To think adult mental health services are shit?

[elementofsurprise]

So... we've had a thread about CAMHS. What about adult services? I'm talking about secondary care - CMHTs and so on. I've come across so many people struggling to get any help at all, being discharged when still unwell, offered inadequate therapy in primary care and unable to access secondary services, waiting lists of years, staff obfuscation, misdirection, inconsistencies and even lies, a general lack of empathy or communication, etc.

I'm half wondering if posters here will be less likely to have had these experiences, as I suspect being a parent means they prioritise you so perhaps posters here have not had issues accessing help. This is in no way a criticism btw, just a suspicion of one way they decide how to allocate limited resources.

However, it's clearly not all about resources as just treating someone like a human being doesn't cost anything...

ps. To the decent nurses working in awful conditions - thank you. Shame about your colleagues and the whole system.

Well I went round and round in circles with a psychiatrist yesterday. They'd lost my records prior to 2010 so we're relying on my memory of 2008/09 while I was mid breakdown.

He'd no read my notes at all as he'd only found out he was seeing me.

Talked to me massively inappropriately about how my dd2s T18 must have be hereditary and we should have been given genetic counselling before getting pregnant with ds despite me giving him a fairly detailed description of T18 and telling him that dd2s amnio showed full Edwards so it wasn't inherited and that ds had a clear harmony for trisomies. He insisted on talking at length about an area of medicine he was obviously clueless about.

I have had mixed experiences of adult mental health but even the good ones I'd say we're not if the same standard is general health services

I'm a mental health nurse and thankfully work in forensics which is one of the few areas where at the moment (in my trust at least) we seem to be doing ok.

However mental health is shocking in the nhs when compared with other areas of the nhs. We are poorly funded, poorly staffed and as with all areas of the nhs bad practice happens. I think it seems worse when things go wrong in mental health series because the system is so stretched as it is.
Apologies to anyone who has had a bad experience... trust me, the good staff that are out there feel just as badly about how shit it is as the patents.

In 2002 I had a major breakdown, severe depression, very suicidal. I had the most amazing CPN who probably saved my life. She persuaded me to take anti-depressants ( which I did need) and reviewed them until I got the best ones. She referred me to a fabulous counsellor, although I paid for this. And she got my husband signed off work for 3 months to look after me. I saw a psychiatrist for 10 minutes who agreed that it was possibly delayed PND, and I never saw her again. This really was fabulous care by one person, but all services have been cut to the bone and the reality is that there are not enough staff to go round. Mindfullness and CBT are the standard support nowadays, in my view these are 'flavour of the month' and in a couple of years something new will come along. I am sorry to hear that you are not getting good care, we have had some awful experiences with CAMHS with my daughter, so I can empathise.

I've had no problems with them in our area. They've always got me in quickly and the older I get the faster I seem to get into the system (probably because my history is becoming quite extensive!)

The irony is that if the NHS helped my physical health I'd never have to touch the mental health team. I'm sure others are very much in my shoes.

Mindlessness is an awful treatment for people like me. Even my cpn agreed but she had to tow the party line

Sorry another post. I've come to the realisation the NHS is only really there for acute illness (physical and mental) and cracks under the pressure of people with chronic issues

It's not the individual nurses/docs who are bad it's the whole system as there simply aren't enough staff available to help those who need it.

DS (19) was seeing a counsellor/psychiatrist last summer before being discharged after a change of practitioner (the new one saw him once before deciding he was fine) - he was going to uni so agreed.

He returned from uni in November after some bad times and tried to get in touch the mental health team - they claimed to have no record of him despite him being seen every 2/3 weeks for 5 months! They then said they couldn't see him as a new patient as he wasn't registered here any longer, so he registered with a new GP in our area. She referred him but it was rejected as he had recently started medication and they wanted the GP to monitor it.

He has just been back to the GP (Monday) and asked for a further referral as he is not going back to uni until at least September and doesn't feel that the medication is enough, we are now waiting to see if they will add him to their list but it's unlikely he will be see any time soon.

