To think its unsurprising mental health services are so under funded..

[abacucat]

when so many people have such awful attitudes to the mentally ill.

After finally gathering the courage to do something about his deteriorating mental health and lessened ability to cope with a very stressful job, last week DP very nearly got denied a referral for a psychiatrist for ADD (ADHD) screening on the grounds that it's "diagnosed in children". He had gathered a lot of evidence and paperwork to support his referral, but clueless GP didn't even glance at it and could not get into her head that someone in their mid fifties had not been diagnosed as a child. I'm sure the small village school up north was totally on the ball about dyslexia and ADHD in the 70's. That would have saved him many beatings by the teachers for being stupid, stubborn and lazy (which he still thinks he is)... Now he has to wait for half a year or so to have the tests. That is, if the GP really referred him! He is a clear textbook case, if the GP just had simply googled the NHS's own website...

I read a statistic somewhere that most GP appointments were now about mental health. They are the front line, so should have some basic knowledge. Or at least the ability to humble themselves to read up on things on the internet, before declaring what you "can and can't have"! MH is such a big issue for (and by!) the society and economy. Something needs to change about the way things are going or it's going to be a time bomb.

I, on the other hand, am on my fourth different antidepressant. With no change. My mental health goes up and down during the years regardless of CBT (rubbish) and counselling (keeps me alive). I guess some of us just aren't built to be able to withstand life with our brains and experiences. Unfortunately that also means that we're unable to lift ourselves by our bootstraps (you try it!).

Wheretheresawill, I appreciate what you are saying but...there is quite a strong crossover in diagnosis between bipolar and bpd, especially in women and where the bipolar might be rapid cycling. And, there are many similarities between the conditions. At some point, when the understanding of the brain/mind becomes more advanced, it may well become clear that their is not a clear division between personality disorders and mood disorders.

At the moment, bipolar disorder has some drugs that in the majority of cases work, but as a blunt instrument with many side effects. And that is why bipolar people are not to blame. If BPD responded to drugs, then those affected would receive a reprieve. Untreated bipolar disorder is also very hungry of man hours, although perhaps in a different way.

This is a side argument. I am very aware that those working in mental health teams are very overworked and it is a thankless job. I am grateful for the help I have received, more so from CPNs than any other profession but, it does make me wince to hear you discuss bpd patients/clients in those terms.

Toys - must have been the same GP as I saw! Took the example that I struggled to say anything in school and said 'well I was shy at school too, maybe I have autism too'

tierraJ forensic mental health is working with ex offenders who have a mental health diagnosis

Many have committed crimes while suffering from psychosis (sometimes drug induced) but not all some (quite a few) have been diagnosed once in prison

Depending on where they live some have good teams around them and support but cut backs have overworked staff

Missed Wheretheresawill1 excellent explanation of forensic mental health

Unfortunately there are within the NHS a number of workers who slack off I think this is across the board within the public sector unfortunately and NHS culture that has become covering yourself/team takes up so much time fear of doing something wrong working within new guidelines it’s just adds to the pressure

But cut backs have meant really good workers leaving as they were struggling. Many (the majority) work really hard the nature of the work is difficult

As to workers becoming hardened to some extent yes you become desensitized you have to but that doesn’t mean I lack empathy I can’t sit there crying even if I feel deeply moved by what I have been told by someone I am working with or look disgusted by what I have been told (some love to try and get under your skin). We should have regular supervision to discuss how we feel. I work in a really good supportive team and we will have patients trying to split the team

Not everyone working in MH is that lucky and it’s absolutely vital

I am sorry for those who feel they haven’t been supported

There is a nurse at the cmht who is really good. Twice now she has answered my queries & dealt with things straight away, then phoned back.

My psychiatrist is actually very good & seems very caring.

Also there's a support worker who had helped me a lot.

I'm not so keen on the crisis team based on past experience but I've heard that they've improved. Not sure - I should've called them last weekend but didn't.

