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  • FIRST POST
    • bellanoisette
    • By bellanoisette 17th Jun 17, 11:11 PM
    • 19Posts
    • 10Thanks
    bellanoisette
    Would i be entitled to help from a CPN?
    • #1
    • 17th Jun 17, 11:11 PM
    Would i be entitled to help from a CPN? 17th Jun 17 at 11:11 PM
    I have long term mental health problems and am not able to cope. My diagnosis history is:

    eating disorder
    generalised anxiety
    clinical depression
    psychosis
    OCD
    autism (not yet diagnosed)
    paranoia
    borderline personality disorder
    body dysmorphia
    social anxiety
    health anxiety
    hyperarousal symptoms

    I get no help and know the nhs is very stretched but feel i would benefit from a CPN but don't know if I would I be deemed a serious enough case? i'm unemployed because of discrimination at work and was stalked (found out he was a sex offender in the paper recently which made me feel sick as he would follow me late at night) and received threats from someone else. This caused me to have another breakdown. I feel I could do with some support just to get my life back on track. My parents are alcoholics and my relationships have been emotionally abusive so i've only ever known life being anxiety filled.

    (please could i ask that you don't quote my post i might want to delete some info as my family and friends know my username off other stuff)
    Last edited by bellanoisette; 17-06-2017 at 11:13 PM.
Page 1
    • Pollycat
    • By Pollycat 18th Jun 17, 8:09 AM
    • 17,978 Posts
    • 45,814 Thanks
    Pollycat
    • #2
    • 18th Jun 17, 8:09 AM
    • #2
    • 18th Jun 17, 8:09 AM
    Hi there
    I don't know much about this but wouldn't you need to be referred by your GP?

    What help are you getting from your GP?
    • Diary
    • By Diary 18th Jun 17, 8:54 AM
    • 571 Posts
    • 750 Thanks
    Diary
    • #3
    • 18th Jun 17, 8:54 AM
    • #3
    • 18th Jun 17, 8:54 AM
    You need a referral from your GP to psychological services and then they will decide if you need a cpn.

    For your own safety.

    Anything you put on the internet can be found for all eternity. Even if you delete/ change your post people can quote it back in its entirety.
    Take care.
    • jenniewb
    • By jenniewb 20th Jun 17, 11:49 AM
    • 12,208 Posts
    • 11,516 Thanks
    jenniewb
    • #4
    • 20th Jun 17, 11:49 AM
    • #4
    • 20th Jun 17, 11:49 AM
    Hi, I've got a not too dissimilar diagnosis description to you (not the same but a few things and then a few other things) and I don't have a CPN either. I used to but was told (at a BMI of 15 and weeks outside of a psychiatric inpatient emergency hospital stay due to suicidality) that I was "not ill enough". Tbh it was not so difficult for me to cut ties because my CPN really wasn't helping at all and I don't think that any longer spent with her would have altered this. So where as a CPN can be helpful, please don't hold up hope that they are all fantastic because there are a mix of people and if they don't feel they can help you, that wont change by setting up one. It really will depend on their criteria.

    It would be something that you could try discussing with your GP- if anyone has suggested seeing a CPN then talk about why you feel they could benefit you because there may be differences to what each service/local authority is funded to assist with.

    It also would be helpful to discuss with your GP if a CPN cannot be arranged (if the things they are funded to assist with are not things which you need help with for example) then thinking about what other services could be useful to you. Do you have/need a psychiatrist for example or a therapist (and then what type of therapy- within the limitations of what the NHS in your area will offer). Also consider referrals to other areas within the NHS, for example if there is a specialist service for your eating disorder or personality disorder which is reachable and feasible to get to frequently.

    If you do feel you are struggling to manage the conditions you have, it is something your GP should be able to help with and the best way to make your point is to ask for help when you need it and feel overwhelmed and struggling. If you share the things you struggle with as much/many times as you need help with, it helps your GP to see what is going on and where you need help. If this is then something they have to also deal with -because you have bought what you are struggling with to their door, it then becomes something they will be able to get a better picture of and may be able to better find something for you if a CPN isn't something they can offer you.

