Mental health referrals on the NHS

[Whathefisgoingon]

Has anyone has a successful referral to the psych/mental health team on the NHS?

After many years of debilitating anxiety, failed CBT and talking therapies, I have asked for a referral. They have done it but I was advised it is unlikely to be accepted and even if it is, the wait will be long.

Did the Gp gave you any specific reason as to why they think MH referral won't be accepted?

If the situation is really difficult for you you can contact the Mental health team emergency line.

How are you coping? Do you have any support or something that has worked in the past therapies?

@Fishandchipsagain They said that they are having referrals for suicidal patients rejected at the moment and they were being asked to refer them to counselling, so there isn’t much hope they’ll accept mine.

I’m not coping really. I had a 10 minute phone call with a mental health nurse practitioner at my GP surgery who reiterated that many referrals are declined and she will see me herself for the time being.

Ultimately I have been in and out of self funded therapy for years, but there is quite a bit of childhood trauma and I feel the need for a thorough assessment with a psychiatrist. Given the inability to manage this and ineffective talking therapy and CBT was, I feel there may be more going on.

That wasn’t very clear. I’m not suicidal, but they made a point that referrals for even severe cases (suicidal patients) are being declined so there is not a high chance they will accept mine which is deemed less serious.

Okay it's good that the Mental health nurse will see you for time being or till you receive any support I presume.

Is your GP ready to give you a psychiatrist referall? Is this something you can possibly fund on your own and then request gp for prescription of medications if any?

I am no expert on this but just didn't want you to face this alone. Sorry if my questions don't make sense you don't have to answer anything on here if you don't want to.

@Fishandchipsagain thank you.

Private psych consults begin at £300 here, then around the same for further appointments, so at the moment I can’t afford it. It infuriates me that it has come to this when we have a supposed national health service.

Yes over the period of years I have heard that MH support isn't as helpful and speedy as it should be.

Can you try to ask about the psychiatrist referral? Please go with the assumption that the wait will be longer as general referalls are taking a couple of months but at least you will know that you are in queue and will be seen at some point.

Is there anything that you feel has worked even a tiny bit in your past cbt or talking therapies which you can use an anchor ⚓ to hold on to?

IMO phsychiatrists just give meds. They do talk to you but it’s more so they can decide whether to give more or less or different meds. If it’s not meds your after and wish to have therapy then it’s a psychologist you need.

Psychologists are even harder to get hold of in nhs than a psychiatrist.

I’m under the mental health team and had to wait until I had a full on breakdown before I was accepted. The psychiatrist doesn’t actually do a lot except make a diagnosis (in my case bipolar) and prescribe medication. If you’re hoping for therapy or something in depth then your probably best off going private as it’s unlikely you’ll get it on the NHS or you’ll be in for a long wait. I’ve been waiting a year for DBT and have been told it will be at least another 18 months before the DBT team will assess me and then another year before I actually start treatment.

I received 12 sessions of NHS trauma/PTSD therapy, including EMDR after I was assaulted. I had to wait about 3 months or so then I got an initial assessment and then was offered therapy.

I was in a really dark place when I started. It was really life-changing for me.

There are mental health charities like Mind that offer therapy as well. You can self-refer. Usually you pay a small fee per sessions.

www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/how-to-find-a-therapist/#CharityAndThirdSectorTherapists

OP do you take any medication?
What else do you think you need/would help? Is it that you think there might be a different diagnosis aside from anxiety?

My dh has just been accepted by the Community Mental health team. He was told that he would probably be declined but he wasn't, so don't lose hope yet. He is currently on a waiting list for a named Care Co-ordinator as I believe there is high demand, but they have been phoning him weekly to check on him and they are doing a full review of his meds.

Thanks everyone.

@Rustnot Possibly, yes. I didn’t realise a psych would only diagnose and treat. I didn’t specifically ask for a psych, just the mental health time, so I assume they work it out on their side.

It is a postcode lottery, and right now, they are overflowing with referrals.
I was under CMHT for years, and was discharged. Was assured that if I had a relapse, I would be fast tracked back in. Nope!
Had a huge relapse last year. The MH nurse at my GP said he could not give me the support I needed... and the over the space of 6 weeks, crisis team referred me to CMHT 4 times. I even had to come up with some document pleading my case.. that they didn't even read in the end. I just got told that I had done DBT twice, and that was my lot on the NHS. Get my folder out and fuck off, basically.
Now, I have fallen into "the gap".

So many people fall into the gap... not ill enough for CMHT, too ill for GP.

I think it is worth thinking about what support you would like from them.

CMHTs will all differ in their structure and support they can offer, but everyone referred and accepted will be under a psychiatrist. Some people may be allocated a care coordinator. Even when you're under a the CMHT, accessing therapy is not necessarily straightforward. There can still be a long wait. This is based on my experience and my particular team, where I know resources are very stretched, so it may be different elsewhere.

I don't mean to sound disparaging or overly negative, but as PPs have said, I think unless it is a different medication regime you would like, you may find there is not much else on offer. Referral thresholds tend to be quite high, so fingers crossed yours is accepted.

Op I work in the nhs for a mental health trust as a therapist. I think you mean a referral more to secondary care/community mental health team yes? what will probably happen is your referral will be discussed then either sent back to your local therapy team for cbt/counselling etc or they'll assess you but then send you back to your local therapy team anyway. Secondary care is now so busy it can only take on people with enduring mental health needs, psychosis, bipolar etc or those very st risk of harming themselves. You can request a medication review though and often a psychiatrist will take a look over your meds but there's a national push to keep mental health teams for those with the most complex needs.
Have you tried any other therapies apart from cbt? X

I've been referred as my GP suspects bipolar but the wait for the psychiatrist to do an assessment is 5 months. I have no idea what happens after that as not had the appointment yet. I'm not expecting much though, they seem overwhelmed.

@biscuiteater you'll be assessed by. Mental health nurse, they'll probably then prescribed medication. You might have a further assessment with a psychiatrist but quite often it's just the nurses and the psychiatrist over sees things. You'll probably be reviewed in 4/6 months and they'll see how you get on good luck x

@sarahc336 you’re saying that even if your referral is accepted, you likely STILL won’t see a psychiatrist? I’ve all the respect in the world for nurses and I see them regularly, but not for this surely?

@sarahc336 Thanks for your reply and well wishes. I rang them because I hadn't had any appointment letter and they confirmed that my case had been discussed and that I was down to be seen by the psychiatrist. I then got a letter confirming this. Last time (many years ago) I had any interactions with psychiatrists wasn't a good time as they were assessing me for sectioning. I kind of feel nervous about seeing one again but I do feel much better in myself now.

@Whathefisgoingon assessments are carried out by nurses or social workers typically, then you would be triaged and seen by a psychiatrist. I am fairly sure under a CMHT everyone sees a psychiatrist, especially as cases that are dealt with in secondary care are more 'complex.'

Yes it's really common in our trust for people to not see a psychiatrist,
All they do is review meds anyway or do a diagnostic assessment. They don't do any form of treatment, that's the job of therapists 😃

Obviously all trusts are different so that's just what happens where I work 😁