My SIL has a diagnosis of bipolar affective disorder but professional opinions vary as to whether she has BPD. She has been passed from pillar to post, she is supported when she's at her absolute lowest, but this usually involves calling the police and an ambulance and getting her sectioned against her will as repeated calls for help when we see the early stages of her becoming unwell are ignored.

As a PP said, we have had to back off massively from supporting her as a family, as it was so draining and hard for us all. She has said and done so many hurtful and violent things whilst unwell that it's hard for us to be around her with our young children.

However, if the teams had the capacity to work with us to help identify and treat early warning signals (for SIL, they can be as simple as her sleep cycle becoming disordered to know that she's on the brink of an episode) we would be prepared to be so much more involved. But every time we ask for help they are so underfunded that we rarely get help, and when we do it's a different person every time and understandably SIL doesn't respond well to that when she's vulnerable.

Worryingly my 10 year old DD is showing signs of MH issues, and we are already scared for her future. We are lucky enough to have the capacity to pay to treat her privately, but there are very few therapists available - even if you can pay - to treat under 14s. So we struggle on, looking for help and thinking that she will have to be at crisis point before she is helped.

We saw the GP and were told she wasn't seriously ill enough for CAMHS. They referred to us to Step 2, which is supposed to be an early invention arm of CAMHS, they gave her 6 sessions and a play therapy kit. 6 sessions didn't even begin to help her, she is so anxious about new people that she masked all her symptoms and pretended she was fine. The counsellor was sympathetic but, when she's seeing children who attempt suicide and could see that she was supported by family, decided she wasn't a priority.

I understand it all logically, but as a parent who is totally unable to help their child it hurts so much. It's breaking us as a family. I guess it's worse as we've seen the potential future in the form of SIL.

Where do we go, who do we ask for help? There's nobody out there to help her until she becomes worse. Which she will.

For those saying these services are underfunded - yes they are definitely.

For those saying that they are shit (I can’t be bothered to tag you all individually) I really hope you are protesting for better services rather than just moaning. Contact your MP, Contact your local MH Trust, contact local commissioning group.

Just a view from the other side. 95% staff are well intentioned & try their best in a chronically cut back and underfunded service.

Many of these staff suffer from depression & anxiety as a direct result of not being able to do well enough. So it’s not a case of us and them. We are human too.

I really hope that you are protesting, for better services rather than just moaning As if patients and their carers could cope with protesting and contacting every Tom, Dick and Harry, on top of everything else. Shows the level of understanding from MH staff, i'm sad to say.

As if patients and their carers could cope with protesting and contacting every Tom, Dick and Harry, on top of everything else. Shows the level of understanding from MH staff, i'm sad to say.

An email to your MP about your experience even if it is one line or completing service experience forms is now as easy as posting on here.

These people need to hear you, not just the staff. Who yes are protesting from the inside to get a better service.

It’s not about taking to the streets. As well as posting on here which you’ve managed to do, email someone.....

‘I had to wait x amount of months for x service it had x effect on my life’.

I say this as a service user & service provider - remember it’s not us and them.

I sometimes think that the recent campaigns to destigmatise MH have done the opposite. Mental health problems are like physical health problems. You can have a cold or you can have cancer, we don't categorise those two illnesses together and yet the recent stuff about MH seems very much to lump it all together and focus on milder forms of anxiety and depression.

Completely disagree with your post tessliketrees

I think that there are far more people now who self-diagnose (my narc MiL etc) as well as a greater need to find an external so that you can be 'forgiven'. For example, no one is anxious anymore, it's a more passive 'have anxiety'.

When people need trigger warnings to avoid anything that might make them have to act like an adult in an adult world and when they can cry ablist / anti-disablist / disablist (I forget what term we're supposed to use at the moment) if anyone dares question them, this is the result. People become less believing and sympathetic and this filters through to the NHS.

Yanbu

Even those who work in mental health aren't listening.

I'm 12 years post first breakdown, on my 6th anti-depressant med, 4th bout of agoraphobia, 8th cpn, 4th psychiatrist, fighting to get long term anti anxiety meds (any fellow OCD/anxiety sufferers who have recommendations I'm all ears) which is what I truly believe is what I need to have any hope of moving forward, but I'm being stonewalled.