Yes they are, it isn't their fault though. 10% funding and 25% of the population having some form of mental health difficulties in their lives. The numbers don't match up!

There was an incident at my mum's workplace last week (a GP surgery), they got let down by the crisis team badly. If it wasn't for the police, the person would be dead now.

It's shit. I went for an assessment recently to see what services I could access, it was a total fuck up at every level. The person I saw thought I was there for counselling, then told me I was unsuitable for any kind of help except medication (which currently isn't working). Any therapy would have been very limited anyway.

I would hope they would prioritise based on need, not whether someone is a parent though.

I've been in the system for 18 years now, and it's never got better. I've lived all over the country, and it's the same in all areas: underfunded, overstretched, and where I am now, they have 2 CPNs for the whole city (one of whom is on long term sick leave).

My last CPN was hopeless and tried to put me into a convenient box to make her job easier - she didn't listen to a word I said, just forced her own views on me about how I should be behaving. I ended up telling her to leave my house and refused to see her again - that isn't care. I'd rather go without than have to see someone like her again!

I'm in Northern Ireland and find mental health services pretty shitty.my mum has been in a psychiatric hospital for nearly 2 years and she is still as bad as she was when she went in-they don't have a clue what to do with her and pulled my brother to one side a few months ago to say that we would probably have to look at putting her into some sort of care home/assisted living facility as there's not much more they can do for her,I feel like we are just being left to it.

There is a real lack of funding and my mum has other health issues which don't seem to be catered for as well as we would like. Getting her into a hospital in the first place was a disgrace,psychiatrists were saying she needed admitted but then we had to go through a CPN who would override their opinion and say that home treatment was sufficient-considering my mum had tried to drink weed killer and was extremely suicidal at this point,home treatment wasn't going to cover it.the same CPN also said that ' people commit suicide in hospitals too you know ' and 'there are people sicker than your mum' which I thought was highly inappropriate.

I hear lots of sad stories about people with mental health problems being let down by the system,it's such a shame it doesn't get the finding that it needs.there also doesn't seem to be much support for family of people with mental health problems

Yanbu. I've had to use almost the last of my emergency savings to pay for private counselling. I gave up on the nhs. Unsympathetic GP and after 3yrs a session with a hopeless nhs counsellor who was a waste of time.

There are huge and numerous issues in MH care, mostly to do with money. Big case loads, long wait lists, high staff turn overs and low staff numbers, increasing targets and paperwork. Lots of staff are leaving.

That said I do also think some people have really unrealistic expectations of services, wanting magic wand fixes that don't exist and being aggreived when told that they have to do a lot of the work themselves.

Or I've met various people who've wanted say, a CPN, because it's nice to have someone to call when you need to vent, who sees you regularly, to make you feel supported but actually what they need is a friend and those sort of situations are difficult because people do genuinely feel they need support but practically it's not possible and they end up feeling let down.

In my experience parents only get priority if they have a baby under 1 year old and that's not across the board.

A recent report into staff working for MH services for the NHS found over 50% were depressed! Roughly more than half that of the general population. If both staff and patients are suffering, what do we do with that?

I'm a CPN. I despair of services. There's so much we could offer people but we're not able to due to cuts in mental health services. I know it seems like we're heartless refusing to see people longterm, but we're so under resourced we're not able to. I also really really wish day centres/hospitals still existed as I think many service users are isolated and would benefit from that kind of service.

Generally, I've found them to be very good within the confines of the funding they have (which is obviously not enough!)

They have to prioritise, obviously, but they are, ime, good where they can be, with the most urgent of cases.

Unfortunately however, they will always have an obstacle that physical health services don't have - there's not often that much they can do. Apart from cases that can be helped with medication, the change has to come from the sufferer not the medical practitioner. So their results are not only dependent on their services but on their service users.

