Waiting for CMHT - how long?

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Waiting for CMHT - how long?

Postby asc » Sun Jun 23, 2013 8:56 pm

It is nearly a month now since I was in that desperate state and asked for a referral - mainly so I could have a CPN or similar, and a reliable crisis line. It turned out that my GP didn't write the letter until the 14th (she's normally very reliable.) I have to see the 'old age' team as I am over 65! Not very happy about that. I haven't heard anything yet. I wonder how long other people have had to wait? When I saw my GP she seemed to think I was 'not too bad.' Just fairly good at hiding it! She hasn't seen me when I have actually fallen apart! I probably said that one day a helpline sent the Community Police Officer to check on me. Five things have kept me from acting on the impulses: my animals, the state of my house, the fact that I wouldn't want anyone else involved (e.g. a train driver), fear of it not being successful, and my Christian faith. However, the CMHT don't know these things - I could easily be DEAD while waiting! How long has anyone else waited? What happened when you did see them? I feel we are penalised for taking a logical and intelligent view about things.

Right - I am better than I was. I don't want my main medication changed as, at my worst, I was only just getting on it. I would like another medication I could take in emergencies. I am still struggling in some ways. Finance and animal problems over the last month have been really hard. At the moment they are talking on the radio about singleness. I feel single and old. I was never able to give my late parents a longed-for grandchild. I am the last of my family. My only children have four legs, tails, and a 2-3 year lifespan. I thought my redundancy money would last longer than it will. On the other hand, being in a close relationship wouldn't have been fair on a partner.

Today has been stressful at times - having thoughts I don't want in various areas. My officers are lovely but I find them a little controlling. I have deliberately made myself accountable to them in certain areas. I did put off Major Lorna's help with cleaning because I was struggling physically. I've come to terms with the pet crisis and God had in fact used it as a picture of His forgiveness. However, the thought of carrying on like this indefinitely is intolerable.
Ann www.annspoetry.weebly.com / www. annssmallpets.weebly.com
"My grace is sufficient for you, for my power is made perfect in weakness" 2 Corinthians 12v9
"You are God's masterpiece." Ephesians 2v10 God doesn't make junk!
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Re: Waiting for CMHT - how long?

Postby Keziah » Sun Jun 23, 2013 10:18 pm

Hi - a good question, how long is a referral. It can legally take until 18 (think it is 18, or 17!) weeks. As that is as long as any referral for anything physical. The only thing that has legally a shorter referral is for cancer diagnosis. So when my son was very ill as a baby we had to wait 17 weeks to see a consultant paediatric specialist.

The CMHT's role is not for crisis care, so they will not necessarily see you in a matter of days or weeks. They usually have a weekly meeting where they discuss referrals. So depending on when the referral was sent and when they have their weekly meeting, it may be the referral got there after the weekly meeting. Then they have to write to you, it gets dictated to by a secretary and then sent through NHS post. So if referral sent on 14th then that is probably too early.

As CMHT's role is not for crisis, it would be the role of your Gp to refer you to a crisis team if the gp thinks you are in immediate danger to yourself, or for a police to hold you on a mental health police section (usually held in a police station) for up to 36 hours. The CMHT, if they see a patient can refer to the crisis team or hospitalisation (here the crisis team workers assess for hospitalisation and thankfully there are never any beds so I have avoided that!!). If someone is under a CMHT and they need more support than what a CMHT can provide, then that is when they use the crisis team. The crisis team can also be referred to by a Gp - so you do not need to be under a CMHT to be under a crisis team. Usually crisis teams deal with severely mentally ill patients who are either at risk themselves, or put others at risk, or are psychotic.

Does that help? A CMHT will assess all referrals to see if they take someone on, then depending on how they are set up as to how they work. People are not automatically assigned a nurse, known as a CPN. Where I live they have a Pathfinders service, which means people get seen fairly quickly by a CMHT (not called that here, called a recovery team but same thing). The Pathfinders service sees people weekly for a set number of periods and that worker then decides on who is referred onto a Recovery Team or whether other services, such as counselling through IAPT, is better. The CMHT's have a team of people working with them, often including Social Workers, Occupational Health Workers and nurses (CPN') who act as the care co-ordinator. Every patient under a CMHT will have to be under a psychiatrist, as the psychiatrist is the lead professional overseeing all care whether the patients sees them often or not.
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Re: Waiting for CMHT - how long?