I'm being told if I don't make headway soon the support will be removed supposedly because 'there's no point if nothing's changing' except things HAVE changed just not enough to satisfy them, and If the support is removed things will get worse again.

I also don't agree that "While there has been a great push towards normalising conditions such as anxiety & PTSD, conditions such as schizophrenia are still stigmatised." All conditions are still stigmatised and seen as 'curable' by sheer will power - not just by the general public but again by mh staff too - who SHOULD know better!

My primary Dx is OCD, with attendant phobias, anxiety, depression, and reactive agoraphobia. I've had mh staff frankly try and bully me into doing things that make me extremely anxious to the point of severe panic attacks triggering asthma and leaving me very anxious for several days if not weeks after.

Neshoma - couldn't disagree more, I think it's more a case of people NOT being dx, NOT being taken seriously and actually ending up being more ill as a result. People rarely admit to mh issues even to their Drs. Certainly that's been my experience both myself and others I know with Dx mh problems - more likely to have been desperately trying to hide it from everyone ESPECIALLY if you're a mother.

ImCatbug - I'm guessing you're talking about cbt? I've tried it several times, it DOESN'T work for me if anything makes me worse yet EVERY time I meet or am passed on to another new mh staff person it's the first bloody thing they suggest! Even if I start by saying "don't suggest cbt it doesn't work for me" they still try to persuade me - pisses me off! On various mh forums there are many of us for whom cbt has actually made matters worse - which begs the question where on EARTH are NICE/nhs getting the idea it works for the majority?!

WarmingUp

A - you're not a sufferer yet think you can get offended on our behalf? I think not

B - what else would you call us as a group?

C - if your focus is more on the language than addressing the actual problems within mh treatment in this country, you need to change your focus!

"For those saying that they are shit (I can’t be bothered to tag you all individually) I really hope you are protesting for better services rather than just moaning. Contact your MP, Contact your local MH Trust, contact local commissioning group." Personally I wouldn't risk it, I've seen how people who are !awkward' and seen as 'troublemakers' get treated - even just asking for a different cpn or therapist can result in being punished by being put back to bottom of lists! Plus - do you not think we have bloody enough on our plates?? It takes me all I have just to eat, go to the loo, answer the phone if it goes! I don't have the mental resources to fight for better services, frankly that's what public servants are supposed to do for us!

"as easy as posting on here." Physically maybe - mentally is a whole other issue as you SHOULD know.

And for those of us suffering significant MH issues - we are simply not behaving as adults?

Actually I did complain. I went to my MP who promised to visit and said MH was one of his personal top priorities (he didn't visit). I complained to the hospital board - who sourced extra finance and hired more staff (I wasn't added to patient list). I also went to the papers and a well-known MH advocate journalist contacted a charity/support network on my behalf and they promised to be in touch and help. Guess whether they followed up or not?

I've tried asking for help.

So don't put the onus on me to ask for more. I did. And people suffering schizophrenia and serious illnesses now get the help they didn't before which is great.

But the only time I see a MH professional is when I arrive on an ambulance.

For kids it's shockingly bad. We are now paying for psychiatric sessions (I paid privately for me for the same condition several years ago).

Yes I've complained.

Same experience as a pp. chased and chased for a year for the appointments then got two letters in a row saying we'd missed appointments and they were discharging. Never received these alleged appointments. In their response they said they'd included copies to 'proof' they'd sent them. No copies - possibly because they'd never existed?

