To think there should be long term support for people with mental health problems

[Tellmelies65]

Ds is under the community mental health team has been for four years. The manager has now said they should really discharge her as she’s an enduring case. I get she’s been under them a long time but where are people meant to get support? A lot of mental health conditions unfortunately aren’t short term.

I am employed to work exclusively with long term MH patients who are deemed too difficult for the NHS.
It fecking sucks.
If I ever mention my job on social media, I get told I have MH problems.

I've been paying for it privately for 9 years. There just isn't any out there.

Yes, like a physical condition, they should work with a patient until they are well - as long as the 'methods' they are using are appropriate and effective

Their argument is that if someone hasn’t improved in that time frame they are unlikely to.

It’s all about episodic periods of care and back to the GP (who may or may not be particularly competent with complex MH). Increasingly that’s the model for children too because of resources being stretched. You have to be so so unwell for long term support. Just know that you can get referred back if you are discharged. The pressure is to discharge after a certain period of support/specific intervention. It’s how the system is set up.

This has been an ongoing problem for decades now I’m afraid. I’ve worked in mental health and have my own experience as a patient too.

Getting mental health support via the nhs is tricky. You have to be ‘bad enough’ to get it, and then you must continue to make progress as a direct result of that support after you do. Remaining still ‘bad enough’ but also not ‘getting worse’ once support is given.

Once you aren’t ‘bad enough’ anymore you’ll be discharged as soon as possible.

And if you DONT show progress as a result of whatever support is given, then yes you’ll be discharged for that also. For being an ‘enduring’ case that shows little chance of recovering.

It’s a very strange system. There are long term mental health supports in the form of CPNs etc but again, you’ll often be discharged eventually for either being not unwell enough anymore, or too unwell. You have to remain somewhere in the middle or they won’t be the appropriate service anymore.

It’s tricky because while there ARE patients who would never make any progress towards recovery or independence if we continued to provide support unconditionally, that’s absolutely not everyone. And is a really non compassionate way of looking at it.

Resources and funding are SO strapped in mental health. They can only give the care to people who’s lives they can prove will genuinely change as a result of it. Therefore the whole model feels a bit like you’ll be punished by being abandoned if you don’t prove you are worthy of the limited resources they have available. Which is a really sad concept and can be quite re-traumatising for some. It doesn’t help people build trust and it doesn’t make them feel worth help.

If you can afford to go private, that might be the way forward. Or perhaps look into long term support workers in the social care sector?

It’s appalling. Any way you can get private help going forward?

@Tellmelies65

Their argument is that if someone hasn’t improved in that time frame they are unlikely to.

That's unfortunately very often the case. My enduring MH issues are managed privately, though my medication is prescribed via the NHS.

Frankly there just isn't support unless you pay- and finding someone private that will take you on when under a CMHT is really hard. I live in a large city and couldn't find a single one (the only criteria I had was that she must be female and registered with a professional body). I was discharged after 2.5/3yrs from CMHT for lack of progress. Very disheartening as I was denied treatments listed in the NICE guidelines for my illness. All the best to your daughter.

Yes I know these such a. Wide range of private options. I just feel for the large majority of people who can’t afford private care. They have suggested my sister go private she can’t due no having worked for ten years due to her mental health problems.