• Apologies for the issue with a bizarre redirect on the site earlier today. There was a large server update and an error in an IP address had the traffic routing wrongly. No hacking or anything nefarious and nothing to worry about. Sorry for any stress/anxiety caused. Very best wishes - SF Admin

Seeing a Psychiatrist in the UK

#1
I have a friend in the UK who goes through cycles of dramatic mood swings, feeling energetic and not sleeping much or at all for a few days, then feeling terrible and sleeping a lot for a few days. She's hasn't been formally diagnosed as having a mood disorder. She's taking verapamil, a blood pressure medication, which has off-label use as drug for treating mania. She's also taking an antidepressant, mirtazapine.

She was seeing a therapist for a while, and for some strange NHS bureaucratic reason, she wasn't allowed to see a psychiatrist at the same time. She later stopped seeing her therapist and went to a CMHT hoping to see a psychiatrist. She eventually saw one, but was told that she wouldn't be getting any follow up appointments, and apparently the fact that mirtazapine was helping her sleep was cited as one of the reasons.

Later, she got a call and was told that she would be seeing the psychiatrist. Then she got another call after that and was told that she wouldn't.

She didn't want to see her therapist again, so she was left with no mental health care, except the medication she was taking. During this time she had suicidal thoughts, and had at least one serious suicide attempt.

She's now thinking of seeing her therapist again. She would also like to see a psychiatrist, and I have recommended that she contact PALS to see if they can straighten things out for her.

Any advice?

@Sunspots @Lara_C @Butterfly @Ash600
 

Sunspots

To Wish Impossible Things
Safety & Support
SF Supporter
#3
How long ago was she in contact with her CMHT? Is she definitely still under their care or have they discharged her? It could potentially be that they have discharged her back into the care of her GP which is why they can't get her another psychiatrist appointment. If she has been discharged they should have written to her to let her know but I know from experience this often doesn't happen.

If she has been discharged she'll need to go back to her GP and get another referral back to CMHT. If she hasn't and they're just being obstructive asshats then I'd really recommend using an advocacy agency. They're generally free to use and do get results - they know all the ins and outs of the laws and regulations.

MIND should be able to put her in touch with some agencies in her area. If she's in a similar area to me I can highly recommend this one..
https://www.theadvocacypeople.org.uk/
 

Sunspots

To Wish Impossible Things
Safety & Support
SF Supporter
#5
So an advocacy agency is something different than PALS?
Yes, PALS is run by the NHS, an advocacy agency will be totally independent.
As @Ash600 said, PALS is more about complaints and resolutions whereas an independent advocate will hopefully help to negotiate a positive outcome before it gets to that point.
 
#7
I think I may suggest that she try contacting PALS first.

It was her understanding that she was discharged by the psychiatrist immediately after her appointment, so there was no time to engage the services of an advocate. If she were to get another appointment, I'm not sure the outcome would be any different. She's also really in no position whatsoever to struggle with the NHS bureaucratic process.
 
#8
She doesn't want to contact PALS. She's reluctant to contact an advocacy agency too.

Her therapist helped set up an appointment for her with her GP.
If she has been discharged she'll need to go back to her GP and get another referral back to CMHT. If she hasn't and they're just being obstructive asshats then I'd really recommend using an advocacy agency
Let's say she gets another referral to her CMHT, and sees a psychiatrist. Then the psychiatrist does nothing and she's immediately discharged. If she's been discharged, does that mean the advocacy agency can't help her?
 

Sunspots

To Wish Impossible Things
Safety & Support
SF Supporter
#9
Does she have anyone who could go to the GP appointment with her?

So she's still seeing her therapist? The one through the CMHT or has she gone privately? If through the CMHT she will still be under their care and not discharged. If she feels that she's not getting the help she needs she could ask for a meeting to discuss this - taking an advocate or just someone she knows who can help her to get across her worries would be a really good idea. If she has tried that to no avail it would then possibly be the time to get PALS involved as they deal with complaints. She's likely to get a better outcome as far as treatment is concerned if she can resolve this without PALS which is why an advocate would be really useful here. She should certainly ask for their reasons for their lack of response. Of course there's the possibility that it's just down to lack of resources as - I know mine is really struggling with demand, especially as during the pandemic most face to face appointments aren't possible.

What are her expectations of seeing a psychiatrist? Over here NHS psychiatrists really only sort out medication. The fact that she's taking an off label drug I'd hope a psychiatrist would still be willing to oversee that. I'd imagine a GP would be fairly unwilling to mess with anything set up by a psychiatrist. My GP won't have anything to do with any of my psych meds.
 
#10
Does she have anyone who could go to the GP appointment with her?
I think it's a phone appointment, but she doesn't have anyone to support her. I'd be happy to join the appointment by phone, but I don't know if she'd want that, or if it would even be allowed.
So she's still seeing her therapist? The one through the CMHT or has she gone privately?
She had been seeing the therapist, but he discharged her and sent her to the CMHT because he didn't think he could keep her safe. The CMHT eventually got her an appointment with a psychiatrist. Her impression was that she was discharged from the CMHT, though they never said anything officially. So then she arranged to see her therapist again.
Of course there's the possibility that it's just down to lack of resources as - I know mine is really struggling with demand, especially as during the pandemic most face to face appointments aren't possible
I think that may be the root problem. They went back and forth about her having additional appointments, so they must have at least been thinking about giving her medication.

My friend has got litterally every sign of bipolar. You'd think the psychiatrist would have asked a set of questions relevant to that diagnosis if she was serious about giving my friend treatment.
Over here NHS psychiatrists really only sort out medication
It's the same here. I'm not sure what my friend's expectations were, but I was hoping they'd finally get her on the right meds.
 

Please Donate to Help Keep SF Running

Total amount
$55.00
Goal
$255.00
Top