[Resident Bipolar]

So yesterday I met my new social worker and I have to say, she is lovely. Or was? Anyway, yesterday we discussed whether a social worker or a nurse would be more suited to be my case co-ordinator and we decided that a mix of both would be best. I also mentioned the fact that I was supposed to be having a meeting when I was being transferred from the child team to the adult team, regarding being put with the Assertive Outreach team. I told my social worker that I was supposed to be put with this team but the meeting was cancelled due to someone being ill and it was never followed up.

Today I ad an appointment with my psychiatrist (I have a meeting with her once a month, though in the year I've been with the adult team I've only met her about three or four times). Anyway, the start of the appointment went very well - my new social worker was also present and we had a nice conversations whilst sitting in the waiting room waiting for my psychiatrist to call us through. Twenty minutes later and our appointment started.

Nothing seemed to be too bad for the first 10 minutes or so of the appointment. My psychiatrist decided that a medication should be added to help me sleep. Fair enough. Then came the cause of an angry outburst today and yet another pointer to the failure of the people responsible for my care. My psychiatrist turned to my social worker and asked her how our appointment the previous day had gone and what has been discussed. Jolie (the fake name of my new social worker) told her that we'd discussed having a nurse as my care coordinator as herself and my previous worker had been social workers but I had a nurse assigned to my case when I was with the child services.

I then pointed out to my psychiatrist that I was supposed to be put with the Assertive Outreach Team and explained that it wasn't followed up after the cancelled meeting. She gave me a patronising look and said "I doubt that, you're probably getting it mixed up with another team." Slightly annoyed but not put off, I said "No it was definitely the assertive outreach team. It's not the only thing either, none of the things in my care plans have been followed, I was given absolutely no help with the transition from the child team to the adult team and I went from weekly appointments with a nurse and monthly appointments with my psychiatrist to the occasional appointment with a social worker and an appointment every one month to two months with my psychiatrist. The conditions for my discharge from the psychiatric unit were not met either and I have been left neglected without much of a safety net or support whatsoever".

She then said yet again (after trying to interrupt me multiple times) "I think you're getting the teams mixed up. Assertive outreach team is for people with multiple conditions and people that aren't compliant with treatment and can't attend appointments".

My social worker then interrupted her and said "Actually, I looked at his notes earlier and it was the Assertive Outreach Team he was supposed to be with". Here it came: my heart was pounding, I was finding it hard to breath. I burst. "See you say it's for people with multiple disorders but I do have multiple disorders. I have a diagnoses of Bipolar I and Aspergers and if you'd have read my notes properly you'd have seen about both the Assertive Outreach Team and that I've not only got the two diagnoses that you know about but also my CPA done when I was leaving the child team explicitly says I've also been treated for anxiety and depressive illness. You claim to know what's best for me but you obviously haven't read my notes properly so how can I know you're doing what's right for my health? Especially when I've only seen you three times in a YEAR."

Then she said " I've got a hundred people on my file, I'm bound to miss notes occasionally" in the most disrespectful way possible. I got up, turned around to her and said "I'm obviously not cared about here. All my care plans and discharge meetings have been ignored. I have not been cared for like I should. It takes a lot to get dressed and come out to these appointments. I needed the assertive outreach team because I have difficulty getting out the house, I have multiple conditions, I have anxiety about attending appointments, I've been known to stop being med compliant, and you haven't read my notes properly at all. You've got a hundred people and you obviously can't handle that." The psychiatrist and social worker tried stopping me from leaving but I just told them to leave me alone. I've now arrived home, self harmed for the first time in a month and am considering suicide once again.

What's it going to look like if a patient with disregarded care plans and discharge documents, with a history of suicide attempts and psychiatric hospitalisations, was neglected and allowed to try and kill himself again? I hope it leads to some sort of an improvement.

They do my medication, my social care, my meds, everything. And they've not done anything that should have been done. They haven't tried to contact me since I walked out two hours ago, despite trying to stop me.

I don't know what to do now. I feel so betrayed.

