Should I pay for a private psychiatric assessment for PTSD?

[Babbiees]

For my PIP claim?

I was awarded PIP 2 years ago based on my mental health issues, eating disorder and autoimmune diseases.

When I had my assessment my only paper 'diagnosis' were anxiety and depression (I bet you are rolling your eyes already) but I am seriously unwell mentally as well as ND and in the last few years I have had a lot of input from my GP and therapists after a seriously traumatic family even about 4 years ago brought everything to a head.

Because I have been engaging with my Doctor and trying to keep a record of my thoughts I have since been diagnosed with OCD.

I previously had several rounds of CBT therapy for 'genral anxiety ' that I can now see was actually OCD going back 2 decades :(

Over the last few months I have had Tier 3 talking therapy (which was originally going to be for the OCD but the therapist decided to do intense talking therapy first because of disclosures I made about childhood and the traumatic event from 4yrs ago, then another course focusing on the OCD afterwards)

So I have been talking a lot about my abusive childhood and how debilitating my issues are in my day to day life.

I mentioned to my GP a while ago about PTSD and he said the NHS is moving away from making those diagnosises now and wouldn't refer me, he said he cannot diagnose PTSD. But everything I read online says to go to your GP for a referal and nothing about them not doing that anymore

Anyways since starting the talking therapy I feel like it has worsened, to the point where a song from my childhood caused me to go back to a memory and I totally spaced out into that bad place as a kid and I urinated myself in the kitchen. Its happened twice in the last few weeks.

I said all this to my therapist who agrees I have severe signs of PTSD but she also said she cannot diagnose me.

Because of my OCD my brain latches on to any negative connotations and of course there has been a lot about PIP in the news lately.

I can't help but feel like my 'diagnosis' of 'anxiety and depression' do not represent what is going on in my life and those things are a symptom of a more serious mental halth struggle, rather than stand alone issues.

And I keep reading that people with anxiety need to get a grip and get a job etc... and they're going to cut down benefits for people who claim for anxiety etc...
I just can't stop thinking about it at all and the NHS doesn't seem to have an interest in me seeing someone who could look at my life as a whole and give me a diagnosis rather than a GP just telling me I am anxious (when I have been suffering from OCD for almost 20 years without them ever putting 2 + 2 together)

I don't feel 'safe' right now at all and my head is spiralling with the worry of losing my PIP. With the shame and embarrassment of reading what a waste of space I am, over and over and with the frustration of knowing that I am not just a bit anxious, there is something bigger going on and I want help.

And the fear that I am going to be forced intondoing something I can't deal with right now just because I don't have the right words on paper.

I feel like treatment for PTSD is very different and it could actually help me if i got the proper diagnosis and therapy.

But the assessment will probably cost in the 4 figures and its a lot of money.

I have therapy tomorrow, does anyone know if NHS therapists can help refer to other services for diagnosis?

Its 3.30am and I just can't sleep thinking about it all :(

My experience is that a hospital admission can accomplish the different things I've mentioned - that is what they are for and why different clinicians work regularly with inpatients. It is certainly the case that clinical psychologists work on a one to one basis with inpatients and medications are often titrated up or switched out more quickly in that environment. Specialist nurses in psychiatric wards often do a great deal more than dispense medication. I do accept that standards of provision vary throughout the UK and there is nothing to say any of that is guaranteed.

I called the Crisis team last summer after not sleeping for 3 days and spending the night in my bathroom as it felt like the only place someone couldn't see me from outside. I said i felt suicidal because I was so fed up of feeling like this. After asking if i planned to kill myself (no because I couldn't do that to my family) the guy on the phone said to 'have a cup of tea, go for a walk or run a bath'

I never heard from them again.

I really don't think I would be admitted anywhere right now as I am mentally competent and 'safe'

Are there are womens mental health talking groups near you. I think you sound very isolated and if you stuck at home, not getting daylight, not doing even gentle walking, well that would make anyone feel depressed.

Maybe as a start you could attend a womens mental health talking group and simply listen to the other women sharing their problems.

You say you dont know what job you could do, most likely having suffered yourself you might be suited to working in something wellbeing related when recovered. Maybe going to uni as a mature student for something.

If you want emdr so badly why dont you just pay for it with your pip money as thats what its for, to help you with your health, you should just do that to save you fighting the nhs for it and wasting your energy.

Checkout https://www.counselling-directory.org.uk/
and https://www.bacp.co.uk/ to browse counsellors. Id personally suggest an older women who is a trained psychotherpaist rather than someone freshly trained. You need an experienced professional.

Have you heard of social prescribing, i think you would benefit from that, so give it a research and see what activities you could work towards trying..

I dont think the way your living needs to be your whole life.

I speak from experience having had a highly abusive childhood and several adult traumas. After seeing multiple drug od's growing up i refuse all medication where possible and have leaned into private psychotherpy, psychology/trauma books, social prescribing and volunteering to provide myself supportive spaces when needed in life. So there are ways to help yourself that dont require boxes of nhs pills and chasing subpar nhs therpies. But you need to help yourself, its true with what they say, no one can do it for you.

