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

848 replies

OwFriggingOw · 24/07/2012 20:32

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?

OP posts:
ElephantsCanRemember · 25/07/2012 07:23

Yes it does make sense. I tried to get more involved but was blocked at every turn. I couldn't get anyone to talk to me. Sadly, ExP died a year ago and my DS1 is without a father. I am just interested to know what more I could have done. Who I could have turned to and who would have listened to me.

OwFriggingOw · 25/07/2012 07:24

Other posters may have more and better advice especially from the point of view of carers?

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ElephantsCanRemember · 25/07/2012 07:26

DS1 is 12, he knows his dad was unwell, I explained to him. But when you are up against a family who don't believe and non existent after care and nobody will talk to you, it is a tragedy.

OwFriggingOw · 25/07/2012 07:28

God I'm SO sorry elephants :( I know some of the charities offer carer support and carer advocacy - my mum's involved with a carer supporter from the Alzheimer's Society regarding my nan who's fantAtic. But I think that's patchy and underfunded, and often not well publicised - we had to find them ourselves. Which is fine if you know where to look! If I find any links re that topic I'll post here as may help someone in your situation in the future. And again, sorry.

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Dolallytats · 25/07/2012 07:30

The waiting lists for counselling (CBT in my case) are huge. When I did get appointments I struggled to keep them because I am agoraphobic and I was unable to travel that far. Although I was grateful for the appointments, I think there could be some kind of 'home visit' service, even if it's just for a few appointments. I realise this is probably unrealistic as MH services are stretched too far already, but in an ideal world it would be great!!
Also, being able to self refer would be good. I have to get to the GP's to get referred for CBT, but I struggle to get more than a few minutes from my house.

amillionyears · 25/07/2012 07:31

So sorry Elephants.

OwFriggingOw · 25/07/2012 07:32

Can see why you may think that amillion

I suppose for me, this feels like something more positive and productive, which might benefit a range of people in terms of links etc. I don't think it would have been helpful for me to start another about anyone person or situation - others may disagree and can start any thread they wish. I wanted to try and gather some of the really fantastic suggestions that got lost among the fighting perhaps?

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ElephantsCanRemember · 25/07/2012 07:33

Thankyou Ow It was so frustrating. ExP knew he wasn't well, but he didn't how/why. Apologies if this is the wrong way to describe him but I don't know of any other way, he IMO was mid level mentally ill. As in, he could manage to live on his own but needed support and assistance. He was on anti psychotic medication but his family insisted he was just tired and stressed. I don't know. None of it makes sense to me. I don't expect you to have the answers, but will keep reading this thread as I think it is an important discussion to have.

OwFriggingOw · 25/07/2012 07:36

Hi Dolallytat - absolutely yes to self referral - I think some services are coming round to this idea though obviously this can be problematic in terms of waits etc, and trying to ensure people have support while waiting possibly?

I wonder if one of the things that's missing a bit is a middle ground home treatment service between the Home Treatment / Crisis intensive support, and CMHT less intense support. It does seem as though some on here have had great support from CMHT's that have been really responsive to individual needs like visiting at different times of the day - I think the CBT type services don't offer anything at home in this area which is a shame.

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OwFriggingOw · 25/07/2012 07:38

Thank you elephants and all best wishes for you and DS - hope this thread is helpful for you :)

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amillionyears · 25/07/2012 07:41

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amillionyears · 25/07/2012 07:42

I will stop posting about her now,but think on.

OwFriggingOw · 25/07/2012 07:46

I'm sorry you see it that way. I know she's not been forgotten - maybe she and others will fell they've helped to create something really useful. And positive, and that lots of people in MH are genuinely willing to listen and take on board other points of view?

I think the way this thread has gone so far - and I'm aware it could have been different - is more generalised support and signposting by a range of voices, rather than another thread about a thread. I'm pleased about that - there's always space for others to open more specific support threads but I didn't think that would have been useful for me to do.

OP posts:
Arana · 25/07/2012 07:55

I'm afraid I haven't read all the other replies, so apologies if the gist of this is wrong.

I emigrated to Australia a year ago. Previous to this, I'd sought treatment/diagnosis on the NHS for a variety of things, including ADHD, interstitial cystitis, joint problems etc with little or no success. If I was lucky to get through the GP stage, I would fail or be fobbed off further down the line.

Since I arrived in Australia (and I am on reciprocal medicare here, not private) I have had successful diagnosis and treatment of ADHD, depression/anxiety, chronic tendonosis (following on from pregnancy) and hypothyroidism.

My GP over here couldn't believe that having recurrent intrusive fears of putting my baby in the microwave when mentioned to the HV weren't picked up as anxiety related to PND, and that I wasn't routinely tested for thyroid levels when I went to the GP in the UK about fatigue (falling asleep uncontrollably almost every day), or even questioned about other things (such as feeling the cold, dry skin/hair and weight gain) which would have instantly rung alarm bells.

In addition, I don't have a lecture / patronising talk when I need a repeat for low-dose, taken when needed oxazepam for panic attacks. The prescription is given to me with a smile and encouragement that hopefully the other treatments will start to take effect soon, and if anxiety is a lesser impact in my life, then I can work on getting better, easier. I know my friend in the UK who had similar issues wasn't treated anything like as compassionately.