So i work in community mental health and thought it might be helpful to see ourside of it.
Our funding comes from GPs, in our area our nhs funding is split between the traditional mental health team that everyone thinks of and local charities. Our criteria is pretty strict thus people feel really palmed off when we assess them and point them towards said charities rather than nhs services. However these charities are paid by the nhs (their budget is actually bigger than the traditional team!) For that purpose

In my area you in theory if you meet the
Criteria (which is fairly high) have 6 sessions with a key worker, if ive still got you open after 6 then every month i have to explain what im doing to get you discharged

I love my job and for all its faults and lack of funding i would like to think im doing the best job i can, but ill explain it like this: your loved one tells you that they want to end their life, you call in distraught for you and your family this is possibly the worst day of your lives. Equally on that same day (and this is just what i did on friday) i might have spoken to 1 relative whos partner attacked her because shes unwell, 2 people in the same situation as you and 1 person who has attempted suicide. Thats on top of my 4 visits i completed that day so sadly the worst day of peoples lives is a pretty usual friday afternoon for me and our criteria is such that everybody is high risk so all of my caseload (aprox 35 ish ignoring covering sickness, duty etc) are likely to be facing similar issues. Doesnt excuse lack of empathy or anything but sometimes it's why my calls back take a while etc

I also wonder how many people are using up mental health resources that don’t need it too. I was diagnosed with anxiety linked to my job. I changed jobs and my anxiety went down so I cancelled the counselling sessions. I still get times when I feel panicky and anxious, but I recognise that that is a normal everyday thing that most people feel. I think sometimes people see people on social media that are showing off their perfect lives and never seem to worry about anything and think that if they are anxious about anything then they must have anxiety. Proper anxiety is not at all the same as being anxious about something.

Another one in the disillusioned to MH services club with CPTSD/BPD. I've ranted about the reasons behind my disillusionment in the past, and doing so again would only make me feel crap, but I have come to a place currently where I would go to a lot of lengths to avoid having to see MH professionals on the NHS. Not because I think they're all nasty and uncaring, but because endless assessments that go nowhere and the kindly-worded put downs (with less than kind judgments between the lines) are exhausting and make my mental health much worse.

Currently, I think there is no help out there for a lot of us. I mean, good therapies and medications and interventions exist in theory, but are not in practice available to the great majority of those who'd need it. The advice to seek help for these issues is actually meaningless, unless you have the money to do so entirely privately (cash paying, not depending on insurance). So you need to help yourself in whatever ways you can, when you're able to do so, and not hope to depend on others. I still have hope that if you actually drop off the deep end into full blown psychosis, there will be some emergency help, but beyond that - nope.

Another one dissilusioned. Been struggling for almost 12 years with MH issues. Finally reached a breaking point 18 months ago.

Have decided to use my PIP to fund private therapy as i am just not getting the support and fed up.

I actually got an appointment through for September 7th to start psychology treatment with a psychologist after being referred last week.

I was referred after keep getting very depressed due to a couple of issues I have. I'm also hoping he can help me cope with the paranoid thoughts so I can take a lower dose of meds?

I was surprised to get an appointment so soon but I'm already in the system as I see a psychiatrist regularly & am diagnosed with quite serious MH illness.

This thread is quite depressing.

I worked in MH for about 25 years and still keep my hand in with lots of different things but this thread has reminded me of the frustrations I had every day.

1. MH services are (largely) expected to deal with any and every manifestation of MH issues. Things like BPD or CPTSD are psychological rather than medical conditions but services have historically been set up to support people within a medical model. Most staff who work in MH will not have been trained in these sorts of issues (although there has been some improvement lately) but attitudes are handed down from existing staff and become behaviour management rather than treatment. Go to a cardiology ward and seek treatment for a broken leg and you will get inadequate treatment, but because policy and society class MH as one thing, it's expected that people will just be able to treat whatever the patient's / service user's needs are.
2. Some people with complex MH conditions present very challenging behaviour, whether this be violence to themselves or others, continuing to engage in behaviours which are underpinning some of the MH problems. Not being downhearted by this when you are trying your best to help in difficult circumstances is very, very difficult. BUT the people who present those challenges are not doing it on purpose, it is a manifestation of their needs and as professionals we should understand and support that without fail. HOWEVER, supervision and support is not always there to allow people to vent their feelings when it should be AND sometimes what is needed is clear boundaries which might not sit well with the person who is in crisis. Anyone that I have spoken to, who has recovered from things like BPD has spoken of how, with hindsight, they understand why certain things happened but that at the time they were so overwhelmed that they just felt angry and let down.
3. In my experience, HCP (in general) have a tendency not to listen to the honest feedback and experiences of SU. They invalidate people's feelings and experiences and get defensive. This is not unique to MH but I'm seeing it on this thread quite clearly.

