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Duty assessment

#1
I'm scheduled to have an appointment with CMHT soon for something that's called a "duty assessment". I don't know what a duty assessment is. I really don't want to have appointments with CMHT, and I don't want to go back to therapy.

I do want to get my medication looked at though, because I go through cycles every few days where I don't sleep at all, and feel great, but then later sleep a lot and feel horrible. Maybe a mood stabilizer would help?

As far as I know, dealing with CMHT and getting an appointment with a psychiatrist may be the only way I can get any new medication.

Does anyone know what a duty asessment is? How do I deal with CMHT?
 

Sunspots

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#3
Hi @Flowerdream
Are you already under the care of the CMHT?

Duty assessment isn't something I've heard of but they all tend to call things something different depending what area you're in.

I would imagine that if you're not already under the CMHT that it is a chat to find out why you have been referred to them and if you really need their services or can be dealt with by your GP. You're correct that only a psychiatrist can prescribe mood stabilisers or more complicated meds.

The best way to deal with the CMHT is to just be honest. Tell them what how you're feeling right now and what you're hoping to achieve by being referred to them. It's possible that they'll want to have a few appointments with you but sometimes you need to play the game a little in order to get where you want to be. Bear in mind though that the CMHT are totally overrun right now so they might be only too happy to refer you on to the psychiatrist without having to see you themselves.
 

Optimistic Goatman

The woolly enigmatic one
Staff Alumni
SF Supporter
#4
I'm scheduled to have an appointment with CMHT soon for something that's called a "duty assessment". I don't know what a duty assessment is. I really don't want to have appointments with CMHT, and I don't want to go back to therapy.

I do want to get my medication looked at though, because I go through cycles every few days where I don't sleep at all, and feel great, but then later sleep a lot and feel horrible. Maybe a mood stabilizer would help?

As far as I know, dealing with CMHT and getting an appointment with a psychiatrist may be the only way I can get any new medication.

Does anyone know what a duty asessment is? How do I deal with CMHT?
Do you have kids, if you don't mind me asking? Most of the information i find looking into duty assessments is around safeguarding children.

As for dealing with the CMHT, in my experience they don't tend to bother you much unless you give them a reason, like you do go to you GP or to them asking for more help. Even then i've usually only had to visit them a few times each time i asked for help. In all likelihood, if you say you don't want therapy, and present a credible case that you're holding it together without, they won't exactly be rushing to invest their already limited resources into giving you that therapy.

When it comes to the medication, they should also set you up with a psychiatrist there who will be in charge of your case from that point on, and you should be able to have a conversation with them about med changes without much difficulty. I've found that setup and access to be a lifesaver, since it rescued me from a misdiagnosis of psychosis. Personally, from my experience i might recommend asking about mirtazapine or amitriptyline, since i'm on a combo of those two and i've found it has helped my sleep issues a fair bit, i tend to sleep at roughly the same times on most nights, they made it possible for me to actually establish a pattern.
 
#6
Hi @Flowerdream
Are you already under the care of the CMHT?

Duty assessment isn't something I've heard of but they all tend to call things something different depending what area you're in.

I would imagine that if you're not already under the CMHT that it is a chat to find out why you have been referred to them and if you really need their services or can be dealt with by your GP. You're correct that only a psychiatrist can prescribe mood stabilisers or more complicated meds.

The best way to deal with the CMHT is to just be honest. Tell them what how you're feeling right now and what you're hoping to achieve by being referred to them. It's possible that they'll want to have a few appointments with you but sometimes you need to play the game a little in order to get where you want to be. Bear in mind though that the CMHT are totally overrun right now so they might be only too happy to refer you on to the psychiatrist without having to see you themselves.
I had a therapist who I was under, until he felt he couldn't manage my risk to self so he referred me to secondary services (cmht). I didn't really want to be referred and my therapist knew that. I was just worried about what's going to happen at this assessment more than anything. Because I really don't want to be put in hospital and if in honest with them I think they might do.
I really hope they do just pass me on.

Thank you.
 
#7
Do you have kids, if you don't mind me asking? Most of the information i find looking into duty assessments is around safeguarding children.

As for dealing with the CMHT, in my experience they don't tend to bother you much unless you give them a reason, like you do go to you GP or to them asking for more help. Even then i've usually only had to visit them a few times each time i asked for help. In all likelihood, if you say you don't want therapy, and present a credible case that you're holding it together without, they won't exactly be rushing to invest their already limited resources into giving you that therapy.

When it comes to the medication, they should also set you up with a psychiatrist there who will be in charge of your case from that point on, and you should be able to have a conversation with them about med changes without much difficulty. I've found that setup and access to be a lifesaver, since it rescued me from a misdiagnosis of psychosis. Personally, from my experience i might recommend asking about mirtazapine or amitriptyline, since i'm on a combo of those two and i've found it has helped my sleep issues a fair bit, i tend to sleep at roughly the same times on most nights, they made it possible for me to actually establish a pattern.
No, I don't have kids.

they won't exactly be rushing to invest their already limited resources into giving you that therapy
That's good. I hope that happens here.
Thank you for your advice.
 

Sunspots

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#9
I really don't want to be put in hospital and if in honest with them I think they might do.
They really do use hospital as a last resort and when they think you're in immediate danger. Telling them you're suicidal isn't generally enough for them to admit you, even voluntarily.

Most therapy offered by the CMHT will have a pretty long waiting list. It's more likely that you'll be assigned a CPN (community psychiatric nurse) who you might meet with occasionally (or talk to on the phone at the moment). You'll be able to contact them if you need to and although they don't offer therapy exactly, they're good to talk to if you need something plus it's generally them who will get you in to see a psychiatrist or on a therapy waiting list.
 
