Any other mental health professionals on here?

[ShrinkInterrupted]

Psychiatrist here. Not finding it easy at the moment (understatement) and thinking of leaving. Difficult to work out if it's me, or the job. Just wondered how everyone else is finding it.

Hello 👋
NHS specialist CBT / RMN here
Just had a quick skim read - but will read through properly later -
Great to see fellow MH professionals here

Psychotherapist here. Small amount private practice, small amount in a voluntary placement, small amount running projects for teenagers who self harm.
I really wish there was more funding. I’m angry about the lack of supervision in some professions and how it isn’t expected that all professionals need to have had their own therapy if they’re offering therapeutic work with others.

I love my job but I wouldn’t if I didn’t have the variety I do!

Lovely to see the new people

@Twitterwhooooo
If you are not sure if a job would be the right ‘fit’, either for you or the Team you are looking to join, there should be a contact person on the job advert. I’d advise phoning first and having an informal chat and ask for an informal visit as well. I find people interview better if they have already met or spoken with at least one key person and have seen the environment.

I don’t work with children and young people so it’s not my specialist area but your experience may well be purely down to high number of applicants and the one they appointed was slightly more qualified/suitable?

If you don’t do so already, ask for a separate meeting/call for specific interview feedback - not just as part of the call when they ring to tell you you were unsuccessful. Specifically ask if you were appointable - if they say yes this is great and means you are on the right track. Enquire if there is something ‘extra’ or different they were looking for. If they say you weren’t appointable you can enquire why, it might be something simple like the way you answered the questions.

You’re clearly doing something right to get shortlisted as this means you fit their essential criteria.

@NewOT
Focus on the reasons you went into OT training
Some areas are more pressured than others so it is not all doom and gloom.

@weaselwords
I hear you.
Interesting some of us are around 25-30 years in the NHS and starting to feel it now.

For me some of it is personal - I’m pushing 50. Like many women of this age I have family commitments (teenagers and ageing parents) plus dare I say it a few hot flushes into the mix.

I have a marvellous OT friend and our (partly serious) long term plan is a joint cake shop/relaxation facility with additional sleep hygiene workshop. That would be amazing for so many patients. In fact maybe we should run it for colleagues instead

Good point !!
I’m early fifties !
Gutted I missed the mental health officer status retire and 55 and return part time as I have seen many colleagues do !
It’s a hard area to work in as you navigate menopause !!!

@CanteenCulture

Mental health nurse here.

Would love a job in Waitrose.

Says it all really 😂

Are you me?

I'm seriously burning out after 27 years, unfortunately my pension is not great having worked part time when my kids were small and then a break in service when I worked in Canada for a few years.

I really like most of my patients too but we are now overwhelmed by referrals and have been given ADHD assessments to do on top of an ever increasing workload and it all feels too much. We are always worried that we are missing things or people are falling through the gaps and I am now constantly looking at my pension calculator hoping it will magically tell me I can retire now.

@Schmoozer
I did think I was having hot flushes a few years ago then I realised it was the intense temperature in my attic office!!
But yes it’s not the best, feeling hot and bothered but trying to remain cool and composed.
I just missed out on MHO status due to a slightly misguided decision I made in the distant past.

@weaselwords there's definitely a sense of the work being manageable as long as your personal life is going well. The second personal circumstances aren't great, it's extremely hard to cope

@TheDaydreamBelievers, that’s the thing. All of us lifers who just missed MHO are now mid 50s, menopausal and with ailing parents plus kids flying the nest and marriages falling apart and our own health problems. We are a perfect storm.

@onepieceoflollipop

Lovely to see the new people

@Twitterwhooooo
If you are not sure if a job would be the right ‘fit’, either for you or the Team you are looking to join, there should be a contact person on the job advert. I’d advise phoning first and having an informal chat and ask for an informal visit as well. I find people interview better if they have already met or spoken with at least one key person and have seen the environment.

I don’t work with children and young people so it’s not my specialist area but your experience may well be purely down to high number of applicants and the one they appointed was slightly more qualified/suitable?