[A Red Panda]

Well. I know what you should NOT do. Do NOT hurt yourself and especially don't you dare try to kill yourself - you don't deserve that and they are not worth it.

It sounds like your new social worker is on the ball though - and she was standing up for you! That's excellent! She might think that if she approaches you right now that you'll completely withdraw from her seeing as how you left quite angry. Why don't you contact her and say that you'd like another session with her as soon as possible?

[mjrwraith]

Don't give up just hang in there. Harming yourself is not the way to get their attention. I am so sorry you went through that.

Sent from my LG-LS970 using Tapatalk 4

[Resident Bipolar]

Originally Posted by A Red Panda

Well. I know what you should NOT do. Do NOT hurt yourself and especially don't you dare try to kill yourself - you don't deserve that and they are not worth it.

It sounds like your new social worker is on the ball though - and she was standing up for you! That's excellent! She might think that if she approaches you right now that you'll completely withdraw from her seeing as how you left quite angry. Why don't you contact her and say that you'd like another session with her as soon as possible?

I'm just not sure what to do right now. My heads a mess. I feel terrible. I have stuff around the house I need to do but can't because this whole experience has completely torn my brain apart.

I feel stuck in a rut and don't know how to get out.

[Resident Bipolar]

Originally Posted by mjrwraith

Don't give up just hang in there. Harming yourself is not the way to get their attention. I am so sorry you went through that.

Sent from my LG-LS970 using Tapatalk 4

I only stopped self harming because I had hope that I'd maybe be able to level out and get back my life. But after today I've lost that hope. Self harm is that one friend that always understands how I feel when I feel completely unable to explain it. I hate feeling bad but not knowing how to explain it.

[A Red Panda]

Well RB: Do something that is relaxing. Screw being productive right now, just do something that you find relaxing. I would have flipped out on that pdoc too - they are an utter waste of a human being.

So just find something that relaxes you (any games? bath? Reading? painting? Going for a walk? Eating a yummy meal?) and do that until you're a bit more relaxed and calmed down. Being upset right now is TOTALLLLLLLLY understandable.

Because really, your pdoc is a twat.

[Speed3]

Oh don't get me started on how many times my so called care team has let me down. It is a disgrace.

I agree we as patients do everything we are supposed to do, and the so called professionals end up dropping the ball.

I am proud of you for speaking up. But please DO NOT TAKE THIS OUT ON YOURSELF.

This round went bad, but I agree the social worker sounds helpful. Take a breath, believe in yourself and your worth.

You sound very intelligent, tomorrow is another day. Work with the social worker and maybe try to get a new Psychiatrist.

It is very frustrating going through this mental health system maze. But you are not alone.

Please do not hurt yourself, you matter to us. Keep on posting

[Resident Bipolar]

Thank you both. Unfortunately I find it difficult to take the advice to relax - I've already started doing the flooring again. Though I must hasten to admit: I am finding it a lot more exhausting to move than I have found it over the past weeks.

My eyes are sore from the lack of sleep, my mind is in overload about today and the future and I'm finding it hard to get comfortable on the sofa or in bed. I have that horrible feeling of being unoccupied yet unable to find something to satisfy my urge to DO something.

My mom is also on the case now - she has been dissatisfied with the quality of care I have received recently and, as she works as a quality assurance officer, I do believe she has a certain understanding of how things should be done.

I can't believe how ignorant this psychiatrist has been. I have had wonderful psychiatrists in the past but now I'm at a loss. If I ask for a new psychiatrist I'm stuck with the same problem. I'm not with the assertive team when I should be. It's a terrible world and not only have I been failed by those in my social group, I've also been failed by the one person who should know EXACTLY what needs to be done for my mental health.

I know there's four or five years worth of notes in my case folder but its her job to read through them to provide a good service. I always used to be proud to be British because of the NHS but its failing not just those with mental issues but those with physical issues, too.

Oh by the way: if she missed a note about the team I should be with, what's to say she won't miss a note about a serious complication or med that should be avoided?