#10
Ive had a 3 CMHT assessments in the past. All over the phone where they ask the usual questions to find out where your at at the moment and what the problem(s) is/are. I had to give them the names and dob of my kids who were under 18. That is quite scary as by no means are they in any danger. From that they write a care plan with the recommendations for next steps what ever that might be. For me lots of signposting to local organisations where I could refer myself or groups I could contact. I did refer myself to cbt counselling which I’m getting at the moment but you only have to do what you feel comfortable with so if you don’t want counselling you don’t have to. They also advise my gp. Recently he contacted them to get advice to switch my medication over. So I don’t actually see them but they sort of oversee things. I guess they would intervene if they felt it was needed but as said above they are so busy they are trying everything else first. Hope it goes ok, let us know. Xx.
 
#11
See here is my problem. I do have a plan. I have made preparations. I have means. My plan is highly lethal. If I tell them this I'm going to be sectioned instantly. But, I dont intend on acting on it (yet) but the preparations are there for if/when I do ever want to.
I half told my therapist the above which is why he referred me to secondary services despite me not wanting that.
So I'm worried about being hospitalized because I can't have people finding out. This is my biggest worry. If they decide I'm not capable of making my pen decisions then they will inform people, next of kin, what ever. I won't be able to handle that at all.
So yeah anyway, that's what I'm holding back aft the minute. And I'm guessing you can maybe see why im reluctant to tell them in depth.
 
#12
Ive had a 3 CMHT assessments in the past. All over the phone where they ask the usual questions to find out where your at at the moment and what the problem(s) is/are. I had to give them the names and dob of my kids who were under 18. That is quite scary as by no means are they in any danger. From that they write a care plan with the recommendations for next steps what ever that might be. For me lots of signposting to local organisations where I could refer myself or groups I could contact. I did refer myself to cbt counselling which I’m getting at the moment but you only have to do what you feel comfortable with so if you don’t want counselling you don’t have to. They also advise my gp. Recently he contacted them to get advice to switch my medication over. So I don’t actually see them but they sort of oversee things. I guess they would intervene if they felt it was needed but as said above they are so busy they are trying everything else first. Hope it goes ok, let us know. Xx.
Mine will be face to face. I wish it was on the phone. No, I wish it wasn't happening at all. I wouldn't mind if they sort of overseen things in the background, or just helped my gp deal with me. With like you said, meds etc. So should I be worried about this assessment?
 

Sunspots

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SF Supporter
#13
I do have a plan. I have made preparations. I have means. My plan is highly lethal. If I tell them this I'm going to be sectioned instantly.
No, they won't. It is only if you have immediate plans to follow it through. I've had a plan and the means to carry it out for over two and a half years. I've been very open about this with both my CPN, my psychiatrist and in the group therapy I attend. At no point have they even suggested going into hospital as I've always maintained I have no immediate plans to use it.
 
#14
I’ve been reasonably open and honest with both my gp, therapist and CMHT assessments. I also have a fairly detailed plan and like you have it in place but do not intend to act on it today. They ask me on a scale of 1-10 how likely am I to do it and I usually say 8. I haven’t been sectioned or hospitalised for saying this. I know people who have actively tried to end their lives who were in hospital for a day before being released. I used to get into a panic thinking that I was going to lose control and that they were going to take over and put me in hospital but I’ve stopped worrying about that now because I don’t think they will ever do that. Originally I was told secondary services would be a bumpy ride but in all fairness they haven’t done much. In fact frustratingly little. Try not to worry and I hope you find you have control over what they do and what happens next.
 
#16
I’ve been reasonably open and honest with both my gp, therapist and CMHT assessments. I also have a fairly detailed plan and like you have it in place but do not intend to act on it today. They ask me on a scale of 1-10 how likely am I to do it and I usually say 8. I haven’t been sectioned or hospitalised for saying this. I know people who have actively tried to end their lives who were in hospital for a day before being released. I used to get into a panic thinking that I was going to lose control and that they were going to take over and put me in hospital but I’ve stopped worrying about that now because I don’t think they will ever do that. Originally I was told secondary services would be a bumpy ride but in all fairness they haven’t done much. In fact frustratingly little. Try not to worry and I hope you find you have control over what they do and what happens next.
Thank you so much. I actually thought I was alone with having a plan in place and stuff. I didn't realise others was in the same position without being in hospital. So thank you both for that. I'll try mirr to worry, I just tend to think worst case scenario and cant seem to reason with myself.
 

Optimistic Goatman

The woolly enigmatic one
Staff Alumni
SF Supporter
#20
I know it's probably not needed by now, but i also wanted to confirm that i too have had the same solid plan in place for the last 2 years or so, and have been very open about that with my mental health support staff, and i've never been hospitalised for it. It would be pretty much guaranteed to work, even if they found me, and while i don't have the "tools" for it to hand, they could be obtained in a matter of seconds if i was committed enough. Every time i have a therapy appointment they have to ask me about these thoughts, if it's the same plan, if i still feel the same about it, and if i intend to act on it. And how they respond depends pretty much entirely on that third question. So long as i say i have no current intent of acting on it, that's fine.

I've been hospitalised 3 times in the past, and 2 of those were because i specifically went to them and said "i no longer feel capable of keeping myself safe, i'm worried i'm going to do it". Meanwhile the third one was because they actually caught me after doing all the prep work for an especially brutal attempt, when i was literal moments away from doing it. I think we tend to imagine they're a lot more trigger happy about putting people in a mental ward than they actually are. In truth they have a very limited number of beds and so try to only give those beds to people they feel are in dire need of them.
 

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