If you don’t do so already, ask for a separate meeting/call for specific interview feedback - not just as part of the call when they ring to tell you you were unsuccessful. Specifically ask if you were appointable - if they say yes this is great and means you are on the right track. Enquire if there is something ‘extra’ or different they were looking for. If they say you weren’t appointable you can enquire why, it might be something simple like the way you answered the questions.

You’re clearly doing something right to get shortlisted as this means you fit their essential criteria.

Thanks. I think the 'fit' is a problem in children and young peoples projects. I've been interviewed by a panel all half my age, which was excruciating and I can understand why someone wouldn't want to manage someone the same age as their mum with more than 20 years more experience than them in the field.

I'm currently doing a lot more looking into the team before I apply anywhere, and won't if everyone else is much younger than me. It's just pointless.

20 years in MH nursing. Currently working in management-the last 2 years have nearly been the end for me. Relentless pressure and the feeling of constantly failing your staff teams. Shortages of doctors, nurses and other professions that feels overwhelming. But weirdly I do feel better lately. Think I’ve made my peace with a better work life balance and that seems to be helping. Being strict about my working hours etc and also being open with colleagues about our own challenges instead of pretending it’s all ok has also helped. But I’ve shed a lot of tears in the last 2 years!

Following as thinking of going into MH

@weaselwords are you me?!

I could have written your last post myself.

@Twitterwhooooo are you looking for frontline clinical / patient-facing roles? You would walk into a job for this sort of thing in most Trusts, but you mentioned project coordinator roles with mental health charities which I'm not familiar with. Would you be interested in support worker Band 3 type roles in the NHS (or private) units for young people, eg activity coordinator, OTA (in which case I'll have suggestions), or have I missed the point completely? You sound lovely and experienced so don't give up!

@Tiredandancient50 part of my wonders if I can ever find this peace - which I would love to - or whether if I stay in the job I'm resigning myself to a life of feeling tense, anxious, frustrated, failing etc... I'd love to hear more about how you got through this.

@caulkheaded that's really interesting and good points about both the variety, and also lack of supervision / personal therapy. I think that's a big part of why things have got this bad for me.

@Schmoozer I am very interested to hear your experiences as a CBT therapist!

My job is like having to build a complex IKEA wardrobe when someone has pinched various key bits from the box, trying my best, then being blamed when it falls over on someone.

[quote onepieceoflollipop]@ShrinkInterrupted
Yes totally agree.

And along the same lines there needs to be some sort of National ‘announcement’ for want of a better word.

The government needs to make it crystal clear to ALL users of the NHS that the following changes have been made (by them or previous governments) nationally and are not the fault or choice of individual mental healthcare professionals.

These include various cutbacks and review of services.
Leading to a choice to reduce the number of beds.
Massive changes to education impacting especially on nurse provision and other professionals.
An end to long term service from CMHTs
Vast reduction in day services and other respite type provision.

Services in some areas being privatised or practically privatised e.g. alcohol services.

A move towards paying charities such as MIND to provide a service. Patients often see a referral outside of the NHS as being inferior and being fobbed off - accusing my clinicians of not giving them what they perceive they would have previously been offered, such as admission or a long term CPN.

I often reflect that if I had a physical health problem and felt I needed an operation, unless I pay privately I have to accept my GP decision and agree to (for example) medication or physiotherapist. And if I didn’t want that I couldn’t start demanding a bed regardless. In mental health some of our patients seem to think a bed can be demanded as a right and are reluctant to engage with discussion about more appropriate alternatives.

And on the subject of self-responsibility. If someone is referred to say MIND counselling or other therapy but chooses not to engage that is fine and their choice. What isn’t fine is then self referring back to the NHS and taking offence when the healthcare professional explores why they didn’t access the therapy. We don’t have a whole list of other better options that we deliberately withhold - but can then give out if the patient complains…[/quote]
@onepieceoflollipop a huge YES to all of this.

I also think our professional bodies (RCPsych in my case, but all of them really) could do a much better job of getting this message across to the public and standing behind their members in the fight to get better care for patients.

I'm at the point you alluded to in your subsequent post about deciding whether it's got too much of an impact on my non-work life to continue.