    I also think it's worth looking at support groups- both online and offline. B-eat (the eating disorder charity) have an online support group which meets every week per eating disorder, (so depending on how varied your disorder is, can mean you can attend several of them!) They also offer a telephoned service where you can talk to someone and I think they've recently just changed the times on this so it runs until 10:30pm each night.

    There are also many actual groups you can attend- I've not got a lot of personal experience of this, I have attended a few groups over the years and know enough to say they are not all the same so if one doesn't work, keep looking.

    These are all ideas to help manage your condition/s but not to treat it or reduce any of the symptoms which is a different thing altogether and it's worth remembering this when you are looking for or asking for help. It's one thing to feel ready to take on the energy, persistence and courage to work on issues and reduce symptoms, which would mean looking for different things from those you see. But what I have suggested (above) is about managing what you have and getting through your time without getting more unwell or relapsing or developing new conditions.


    It is important to keep this in mind when asking your GP for a referral to a CPN, because IMO few people actually realise that these are two different situations to be in and either are fine and it's a sign of personal emotional intelligence IME to realise where you are at yourself and accept that this is where you are for now, but it can often be something you need to remind people of when or if you are refused treatment or assistance because someone feels all people in your situation should be either working on recovery or should be accepting where they are at without the focus on recovery- I hope that makes sense- it's just worth thinking about what you are asking for and sticking to this when asking because not every medic of specialist realises this. It's one of the areas physical and mental health differ and those not well experienced in mental health may not realise this.
    • bellanoisette
    • By bellanoisette 20th Jun 17, 1:11 PM
    • 19 Posts
    • 10 Thanks
    bellanoisette
    • #5
    • 20th Jun 17, 1:11 PM
    • #5
    • 20th Jun 17, 1:11 PM
    Thank you for your replies. My GP is trying his best to get me an emergency referral but it's taking months. Other GPs in the practice have referred me for CBT despite me saying I need more help than that from a psychiatrist as I'm not well enough to carry out CBT. I would like a CPN to help with more practical things that I struggle with. I am too paranoid and obsessional to join online forums especially for eating disorders. I had recovered for almost a year in my teens but met a friend in college who was bulimic and over the course of a year I went down to under 5 stone from 9 stone. Whenever I went to my GP then they would give me a diet sheet and send me away. I eventually got to see a psychiatrist who laughed at me, called me paranoid and when I reacted emotionally he said something along the lines of "see, she's unhinged" and let me walk out. I went back in the room and apologised for getting upset and he laughed again and didn't speak to me but my mother. I also have great struggles getting out the house and fail to attend appointments/groups thank you for the suggestions though. Hopefully I can get to see a psychiatrist and in the future be well enough to attend peer support as I am a great believer in it.
    • IAmWales
    • By IAmWales 20th Jun 17, 2:12 PM
    • 1,474 Posts
    • 3,077 Thanks
    IAmWales
    • #6
    • 20th Jun 17, 2:12 PM
    • #6
    • 20th Jun 17, 2:12 PM
    If the appt is taking months then it's a standard referral. An emergency referral would have you assessed in days, but that would only happen if you were deemed to be at immediate risk of harm.

    What help are you looking for, can you be more specific? If you are allocated a psychiatrist you'll only get an appt every few months, unfortunately they are so under resourced that's all they can offer. Chances of you getting to see a CPN regularly are low unless you are actively psychotic or in crisis, or you need medication that can only be prescribed by the mental health team.

    Have you actually tried CBT? Have you been assessed by the personality disorders service?
    • bellanoisette
    • By bellanoisette 20th Jun 17, 2:58 PM
    • 19 Posts
    • 10 Thanks
    bellanoisette
    • #7
    • 20th Jun 17, 2:58 PM
    • #7
    • 20th Jun 17, 2:58 PM
    Yes, I called and they just said it's been downgraded by triage My doctor said I am in crisis (been diagnosed with psychosis and everything listed except autism). I'm hearing voices, and dealing with suicidality. My GP is very concerned that he was willing to act as a social worker (his words) until the appointment came through because he thought it would be quicker. Now it's a 2 month wait. I can't get out the house to see the GP now and had a panic attack at the thought of being left on my own with no support for 2 months. I have no counsellor or advocate.

