Worried and unsure

[Messupmum]

I've got to make a decision whether to be discharged from the cmht next week when my cpn leaves, or get a new one for a month or so while I get used to new meds.

I'm currently having weekly group therapy, which I'm finding hard and don't feel comfortable at yet. I think I have a bpd diagnosis as well as depression and anxiety.

I've been under cmht for approx 18mths, had too many cpn changes in that time. I have attachment issues and deal with changes quite badly.

I've not been good recently, currently under crisis/day hospital and this is where I had a meeting which left me sobbing. They let me leave early in this state. I asked for a phonecall today as I feel confused and low. Nothing so far. I'm scared of being left with no support very soon. I don't feel ready, but I'm worried I'm coming across as needy and pathetic. I am so confused and don't know what to do.

Hi I have bpd and while I am slightly different to you I disassociate myself from people so don't get attached easily but once I do boy is it hard to say goodbye. I think as your changing meds you should take the new cpn just in case there are any issues.

Sorry your having such a hard time right now hope things improve soon.

This is terrible care they are giving you - you aren't needy or pathetic, you are poorly. At the very least you need a new CPN - don't let them talk you into discharging yourself, you do not sound well enough (and I've been there!) big hugs to you

Preferably you need an advocate (official or otherwise) - you shouldn't be left with these decisions and you shouldn't be treated like this. It might be worth calling the Mind helpline and asking for an advocate to help you. Does your GP know they are doing this? S/he might be interested to know that one of their patients they have entrusted to the care team is being treated like this.

I'm so scared, but they've put doubts into my mind whether I'm worthy of their care. They wouldn't have suggested it if that's not what they really want to do. I think they've got to a point when they don't know what to do with me. And I'm still getting suicidal thoughts, feelings of detachment and get so anxious sometimes it prevents me from going out.

I'm not very good at saying what I want, as I can't help but feel needy and attention seeking. I found seeing my cpn regularly helpful as I could cry! talk about work, dd and other support I can access if needed. And just knowing there's someone I can call, who knows me, when I'm having a shitty time.

Maybe I'm expecting too much. Maybe I have got bpd plastered all over my notes, and they know there's no quick fix.

I'm crying again now, and getting urges to go to the shop and buy stuff that I shouldn't. This plan has been at the back of my mind all week. I'm letting everyone down and that breaks my heart, everything feels pointless at the moment.

Before all this happened, I changed GP surgeries. My own stupid fault and a big regret. So the new GP doesn't know me.

You aren't expecting too much - just proper care for an illness. You are MORE than worthy of their care - they exist to care for you. Your GP may still want to know what you are experiencing even if they don't know you - in my experience they do NOT like their patients receiving poor care from team who are meant to provide a service.

Anyway, rant over! Do you feel you could call someone - Mind, Samaritans, anyone? You are worthy of help and support xxxxxxxx

I have tried Samaritans a few times but don't always find them very helpful, but that's just me. I know they're a lot of help to others.

But how long are you meant to have a cpn for? If you have long term problems and not just short term blips?

I think you should stay with the cmht. Do you have a care co-ordinator? I would have thought you should because you have input from crisis, day hospital and your group therapy.

Is the group therapy run by the CMHT? If so surely you need to stay with them in order to keep accessing your therapy.

I'd definitely stay under the CMHT if you're still not good. I've had a CPN - although they keep changing - for over 18 months now. If you're still at day-hospital level then I'd definitely stay.

You don't come across as needy and pathetic. You come across as someone who's still quite poorly.

Is this Crisis or CCTT? Crisiss is only for a few weeks, normally, but CCTT for much longer.

The care co-ordinator is the cpn who is leaving in a few days, and they haven't assigned a new one, if they do, they said it will be short term, but no explanation as to why. And in my distraught and muddled state, I didn't ask.

The therapy is nhs but seperare I think, others in the group don't have cpn's.

Feeling so and lost

Just had crisis number and been to day hospital for a week, due to end on Monday.

Wouldn't it be nice if when you rang the crisis team in tears saying you felt like nothing is real, and all you can think about is hurting yourself as everything feels so pointless, someone could come and sit with you. Or at least arrange to visit in the morning? I know they don't have the staff, time or money. But someone in that state doesn't respond too well to being told to 'do something different' and tell someone on Monday.

Yes, well that's the problem isn't it? MH services are pared down to the bone. Huge case-loads and not enough staff to do all but the minimum.

