Talk psychiatrists to me..

[psychconcerns]

DD is trying to get a referral after 6 years of struggles. ED, anxiety and depression on various combos and at various levels.
She's seen a therapist off and on and been on and off citalapram. Her therapist has suggested a psychiatrist
I'm feeling wobbly about thsi. But she's 25 and lives and works a long way away.
May I please ask for experiences goid and bad?

Daughter can ask her GP to make a referral to a community mental health team for psychiatric assessment and review
She may initially be seen by an assessment team / single point of access SPA team who have psychiatrists
Is she taking medication at present?is it having a good effect?

what is daughter opinion, what is she hoping for from an assessment with psychiatrist

She feels quite disassociated and depressed. Tbh her poor brain has been battered by anxiety and her ED for years, all while forging ahead with degree and job and outward success.currently in citalapram but feels she needs something different, and doesn't trust a GP to get that prescribing right

Ok,she asks GP ago refer to local Mental Health Team for an initial assessment and medication review
Gosh she cope with a lot I wish her well and hope it’s a constructive assessment

I am very worried about her doing this on her own. It feels the very act of seeing a psychiatrist means an escalation. It's not really like that tho - it's more that she feels the citalapram
Isn't working and she doesn't trust a GP to make the right call on the next stage.

What makes you feel ‘wobbly’ about her seeing a Psychiatrist OP? They’re just specialised doctors trained to work with the mind and prescribe psychiatric medications.
x

I think it feels like a step change @Dogsarebetterthanhumans . And unknown territory. I know plenty of people who have seen therapists or who are on meds prescribed by GPs. But no one who has seen a psychiatrist. Or mental health team.

And I wholeheartedly agree with the sentiment of your username!

Like everything else in the NHS there are not enough psychiatrists. Unless she is in a crisis (e.g. post suicide attempt) she is likely to be on a waiting-list for some time. Appointments are short, there is often a high turnover and little continuity of care.
A psychiatrist does not automatically section all their patients if that is what you are worried about. They do have a better knowledge of medication than GPS and also know which medications can be combined.
If this has been going on for 6 years was she not under CAMHS or an ED service?
And is her current therapist private or NHS? If it is an NHS therapist they may be able to make an internal referral.

I think the main issue for your daughter with seeing an nhs psychiatrist is that the waiting list might be long unfortunately.

In my experience the role of psychiatrists is that they have a specialist knowledge of medication relating to mental health. It is just like being referred to any other consultant for their specialist knowledge. I wouldn't see it as an escalation, just as a targeting of provision.

Very best wishes to your daughter. I'd be concerned about waiting times too. However, for what it's worth, a GP friend of ours recently said that in his practice if someone had tried two antidepressants and still wasn't stable they would automatically refer on to a psychiatrist as they are the specialists when it comes to mental health medication. This makes sense as all their training from shortly after graduating in medicine has been in psychiatry and a large part of psychiatry is prescribing.

If you need to be medicated for a mental health illness a psychiatrist is the best person to see as they're a specialist. Where I live, there is no access to mental health medication apart from through a psychiatrist. GPS aren't even allowed to prescribe antidepressants.

@Roseau18 no to all those questions. The problems began at university where she was poorly served by a GP. She then moved to London for a masters and then got a job. The peripetaic nature of life as a young adult isn't helpful.
Her ED, while it consumed her, was never judged bad enough. It has to be BAD to get a referral.
She's had ups and downs. But is def on a down. And has decided enough is enough. She's also used some worrying language

As others have said, she is likely to have a really long wait to see an NHS psychiatrist, if she can get a referral at all.

She could ask her GP to refer her to a private Eating Disorder psychiatrist at The Priory, who would then be able to review her medication including antidepressants. I think it costs about £300-£400 for an initial consultation, so not a huge amount if she is really struggling with her issues.

@Feetinthemudandleaves do you have experience of the Priory and EDs? Because I can't help thinking that might be a good idea for DD. I think her feelings of hopelessness came after the ED which crept up on her 6 years ago, and has had her in its clutches since

Yes, I would recommend Dr Sekar, ED psychiatrist at the Chelmsford Priory. He has really helped me with my longstanding issues with ED and depression and I have found him to be kind and understanding. I think he can do appointments via Zoom if your DD is too far to visit in person.

Thank you @Feetinthemudandleaves
DD is in SW London so maybe Zoom might be possible.

I hope she can get the help she needs

Her therapist can make the referral to the local psychiatric team. Whereabouts in SW does she live, it this isn't too outing?

She won't wait for months to be seen by a psychiatrist; could be 2-4 weeks. She may see a doctor in training, supervised by a consultant psychiatrist. She may be assessed/triaged by a psychiatric nurse in the first instance.

If her medication isn't working and she feels this is beyond her GP, I strongly suggest a referral. And you shouldn't have to pay for it!

@SophiaElise Clapham area.
I need to have a proper phone chat with her this weekend and see where she's at.
This thread has been helpful, so thank you everyone x

That likely comes under SLAM (Maudsley NHS Trust)

That's a centre for excellence - and it's free.

Hope she gets the help she needs...

@SophiaElise
If you have had recent experience of a 2-4 week wait then I think you have been very lucky.
@psychconcerns For information about how to get help for eating disorders, look on the BEAT website. They have linformation and online resources both for the person suffering from the ED and for their parents/carers, including support groups. They were a lifeline for me when my adult daughter had anorexia.

I have no idea where you live that psychiatrist appointments take 2-4 weeks, here the wait is up to a year for a non emergency psychiatrist appointment.

@SophiaElise Do you work in this field or have first hand experience of waiting times of 2-4 weeks for referral to NHS psychiatrists?

To sum it up:
Psychiatrists = drugs
Psychologists = therapies

So whether one is useful to you depends on whether you are interested in changing doses or trying different meds

It isn’t that clear-cut in my experience of both NHS and private psychiatrists.