To feel like mental health services are abusing me

[Westendtown]

I’m struggling living alone and want to be in supported housing. For reference other professionals have said I’m clearly not doing well when I’ve had paramedics and police to my accommodation. They just won’t accept this and keep telling me I’m too capable for supported living because I’m a uni student and volunteer. I do this to give me a focus as I would completely spiral without it. Again they can’t see this. Nearly every night I’m crying and struggling. My rooms a mess with fruits flies and I don’t even know how to start sorting it. My hairs matted yet they are telling me I’m fine it feels like gas lighting as it’s making me like I’m making this up and maybe I’m fine. I have care in place but don’t feel it’s what I need as I’m still struggling a lot and don’t have hours when I really need them most at night. I’m at a loss what to do as they just won’t listen to me, do you think I’m attention seeking?

You do not appear to be properly reading or understanding my posts either.

I know all about DBT, please stop talking to me as if I'm clueless.

I have described situations I have seen where the person diagnosed PD cannot get support from services and so things have escalated - or, where there is no escalation, the person has quietly become more despairing (including my friend who killed herself in the end). Of course the services are at fault if someone cannot legitimately ask for support! You can't blame people diagnosed PD for not asking for help in "the right way" if you've decided there is no right way for them to do it!

I totally understand your point that some people might approach services "asking for problems to be solved" whilst others "ask for support", but you appear to be basing the difference on diagnosis, rather than the actual actions or ways of asking for support the person uses. As if someone with a diagnosis of depression would get some help, whilst someone with a PD diagnosis who asks for exactly the same thing in exactly the same way is expected to go away and "use coping techniques" etc. (This would be a really interesting experiment actually. Using recordings of conversations and saying either the person has a PD diagnosis or something else, and seeing how that affects staff interpretation of/responses to the same conversation.)

Taking the locus of control thing too far can become victim-blaming. It's not purely actions and choices that determine outcomes - situations, the hand you've been dealt in life, have an impact too, so let's not pretend everyone should be able to be fine and dandy without input at some point. Where does someone stand if they know their mental health is poor, they know they are feeling shit, and could do with some help making things better? You seem to think some people (diagnosed PD) should just try harder, cope alone, and it's a sign that their locus of control is all wrong if they can't magically make things better. Nevermind the role of trauma that most will be needing to heal from. Yet those with another diagnosis are not treated as personally failing if they need some help recovering.

My basic points have been
(1) that it's important those with PD diagnosis have a legitimate and effective way of asking for/receiving support (and treatment). I haven't denied that people try to get help in the wrong way, but that it matters that a right way is provided (which it so often hasn't been). And
(2) that people with a PD diagnosis are deserving of compassion and kindness as much as others. (And yes, they may require guidance as to how to ask for support appropriately, but the point is this should be done in a warm, compassionate way, not cold and punitive.)

Neither of these things should be controversial.

I have read your posts several times to ensure I don't repeat myself and I have answered appropriately.

1. This is quite off the topic. But I'm aware people may come across this in future, so want to ensure it should be helpful. However, atm its actually just an unhelpful criticism of services. It feels this is potentially a reaction to percieved rejection by services. Which is fine, but it doesn't feel like the place nor is it a positive influence.

*You said:-
I have described situations I have seen where the person diagnosed PD cannot get support from services and so things have escalated - or, where there is no escalation, the person has quietly become more despairing (Ie including my friend who killed herself in the end.) Of course the services are at fault if someone cannot legitimately ask for support! You can't blame people diagnosed PD for not asking for help in "the right way" if you've decided there is no right way for them to do it!"

**Again, I covered this in earlier posts. I have NOT said there is no right way, infact quite the opposite I gave an outline and highlighted what it showed for each question.
I can only presume this is a response to how you feel about services in general and your relationship with them.

3. You said "I know all about DBT, please stop talking to me as if I'm clueless"

• Apply DBT to this situation and the ones you quoted.

You will identify that an aspect is Interpersonal Effectiveness- so effective communication, yet you say this is not the persons responsibility to effectively communicate, because you percieve services tell you there is no right way. However, the HCP who likely has 20 people with similar presentations on their caseload. Is responsible to clearly describe to each adult how they can communicate distress. I can only infer you believe responsibility is placed on the HCP for all their patients not just you. That's a lot. But DBT, is effective, not just for PD, but many mental illnesses including depression and is about managing distress too. Modules are Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness. The aim is to reduce a reactive approach which is where high risks sit with PD. There is often a 24 hour window where no contact is made with the HCP after impulsive risk takes place to prevent reinforcing the maladaptive behaviour. Ie dsh, then access to HCP or admission.

