Community Mental Health Team

[Queenanne20]

My dh is with the local CMHT and has been for about 3 years. During that time he has had 3 different Caseworkers (he's currently on the 3rd), as they keep leaving. I just wondered what kind of service other people receive from their CMHT? Dh sees his Caseworker, who visits him at home, approx once every 6 weeks for a half hour visit. We only get a phone call in between to book the next visit. He's seen a Psychiatrist once, who recommended PTSD therapy and anti anxiety therapy. He's had the anti anxiety therapy about 2 years ago but we haven't heard anything further about the PTSD therapy and he's never seen the Psychiatrist since. All meds are now dealt with via the GP but the annual medication health check, ECG etc is organised by the CMHT. When the Caseworker visits he doesn't seem to do much, in fact there are certain actions that are triggers to my dhs mental illness and it's obvious this man hasn't a clue what they are, as he has done some of them in front of dh. There is also a language barrier, we find it very difficult to understand what this man is saying sometimes and there have been misunderstandings and he has admitted himself that this causes him problems with clients eg he thanked us for giving him a chance as others have complained about his accent. When his previous Caseworker left she marked down in her notes that dh was a very vulnerable person who needed the ongoing support of the CMHT, yet this man had only visited dh twice when he suggested putting dh on the "back burner". I argued with him over this and he apologised but as I haven't heard from him for many weeks now and dh recently lost his father, which has deeply upset him and this man hasn't even bothered to check up on him, I've a feeling we have, indeed, been put on the back burner. I'm wondering if I can phone the CMHT and ask to either speak to his manager and explain the difficulties we are having or ask for a new Caseworker. Has anyone else ever asked for a new Caseworker? I'm scared that if I complain about him ill be accused of being racist or that they'll discharge dh completely from the service and it's so very hard to get taken on by them in the first place!

It's been three years, has there been any progress with your DHs mental health?

Anxiety UK do reasonably priced therapy for those on a low income.

I left hospital on the urgent list for a cc, my discharged was delayed by a week to ensure I had a Cc. He came once then left. No one contacted me for 3 months, someone came twice a month a part then left. No one told me had no contact for 3-4 months. Got a new Cc she came once a month for 3 months before I moved. Each time she asked my diagnosis, checked I wasn't suicidal or experiencing psychosis then left.
I moved house new cmht, got a cc he came once said he would come once a month. That was 2 and a half years ago and I haven't seen or heard from a cc. I get psychiatrist appointments every 3-6 months.
I've been under various specialist services and cmhts over nearly 20 years and broadly the specialist services have been good and the cmhts poor unfortunately.

Thank you for the replies. Dh also has psychosis and was under the care of the local Early Intervention Team for Psychosis for the maximum three years, it was them who referred him to the CMHT. We were absolutely spoiled by the Psychosis team, it was as if they wrapped their arms around you, they visited at least once a week and we had regular contact with their Psychiatrist. Without them, I don't know how the whole family would have survived the first few years of dhs illness. The difference in the treatment from the CMHT has been a real shock.

I think rather than phone and complain you could instead ask them what your expectations should be regarding your DH's care. How often reviews are made? Is there a care plan in place? What is the ongoing care?

I think it is reasonable to say you have not developed a good relationship with your case worker. You DH has to feel comfortable and able to trust them.

I had a caseworker for a couple of years. I had the same one who coordinated all the other health professionals I was seeing. We regularly talked about progress, she wrote to my GP frequently, I had regular reviews. I liked her and trusted her (though it was a difficult time for me so it was challenging as well).

I did see 3 different psychiatrists over 3 different appointments which I found very upsetting as it meant I had to tell them everything before we could even get started. Of course I understood the strain on services but it didn't help me at the time. I also had to wait quite a while to see a psychologist because the service didn't have one for a while. This might be why the caseworker was more attentive.

I had very good care at a very difficult time of my life.

Editing to add - maybe I am confused. This was a specialist service, but within the community. I thought that was called CMHT.

@denhaag Thank you, that's a good point about the Care Plan, his last Caseworker wrote one so I'll dig it out, I'd forgotten all about it. I think I'll then go through it with his Caseworker (if we ever see him again). We have got on with everyone who has been involved in dhs care so far, apart from this man. He makes both dh and me extremely nervous, if he phones and I don't answer quickly enough he demands to know why I didn't answer it immediately. I am dhs full time carer so the Caseworker liases with me and I dread having to phone him or him phoning me.

Can you ask what is happening with the PTSD therapy? Has he been referred to a psychologist for this?

@Allthesnowallthetime It was during the one and only meeting with the CMHT Psychiatrist, almost three years ago that the Psychiatrist told his Caseworker that dh needed therapy for PTSD and to put him on the waiting list. They explained there was a long wait for the therapy so, in the meantime, they gave him therapy for anxiety management. Nothing at all has been mentioned since then about the PTSD therapy.

I had brilliant experience with the early intervention team. I was under them for 3 years too and it made such a difference

I'm on the severe mental illness register and through that I get input from someone through my GP practice. Initially it was once a year for a review. One review I was struggling a little but not so much to pester the cmht for support. I now see her every 2-3 months depending on how I'm doing. It's good that have someone to touch base with and if needed nudge me to pester the cmht if things are going squiffy. My mental health is fairly stable at the moment

@Superscientist I've never heard of the severe mental illness register?

https://www.rethink.org/advice-and-information/living-with-mental-illness/physical-health-and-wellbeing/severe-mental-illness-and-physical-health-checks/

This explains it, it's mostly to make sure primary care keep an eye on those with certain conditions. I get covid vaccines each year because it to. Each year I have a load of blood tests, weight and blood pressure, alcohol intake etc. in my current surgery I get a nurse I can see. Previous surgeries was just the bloods

@Superscientist thanks so much for that information. I'll check with my dhs GP whether he's on the register. He gets a check up once a year weight, ECG, bloods etc due to the meds he's on but I never knew of the existence of this register. Thanks again!

@Superscientist sorry, forgot to mention he also gets covid vaccinations and flu jab every year so I'm assuming he must be on some sort of register with the GP.

I have to pay for flu vaccines as they have different criteria
During the pandemic they found that those with severe mental illness were impacted more by covid and got more unwell so we were included in one of the preexisting condition groups. This is something I had suspected for a while I seem to be badly impacted by colds and similar more so than my partner. Plus physical illness makes me at risk of an episode and because of this I always pay for a flu jab.