    I need a psychiatric assessment initially before I can attempt CBT again. I can't help myself yet if that makes sense so it's a waste of time as it stands. I have no energy and don't go out so can't do any exercises. It would be like an unwilling alcoholic being forced to go to rehab. I was under a psychologist for psychosis and CBT was a part of it but not the main focus and it was the first time I started to see an improvement but I had to move and no longer saw her. I had CBT a few months ago but she said my issues were too complex and to just try the exercises anyway, I couldn't get to the surgery to see her again so left it as I'd felt I'd waited 18 months for nothing. No one takes me seriously, even when I weighed less than 5 stone and I'm 5'7.
    Last edited by bellanoisette; 20-06-2017 at 3:08 PM.
    • IAmWales
    • By IAmWales 20th Jun 17, 4:49 PM
    • 1,474 Posts
    • 3,077 Thanks
    IAmWales
    • #8
    • 20th Jun 17, 4:49 PM
    • #8
    • 20th Jun 17, 4:49 PM
    I'm sorry to say that this is the state of mental healthcare in the NHS, the great majority of people are left to it. My local advocacy service had to shut too because of funding cuts.

    I would look up whether there is a personality disorders service in your area. Your GP may be able to refer you directly. There will still be a wait but it's another option to pursue.

    In the meantime, look at self care. Meditation may be difficult with psychosis, I do yoga as an alternative. And if all you do one day is get out of bed then that's an achievement and something to be proud of. Baby steps are the way forward.

    If you do feel you want to act on your suicidal thoughts, please call 999. It is an emergency, just the same as a physical condition would be.
    • bellanoisette
    • By bellanoisette 20th Jun 17, 5:21 PM
    • 19 Posts
    • 10 Thanks
    bellanoisette
    • #9
    • 20th Jun 17, 5:21 PM
    • #9
    • 20th Jun 17, 5:21 PM
    Thank you it helps just to have that acknowledged. Trying not to let it all send me completely over the edge. Ive been diagnosed with a lot in the past in different parts of the country and they're not linked in so now they just say I have anxiety and depression. I have problems with my memory and only found out I had been diagnosed with this stuff from old emails to my psychologist. I might have to sell my belongings to try and see a private counsellor. I can communicate how I feel to an extent but I'm so impaired in other areas if that makes sense. I might be able to make a phone call but they don't acknowledge I have spent all day in the same spot on the sofa, not dressed or showered or eaten with horrible paranoid thoughts after a night of nightmares and took diazepam/alcohol/beta blockers just to make the call. I can't maintain personal relationships of any kind. Under pressure I am usually manic but in my daily life I'm terrified of making eye contact on the rare occasions I go out and would never converse like I do with a doctor when I'm having a major panic attack. I call Samaritans a lot as I have no one else. I will look into the personality disorder services.
    Last edited by bellanoisette; 20-06-2017 at 5:26 PM.
    • jenniewb
    • By jenniewb 21st Jun 17, 2:48 AM
    • 12,208 Posts
    • 11,516 Thanks
    jenniewb
    Thank you it helps just to have that acknowledged. Trying not to let it all send me completely over the edge. Ive been diagnosed with a lot in the past in different parts of the country and they're not linked in so now they just say I have anxiety and depression. I have problems with my memory and only found out I had been diagnosed with this stuff from old emails to my psychologist. I might have to sell my belongings to try and see a private counsellor. I can communicate how I feel to an extent but I'm so impaired in other areas if that makes sense. I might be able to make a phone call but they don't acknowledge I have spent all day in the same spot on the sofa, not dressed or showered or eaten with horrible paranoid thoughts after a night of nightmares and took diazepam/alcohol/beta blockers just to make the call. I can't maintain personal relationships of any kind. Under pressure I am usually manic but in my daily life I'm terrified of making eye contact on the rare occasions I go out and would never converse like I do with a doctor when I'm having a major panic attack. I call Samaritans a lot as I have no one else. I will look into the personality disorder services.
    Originally posted by bellanoisette
    Make sure you ask about sliding scale fees as some therapists will reduce their fees for people on a reduced income. Also check the B-eat website who have a list of therapists and counsellors (two different things!) which may be a helpful starting point if you are looking privately. Often if a therapist doesn't feel he/she can help you, they may be able to suggest or refer you to someone else they do know who may be more suitable.
    • jenniewb
    • By jenniewb 21st Jun 17, 2:58 AM
    • 12,208 Posts
    • 11,516 Thanks
    jenniewb
    Thank you for your replies. My GP is trying his best to get me an emergency referral but it's taking months. Other GPs in the practice have referred me for CBT despite me saying I need more help than that from a psychiatrist as I'm not well enough to carry out CBT. I would like a CPN to help with more practical things that I struggle with. I am too paranoid and obsessional to join online forums especially for eating disorders. I had recovered for almost a year in my teens but met a friend in college who was bulimic and over the course of a year I went down to under 5 stone from 9 stone. Whenever I went to my GP then they would give me a diet sheet and send me away. I eventually got to see a psychiatrist who laughed at me, called me paranoid and when I reacted emotionally he said something along the lines of "see, she's unhinged" and let me walk out. I went back in the room and apologised for getting upset and he laughed again and didn't speak to me but my mother. I also have great struggles getting out the house and fail to attend appointments/groups thank you for the suggestions though. Hopefully I can get to see a psychiatrist and in the future be well enough to attend peer support as I am a great believer in it.
    Originally posted by bellanoisette

