CMHT.... A broken service

It's sad to be writing this but as a first entry I would like to talk about 1 of many mental health services within the NHS and my experience of it.

I wanted to keep this first entry quite short so I won't go into the in's and out's of all of my health problems for now.

Let's just say after years of trying to get help (and failing due to services), I found myself for what must have been then 7th time trying to end my own life.

This time in hospital it was different. On previous occasions in hospital I would be waiting for hours to see a mental health team who would play things down, tell me to read a book, do breathing exercises and that my attempt was "silly" (with different teams using different words and phrases).

But....

This time I saw an Occupational Therapist. This OT was understanding, fair and really wanted to help me. I never thought or had it suggested (by the countless GP's and MH teams I had previously seen) that an OT could really benefit me, but they explained what they would do, how they could help and it seemed like an important service for me.

You see, mental health problems are very unpredictable. Living alone and isolated is a struggle. Task's soon build up. Washing up, general cleaning, washing clothes, taking rubbish out. Endless tasks. If i'm having 1 of my unpredictable mega low days I simply cant get any of these tasks done. Which means more tasks get added to that pile and it puts me at a point where too much needs doing and I can't focus on it. It's like it overwhelms me.

For example. Putting the washing away. In order to put that in the cupboard I then have to sort the cupboard out, move things that are in there (It doesn't help that I have become a hoarder since my mother died with her belongings) and put the washing away. Then I have generated more tasks with having to find space for those things. 1 task becomes 5 which due to the issues I have, overwhelms me to a point where even planning it makes me feel like my head will explode and I feel lost, struggling to know where to start.

From what I understood, an OT can partly help with some tasks but also try and break down the tasks for me into manageable chunks. Great!!

At the time I was on the long waiting list for CBT (more on that in another blog post), and this OT believed having access to their service would work really well alongside CBT.

The barrier between getting this help? CMHT's.


This OT had booked me in to see a CMHT made up of 1 OT and 1 CPN. It was due to be an assessment where the OT discusses with me how they can help me and if all seems good, I would be referred to secondary mental health services and gain access to that OT.

This was booked for the start of December 2017. Unfortunately due to the bad weather (snow) it was cancelled and rescheduled for January 2018. This new appointment wasn't with an OT but 2 CPN's.

So the appointment.

I arrived alone as I have nobody else. The male CPN said nothing throughout. All questions were asked by the female CPN.

How can I explain this? All I can say is it was like I was blamed for everything.

I explained about my suicidal tendencies, which were ignored. In fact as I was talking about it the woman started smirking at me.

Actually, to save me repeating myself I am going to show you a copy of the report sent to me after this appointment. I have covered up methods of self harm and names for obvious reasons. Let's look at part 1.

"You have not self-harm since September 2017" - False, I told them about feeling suicidal (when she was smirking) and told them of 3 other occasions of harming myself since then.

"You are unemployed" - Definition - "(of a person) without a paid job but available to work". I am not "unemployed" I am unfit to work due to health problems.

"You do not know your father" - Untrue, I explained about that to them and it has no relevance anyway.

There were other things I could comment on now but I will leave that until the end.

Part 2:

"You were bullied at school" - No I wasn't, I told them I wasn't and explained I struggled to integrate with peers due to anxiety problems.

From Part 1: "You have no social network" and from Part 2: "Never found your place in society", "left college with no qualifications", "not managed to sustain long term employment".

These things are grouped because yes they are as bad as they sound. So to explain....

I said those things (not in the way they mentioned), to give an idea of how much my health problems affect me. For example I said "I didn't do well in college because the symptoms were so bad, I couldn't concentrate or integrate with others to work as a group". They took that as "I didn't do well at college, i'm so hard done by. Life isn't fair".

I don't care about college. It's the past, yet these health problems are not in the past, they affect me every single day.

That's how the appointment was with them. I would explain things and give examples and anything I said would be seen as "excuses" (yes they even said that), or that i'm so hard done by and feel life isn't fair.

Neither of which are true. I need help, i'm reaching out and i'm being refused that help for the wrong reasons.

Part 3:

"You have not being able to access 1:1 ****** counselling" and "You do not answer witheld number as in the past you had problems with gambling".

In the appointment I said I received a letter from the bereavement counselling service saying they tried to call me from a withheld number. I told them I struggle to answer withheld numbers because of my anxiety and nervousness issues (fair enough right?) and because I have had problems with gambling as casinos would call me off withheld numbers and try to lure me back in, which worked on really low days (fair enough again right?). I informed them when I received that letter saying they tried to call me from a withheld number, I responded in the post and had arranged a date for home bereavement therapy.

In the appointment itself the female CPN said in response, "You are just making excuses now".

"GP has called you for a medication review but you have not managed to visit your GP" - Not true. I told them I struggle with the being on medication again because let's just say medication in my possession is a trigger to self harm. Each time I have been on medication and simply left to it on my own, I have ended up in hospital (the last time I had to have ECG's as it caused problems with my heart).

So what good will it do unless I have access to a support service that can help me manage and moderate my medication? The trigger will be there again and I will end up in hospital again.

"You explained you are unable to do multiple appointments in one go" - Yes? That's because of health problems? I can only take on 1 thing at a time, because too much put on me causes me to crumble. Where's the offer of help to tackle this problem? Oh wait, I told told i'm "making excuses" in the appointment.

Now for the final part.... Part 4:

"We agreed with you to make an appointment with your GP to review your Anti-Depressant" - No we didn't. I won't put anymore about this because I have already spoken about this above.

"You are already on the waiting list for ********* to access CBT" - I won't mention CBT in this blog entry as that will have an entry of it's own.

"When you are ready you can access Bereavement Counselling with ******" - Actually "when you are ready" is nonsense. It was forced upon me there and even when I explained how I was having it (after not realising they call off withheld numbers), they told me i'm "making excuses".

"We are not recommending Secondary mental health service for you at this stage" - So ummmm.....

I was referred there by an expert who works as part of secondary MH services (an OT) to get access to that service. There was evidence and understanding that I would benefit from that service. 

Yet... a team who are not OT experts deprived me of having access to that service because??? Because they simply wouldn't listen or understand and were keen to just blame it all on me.

That's another point, they even questioned why I even bothered making that appointment? They said "What more do you wan't, I don't know why you booked this appointment as you have already seen a mental health nurse".... Umm....I didn't book it, an OT did for a specific purpose on getting me referred to their services?

Even my CBT therapist (Again, there will be a blog entry about CBT) said "that's a shame. I can see that Occupational Therapy would have really helped you and would have worked well combined with CBT". 

What's the impact of this?

Firstly, I didn't end up having the help I badly needed. It's a blemish on my medical record, a false report which can be accessed and looked at by other NHS staff I might see in the future. Who then could think i'm more well than I am and not give me the right help.

Not having the right help means how can I get better? I'm claiming ESA and I can't exactly say to assessment staff "Sorry, haven't made any progress this year because mental health staff didn't listen, so I didn't get the right help this year".

My trust in the NHS was at an all time low after this and on receiving the letter, I was upset, annoyed, frustrated and spiralled downhill. I harmed myself multiple times again and went heavy on the alcohol.