[A Red Panda]

I find cleaning relaxing. If you can find it relaxing or calming then that would be great!

I'd be very distrustful of a pdoc who was like yours... I've got mega trust issues. I don't expect them to remember everything about me - but to actively contradict me and say that I'm wrong when I'm not?? No, thanks.

[pegasus]

Hello Resident Bipolar,

The Assertive Outreach team are for people who are difficult to engage, tend not to take their medication, have multiple health issues as in mental health issues AND physical health issues. People who would not normally willingly go to appointments to see their social worker, GP, psychiatrist etc. So I hope you can see why the psychiatrist questioned why you would have been put with the assertive outreach team. From a professional point of view, you should have been passed on to the Adult Community mental health team, NOT the assertive outreach team.

Putting all that aside, please contact your social worker and community mental health team tomorrow.

[Fuzzybear]

.......

[Resident Bipolar]

Originally Posted by pegasus

Hello Resident Bipolar,

The Assertive Outreach team are for people who are difficult to engage, tend not to take their medication, have multiple health issues as in mental health issues AND physical health issues. People who would not normally willingly go to appointments to see their social worker, GP, psychiatrist etc. So I hope you can see why the psychiatrist questioned why you would have been put with the assertive outreach team. From a professional point of view, you should have been passed on to the Adult Community mental health team, NOT the assertive outreach team.

Putting all that aside, please contact your social worker and community mental health team tomorrow.

That's the thing though, I do have periods of being non-compliant with medication and treatment. I have dropped out of DBT three times, and I quit CBT and refused treatment and was sectioned against my will multiple times. I have issues attending appointments because of social anxiety and Aspergers. I have a long history of refusing to attend appointments and have not attended appointments in the past on a very frequent basis. I usually have to be forced to attend and will sometimes tell me family I have been but instead just sit on the bus for an hour.

I go out only once a week due to anxieties and have PTSD currently being assessed for. I also have asthma and hypersensitivity and have extremely bad memory issues. I suffer from panic attacks on a daily basis, which is why I'm on Propanalol and Lorazepam (as well as Salbutamol and Beclamatasone for asthma, loratadine for allergies, Quitiapine for mood stabilisation, Sertraline for Depression, Risperidone for sleeping and Circadin for regulating sleep patterns (slow release melatonin).

Due to the comorbidity of Aspergers, Bipolar and Anxiety (definite diagnoses') I find it extremely difficult to explain how I feel and close myself off when questioned about emotional things. My social worker has for this reason agreed that the Assertive Outreach Team would be more suited, as did my previous psychiatrist, who knew me over the course of 5 years.

Maybe I should have explained my medical history more. But I meet the criteria, and that is why it was recommend by my psychiatrist and by the doctor who discharged me from my four month stay at a psychiatric inpatient ward. This was decided during my transition to the adult mental health team.

RB.

[pegasus]

Click on the link to the Assertive Outreach factsheet Assertive Outreach Factsheet - Rethink


It tends to be a service provided for people who may be homeless or on the verge of, have severe mental health issues and/or have drug/alcohol problems and many hospital admissions. It's usually attached to the community mental health team.

Just trying to help.

[Resident Bipolar]

Originally Posted by pegasus

Click on the link to the Assertive Outreach factsheet Assertive Outreach Factsheet - Rethink


It tends to be a service provided for people who maybe homeless, or have drug/alcohol problems, many hospital admission. It's usually attached to the community mental health team.

Just trying to help.

Thank you for the help. I've seen all the data though - I tend to research these things heavily when they're happening in my own personal life. This was discussed in depth when I was being moved from the child team. We had many home visits to discuss which team would be appropriate and it was decided Assertive would be the best option, so I researched it.

I'm ashamed of certain things so I refuse to admit them, but I meet more of the criteria. Ones that the child team knew. Is 9 hospital admissions (psychiatric) and over 20 general hospital admissions in a five year period a lot? I'm not sure what defines a lot, as there are people that have had many more admissions than I have.