    Sounds like you need someone just to keep your head above water- it's worth asking your GP if they also know of any other services (eg charities). When I was discharged by my CPN at a stupid weight because I didn't fit their criteria (which of course means I am totally fine and need no help...) my GP wasn't too happy and I was referred to a charity who worked with the mental health services and pretty much acted as a CPN and would be far more flexible with meeting me (we'd meet in the pub/caf! (no alcohol though!) rather than the mental health offices for example and if I'd needed anyone to help me shop they would have been able to do that. It isn't ideal for a charity to be picking up the effects of poor government funding, but that's a separate issue.


    It sounds like your GP is very willing to do what they can and I'd suggest if things still are not happening, to try your MP, a GPs support counts for a lot and I'm sure you wouldn't have much of a problem if you went through that process. Most MPs will have an email or phone number to contact them and they all should have surgeries where you can arrange to speak with your MP to get things resolved.


    I hope you get somewhere with this though, it sounds like a lot of work at the moment and without wanting to sound patronising at all, you're doing the right thing by trying to sort this out. Hopefully once you can get into managing a basic level without feeling so overwhelmed, you can then have the option to look at therapy but make sure you get the basics under control first because therapy can be pretty hard going sometimes and the last thing you want is to end up more unwell and too unwell to keep going to sessions. Everything can be done, just not always at the same time IYSWIM!
    • Helping_Hands
    • By Helping_Hands 21st Jun 17, 1:56 PM
    • 20 Posts
    • 7 Thanks
    Helping_Hands
    OP, I am in a similar situation to you. I had a great CPN whose care I was under for 4 years, but once my therapy ended I was discharged from the CMHT, I was doing ok. I was always informed if I needed help again I could access it.


    I relapsed last year, triggered by several different things and my GP referred me back to the mental health team. I was also assessed by the crisis team in A&E after being sent there by my diabetic consultant.


    8 months on and I am still ill and seem to becoming more suicidal than ever. My GP is good, but even they know cutbacks means it is so difficult to access the services I need. I was seen by a locum psych last year but never got a follow up appointment.


    I am tired of reading about how money will be provided for mental health services, when all that seems to be happening is cutbacks after cutbacks. I feel if I still had the support of my CPN, my physical health and mental health would still be stable, perhaps enough for me to have achieved something I wanted so badly, but have now failed. I am personally at a point of knowing I am not sure how much longer I can survive in this world.
    • Teapot55
    • By Teapot55 21st Jun 17, 2:27 PM
    • 181 Posts
    • 172 Thanks
    Teapot55
    There used to be something called The Expert Patient Programme. It is still around in a few parts of the country and it is definitely worth typing 'Expert Patient Programme' into g**gle or another search engine.

    The Expert Patient Programme had courses local to where people needed them. There would be about a dozen people in each group, all suffering with different conditions (physical or mental or both) but they would discuss the symptoms that caused them the most trouble, for example, pain, panic attacks, or tiredness and very often there would be a lot of symptoms that were common to different health conditions. Then they would study different ways of coping - there was a volunteer course-leader who had been on a previous course who would facilitate this and invited-in experts to speak on specific topics.