"try to distract yourself"
"have a bath" (I swear to god people with MH problems should be the cleanest on the planet the number of times they get that advice).

and the worst "what do you think would help". Well, if you knew, you wouldn't be ringing.

You have my full sympathy.

Another one recently 'what can I do over the phone?!. I don't know, who else am I bloody supposed to call when I've got a ligature infront of me. I'm not ringing them for a chat, I need help but they've got a way of responding that makes you feel stupid and a nuisance.

Yes. The not very good in a Crisis team around here do the same.

I can't get out of bed, I need to but I feel like I'm not able to. I feel shaky and light headed and need a drink, but I don't want to face the day. I don't know where to start, dd deserves better, she'll want to do something today but I'm letting her down.

Hi, you said others in your therapy group do not have cpn's which is encouraging. In that they are getting therapy without need for a Cpn's. Will you still be able to access the group therapy and finish the course if you have no Cpn? The group therapy and gp can refer to crisis and day hospital not just a Cpn.

Where I am based it all depends on your diagnosis as to who provides what treatment. So if under a Cpn here then that is all the provision of help you get, no group treatments etc. if at gp level can access short term talking therapies that cannot get if under a CMHT. If in longer term group therapy etc that is a different team from CMHT. Aware this is not the case everywhere in UK.

My only thought is you do not have a diagnosis for a CMHT to work with hence you under whichever team provides the group therapy??

Cpn's do move jobs, go on mat leave and all sorts. Not ideal. I was given therapy and then after a few sessions the therapist told me she was moving jobs and that was the end of that. Not finished. Told 10 month wait to have the rest of my 12 sessions with someone new.

Think Jen summed up he crisis tea, very well.

If you think seeing a new Cpn for a month would help it is your right to take those sessions. You can ask about who is in charge of your care as well - the gp, the psychiatrist, the group therapy team?

Oh and the best way to get attention from a crisis team I have learnt is to tell them the specifics ( eg you mentioned you have a ligature) and that I have a young child at home with me alone and ask them what they will do about that!!! Then they tend to do more than tell you to have a bath.

I do have a diagnosis though. I assume cmht are in charge at the moment, then it will be GP. It gets to a point when you've asked for help so many times, that it's not worth it anymore. I feel like just hiding away now and not bothering anyone.

I would have thought if you are still doing the group therapy you would be under them though? So that is your source of help? Can you ask the others in your group how they are supported if they struggle as you say they do not have a cpn.

Try not to feel that because you will not be offered the resources of a cpn that you are not getting help. It is just the help may look different to what other people get as help.

Can you talk about this in your group next week? Others may offer some useful insight if they live in the same area as you as they will understand how that area works?

Where I live people with BPD are not treated under a CMHT if that helps.

And you still have the crisis team number until they refer you back to your other mh workers, so you can use them. Can you tell crisis how you are in distress because of cpn situation? The crisis team can be really helpful at passing on this key info to a CMHT as they obviously want to reduce the number of people in crisis, so work with CMHT's to reduce crisis referrals. Worth a try?

Ok, I'll go to day hospital tomorrow although I don't know why, as I'll just go to be discharged, then I'll agree I don't need a cpn, it won't benefit me to have one short term.

I know I need to cope with this, I made this my life. If I decide to end it, I don't want anyone stopping me. Been out for a walk and to the park, but I feel agitated and scared for no particular reason. I can't help it though, I'm really sorry, I want the best for dd but I can't do this!! God I hate myself so much. I feel like screaming and crying but I'm holding it in.

Day hospital tends to be short term intervention for a crisis, if you feel you have a new crisis episode tell them otherwise they will not know .

I would accept a cpn even if short term as it sounds like you are unsure of your future health care and a few sessions with a new person may be really helpful to monitor the new medication and tell you how it will work for you without a cpn?

Oh my only other thought is would you benefit more from having a support worker to help you do things with your dd? If so you can ask the cpn to set up an assessment to see if you would qualify?

Ss, hv and various others agree I don't need support with dd as I do everything I should. All that's wrong is my head. I just think I need to die. But no one takes me seriously, even on here, I feel that others get more support and understanding. And that's how I feel in rl too. God sorry I sound like a selfish, self absorbed, heartless cow, I don't mean to be, I'm sorry, I can't control anything anymore.

Also I know I'll get flamed for this, but others get advised that maybe they should be in a psych ward, I get told that that's a last resort and I don't really qualify for a cpn. Sorry, I feel angry and need to let it out. Maybe I should just leave now.