I'd come to that cake shop

When you add it all up, it is a lot for us all to cope with, isn’t it? Strangely, I forgot the pressures of Covid (and WW3 breaking out) in my list .

Sertraline has stopped the panic attacks and pulled me out of a pit if apathy and the rest is up to me. Looking after myself and setting limits is my number 1 priority. It’s the only way I will be able to keep going.

@ShrinkInterrupted what are you interested in re CBT ?

@Schmoozer essentially what it's like to work as a CBT therapist, how your working day looks, good and bad bits, whether you'd recommend it - that sort of thing

The bits I like about my job are listening and talking to people, figuring things out / formulating the problem, being supportive and working alongside people, and teamwork with colleagues. Hard / intense work is not a problem; neither is emotionally demanding work. The bits I don't like are being unable to leave work at work because I'm accountable for everything, and all the associated anxiety and constant "on" state that brings, and the relentless pressure of leadership and high-stakes decision-making. It would be good to know how this compares to your job.

@weaselwords - setting limits and looking after ourselves is definitely key and something I've let slip

Oh @Schmoozer if you meant which area of practice - I am thinking of going via the CBT IAPT recruit to train pathway initially, then - who knows. Possibly continuing with IAPT, though I do enjoy working in an MDT clinical environment (inpatient / CMHT etc).

@ShrinkInterrupted - on the whole it’s a great job !
Using evidence based treatment protocols for anxiety disorders including PTSD and mood disorders
We are secondary care so complexity, co-morbidity and treatment resistance is the norm.
Supervision and team support is great
The problems are managing the huge amounts of inappropriate referrals -
Referrals that are for people who are seeking support not treatment
Seeking Long term, not focused, goal specific time limited therapy
Those who are too dysregulated and decompensate in therapy
Those who are looking to be fixed as opposed to taking responsibility for active change and collaborative therapy
Those with ptsd who don’t want or can’t tolerate processing trauma memories
Those unwilling / unable to attend regularly, engage with homework tasks etc
Those are who refuse to engage with medication and are too unwell for psychological treatment but want therapy !
Those who come along because family insist but actually don’t wish to engage !
Etc etc !!

Camhs here- 15 years and now a manager. On my backside with it all! I have a therapy training I can barely use, feel like I’m pivoting between crises at all times and am so good at juggling various tasks I could join the blooming circus. Spend my life robbing Peter to pay Paul in terms of having no staff and the constant demand to meet the unrealistic targets set; have pissed off most parents in my county by saying no to CAMHS input (or that’s how it feels); and spend my entire day wanting to yell that therapy doesn’t fix poverty, poor parenting, learning issues or autism or almost any of the other things we get referred to us (3 year old that doesn’t like to share was one memorable referral. Am going to go and work in the private sector soon because the pension isn’t worth the cost to get it.

@Schmoozer thank you - that's really helpful

@whatwouldnigellado that all sounds very familiar! I hear you on the robbing Peter to pay Paul - ironic as our service manager is called Pete and the manager of the sister service where staff get pinched to is called Paul (outs self to any colleagues reading this thread)

[quote Schmoozer]@ShrinkInterrupted - on the whole it’s a great job !
Using evidence based treatment protocols for anxiety disorders including PTSD and mood disorders
We are secondary care so complexity, co-morbidity and treatment resistance is the norm.
Supervision and team support is great
The problems are managing the huge amounts of inappropriate referrals -
Referrals that are for people who are seeking support not treatment
Seeking Long term, not focused, goal specific time limited therapy
Those who are too dysregulated and decompensate in therapy
Those who are looking to be fixed as opposed to taking responsibility for active change and collaborative therapy
Those with ptsd who don’t want or can’t tolerate processing trauma memories
Those unwilling / unable to attend regularly, engage with homework tasks etc
Those are who refuse to engage with medication and are too unwell for psychological treatment but want therapy !
Those who come along because family insist but actually don’t wish to engage !
Etc etc !![/quote]
We get exactly the same in IAPT too! The vast majority of our ‘high intensity’ referrals are t really appropriate for primary care but we say yes because if we don’t there’s literally nowhere else for them to go. Which isn’t always the right thing for the clients, also it attempts to plug a gap when it should really be highlighted.