To think that I need a MH assessment *TW*

[Wantthistoend]

I've suffered with self harm, suicidal tendencies, depression, chaotic behaviour essentially my whole life. I also have an eating disorder and what seems like OCD.

I get these spells where I believe thing slike people are building cases against me, I've committed fraud, people are recording me, I've quit my job and moved house because of this, empty my bank accounts, delete all my social media etc.

When I'm not in this frame of mind it's easy to shrug it off even though the thoughts are always there, but when I'm in it it feels so real.

I've asked for a mental health assessment but been told because I'm 'ok' just now I won't be referred. I've been offered SSRIs but to be honest I'd like to speak to a psychiatric professional before I start taking meds.

I was diagnosed with bpd in the past but I didn't feel that they spent very long with me to form that diagnosis.

I'm really suffering and I use drugs and alcohol to cope. I hate being in my own head. I got clean for two months because I thought they would then take me seriously but they just gave me a list of websites.

I'm in a toxic relationship and my job is suffering too - I hate it and it causes me a great deal of anxiety but I live on my own so I can't quit. There's a good chance I'll be fired because of all the time I've had off 😔

I feel like ending it all at times and I don't really know what to do.

I also had a miscarriage recently and have experienced a lot of trauma. I keep messing up and I feel like I've done irreparable damage to my life. And that people will use information against me. I'm scared even posting this.

A mental health assessment sounds absolutely appropriate- your GP should not be refusing this, I would advise making another appointment and asking to be referred to your local mental health team for the reasons outlined in your post. Please advocate for yourself, you deserve support.

That’s really tough. It’s very hard to get MH support at the moment.

Can I ask why you won’t try medication?

Have you spent much time with your GP? They can refer you to the Community Mental Health Team who can arrange a psychiatrist appointment for you.

I have psychotic spells. I believe I am being watched, that people are evil. That the government are out to get me. That I’ve been microchipped and I need to kill people.

Last spell it took 3 weeks before they decided I needed to go into hospital. I was a real danger to those around me.

What do you hope to get from a psychiatrist appointment? I’m wondering if there are other ways to get you the treatment you need.

Agree with first poster. You absolutely need to push for intervention.

It wasn't my GP, whenever I ask to speak to them about mental health they tell me to make an appointment with the psychiatric nurse at the practice. I've done so twice. I've told her that I'm scared of these spells and I wanted to see if they can be prevented. She just told me because I wasn't having one then, that she could see no reason for referral.

It's so hard 😕

They prescribe me SSRIs which give me really bad side effects which triggers the thoughts and then I freak out with health type anxiety.

I'd be happy to stick with them if I knew that I'd been properly assessed and it would be worth it. I'm pretty frightened of the medication too which is probably part of the problem.

Can I ask - when you're not having a spell can you see that it was nonsense? But when you're in it you can't see it? It feels so real

Yes when I’m psychotic it feels very real but it doesn’t end without intervention. So a change in medication has been what ends the episode. When I look back on it I find it all very confusing as the people I see (I get hallucinations) are very real. I also get feelings of bugs on my skin and I try to cut them out.

I am in multiple medications now. I tried to come off my anti psychotic at the end of last year and that was a disaster so I’m sticking with it!

It really shouldn’t be so hard, what a nightmare. I’ve never heard of GP practices having psychiatric nurses. Could you ask her for a referral, outlining what you’ve told us here? The system can be so disempowering but please gather your courage and say what you need. If the nurse still refuses, you could ask for a GP appointment on the grounds of not getting the care you need - someone needs to action this referral, it is better to be proactive than wait until crisis. Sometimes health professionals need to be pretty much told what to do unfortunately, as so much gate keeping goes on between primary care and secondary care. Please be assured that a mental health assessment is clinically indicated here (I’m a psychologist).

That's really good that you've found something that works at least. I'm just curious if they have my diagnosis wrong because I just don't feel like it's manageable right now, they've told me I'm coping but I'm not. I haven't eaten in two days because I'm so distressed.

I think because I dont get hallucinations or hear things they don't seem to be taking me seriously. I know that I do take pretty extreme reactions to the thoughts so they don't feel like just thoughts, if that makes sense? They feel like core beliefs. I hope I'm making sense here.

