wants it.

Agree with this! If doctor's appointments were more accessible,and we didn't have this 8 am scramble to be in with a chance of an appointment,then there would probably be far fewer people going to A and E with relatively minor ailments or injuries. It would also help if doctors were more willing to do home visits.

I'm so glad you've said it! I still have to be seen due to medication for my mental health affecting my heart. You treat one thing you affect the another. Have tried positive thinking, exercise, mindfulness but it won't shift 3 distinct mental illness and autism. Maybe this studies focus should be on the way mental illness is treated.

A lot of people access MH services who really do not need it, same as people accessing AnE who do not require urgent care.

Examples include

1. People lying saying they are hearing voices and are caught out lying…asking for PIP letters, requests for PIP support letters are common.

2. Bereavement- it’s normal to feel deeply sad following a loss. Unless it was complex and traumatic the it’s not a MH problem despite being distressing

3. Relationship ending - hurtful and painful but not a MH disorder

4. You’ve messed up - crashed car/underperformed at work/gross misconduct - awfully stressful situations and knock on effects but it’s not MH issues -

5. Perpetrators- seeking therapy because they think it will ‘look good’ in court or for social services….fake secondary gains

6. People who have had a traumatic event and claim PTSD but are lying ….until they get a payout - don’t see them for dust

7. Life is rubbish and unfair sometimes but the negative aspects don’t need to be pathologised and ‘treated’ feeling sad angry and low are all normal - it’s when they are persistently present and impact functioning they have become an issue, usual coping is not helping.

There are people clogging up waiting lists for therapy. Some do not want to put the work in outside of sessions- they are given several chances.

So the system is not perfect and under resourced but is also abused by some users

I think if Gp surgeries open at the weekends, 7 days a week and late evenings would help too.

What sort of things are you referring to OP?
I was recently at A&E for genuine reasons and I couldn't help but feel like most of the people waiting didn't seem that ill or in pain/injured but I know that doesn't really mean anything as a lot of people are good at masking. What did you overhear that you thought was just anxiety?

Royal College of Pyschiatrists don’t agree p43

https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/college-reports/college-report-cr228.pdf?sfvrsn=c64e10e3_2

CAMHS CBT did fuck all for my ASD dd. She got a fancy certificate. That was helpful.

I also found CBT made no difference to me.

This newspaper headline really pissed me off, talk about victim blaming. So people can't get GP appointments so get anxious and end up going to A&E as a last resort, then get blamed. You couldn't make this stuff up.

How about ensuring people can access GP or even nurse appointments in the first place. Or even opening up some urgent care centres like they used to have, so people can get the help they need.

Also if so much of the population have health anxiety, how about some sort of empathy and treatment for that....Probably the difficulty in accessing proper health care is making alot of people's anxiety worse.

Not that many years ago, folk were aware that many illnesses were self limiting. A cold was a cold, not a viral infection, and people knew when to go to the doctor. I think there are two issues that have changed this stoic attitude to ill health. One is the never ending stream of ordure that comes from the media about rare health complications that most doctors don’t even see once in their working lifetime. And two, people were scared witless by COVID. The government of the day caused this, and the government should sort it out. Incidentally, when did hypochondria become health anxiety?

You would be absolutely amazed at the amount of people who “know their own body” and think they need antibiotics, when the vast majority of the time they do not. In most cases of sinusitis, tonsillitis, mild chest infections antibiotics are really not required and may make you feel better by a few hours maximum if at all! I saw a chap last week who “knew his own body” and demanded antibiotics for his cough despite all his obs being normal, chest clear and even a blood test to show his inflammatory markers were normal.

I agree with this. Being unhappy or worried is not a mental illness. A CBT app may help you, but in most cases you need to make changes to your life.
So if you are in a bad marriage for example, Mental Health services can not solve any depression or anxiety you have as a result of that bad marriage. You need to leave the marriage.

Just because you saw ONE person at A&E who didn’t need to be there does NOT mean everyone is an NHS time waster. There is always going to one like that anywhere in the world. If GPs were available to book, that person would have gone there instead (not advocating wasting time, but getting seen by a nurse to reassure them they are ok at the gp practice is less wasteful than an A&E visit).
Our local surgery has a window of ten minutes at 8am where lines open and email enquires open. Once they have reached maximum capacity they shut them down with no chance to book routine appointments or anything. Computer says NO. How is that acceptable?

I really don’t agree with this.

1. Are you saying people fake a serious illness like psychosis to get PIP? And get anti pyschotics? Which only a psychiatrist can prescribe initially? That would take some amazing acting skills.

2. People react differently. Some cope some don’t. Those who don’t need mental health support.

3. As above. Some people are suicidal in these situations.

4. Work is one of the biggest causes of mental health issues. Being micromanaged by twats. Of course it’s a mental health issue if it impacts your life seriously.

Don’t know about the rest. Apart from PTSD which l have and is not related to a payout of any kind.

People are individuals and react different. Good childhood, few problems, bad childhood, probably struggles with a lot of those.

@Redty10 in quite concerned that so many doctors feel so comfortable dismissing their patients out of hand

What is that I’ve said that this disagrees with?

Or you may not! There are lots of fab ACPs and GPs and there are also not so great ACPs and GPs