My Mental Health Pathway in the NHS

I didn’t create this blog for personal rants and the like but I think this could be useful for people to get a bigger picture of how absolutely awful the NHS can be when dealing with mental health problems. I’m not going to use emotive language, or provide too many details, this is just aiming to be a factual time-line of my contact with NHS mental health services and my lack of support. It will be left to the reader to infer how this can further impact on recovery and mental wellbeing as I know I’m not the only person to have these types of experiences. 

March 2011: First contact with NHS mental health services. (I had some support for a few months before this time, namely with Connexions which was a young people’s organisation that no longer exists as far as I’m aware or at least doesn’t offer health-related support anymore, and with the sixth-form advisor at my school who I was seeing weekly.) My sixth-form advisor referred me to the Liverpool 16-18 team, a mental health service for users between those ages, ran by Alder Hey Children’s Hospital. I was assessed twice by a psychologist and a psychiatrist, and diagnosed with chronic depression that had appeared to start mildly when I was 12 and gotten gradually worse. I was referred to the Young People’s Advisory Service’s counselling team and my file was closed in June 2011 when I got the report from them.

April 2011: Started seeing YPAS counsellor but was unfeasible because of my school commitments and the necessity to hide it from my parents. My counsellor was great, and helpful for my anxiety problems that had spiralled out of control. I continued to see her until September 2011. I must reiterate though that this service is run by the voluntary service only in conjunction with CAMHS and is not really an NHS service though I think they receive maybe some funding from them as the service is free for users. 

March 2012: Visited a GP about my worsening depression and was formally diagnosed with Major Depressive Disorder (MDD). Was put on 20mg of Citalopram daily. 

April 2012: Visited a GP to ask about a referral for an Autism screening on the advice of my new sixth-form advisor. Was subsequently referred. 

August 2012: Attended the Autism screening and it was decided that the full diagnostic assessment would proceed.

October 2012: Had the Asperger’s diagnostic assessment, but was not diagnosed. In this time I had been diagnosed with dyslexia by the university. Also started a course of counselling with the university’s counselling service around this time but was limited to a 6 week course. Again these last two are not NHS services though they were free for me.

March 2013: Was formally diagnosed with Generalised Anxiety Disorder (GAD) by a different GP. Had my medication increased to 30mg of citalopram daily.

May 2013: Went back to see the above GP as the increase in medication made no difference at all. Was subsequently taken back down to 20mg of Citalopram daily with 30mg of Propranolol to manage the physical symptoms of anxiety when required. 

June 2013: Attempted suicide by overdosing on Propranolol and Citalopram. My partner called an ambulance and I agreed to go to the hospital knowing full well that I hadn’t taken nearly enough tablets by that time to die. Spent the night therefore in the Leicester Royal Infirmary. To be honest my experience there was quite positive, the nursers and healthcare assistants in particular were lovely. It was just unfortunate that I was admitted at about 10pm and had to wait until about 3am for a bed on a ward to be available. The next day I was seen by two psychiatrists from the hospitals’ Deliberate Self-Harm team who discharged me with no further treatment other than telling me to see my GP. I saw my GP who wanted to refer me to Cognitive Behavioural Therapy, however I was soon to go home to Liverpool for the summer holidays so she wrote to my Liverpool GP and asked them to refer me there. I was referred through the Improving Access to Psychological Therapies (IAPT) service in Liverpool by my Liverpool GP to have an assessment with the Inclusion Matters team. 

July 2013: Was scheduled to have my Inclusion Matters assessment, but it clashed with me being abroad on a uni summer school. Also realised due to waiting lists I would not have time to have any other appointments other than the assessment before returning to Leicester in September so discharged myself from that service.

September 2013: Returned to Leicester. Leicester GP referred me through the IAPT service to Leicester Open Mind talking therapies service.

November 2013: Had my Open Mind assessment. Therapist agreed to refer me to Cognitive Behavioural Therapy. 

December 2013: Visited GP again about worsening of depression and anxiety. Had my Citalopram increased again to 30mg. Also found out I had accidentally missed my first CBT appointment because they were supposed to send me a text message with the date and time of my appointment which I never got. The next appointment they could give me was in February of 2014. 

January 2014: Visited GP again about extreme anxiety and was prescribed 5mg of Diazepam to take as required. Another visit resulted in me being told to buy a book about Mindfulness and try the online resource MoodGym which I had already tried and failed to maintain in the past.

February 2014: My CBT appointment was cancelled on the day because the therapist had family problems. The next appointment they could offer me is April 2014 which is university summer holidays so I won’t be in Leicester. This means it is likely I will start in May 2014 which will have been a total wait of 11 months to start any kind of talking therapy despite my severe difficulties. I was then referred by my GP for a psychiatric assessment by one of Leicester’s Community Mental Health Teams, P.I.E.R which stands for Psychosis Intervention and Early Recovery. At the end of the assessment conducted by a psychiatrist and psychiatric nurse I was told that I definitely didn’t have schizophrenia (like I didn’t already know that…), but instead had mixed anxiety and depression (newsflash!….). I was told their service mainly works with people with schizophrenia so they were discharging me and I would have to wait until May for the CBT and they would advise my GP increases the dose of my antidepressant Citalopram to 40mg in the meantime or switches me to another antidepressant to try.

So that’s it. 3 years in the system and I have just gotten worse and more medicated.

 

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