Postby Keziah » Sun Jun 23, 2013 10:27 pm

Sorry - yes the CMHT's are split up depending upon age, as each age group has different social needs. So under 18's have CAMHS, 18-65 the CMHT and over 65's have the Older Adult CMHT (plus younger people with dementia are also covered.) I just looked up my area's blurb on this category for you to see if I could find out any more details. It said:

"The Older Peoples Community Mental Health team provides a service for people with functional and organic illnesses whose needs are above the level that can be appropriately met within primary care. As a general rule those people will be over 65 years of age, however a degree of flexibility allows individuals needs to be addressed in a person centred/needs led way. This is particularly relevant for those who suffer from a dementia type illness, in such circumstances we accept patients regardless of age. Diagnosis, initial assessment and ongoing treatment programmes in relation to dementia are our specialist area of expertise. We also see individuals 65 and over who are experiencing a first episode of a diagnosed severe mental illness that significantly impacts on social, cognitive, occupational, interpersonal and financial functioning. Typically this individual would have high levels of risk and need complex multi-agency approach to care."

I guess you have been referred to the Older Adults category as some of the issues that you identify struggling with would be more common for workers to deal with, such as finances, managing physical health etc - so if you can try to see that as a positive.

If you are struggling in the meantime you can always go to your Gp again, or if Gp's closed you can phone 111 who can direct you to an out of hours service. An out of hours service can do more after 5pm than any CMHT can as they are closed then!! So whilst you wait for the referral to go through (I know how frustrating it is, having to wait over 4 months twice now this year for referrals for my baby has been horrible, as needed 2 referrals to different hospitals for different things!) but sadly that is the way of the NHS. That is why police and A+E are at breaking point for dealing with people with mental health issues.

If you are struggling more you could always ask your Gp to refer you to Adult Social Care team to assess you, to see if any more support available. That is often a way to get help expediated or for further services. They can then liase through a CAF with Mental Health teams to offer up a joined up package. Your gp can refer you to this service as well, and they tend to be much quicker at acting!!
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Re: Waiting for CMHT - how long?

Postby Keziah » Sun Jun 23, 2013 10:39 pm

Sorry for essays - just found the bit that might help the most. In my area it says for Older Adults: "As soon as a referral is received it is triaged by a band 6 team member (duty worker) to establish level of urgency. In hours of opening the team will respond as a crisis Team if required, routine referral will be discussed by the full team at weekly meeting. Routine referrals will normally be seen for assessment within four weeks of referral."
- so despite the NICE guidelines saying has to be seen in 18 weeks, here the Older Adults CMHT will see people 4 weeks after the weekly team meeting. So all depends on how quickly the referral got in the hands of the team, whether it missed a weekly meeting or not. So if you allow 5 weeks after Gp sent it (allowing for post?) then perhaps then go back to Gp and ask what time frame your CMHT works on? If you know the name of the team you may be able to find out online like I did - as I imagine each area works slightly differently, like I found out the city near me is different to the county team!!!
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Re: Waiting for CMHT - how long?

Postby asc » Mon Jun 24, 2013 9:58 am

Thank you.
Ann www.annspoetry.weebly.com / www. annssmallpets.weebly.com
"My grace is sufficient for you, for my power is made perfect in weakness" 2 Corinthians 12v9
"You are God's masterpiece." Ephesians 2v10 God doesn't make junk!
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Re: Waiting for CMHT - how long?

Postby sally » Mon Jun 24, 2013 4:28 pm

Ann,

seems like Kezzie has found out lots of helpful information about the CMHT. All waiting is really hard isn't it.