Anyway, this is just one thing in a list of MANY that haven't been pursued, when I was only discharged under the conditions that they were. All the CPAs and discharge meetings seem to be worthless. If the Dr at the ward knew how things have gone since I was discharged, I'm sure he'd have something to say about it.

The psychiatrist that worked with me for the longest is the one that decided the assertive team. I guess that is why I agree with her - she knows me best, out of everyone I know (besides some family members). I miss her, she was so very good at dealing with my absence from appointments, home visits and my public meltdowns.

RB

[Resident Bipolar]

Also need to add to my previous post: I see self harm is another criteria I meet. I've hit arteries and had multiple infections from self injury, once losing pints of blood and needing surgery to repair the blood vessel.

I've also failed to commit long term to CBT and DBT and have a history of abusing prescription medications, alcohol dependence (hospitalised for alcohol toxicity and resuscitated twice during that night). Had multiple suicide attempts, once of which was near-fatal.

Held against my will numerous times in psychiatric hospitals. Addiction to self injury, cannabis and nictotine are currently present. Also have huge difficulty managing money and am in thousands of pounds worth of debt and this week I am going hungry as the payment for my online food shop (I can't go shopping in person, I find that too intense) was declined due to insufficient funds.

RB

[Resident Bipolar]

It's all in my medical records, which I could upload to give you a better idea of my medical history.

Did I also mention that my psychiatrist in the child services used my case in a presentation for psychiatrists on complex mental health issues? She had to ask my permission first obviously.

RB

[Resident Bipolar]

The thing I'm annoyed about the most is the way I was spoken to. Manners cost absolutely nothing. I was interrupted and patronised. I have Aspergers and Bipolar disorder, I'm not dumb! But she spoke to me like I was. The only thing that lightens the experience is that my social worker defended me and stood up for my rights.

[pegasus]

It's ok, I don't need to see your medical notes, I believe you.

I can see both sides. I can see why your previous psychiatrist may have wanted you to be with the assertive outreach team but I can also see why the new psychiatrist does not. It's a bit gung ho to plonk you with the assertive outreach team if you might actually get better support with the community mental health team. That's my opinion because the assertive outreach team are more likely to 'force' things where as the community mental health team are more gentle. Saying all that, a lot of the assertive outreach teams have been disbanded in the UK as has many of the drug rehab teams.

I can surely understand your anger at this situation having been left for a while and then having to see a new psychiatrist.

Please get back to the social worker and discuss this further, you deserve help and support.

One other thing, I am concerned that you are on resperidone for sleep, it is an anti - psychotic and not usually for sleep issues.

[Resident Bipolar]

Originally Posted by pegasus

It's ok, I don't need to see your medical notes, I believe you.

I can see both sides. I can see why your previous psychiatrist may have wanted you to be with the assertive outreach team but I can also see why the new psychiatrist does not. It's a bit gung ho to plonk you with the assertive outreach team if you might actually get better support with the community mental health team. That's my opinion because the assertive outreach team are more likely to 'force' things where as the community mental health team are more gentle. Saying all that, a lot of the assertive outreach teams have been disbanded in the UK as has many of the drug rehab teams.

I can surely understand your anger at this situation having been left for a while and then having to see a new psychiatrist.

Please get back to the social worker and discuss this further, you deserve help and support.

One other thing, I am concerned that you are on resperidone for sleep, it is an anti - psychotic and not usually for sleep issues.

I know, I was also given Olanazpine to help me sleep, which as you will know is also an anti-psychotic.

And Pegasus, this is the thing. If I was getting sufficient help from CMHT, I wouldn't have even mentioned the assertive team. But I'm not getting the help I need. I feel as though there's no support for me now. I've only had a social worker and a psychiatrist for a year - both of whom wouldn't chase me if I missed an appointment (which I need as I am very forgetful) and both of whom offered appointments only every month or so, when I should be having an appointment with a nurse weekly. I also need home visits because of the difficulties I face in public but haven't had them either.

I had to phone my social worker at least 15 times last time and still didn't get an appointment. This was my old social worker who thankfully moved to a different job.

