What could be different in mental health care, what helps, and what have you found to be useful reading?

[OwFriggingOw]

First off - this is a thread inspired by another thread - not about another thread.

I am a lecturer who teaches mainly MH nursing students, but also Adult, Child and Learning Disability field nurses about MH, and also occasionally medical students. I have no agenda for this thread bar a genuine desire to listen, share ideas, and have an open discussion about what is helpful / less so. I worked in NHS MH for 13 odd years.

In case anyone links the other threads that inspired this thread - I have been comissioned to edit a book about people's experiences (service users and carers / family / friends) within MH services and with MH issues. NONE OF THE POSTS HERE WILL BE USED IN ANY WAY, SHAPE OR FORM FOR THIS BOOK. You have my ABSOLUTE word on that. Similarly, NONE of the posts here will be used in any of my teaching.

My aim in starting this stems from several PM's and several on-thread comments about how this would be useful/ I hope it can be a helpful, supportive and productive meeting place for thoughts and ideas about what people have found helpful with regards MH care / services / support (statutory and non statutory) and what has been less helpful. Most importantly with regards the less helpful - what can be done differently?

And - beacuse I like books - maybe we can share reading ideas :)

Would it be helpful if I shared parts of my long thread from earlier regarding what I see as needed, without any other details from the thread?

I don't know garlic, am not eligible for IAPT

Thanks for both links - not come across either :)

Self injury sites - I used to direct to National Self Harm Network which had a long page on distraction - not sure how helpful that one may be? Can't link as on phone.

Will have a look at both tomorrow, thank you.

i think the way i ended up seeing self harm (rightly or wrongly) is that sometimes self harm is the better option at the time. it can cope with the feelings and express them instead of a potential suicide/ suicide attempt. obv the preference would be for talking to help etc but sometimes it is not available or doesn't. i initially worked in therapeutic communities and then out into community housing projects and then on to secure hospitals where i went into advocacy and my opinion did not change. i don't see it as "wrong" although it is self punitive which is tragic, however i do believe in harm minimisation. excuse blubing- tired!

ow - www.nshn.co.uk

and maryz that is great news. and joyful.. very welcome. x

i think support for family members is crucial. i think it is v relevant maryz.

Excellent maryz :)

And glad you had useful support joyfulpuddlejumper

IAPT is accessed through GP or (here at least) can be accessed through referral from Psych Liaison via local A&E when people are in crisis? It's generally brief or lower intensity psychological input, often CBT based, around here. Is there a different GP you could ask for a referral through? Possibly even practice nurse? (aware I don't know circumstances and that this may be a totally unhelpful suggestion).

Checking in as sounds an interesting thread.
I'm a nurse, qualified in LD & MH, I no longer work in either field as to be honest there is pretty much nowhere I can work locally that I can do my job properly.

I adore working within old age psychiatry for example but I just find the standards of care in this sector disgusting, and yes I have made complaints, reported nursing homes & staff when I have done agency.

I currently work in complex care, part of a small team looking after people in their own homes, 1-1 care.

Totally relevant maryz and really important points. Fam

Family support can be vital, and the massive stress on families is often underestimated I think.

it does make complete sense, am glad the family therapy was helpful (for us it was often just me, as daughter wouldn't participate either but the format was me and one therapist with several others watching through the mirror before we changed places so me and the therapist could watch the others discussing the session, anyway I hated that) - just awful that it takes so long to get to the help

my daughter also started having serious difficulties from quite a young age but every time I tried to get help it was brushed aside or soothed as misplaced guilt on my part. It really did have to become a blue light sort of emergency (anorexia) before anyone started taking it seriously.

Welcome fannyfifer :)

I wonder how many people are / have / will end up leaving due to changes in service provision among other areas? Suspect there's huge dissatisfaction among services at moment especially when people have huge caseloads, targets and an abundance of rating scales to complete :(

Thanks Aesop - summary re Self harm makes a lot of sense.

More than half of the group I qualified with in LD are no longer in nursing.

I was horrified by the wait a friend recently had for CAMHS for EArly Intervention - somewhere around 16 weeks after initial crisis assessment deemed her to be less priority at that point :( By the time intervention started, her daughter was really in a bad place and everything was panic stations reactive rather than proactive.

CAMHS needs a huge amount more funding - some of our local CAMHS only have 2 CPN's and a psychologist, and a couple of support workers, to huge population. Goes back to my point re: short sightedness of the cuts - maybe investment in CAMHS would reduce Adult service use?

i couldn't have gone into psych nursing- could not agree with forcing people to take meds on sections etc no matter if diagnosed as needed. for me it is a human rights issue. i don't want to offend anybody here but i do have real issues with the removal of liberty and basic rights of a person and i do not have the answers as to how this can be addressed in cases where there is nowhere else for people to go

i believe that investment in camhs would definately reduce adult service use/need and more importantly reduce long term damage to a person. however it is unlikely to happen isn't it :(

I have to say we've never been stuck on any sort of waiting list for CAMHS or adult services. I did have a long wait for CBT the first time because my consultant didn't agree with it and said my mood had to be stable first, and the second time because I was told they had to find someone who would have the appropriate experience or something but she said she couldn't help me anyway (actually she said I was beyond the reach of therapeutic help which stung a lot).

wow fannyfifer - that's really sad. Though I can see why.

Maryz - can see why you may not want your DD to work in the field - it can be really tough. A lot of my students and the students we interview for the course have very close personal experience of MH either themselves or within family - they often make excellent nurses with real empathy, but do also risk higher levels of burn out I think.

Maryz, I'm so glad to hear DS has felt better this year. Must be terrifying as a mother.

I use Moodgym, too. It's a bit shallow for my purposes, but gives me a metaphorical kick up the arse sometimes. I'm always recommending it, often with enthusiastic feedback.

Family therapy seems a strange thing - it looks blindingly obvious to me that it should help (because of personal background) and I had an idea of what it must be like (because of family group sessions in good hospital). But every experience of it I've heard in real life sounds hopelessly ... inept. None of the families continued with it, even though they had at least one child in and out of hospital.

Thanks for replying about IAPT, Alameda. If you have to be 'eligible', maybe I'm not either. My relapse plan is now in my mug cupboard, I need it so often. I've got excellent workbooks and some great online friends, but am really missing the focus & motivation of a weekly meeting :( It's really hard to care that much about myself when ... actually, I don't.

Ow, I don't know whether you have any interest in assertiveness training as part of your trajectory? They did a lot of it in my hospital and I recognised it from courses I'd been on. The effect on people's attitude was really uplifting!