It's good to recognise that things aren't at such a critical level as they were, but you have definitely had several knocks with saying goodbye to rats and injuries and the finance concerns and getting through each day still sounds like its a big effort and challenge for you.

It's frightening when you feel that a health professional has missed just how serious things feel for you, like your GP just now. If you are able, please tell her that when you next see her. I sometimes wonder if support/ medical services hope we will seek help again if things stay at such a desperate critical level and the crisis situation returns or escalates.

I will keep praying for you as you face the challenges of each day during this time of waiting to hear what support might be offered to you. Could you ask your GP if you could see her more regularly until the CMHT referral goes through, if that might help you.

best wishes, Sally
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Re: Waiting for CMHT - how long?

Postby Hash » Mon Jun 24, 2013 8:58 pm

That's a good suggestion of Sally's that you see your GP more regularly whilst your waiting for the referral and don't forget your completely entitled to Crisis or home treatment team support if your in Crisis and you can access that through your GP or through A and E at any time night and day.

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Re: Waiting for CMHT - how long?

Postby sally » Tue Jun 25, 2013 1:41 pm

How are you feeling today Ann?

I'm praying for you,
Sally
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Re: Waiting for CMHT - how long?

Postby asc » Tue Jun 25, 2013 7:02 pm

I saw my GP today. She's very good, but does seem to have exaggerated impressions of how well I cope and thinks I'm an extrovert because I've booked on a Be Creative retreat and the Digital Photography Days! I'm struggling physically at the moment. Part of me feels I wish I could reduce and ultimately stop my steroids, but if this is PMR then I may even need more, rather than less. People who are made euphoric by steroids are lucky.

I had to postpone my bank appointment today as I had a splitting headache - but am trying to work on some documentation from which I can draw up a budget. I have a lot of things to do at home by next Tuesday, when the boiler work starts - and a rat show on Saturday.
Ann www.annspoetry.weebly.com / www. annssmallpets.weebly.com
"My grace is sufficient for you, for my power is made perfect in weakness" 2 Corinthians 12v9
"You are God's masterpiece." Ephesians 2v10 God doesn't make junk!
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Re: Waiting for CMHT - how long?

Postby Keziah » Tue Jun 25, 2013 8:22 pm

Hi - I doubt she thinks you are an extrovert, but in terms of people with severe depression say that she would be comparing you to some people would not manage to go to events so perhaps she was trying to encourage you that you are doing positive things that you enjoy?
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Re: Waiting for CMHT - how long?

Postby asc » Wed Jun 26, 2013 10:32 am

She actually said that I was! I've just learned to 'put a face on' and to use my logical way of thinking to do the best I can while handling long-term depression. I like things where I can be in control and share knowledge that I have, so can handle situations where I have a lot in common with others. I do struggle sometimes in the 'rat community' and feel that I'm not accepted by some people as I'm not a breeder, and have no desire to be.

I'm struggling physically and emotionally at present. I really must get the house sorted out by Monday night as I have the boiler replacement starting. I've put it off twice, so can't do it again.
Ann www.annspoetry.weebly.com / www. annssmallpets.weebly.com
"My grace is sufficient for you, for my power is made perfect in weakness" 2 Corinthians 12v9
"You are God's masterpiece." Ephesians 2v10 God doesn't make junk!
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Re: Waiting for CMHT - how long?

Postby sally » Wed Jun 26, 2013 12:54 pm

Ann,

I'm sorry you are struggling so much both physically and emotionally. I know the prospect of the boiler team coming in is a huge thing for you. Its sounded as if you have tackled different areas for sorting gradually, so can you just aim to keep up with that over the next few days for short chunks of time each day? It doesn't have to be perfect so try not to put yourself under unrealistic pressure.

Obviously, the rat show on Saturday will be a day off from sorting. I pray that goes well and with the increased activity you can manage the pain as best as possible.

It does seem strange that your doctor percieves you as an extrovert. Please try telling her that that isn't how you are when she makes statements like that. Maybe try to explain why to push yourself to do these courses. I feel I use similar groups for 'safer' socialising, on a course with others interested in the same subject.