I feel abandoned and forgotten. Do you not agree that with my history I should have been helped more with the transition? When I said this to my social worker (old one) she simply rolled her eyes and said: You're 18 now, you're an adult, act like it. Be independent.

But I have comorbid conditions and especially Aspergers make independence extremely hard. It's why I'm hardly ever left at home by myself, why I never go out, why I can't go shopping, why I was turned down for a driving license.

I appreciate that I'm 18, but I need that encouragement and support with appointments like I used to have. I'm still not well, at all, which is probably why I had that panic attack today.

I've been left alone, and that is what's making it all worse. I need at least bi weekly appointments with a therapist, I need reminding, I need that help.

It's been so long. When I got put on the adult team it took me reaching suicidal lows and almost a year to get any type of appointment.

What do I do? I feel so lost and lonely. And scared and hopeless. I absolutely hate those moments I feel like suicide is my only option, but I'm stuck in that situation right now. This forum at the moment is my only helpline. I feel so isolated and broken. I'm autistic. High functioning autistic, yes. But I can't handle all this yet. It confuses me and I'm so lot and confused and I don't know where to turn or what to do :'(

RB

[pegasus]

I do think there should have been more support in the transition to adult MH services. If I were you I would be asking for a CPN to visit you at home once a week. They are not going to refer you to therapy until you are stable enough.

If you are feeling really bad, please contact the CMHT, there should be an out of hours service number. Contacting them out of hours will escalate your 'case' and then they will have to act quicker.

Please be safe.

[A Red Panda]

Turn to your new social worker RB. I know that it will be hard to trust her, but right now she's working for you and stood up to you. Turn to her for guidance right now and let her know all of what you've posted here. That you feel like you need more support in transitioning into being a highly-functional adult. And that you feel scared and lost. You probably have already, but resay it all again and that you're scared that the psychiatrist doesn't actually have your best interest at heart, and that the things the pdoc has done and said reinforce that worry.

[Mollywisk]

Originally Posted by A Red Panda

Turn to your new social worker RB. I know that it will be hard to trust her, but right now she's working for you and stood up to you. Turn to her for guidance right now and let her know all of what you've posted here. That you feel like you need more support in transitioning into being a highly-functional adult. And that you feel scared and lost. You probably have already, but resay it all again and that you're scared that the psychiatrist doesn't actually have your best interest at heart, and that the things the pdoc has done and said reinforce that worry.

I agree! It sounds like she thoroughly reviewed your case, asked you questions instead of assuming and then stood up for you with the pdoc. It sounds like she can be a strong source of support.

[Victoria'smom]

Is there any way you can set your phone to alarm you when you had an appointment? can you work out something so that if you can't come you can "call-in" to the appointment?

[Resident Bipolar]

My social worker phoned me yesterday and apologised for the way my case has been handled over the past year. She said she understood the way I reacted and that feeling attacked and cornered was understandable due to the presence of my psychiatrist, herself and a trainee psychiatrist that I'd never met before.

I was told that I was indeed referred to the assertive outreach team but it has since been disbanded in my area. I have an appointment on the 2nd September at my home with her to discuss an alternative to the AOT and assured me that despite being overdue a CPA for more than a year, a CPA will be done within the next month or so.

I feel a lot calmer now, though suffering with psychosis intermittently.

Thank you all of you for your replies, it is so very appreciated. It really helped to diffuse the situation at home slightly. I just feel exhausted and unmotivated now.

Once again thank you all

RB x

[Resident Bipolar]

Originally Posted by Miguel'smom

Is there any way you can set your phone to alarm you when you had an appointment? can you work out something so that if you can't come you can "call-in" to the appointment?

Great suggestions! Unfortunately I find it difficult to converse over the phone at many times. Despite having my phone to set alarms, sometimes I can even forget what the alarm is for! And the sudden notification of an appointment will throw my schedule off track and cause yet more distress.

Luckily home visits are most likely going to be a possibility after my next CPA.

RB