4. So, in an attempt to help OP or anyone in future.
   -What HAS worked for you?
   -What HAS improved your communication with HCP, friends / family etc and moved away from reactivity and concern causing?
   -How do you regulate yourself when distressed?

5. In your opinion, what is appropriate support or treatment to receive from services at times of distress when people are reaching out? To you, what is an acceptable way of "reaching out" and what isnt? Given you said this should happen to prevent escalation. How does the HCP prevent escalation, as you have said its their responsibility.
   N.B given your comparisons of someone with depression and someone with a diagnosis or traits of PD are different. Let's recognise that as someone who has had friends with personality disorder and other friends with bipolar depression fundamentally the expressed need is different. I also stated that it was the picture as a whole that indicates what is going on.

I think focusing on negatives perpetuates problems and make the focus just that, and creates a self fulfilling prophecy. But focusing on what works gives people a place to start from and try.

1. “So, in an attempt to help OP or anyone in future.
2. -What HAS worked for you?
3. -What HAS improved your communication with HCP, friends / family etc and moved away from reactivity and concern causing?
4. -How do you regulate yourself when distressed?

Just musing on this myself.
What has worked for me is antipsychotic medication but it has been removed as an option for me now. Family have requested I go back on it, MH services say no.
What has helped communication wise is weekly visits from my CC however I’m not allowed them now as I’m deemed too dangerous to visit.
I used to regulate with diazepam (now not prescribed). Now have constant voices, angels visiting me. Bugs on my skin. Told to get rid of evil people. Tried headphones, they talk through them. Play games on my laptop, they speak through that too, watch tv and they talk through the tv.
I cannot go out as I’m being watched.

That’s interesting. What have you said or done to make them say that you are too dangerous to visit?

Can’t really blame them for not visiting you then!

No I do understand that but don’t understand why my family are deemed safe when they won’t visit? And family have stated I am better on medication but they won’t prescribe it!

If they deemed that your family was not safe then they would have to lock you up in a psychiatric hospital again so good job they don’t think that

I’ve begged to be locked up again. It’s the only safe way. But they won’t.

It does sound like a difficult situation. i hope you can keep yourself and your family safe.

Thank you so much for saying all this. I don’t have a PD but I sometimes have mixed bipolar episodes which inexperienced practitioners conflate with EUPD and treat me (or don’t) accordingly. I wish I’d had a practitioner with your outlook when I was suffering the worst mixed episode of my life a couple of years ago.

This post is really interesting to me.

My point was what have YOU done that's worked for YOU, so people can try this. Rather than other people, ie medication (drs), hcp visiting etc. As I see it, everyone has to do the work over a long period of time to see and benefit from the changes. This is also the case for someone with no mental health illness.

An example of this is, if someone with diabetes eats an unbalanced diet with lots of sugar, but has the correct medication, has all the appropriate classes to manage their illness. They could not possibly expect their illness to be managed well if they themselves are not doing the basics for themselves- lowering their trigger. It would simply mean they have to keep increasing medication.

Medication is a plaster, realistically short term, to allow for other coping strategies to be brought in. Diabetes would be managed alongside diet and other lifestyle changes.

The information you have given highlights complexities in not just yours but everyones situation, which makes me very reluctant to make any specific comments on care as I do not know the whole picture, but I think reflections are relevant.

My point is and has been, there is always something the individual can do to help the situation, even if its small, like eating, sleeping and hydrating regularly.

What I find most interesting, is the focus is on what others have or haven't done and what others have removed. Particularly services or HCP. What has struck me is the plan worked for you. But, how long was it meant to be in place for?
It's really obvious to me that it cannot be a long term plan due to annual leave, sickness, etc.

I say about an individuals impact as, like in physical healthcare, there will be a lot of professionals individuals come into contact with. The only constant factor is you, what you do, how you show up for yourself.

I am genuinely so interested in changes YOU and others have managed to make for yourself that has resulted in a positive change, because ultimately that is a huge achievement. I just think that is something that can help others. Which again would be another huge achievement in itself.

Sorry - can't remember if anyone's suggested this - I did RTFT but have forgotten what's been said. But have you looked into finding an advocate OP? People with mental health conditions are entitled to one to help them from what I understand. It kind of sounds like you need something like that. Mind or Scope might have further information.