I will keep praying for you,
Sally
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Re: Waiting for CMHT - how long?

Postby Eppie » Mon Jul 01, 2013 7:20 am

Hi Ann
How did the rat show go on saturday? And is the boiler work completed?
E x
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Re: Waiting for CMHT - how long?

Postby asc » Mon Jul 01, 2013 10:56 am

The boiler is now on the 18th-19th as I realised I had an appointment on the second day this week. It's a good job as I have laryngitis at present.

The show was pretty good, although none of the rats did well.
Ann www.annspoetry.weebly.com / www. annssmallpets.weebly.com
"My grace is sufficient for you, for my power is made perfect in weakness" 2 Corinthians 12v9
"You are God's masterpiece." Ephesians 2v10 God doesn't make junk!
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Re: Waiting for CMHT - how long?

Postby sally » Mon Jul 01, 2013 12:47 pm

Anne,

so you haven't got a voice? I'm sorry you are feeling physically poorly. Is it a relief to have a little longer until the boiler team arrive or would it better to just get it over with?

I'm glad the show went well, even if no big prizes. You did well to manage that.

Praying you will quickly be feeling better,
Sally
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Re: Waiting for CMHT - how long?

Postby asc » Mon Jul 01, 2013 6:12 pm

It is a relief, so long as I work on having everything ready, and I have made sure that, even if I'm still having fortnightly counselling, it won't interfere with it.

At the moment I'm having quite a bit of pain - I seem to have enough steroids to exacerbate my depression, but not enough to suppress the pain. Must get quite a bit done tonight.

I met some good people at the show, but don't feel that I fit in with the breeders etc. I find it annoying that people let me take their photos, don't say anything, then complain when their photos go on Facebook. If they said, I'd make sure that only the rat (or a gorgeous skunk!) was on.
Ann www.annspoetry.weebly.com / www. annssmallpets.weebly.com
"My grace is sufficient for you, for my power is made perfect in weakness" 2 Corinthians 12v9
"You are God's masterpiece." Ephesians 2v10 God doesn't make junk!
asc
 
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Re: Waiting for CMHT - how long?

Postby asc » Mon Jul 08, 2013 10:03 am

I saw my GP on 5th June, saying I was fighting suicidal temptations.

Letter sent to CMHTOP on the 14th! Received by them on 19th.

Appointment received on the 5th - for the 24th!

Right - I coped - some people wouldn't and would be dead by now! I'm thinking of making a complaint - for the sake of others.
Ann www.annspoetry.weebly.com / www. annssmallpets.weebly.com
"My grace is sufficient for you, for my power is made perfect in weakness" 2 Corinthians 12v9
"You are God's masterpiece." Ephesians 2v10 God doesn't make junk!
asc
 
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Joined: Sun Apr 27, 2008 1:36 pm
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Re: Waiting for CMHT - how long?

Postby sally » Mon Jul 08, 2013 1:27 pm

Hello Ann,

I'm glad your appointment has come through but sorry it is still quite a wait. How are you feeling today?

What contact did your GP suggest for the interim.

I agree 'they' seem to take huge risks by not responding more quickly.

best wishes, Sally
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Re: Waiting for CMHT - how long?

Postby asc » Mon Jul 08, 2013 2:15 pm

I improved quite a lot, then had another setback, during which I used the helplines, but the GP had no suggestions! I'm picking up again now - not coping well with the heat, and a bit overwhelmed by all I have to do at home. If I can bring myself to get on with some things now I might start feeling better.

How are things with you, Sally?
Ann www.annspoetry.weebly.com / www. annssmallpets.weebly.com
"My grace is sufficient for you, for my power is made perfect in weakness" 2 Corinthians 12v9
"You are God's masterpiece." Ephesians 2v10 God doesn't make junk!
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Re: Waiting for CMHT - how long?

Postby Hash » Mon Jul 08, 2013 8:08 pm

hang in there Ann and try and do things in the home in little chunks breaking them down into manageable chunks then treating yourself afterwards.

The heat is hard isn't it.

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