It usually passes but takes a week or two and by that point I'm suicidal or have done something stupid like handed in my notice. I'm pretty close to that just now

Acting impulsively is another reason why they should refer you for assessment. I think you need to go back and push for it. Really lay on thick about the suicidal spells. It’s terrible so many people are falling through the cracks in the system.

I wonder if it's a Scottish thing, I have a support worker from addiction services and she said most of them have one now.

I basically begged her the last time and she spoke to me like an idiot. She told me I will never see a psychiatrist and that it would be a 6 year waiting list anyway.

I know from experience that even extreme measures like overdoses etc don't get me any help. They always send me home again with no support. I'd be reluctant to even ask for help with that type of thing now.

I will do an econsult on Monday and hopefully the GP will see me. I thought the same - that I didn't want to end up in crisis again so that was why I asked her a second time.

My support worker isn't all that useful she hardly answers her phone even though she's supposed to advocate for me. It's a nightmare

I've been saving up pills for months as a security blanket. I've told them I have access to substances that I could overdose with easily - that I don't want to I'd rather get help. She just told me "well you haven't, have you" I've even been thinking of chucking myself in front of a car. But I wouldn't want to hurt anyone else.

You've put it perfectly, I really do feel like I'm falling through the cracks right now

This sounds atrocious, you really need to get some help. I know that in this area you are able to self refer online but evidently it’s different where you are. I think you may have to keep pushing and tell them you cannot live like this any longer. I don’t know what the escalation process will be where you are but there must be one and you are totally justified to advocate for yourself here. I am sorry you are having such a hard time.

I feel like you may have to accentuate your negative feelings. I have experience of mental health issues with family members- it seems like there is such a shortage of help that only those who are gong to hurt themselves or others get much support.

I agree. I work with clients with mental health problems and it seems to get harder to get help with every year. Services are over-stretched and under-resourced, so only those most severely affected get help.

Hi, OP. The Mental Health Practitioner should absolutely be referring you to the Early Intervention in Psychosis Team for their assessment (providing you're under 35 years of age, or if over 35 the experiences have been happening for less than one year)

Your behaviour and response to your thoughts are concerning, ie moving house suggests in the moment you believe your thoughts with high levels of conviction. The fact they resolve without treatment within a week or two suggests either you're having blips (which may mean you can receive therapy from a different team, depending on your area), suggest substance misuse (I know you said these experiences continued when you stopped for two months, but the EIT works with people regardless of substance use) or indicate an acute stress response. How often do you have these experiences? EIT may not accept you depending on some factors (I'd need to ask more questions to know for sure) but the Practitioner can't make that decision and should refer you to the specialist team for their consideration.

If you send me your area via PM I'm happy to point you in the direction of services who maybe able to help. You can actually self-refer to the Early Intervention Team or I can help you find an assessment team for an overall assessment, again depening on area. X

The fact you're not experiencing hallucinations doesn't actually matter, paranoia is also extremely common with psychosis and not everybody experiences hallucinations.

Call your NHS crisis team re: Assessment

Push for assessment
even if u have to sit it out in A+E
look up EUPD - does that describe your experiences ?

@Wantthistoend I’m in Scotland! And spent years working in addictions. Does this mean you are currently being seen by an addictions team? If you are then you won’t be referred to a community mental health team as you are already ‘open’ to a service, if you see what I mean. Psychology and psychiatry provision is limited in addictions which is a big problem. Has the nurse carried out a mental health assessment for you?

It does kind of but it's the long phases of depression and these scary thoughts that have me wondering if it's totally accurate. I also think I have cptsd but I know it's not that well recognised

I am being seen by an addictions team but they're not doing anything. I got sober on their advice to request a psychiatric assessment.

I don't have a nurse, just a support worker. She told me to ask for an assessment at my GP. And here I am😕

When you say BPD is that borderline personality disorder?

Someone I know experiences similar episodes and she is diagnosed with bi-polar.

Where I live, a GP would refer you and you would have an initial assessment within 28d with a psychiatrist or nurse. It’s astonishing you have not been referred for a psych assessment. You very much fulfil criteria. Needing diagnostic review is absolutely a valid referral reason. Appalling.

Yeah I was diagnosed with EUPD but it's the same things as BPD.

I have wondered about bipolar but it's hard to tell if it's impulsivity or mania at times. I'm not sure if that even matters