    There were all sorts of techniques recommended which people could try out at home then report back, such as relaxtion exercises and breath control.
    • teddysmum
    • By teddysmum 21st Jun 17, 4:41 PM
    • 8,339 Posts
    • 4,961 Thanks
    teddysmum
    Mental health help is dire across the board.


    Two years ago, I accompanied a family member and child to a meeting with one of the departments that looked after children having behavioural problems. The person could see what the problem was and said the child needed help, but whereas 20 years ago, children with lesser needs would have been referred to an assessment unit ,these are now reserved for children in immediate danger of taking their lives or endangering others, as the system can't cope.


    Two years on, the child may be getting help.
    • bellanoisette
    • By bellanoisette 21st Jun 17, 5:32 PM
    • 19 Posts
    • 10 Thanks
    bellanoisette
    Thanks for all the useful info and kindness. I am sorry some are in similar positions and wish you the best.

    Jenniewb- That's exactly what I need, just someone to keep my head above water and get the basics under control. I never got any help as a child despite obvious signs of abuse/neglect and as a young adult I was only given support after moving and complaining to my old PCT for the horrendous experience with the old psychiatrist guy. It left me very angry. I really want to get some control before I become any older and am deemed 'less worthy' because that seems to be the cold reality. I wasn't aware of sliding scale fees so that would be good. I would sell what little belongings I have to speak to someone rather than live in this purgatory.

    Helping_Hands- It is so frustrating isn't it. My recent psychiatric report said I had spoke about plans for the future (she asked me about what I was up to in general) so was at no risk of suicide. This was despite me saying I felt all of that was out the window now and I was there as I was at breaking point. I know they have targets and tools but really ought to be mindful of their client reading that kind of thing. When you're suffering that feels like a low blow. If you ever need to offload feel free to message me.

    I know there is some charity stuff in my area but the website is so confusing and I open it and close it because it is so daunting as the search results throw back loads of irrelevant ones. I also can't get out the house right now so I'm stuck until I can get some help. The Expert Patient Programme is something I will look into though, thanks Teapot. I am a big believer of peer support and think money should be put into that.
    • bellanoisette
    • By bellanoisette 21st Jun 17, 5:38 PM
    • 19 Posts
    • 10 Thanks
    bellanoisette
    They even make me doubt myself now. I have always been better at communicating by text and I go over and over what I have said. I'm worried I could've offended someone now and about what replies I will get etc. If you can post on a forum you can't be suicidal, right? Sigh.
    • UKTigerlily
    • By UKTigerlily 17th Jul 17, 10:44 PM
    • 4,309 Posts
    • 5,368 Thanks
    UKTigerlily
    bella, I only just found this thread but suffer with mental health problems too. You can PM me anytime you like & I will reply as soon as I see it. I hope you're doing ok, please update the thread as I know how it feels to be desperate & for the NHS etc to be next to useless x
    2015 weight loss: 86/100Ibs
    • jenniewb
    • By jenniewb 18th Jul 17, 1:35 AM
    • 12,208 Posts
    • 11,516 Thanks
    jenniewb
    The trouble is, that now unlike years in the past, mental health care is not ever going to be long term, any treatment or support given will straight away start from the stand point of "how do we work on discharge". It used to be the case that longer term support could happen or even just support for more than a few months at best, but things just don't work that way any more.


    The reasoning given are that longer term support creates a system of dependency, but to be honest and IMHO I think this is just another excuse to input even further cut backs. It makes me as a service user feel very worried and very unsure of my own future and it also makes me wonder just how much they expect of "society" to pick up the tab and to do so in a healthy and positive way.


