Would i be entitled to help from a CPN?

bellanoisette

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):(

Pollycat

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

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

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

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

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

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.

IAmWales

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

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.

jenniewb

bellanoisette wrote: »

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.

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

bellanoisette wrote: »

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.

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!