Like many people with a mental health issue I am meant to have access to and services & support from a local community mental health team, (CMHT).
In my own case I have only received a visit from my care co-ordinator twice since September, despite having real needs and real issues, the support provided to me has been sparse to say the least.
Now you might think perhaps things weren’t too bad and so they had prioritised others needs ahead of my own, but that wasn’t the case, we have faced a huge crisis period including a key trigger date which sent us into a spiral, we were utilising bad coping strategies including self harming; something we hadn’t had to resort to for some time previously and in the past few weeks we have just started working with a new therapist, yet throughout all of this our CPN and the CMHT have been absent.
Is this unusual? I don’t think so, sadly it appears that this is the state of care in the community for many people. In my opinion the government and the management of the NHS should hang their heads in shame, they are allowing service users, vulnerable people to be failed.
Since my discharge from hospital 4 years ago I have had so many CPN’s, 9 in total, this equates to 1 every 6 months…now to be fair our current CPN has stayed in post more than a year. .. but 9 in 4 years isn’t giving consistency of care.
Unsurprisingly relationships with my CMHT are to be blunt at an all time low. We have had to endure months of waiting and protracted dialogue in order to finally start getting the therapy everyone agrees we require. Much of this as a result of the way Clinical Commissioning Group’s organise their funding panels; which need to make decisions about client services. In my own case therapy has had to be sourced externally as my own local NHS trust didn’t have anyone suitable to undertake the work.
We have faced hi-jacked meetings where we were invited to attend the CMHT offices to discuss a plan for potential therapy starting, only to find on arrival they had plans of their own which revolved around me signing away any right to therapy again if this new therapeutic relationship didn’t work out. No matter what the cause, so if my therapist needed to end our contract early They wanted me to sign away any right to ask for a new therapist!
Luckily myself and my nearest relative realised what was going on and managed to seek legal advice before we did anything, and surprisingly once they knew that I would not sign anything they no longer wanted to meet to discuss this issue.
Now I know that having dissociative identity disorder makes me ‘complex’; their words not mine. But as a survivor of child abuse we need consistency, understanding and someone who we can both trust and build a rapport with. None of these difficulties have helped us in any way, all they have led to is me relying more and more on my family and friends and less and less on the statutory services put in place to assist me.
I recognise that my relationship with the CMHT is flawed, I have real issues with the power imbalances that exist, I am left feeling out of control and that triggers me and frightens me. I can’t help that, it’s just my reality and one which I am trying hard to work through.
You see these individuals belong to the body of professionals who sent us miles from home, detained us, forced medication upon us, stripped us of our dignity and worse. They are the people who would use coercion to get us to go into hospital as a voluntary patient with the words “if you are not willing to come in voluntarily then you leave us no choice but to detain you”. It was in reality a section by all but name, and I knew each time that if I chose to leave then they would just bring me back and detain me anyway. So a 2 week stay would become 6 months and I really had no say in all of this.
Being detained or forced into staying by coercion is not only an unpleasant experience, but it strips you of any feeling of control and for me as a victim the last thing I wanted was to feel out of control, worse still to feel controlled. So sudden transfers, locked doors, forcible treatment is horrendous.
But these professionals are the only source of help I can access and so 2 visits in 4 months isn’t helping me maintain stability or providing care in the community. It leaves me vulnerable and at greater risk. Risk of mismanaging my medication, self-harming or worse.
Am I the only person that is treated like this, sadly NO many people are left alone and vulnerable to cope in intolerable situations. I know I am fortunate I have a family close by who can offer some support, many don’t have that luxury. CMHT’s appear to have ever decreasing staffing levels and increasing demands placed upon them it’s a further example of the disparity that exists between mental health and physical health care.
So I decided last week I needed to try and rectify my relationship with my CMHT, I emailed my CPN requesting a visit. This week on Monday, I met with my CPN in the hope that we can get back on track and in turn they can provide us with the support we need. I am willing to work at this, but now I wait wondering if they will be able to understand me and my condition, will they offer support and be willing to help. I can’t predict if they like me will be willing to adapt and work at making this a more positive working relationship. One that I hope can be based on equality, fairness and collaboratively working.
But what I do know is that when NHS services work well it has such a huge impact upon the service users, leading in turn to better outcomes and the use of less resources. In other words it’s a win, win for everyone.
I also know that there are examples of good practice out there, there are service users receiving a positive experience and support from their CMHT’s. I just need that to be replicated locally, not just for my benefit but for others too. I need my CPN and my CMHT if I want to maintain good progress and stability in my mental health.
Maybe this Christmas mental health professionals could think about how they work, how they engage service users and review if they are able to improve services.
I know they are over worked, under resourced and placed in impossible situations, day after day. But perhaps if they could remember we are human beings as well, with feelings and needs ,just like they are it might make a difference.
I know I didn’t ask to have my condition, it’s not easy for me or my family. But neither would I wish this on anyone else, yet mental health issues affect people from all walks of life. With statistics of 1 in 4 people having a mental health issue it so easily could be my CPN or any other mental health professional facing my dilemma this time next Christmas. I do wonder if any of them have ever thought that It could be them standing in my shoes!
My hope personally is that the relationship with my CMHT can get back on track. As much for my sake as theirs, I have been willing to reach out an ‘olive branch’ towards my team. That hasn’t been an easy step, it has taken me a lot of courage, but I knew it was a step I needed to take, and one that I took knowing I had nothing to lose and everything to gain.
My wish this Christmas is that the CMHT are willing to take hold of that ‘branch’ and seize the positive opportunity they have been offered. I guess only time will tell.