    I can see this all ending up in a very unhappy and worrying future. It's almost as if it's got to be proven wrong before they stop messing up people's lives, but I fear this wont happen for another 10-20 years where the negative effects of this short term care is too big and too lethal to ignore.
    • bellanoisette
    • By bellanoisette 20th Jul 17, 12:56 AM
    • 19 Posts
    • 10 Thanks
    bellanoisette
    bella, I only just found this thread but suffer with mental health problems too. You can PM me anytime you like & I will reply as soon as I see it. I hope you're doing ok, please update the thread as I know how it feels to be desperate & for the NHS etc to be next to useless x
    Originally posted by UKTigerlily
    Thank you Tigerlily <3 It's so nice of you and I will try to reach out when I'm feeling low. It means a lot for you to offer that x

    I've got an appointment for the access team now. They said I wasn't urgent but my GP has been seeing me weekly and rushed it up. Hallucinations and paranoia has worsened. Due to my GP's concern they called me and after what I told them, or could remember to tell them, said it's very urgent they see me and want to try and get me in for a cancellation. I've felt so numb and my anxiety is through the roof, even sleep brings no rest as I'm having vivid nightmares and waking up in cold sweats. I'm drinking more to try and cope but then I feel fat because of the calories


    The trouble is, that now unlike years in the past, mental health care is not ever going to be long term, any treatment or support given will straight away start from the stand point of "how do we work on discharge". It used to be the case that longer term support could happen or even just support for more than a few months at best, but things just don't work that way any more.


    The reasoning given are that longer term support creates a system of dependency, but to be honest and IMHO I think this is just another excuse to input even further cut backs. It makes me as a service user feel very worried and very unsure of my own future and it also makes me wonder just how much they expect of "society" to pick up the tab and to do so in a healthy and positive way.


    I can see this all ending up in a very unhappy and worrying future. It's almost as if it's got to be proven wrong before they stop messing up people's lives, but I fear this wont happen for another 10-20 years where the negative effects of this short term care is too big and too lethal to ignore.
    Originally posted by jenniewb
    I agree I called A&E and they told me we'd just discharge you and you have to wait for the access team. Are you on Twitter? Lots of interesting stuff on the traumanotPD hashtag, it's helped me feel 0.01% less alone I was diagnosed with a personality disorder but it's still an interesting debate if you haven't.
    • jenniewb
    • By jenniewb 20th Jul 17, 2:53 AM
    • 12,208 Posts
    • 11,516 Thanks
    jenniewb
    I agree I called A&E and they told me we'd just discharge you and you have to wait for the access team. Are you on Twitter? Lots of interesting stuff on the traumanotPD hashtag, it's helped me feel 0.01% less alone I was diagnosed with a personality disorder but it's still an interesting debate if you haven't.
    Originally posted by bellanoisette

    I am on Twitter but tend to stick to non-important stuff like magazines and things that may get me free tickets and etc. I rarely use it for anything else! I was/wasn't diagnosed with a PD (avoidant/dependant) but was in "crisis" and the diagnosis happened in less than 20 minutes by a psychologist who had flicked through the notes of me in my crisis (for anyone else reading; a crisis is where everything spins out of any self-management and you go crazy watching it happen or very despondent) crisis teams are supposed to help but I was not helped and this made me much worse. I was not in a good place when the "diagnosis" happened- it was then not recorded on my notes, possibly because it holds no water if an assessment was only 20 minutes with someone I'd never seen before or have seen since. I did my own reading on what PDs are and listen to people on podcasts (free if you have iTunes or an Apple device). I learned a lot, though as to the negativity and the very bad examples of PDs which is all and only what we see of those who are diagnosed; you really have to pick and choose who you listen to or you walk away feeling unable to speak to another person again.


    There used to be long term support for people who needed it, but in recent years and what is being unrolled at the moment is short term "boosts" where people are left to their own devices (or to "struggle" alone in the "community") and when they are almost bad enough to warrant a hospital stay, a team will step in, for a few sessions give them a "boost" and they'll keep the patient out of hospital. This is about as long term as things are looking- the next replacement comes as people and appointments are replaced with online therapy and CBT in the place of support.


    If it's any help, I think what is happening with treatment and support being so heavily cut back or services cut, is a daft idea at best and at worst neglectful to those I've seen become more and more unwell. But the changes are being set in motion already. I have in the past had longer term support and it was amazing and kept me alive, now it's being cut I'm seriously worried. I know already that anything new that will be offered will be very short term and that's if I am offered anything at all due to some sort of invisible funding purse attached to me and I've no doubt overspent on having had some help in the past already. Frustratingly I'm still struggling. Not as badly as I was back before treatment started, but enough to leave me feeling demoralised.
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