I have a problem with my pelvis at the moment. It's a chronic ongoing thing since I had DD (nearly 3 years ago) that has got worse since I've started running. In the UK I had an ultrasound scan (that took 3 months to be referred for), nothing was found, so I was put on long-term pain killers and told to stretch more. In Australia, I first went to the doctors about it a month ago. I've had 5 sessions of private physiotherapy since then. I went back today saying that I was still in considerable pain, and the physio thought I had severe tendonitis and tendonosis. I was referred for a cortisone injection for the pain, and to relax the muscles. I'm having this on Friday, but only because I wasn't able to make the appointment tomorrow. This is fully paid for by medicare.

There are differences that are due to the way the Australian system is funded compared to the UK system. For example, I'm trying a new anti-depressant. It's new, doesn't have much of a track record, and works in a totally different way to normal ADs. It's also much more expensive than your sertralines and citaloprams. I know this drug isn't available on the NHS, so I would never be able to try it in the UK. It might not even work, but at least I can have the choice to try it.

The way counselling works as well is different - I have to pay part of the fee (about 15 pounds for a 45 minute session) but I was able to access this within a week.

Individually, you will always get good healthcare providers and bad ones, one of the GPs I've seen in Australia was shocking (I was told to try meditation when I was bouncing off the walls and cutting myself every other day) and one of my GPs back in the UK was great. However, it seems like the quality of care in Australia is supported, rather than held back by the public AND private provision in healthcare. Australian hospitals are either private, or public, not the pseudo public PFI that you get in the UK, and I think this helps to reduce some of the beaureaucracy and red tape.

From the Guardian:
For example, while the capital cost of rebuilding Calderdale Royal Hospital in Yorkshire is £64.6m, the PFI scheme will end up costing Calderdale and Huddersfield NHS Foundation Trust a total of £773.2m. Similarly, the cost of building the new Walsgrave district general hospital in Coventry will jump from an initial £379m to an eventual £4bn.

Also funding is allocated per person rather than per area, so you can apply for a certain amount of allocation for things like counselling, physiotherapy etc, after which you have to re-apply to see if you still qualify for subsidised treatment. And this is qualified for by a need basis rather than means tested.

That's my 2p on the matter. Or 2c as is it in Australia :)

Arana · 25/07/2012 07:58

Oh, and DS has been referred for speech therapy in Australia that we tried to get, and were told we wouldn't be able to be referred for until he went to school in the UK.

OwFriggingOw · 25/07/2012 08:19

Great services in Australia! I often hear that Australian services are particularly well run.

The funding in the UK just isn't working at the moment - with I knew why, but same for physical health services. Currently at GP - I'm VERY fortunate to have an excellent GP and excellent consultant for long term endometriosis, but it's another area that's very hit and miss and patchy in terms of referral and treatments.

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Arana · 25/07/2012 08:31

Sorry, I meant to add as well, on the useful reading subject, I downloaded a brilliant ebook a few weeks ago that has really helped. It's called Getting Unstuck: Unraveling the Knot of Attention, Depression and Trauma. it was free when I downloaded it, but I'd still pay the Amazon price for it.

www.amazon.co.uk/gp/aw/d/B006P5M5MU/ref=redir_mdp_mobile?ref_=sr_1_1&s=digital-text&qid=1340947452&sr=1-1

strawberry17 · 25/07/2012 08:59

I'm sorry I haven't read the whole thread through and I apologise if it's already been mentioned, but I would like to see much more investment in other therapies as a first line of treatment, it seems like doctors are so pushed drugs are the first line or only treatment available.
I would like to see information about how to get people OFF the drugs as well through the NHS. Many many people have problems with this and the information about how to taper safely is not in the public domain and doctors are not given the information, Mind have recently produced some information:

Mind - Making sense of coming off psychiatric drugs

This is something that many many people struggle with and there is no information or support.

My experience

aesopslabials · 25/07/2012 09:36

daisee has very much not been forgotten amillion and i resent that. you can't bloody win on this site can you. there will always be somebody...
i have come in here looking for daisee, checking to see if she has posted. the point of THIS thread (which also received tons of flack and abuse when suggested) was to look at the issues daisee raised.

PLEASE can you not derail this thread into a bunfight. i am waiting for daisee to post again to see how she is.

aesopslabials · 25/07/2012 09:38

i also think that it is very rude and abusive to start threads about posters and to have whole threads talking about a poster as if she isn't there. she has been depowered enough and i will not do that. please can we keep this thread positive.

Maryz · 25/07/2012 09:43

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Maryz · 25/07/2012 09:44

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amillionyears · 25/07/2012 10:01

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Maryz · 25/07/2012 10:09

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amillionyears · 25/07/2012 10:13

Actually I will take the opportunity now to ask MN publically if they know anything more about Daisee.Pretty sure MN is reading this thread.
Mumsnet,have you heard about Daisee?She posts overnight,but when the other thread filled up last evening she did not cross over into this one,like the others did.
tried to email MN this morning already,but not sure it went through properly,so either you already have 2 emails from me at present,or none.
Thanks.