To really consider an inpatient programme?

[Anxiety7836]

I have suffered from really severe anxiety, a specific phobia and now agoraphobia where most days I can’t even leave my house to go somewhere 4/5 minutes away. It’s affecting and controlling every aspect of my life to the point where I can’t even travel to the doctors for care when I’m unwell - it’s like living in a prison.

I have tried medication, CBT multiple times which does nothing for me, exposure therapy which didn’t work because then I ended up doing other behaviours to compensate for the exposure and so on.

It’s honestly getting to the point where if I don’t knock this on the head I can HONESTLY see myself being one of those people who haven’t left the house for 20 years.

I’m getting to the point where I’m considering an inpatient programme as an absolute last resort - there are 2 hospitals I know of that deal with phobias and have specialist units - one private and one NHS.

On the one hand I think I need that daily intervention that they can offer but on the other hand a few things terrify me - like what if I go in voluntary and then they don’t let me leave, or what if they take away my phone and I can’t contact my daughter when I need to (under 10) or what if I go in aiming for a short stay and then they keep finding reasons to keep me there longer and longer - if that makes sense.

Can anyone offer any advice or insight please?

It's unlikely that you will get funding unless you are very ill and have risk issues around self care for example. Are you thinking of the Maudsley?
Again unlikely you will be sectioned or kept in unless you are a severe risk to yourself or others.
Inpatient is intense exposure. There is no way around it.

If they think it's serious enough to admit you, I don't think you'll be allowed to call whoever you want (even your daughter) whenever you want to. It'll be a strict regime.

@AliceAbsolum I have health care insurance that includes mental health inpatient so I could access them through that, I think I need that daily intense work because community things just have not worked

I have been sectioned before. You absolutely can have your phone and use it anytime.

The only issue is you aren’t allowed the charger. So it ends up in a que for charging in the office half the time.

I'd look into it and find the answers you are looking for by asking the questions, rather than it whirl around in your head.

Well if funding isn't an issue then why not. Anxiety is treatable.

Try the lightning process.

I think people think they’re some kind of perfect haven but they’re really, really not. (Not a dig at you op)
they are actual hell

Is the NHS place is the ADRU at Bethlem? If so, it isn't an inpatient ward, but a residential unit visited by clinical staff during working hours Monday to Friday. Kind of like a glorified house share on hospital grounds. Residents are allowed to come and go as they please; they can go to the pub or wherever in the evenings, and can go home over the weekends.

Even if it is a different, actual ward, I wouldn't worry about getting there and them changing your stay to involuntary and indefinite for anxiety and phobias. Or them taking away your phone and preventing you from contacting anyone.

I have experience of being assessed for an NHS specialist inpatient ward for OCD. I didn't take up the place offered last time but am being referred again now. The ADRU is also on the cards but I don't think they'll accept me due to my being unable to self care (by their standards; I live alone without carers, albeit very dysfunctionally), so I supposedly need somewhere with 24-hour nursing staff. Have you looked at the criteria you need to meet to get funding from NHS England? The threshold is high just to get funding for an assessment, and even then you may not be accepted by the unit. You can get funding through your local CCG; they have no specific hoops for you to jump through, but they don't like allocating such large amounts of money to individual patients if they can help it so a different obstacle there.

Are you under secondary care and has this option been suggested to you as necessary?

Also, the treatment you'll get will almost certainly just be CBT and ERP, because that is the treatment for phobias. And if it's the ADRU, you won't be getting it every day. Most of your time will probably be filled with occupational therapy-type group activities and hanging out with the other residents. Which might be helpful for you, but that sort of thing doesn't do it for me. I've also heard from patients who've been there that the CBT is only to pretty much the same standard as what they'd had from local services as an outpatient. It's one of the reasons I declined the chance to go to the different NHS hospital for my OCD: I thought there would be a full timetable with super-specialist, tailored one-to-one therapy taking up the whole day 9-5, but there isn't. The private place (the Nightingale?) might be different. I'd look there first if you have insurance that will fund it.

@Keyansier Honestly why post things when you don’t know what you are talking about? It’s a hospital not a prison, the OP will be able to talk to her daughter regularly.

It sounds like a good idea OP, but there will a waiting list for NHS so talk to your GP, and can you restart home treatment in the meantime to at least maintain at your current level. Realistically the treatment offered will be similar so if it hasn’t worked, talk to your community mental health team for their suggestions.

They won’t keep you any longer than you want, being sectioned is something that happens if you are a danger to yourself or others, which you clearly are not.

Life is worth more than what you are experiencing now. This is no way to live.
Do whatever it takes to get better. I wish you all the very best OP

I don't think they would keep you there any longer than the recovery programme time. So if the recovery programme was for three weeks, during that time they would give you the "tools" to help you overcome your anxiety and phobia. Then once you left it would be up to you to continue with the programme.

In case it is the ADRU and my post above sounds negative. I actually want to be referred to the ADRU this time rather than the place to which I was referred before. It reports good outcomes and seems to get better reviews from people who've been there. I'm just not sure treatment is as intense as what you may have in mind, because it certainly wasn't what I expected. They do look at each patient's needs in terms of treatment, but only guarantee 2 sessions of CBT a week (the OCD ward which I turned down only guarantees 1, so even worse!). The rest of the time during weekdays might feature scheduled activities but most of your time will not be spent in therapy. I would be looking at private options if they were open to me.

I've been an inpatient in similar circumstances.

If you're there voluntarily (which you would be), you can leave at any time.

You can find out their rules on contacting family beforehand. But I'd add that even on programmes where contact is very limited (which tend to be those for addiction rather than phobias), exceptions are often made for children.