If I was in charge of the world
a) there would be specialist training and services available for different areas of MH. Treatment wouldn't be farmed out to charities who operate on a month by month basis and have to keep their fingers crossed for funding.
b) Supervision would be available for and expected by everyone - and not just used as a bollocking session as it is for some professions.
c) Service users would be involved in training, recruitment and ongoing quality assurance of services. Creating a culture where we listen with open minds.

There are probably other things I'd do if I was in charge of the world too.

graphista there are a lot of people suffering in silence, not getting dx when they do genuinely have a problem. And one of the reasons many don't come forward/ admit it is because of a minority of very vocal armchair dx types.

By vocal I'm not referring to being open in rl when it's relevant, let alone on here. Or even the very one sided view that can be a symptom of some mental illnesses. More vocal when it's convenient, or when anyone else is hesitantly trying to raise their own concerns.

Eg person a is at that robotic, functioning on the outside and dying inside level of pnd. But don't get chance to even hint at needing a bit of support, because person B with their armchair dx is loudly demanding the attention and support of person A and everyone else. And despite sharing their every symptom in great detail, at the worst has the type of mild anxiety that could be improved with self help strategies. Or if you were feeling less forgiving you might think they didn't even have that, given their symptoms always seem to arrive at convenient times.

Again I'm not referring to conditions/ severity or situations where it can dominate interactions unwittingly.

Hogfather - yea that's one reason. Another is fear.

Fear of the stigma
Fear of the treatment
Fear of the consequences (as a result of stigma - eg job loss, loss of home, loss of partner/friends, loss of children) which I'm sad to say can and does happen (mainly job loss - it's disguised as 'performance issues' or whatever but it's far too common). As a Lp with abusive parents of my own that I would NEVER have wanted dd to go to (the root of my issues ironically) I feared ss involvement in case they decided I couldn't look after her. In my case as it happens because my main 'thing' is OCD I'm TOO careful, hypersensitive to 'being a good mum'. I'd been afraid to cook for about 2 weeks when crisis team (and ss) got involved and I truly thought they'd take dd off me because I wasn't cooking home cooked dinners, instead feeding her a combination of cold food (sandwiches, pies, sausage rolls), takeaways and supermarket cafe meals. As it turned out the sw said 'a few takeaways does no harm, she's being fed is the important thing, and you're giving her plenty fruit and veg still' which I was, just not chopping or cooking it (as j didn't trust myself with gas cooker or knives, in my messed up head I was afraid I'd leave the gas on or leave a knife lying around for dd to hurt herself on - I wouldn't have precisely BECAUSE I was paranoid I would and so checked everything).

But at the time (and I weep as I write this just at the memory) I was TERRIFIED they'd take dd and that WOULD have finished me.

So...that's another reason people don't go to get a Dx - fear/shame.

graphista my issues had the same root cause as yours, but manifested differently.

I agree with everything you say, but for me it was a bit different. My entire life experience had taught me that you cope, or you break. And that if you do break, nobody gives a shit, you stay broken until you can mend yourself.

I did have friends I trusted, but had always been in the role of the supporter, not the supported. Not just genuine mh problems, but practical things, it was 'hog father will know what to do'. So I didn't feel I was allowed to break. Stupidly when I first tried to open up about it, I didn't want to burden the two people who would have helped and understood, because I knew they had their own battle scars & illnesses. Instead I tried with people who were extremely open about their own (I now realise none existent) mh, and got shat on. Because of course by functioning as a lp, I clearly couldn't have real problems like them, or I'd be asking my dear parents and dear hubby to do that for me whilst relishing the role of Victorian invalid.

And different problems to you, but essentially the same underlying motivation, that my dd would have a wonderful carefree childhood no matter what it cost me.

And to a lesser extent, no desire to be lumped with the armchair dx group I'd encountered.

I just didn't feel I was allowed to have any difficulty.