So thats some ideas of mine for you. Good luck x

Pip isn’t about paper diagnosis so won’t help you.

pip is task based as in what things in your day to day life are more difficult due to your disability/what do you need to be supervised to do/need help with/encouraged to do. Eg my dc needs supervision in water due to blackouts, this includes baths but equally due to nd needs to be persuaded (cajoled or downright bribed) to shower, needs supervision to eat due to Ed’s and refused to handle many foods for sensory reasons. needed supervision in busy places…

think about what help you need to enable you to function, it could be your anxiety means you can’t shop alone for instance, you may need help to manage medication and so on. Having a named disability doesn’t mean you get pip especially where it doesn’t impact on these practical life skills (work doesn’t count as that’s different funding)

I'm sorry that contact with the crisis team didn't lead to more help, OP. If the day comes when you're unable to keep yourself safe, please make that extremely clear to them. Don't try to be brave and don't allow them to think that a family member can keep you safe as this is rarely true. You have to be very direct with the crisis team.

Where have you seen these things done and was it as a patient, relative or clinician? It all sounds like what should happen in theory but never does in reality.

I’ve had 15 admissions and only two of them involved psychologists. One was an NHS ward where an assistant psychologist (so hadn’t even completed her masters) ran a DBT skills group every two weeks. The other admission was a specialist rehab ward, private but funded by the NHS at the bargain price of 250k a year. It is absolutely the exception, not the norm, for psychologists to be on wards.

Exactly what @Trumptontown said.

It's so upsettingand misleading frustrating to perpetuate the idea that you get admitted and pooft! therapy, support and intervention is magically there, because it's not.

And unfortunately it's a common misconception with the general public.

@Stopthattractor I'm interested in the context and breadth of your experience

Also aware that I'm participating in derailing OPs thread. OP I will bow out, all the best.

Exactly. Whereas, unfortunately, the reality is you’re likely to come out with even more trauma. I’ve been assaulted by other (very ill) patients, seen staff attacked who had their cheekbones and noses broken, and witnessed people being resuscitated.

This is more like what I recognise sadly

OP, I don’t wish to sound pedantic but are you sure this was the crisis team and not the crisis line? Cos they’re not the same thing. Patients are normally referred to the crisis team after discharge from psych wards, from A&E psych liaison teams, or the CMHT when the CMHT / care co can’t manage risk / offer intensive enough support by themselves. The crisis team offer assessments and can visit you in your own home (my particular trust will offer up to two visits a day) as an alternative to going in to hospital. All this to say, don’t write off the crisis team if it’s ever offered to you. 🫶🏻

I'm not willing to say in what capacity or in what area but I would not misrepresent to the OP what I know to be true.

Although psychiatric wards are difficult places to be, it's inaccurate to suggest they offer no help and do more harm than good. I can't speak for every ward and every admission but that is absolutely not the case every time.

People do often forget or not realise how unwell they were when they were admitted which compounds misunderstandings. With that said I appreciate it's an underresourced area of medicine and many patients don't receive care that reflects best practice. Even with that said, there is help available and it is sometimes the safest place to be for individuals and their families despite theoretical risk within the ward.

@Stopthattractor , I hope you're not a clinician ?

Your comment about people being unwell which compounds misunderstanding frankly reeked of gaslighting.

Furthermore, you contradict yourself. You say you would not misrepresent what you "know to be true" but then say you do not speak for every ward or every admission.

Precisely. You don't. Nor do you speak for me or my experiences.

If you are a clinician - which I hope you're not - you may wish to consider reflecting upon the need for humility.

I call bullshit on @Stopthattractor.
She clearly has no real life experience of NHS MH admissions, just googled some NICE guidelines which bear no resemblance to what actually happens.

I don't think it's helpful to anyone, least of all the OP, to be adversarial on a public forum. To anyone who felt I had undermined or questioned the validity of their personal experience, I'm truly sorry. With that said, I do speak from first hand experience and it would be harmful for anyone reading this thread to assume that the individual experiences of a few are representative of a hospital admission. There are circumstances in which a hospital admission can be effective and positive. To say that there are situations where someone coming into hospital doesn't have clear memories of their state of health at the time of their admission is only what anyone would expect in a psychiatric unit. I did not mean to imply that any specific posters on this thread fell into that category as I simply couldn't know, nor would I want this to be a way for the NHS to dodge accountability. It's just a complicating factor that I have seen.

OP the NHS are shocking at mental health diagnosis and treatment. It’s appalling tbh.

There are 2 things here you need to look at.

Get a PTSD/ Child Trauma specialist therapist - it will be the BEST money you have ever spent and could change your life. It’s not a quick fix and you might be there a couple of years building yourself back brick by brick. This is genuine investment in your life. The therapist needs to be able to take you all the way back to when you were born and and go through your entire life. Pin pointing pivotal moments that have affected you and those issues still cause issues in your adulthood. And showing you how to release and work through them.

There is no point in getting a diagnosis and doing fuck all about it. It’s like getting a diagnosis of diabetes and not ensuring you get insulin.

2nd - As previous posters above said PIP is entirely dependant on your capabilities.

Your aim should be genuinely healing and fixing yourself - not getting the PIP because you can’t work. If you genuinely invested in yourself and healed you wouldn’t have to worry about the PIP because you’d be able to live again.

I know you need financial help right now - but I wouldn’t worry too much about it being snatched away from you just get x

“first hand experience”?
Your experience seems to be pretty unique for the NHS so it’s hard to believe without any details about that. Just read a few threads on this forum to see the actual state of the MH services and the trauma that patients and their relatives suffer when trying to get adequate support.

You're free to believe what you choose. There are psychiatrists and other mental health practitioners up and down the UK doing good work, sometimes in residential settings, yet I'm sure they would acknowledge many of your criticisms. There is a shortfall in provision.

It would be a pity if the times when help is effective and available were never represented as it could discourage others from seeking help when they need to.

If true then why the reluctance to say in what capacity you have experienced this good work?