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Archive for September, 2010

Testing Times

My psychiatrist appointment is going to be rearranged – my care-co couldn’t make it, and I declined to go alone.

I had my “initial assessment” with the PCMHT today. I wish I could say it all went swimmingly and will be referred onto psychology as planned.

It didn’t start well when she revealed that she knew next to nothing about me. Past notes are archived after two years, and the only thing she had about me was a letter from my old psych – written in June. Not a trace of my GP’s referral, which was the one my care-co said he’d been told they were acting on. So, this was referral #3. With #1 never having gotten off the starting blocks, and #2 seemingly MIA, I was left wanting to throw something very messy at mental health services.

The truth is, it seems, there may be some issue about who funds this therapy that everyone seems to agree I need. It’s apparently “very unusual” (sounds kinda familiar) for the PCMHT to see someone who is also seeing the CMHT. I showed her my care plan, in an attempt to clear things up, but it backfired spectacularly – after she’d read it, she told me that what she’d read in it made her think I should be seen by secondary care psychology. She almost looked intimidated – I could practically see her mentalist alerts flashing, which was rather disconcerting, and gave me a lot of guff about “knowing how annoying it can be when different services keep saying no to you”. She did then try to ring my care-co, but he wasn’t in the office (he never is), and that was very nearly an end to the appointment – but I did manage to convince her that going ahead with the assessment would save time just in case, especially since my care-co is only planning to stay involved “until the psychology referral is sorted” (having been the person who first uncovered what a mess the professionals have made of this, I think he’s trying to make sure I don’t slip through the cracks again).

It then took her an hour to do the flipping risk assessment. I was surprised at how affronted I felt over being asked to “give my assurance that I wouldn’t try to hurt myself”. I tried to explain that not even my worker at YP-place has ever asked me for that, and there was no way I’d give that to some random lady, however well meaning, that I’d only just met. The only person I can recall who ever asked me that was a psych nurse in the hospital, who was trying to work out if I was OK to discharge (having spent the whole weekend in a 12 hour assessment unit, while other patients came in and were sent home around me…). Even when I’m suicidal, asking me questions like that only makes me lie – how is that a productive question to have on a risk assessment if it turns your clients against you?

In the end I offered up an alternative question that I was happy to answer (and luckily, in the negative), stolen from previous risk assessments “How likely is that you might try to harm yourself?”, but I don’t think I managed to get across to her just what my objection was. Apparently they “always ask everybody that question”.

By the time we finished the risk assessment, we were already 90 minutes through a 60 minute appointment, and she was struggling to fit everything into the small boxes on the form. She suggested we break it there, and meet again to finish the assessment, which we were, to quote “nowhere near finishing”.

Then she started in on the page headed in big bold letters “Evidence of serious mental illness”, trying to cram more of her very small writing into too-small boxes. I reminded her that she’d already proposed to stop – she countered that this bit was important as it could be “the sticking-point”.

All I can say is that I’m glad I finally convinced her that I was getting really fed up of it and wanted to stop there before we did any more “just the next page”s. She never did get to finish quizzing me on hallucinations, illusions and delusions, which was a good thing, as by that point I was downplaying everything, trying to convince her that I was mental enough to need a psychology referral but not so mental that it was inappropriate.

I did, however, have to wait for yet more time, while she photocopied that oh-so-damning care plan.

Outcome: I have to wait to hear whether I’m deemed too severe to be seen by primary care, and booted up to secondary care (who, of course, as we all know, only see people with Severe and Enduring Mental Illness, which of course I’ve repeatedly been deemed not to have).

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Q: Why Do Buses Come In Threes?

With very little to take me out of the house, my days have been melding into each other, each one with its own small challenges to surmount – food, washing, keeping the electric meter fed with credit.

And now suddenly everything else has come up at once.

I have…

  • Tonight until the weekend – time with my grandma and parents
  • 6th September – appointment with my old psychiatrist to see if she would be willing to back my application for ESA, despite having told me I should look for work last time she saw me.
  • 10th September – appointment to have two tenacious baby teeth removed, as some sort of “gentle introduction” into having dental work done.
  • 13th September – appointment with a “mental health practitioner” from the PCMHT for an initial assessment (same as in May 2008), as a response to my psychology referral.
  • 16th September – appointment for my ESA medical

Since I don’t seem to have the option of just sleeping through the next fortnight (doubly true while I’m being more insomniac than usual), I fear the next two weeks are going to be lurching from one raw wound to another. I shouldn’t cancel the dental appointment – delaying it is only going to make me more nervous about it, but I don’t think I can cope with worrying about it on top of everything else. Also, physical pain tends to make me forget everything mental related for a while – which is perhaps not what I want directly before two assessments where, in some wierd sense, I need to be as mental as possible in order to get a positive outcome.

Sheesh, I sound like I’m faking it just for the money. Since I started applying for benefit I’ve become a lot warier of things like that – it’s hard not to be, in the current climate, with news articles like this and this (by the way, my grandma reads the Torygraph).

Especially since I’m much better and should be applying for work, right?

Also, how do I explain to my (generally disbelieving) parents that my psychiatrist discharged me and told me I’m much better but I’m seeing her again because I’m applying for sickness benefit?

If only real life worked the same way that we all think the systems should work.


A: Because travelling alone is dangerous

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