For example, I've had 2 inpatient stays in eating disorder units during my adult life (and 2 others as an adolescent) - am I 'cured'? no. Is that the fault of the mental health services? Not at all! They did exactly what they were supposed to do.

I've been on both sides - patient and worker. YANBU, services are awful, mostly due to underfunding and I hate to say it but in 2016, there is still too much stigma and discrimination. Staff are stressed and stretched to the point that could drive mother Teresa to grumpiness. Overall, I've found that most staff do care but many are disheartened by the system.

Mental health services are shit at dealing with very ill people who, for various reasons, cannot or will not engage with professionals. There is evidence to show that we can work with people who, for example, have severe psychosis without drugging them up to the eyeballs but it uses resources; people and money.

There is a national shortage of nurses and social workers. The pay is very average for the hours you need to work and the stress that you are put through.

I could rant on forever. I'm drugged up myself (painkillers though) so sorry if this is incoherent rambling. I'd love to be in charge of funding and overhauling the system. Obviously not while doped up on codeine and tramadol though!

An arrogant clinical lead of one MH trust said to me; we can't stop women having babies but we can cut funding to people with mental illness. Why can't we do both? Look at our Scandinavian neighbours, they have high taxation but excellent quality public services and I'm willing to bet my firstborn that they're happier overall.

I agree. I had a big problem a few years back, went to my GP. She was very understanding, but gave me two choices, either get sectioned and go into hospital for whatever length of time 'they' deemed necessary, or ship up at the local centre for people with alcohol and drug dependency issues; that was the only entry point, she could not refer me.
I took the latter, trying to hang on to a job etc. I had 3 months of being asked about my drug/drink 'problems' (neither which I had), being breathalysed, asked to pee into a plastic bag and generally mis-treated before I finally got sent on to the next level. They could give me lots of drugs, that was all. Finally, after a lot of pestering I got onto an intensive CBT course. It helped, a lot. Luckily I knew people who could prime me with the right things to say.

I get the impression that mh services must be one of the most frustrating areas to work in. Underfunded, over worked, lack of staff, stigma and far too many patients.

I was offered counselling, luckily I am already having it and paying privately because the waiting list is 3-4 months. Which is streets better than when I was in London where it was 18 months for emergency referrals

I have had several relatives with enduring mental health problems. I found the in care for geriatric patients with mental health problems to be very good, I was pleasantly surprised.
The Crisis Team I am not impressed with. They seem well meaning, but out of their depth a lot of the time. I have met a fair few of them, and they would have been fine to visit someone regularly who was a bit depressed and just needed someone to take an interest, but they seemed under trained to deal with people with very serious mental health problems.
The crisis team also at first refused to visit a relative as they said they though she did not meet the criteria - the GP had asked for this. And when I pushed and they finally agreed to visit, after 20 minutes they were talking about sectioning.

I also accessed counselling myself as a carer. I was seen quickly and the 6 sessions I had really helped. But I just needed a bit of support, and to be able to talk through some strategies to make my life easier.

I had a 6 month wait for outpatient CBT sessions. It was a long wait (due I expect to the ridiculous underfunding of mental health services in this country) but my counsellor was absolutely lovely, I'll never forget how much she helped me. She managed to get to the root of my many and various manifestations of anxiety, which she helped me realise was due to lifelong extremely low self esteem. She was such a good listener and I know her caseload must have been huge. I do feel better able to deal with things now thankfully.

Totally agree, I work in mental health and could write a book on the failings i've seen as I presume everyone else who works in this sector.
I could also write a book on the wonderful and dedicated staff who go above and beyond in the shitiest of circumstances whilst being under paid and overworked.

I've had mixed experiences, some good and some bad. I've been lucky though as it's been mostly good. I had especially excellent care when I was pregnant and for the first year DS was born. I would almost certainly have ended up in hospital or worse if it wasn't for the close monitoring and early intervention of the excellent psychologist and psychiatrist who were treating me. I've been in services for 15 years on and off and in my experience it can be difficult to get into the service but once you're in, there's a lot more available to you.