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  #1  
Old Jan 23, 2012, 12:41 AM
Anonymous32511
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Hi all

Since the age of 15 ive been hospitalised 4 times whilst in a crisis. 3 times privately and once through the NHS. This all stemmed from the fact that it took me forever to get the right diagnosis and therefore the right treatment. I still haven't got it and im at the stage now where im basically being refused the option of appropriate treatment on the NHS. I don't know why this is and sadly my psych won't give me a clear answer - i think it may be because im not considered severe enough (ridiculous). What their offering me instead is a 6 month group therapy programme followed by a possibility of being referred to the personality disorders team. At this private hospital ive been to in london, i couldn't quite afford the correct treatment programme id need to go on but on the general programme id would be appointed a dbt specialist who not only would know how to handle me appropriately but would most likely (based on what i have enquired) do some 1 to 1 skills sessions with me during the duration of my stay. Its got to the point where i would rather go into hospital to get close to the right care then go on a 6 month group therapy programme which is not intense enough or relevant to whats actually wrong with me (i know because ive sampled it). Im not trying to knock the NHS but it just seems a waste of money offering me the wrong treatment when i could in fact get through there system a lot faster by having the right therapy made available to me. Ive been in the system 5 years now - just think of the cost.

ANYWAY. My question is, as i don't have private health insurance i would have to use my mothers and seeing as how strained our relationship is i don't think i stand a chance in hell of her letting me go. I entered a really bad phase at the end of last year and she wouldn't let me be admitted and made up all sorts of excuses like a psychiatrist would have to approve it which is rubbish - i went 3 times before on a GP referall as there was basically nowhere else i could have gone and i didn't really adhere to a programme it was really just about keeping me safe. This time however i actually want to engage with whats on offer - its amazing i have the energy seeing as what treatment ive had on the NHS (everything from art therapy to 1to1 etc).

How do i go about asking her? My main argument is that i don't want to wait 6 months before possibly being referred to the personality disorders team to see whether they can help me. I want to go back to work but i can't until i know i have the skills to cope when things turn really bad. I need a full time job because of my rent etc but i can't juggle that with 4 therapy sessions a week. It has to be one or the other atm. At least if i went into hospital i could come close to the right care for me - and id only be in there 4 weeks. The group therapy sessions i had under my local team were just outrageously bad. Im starting to loose hope with the whole thing to be honest. I shouldn't have to beg my mum to let me go to hospital because im sick. But there we have it. I know recovery doesn't go in a straight line and i know a 4 week hopsital may not be enough or even the right thing to do but im running out of options. Im sorry for such a long post but id appreciate any sort of advice on the matter.

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  #2  
Old Jan 23, 2012, 10:02 AM
gma45's Avatar
gma45 gma45 is offline
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After reading your post I believe your best choice would be to do the 6 months rather than just going for the 4 weeks in hospital which you have done before, either way you will have to move if you can not work 4weeks or 6months. If you do the 6 month option you won't have to beg your mom, right? Just as long as you get some care that is what is important if it makes you feel better. I wish you the best.
  #3  
Old Jan 23, 2012, 02:41 PM
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dragonfly2 dragonfly2 is offline
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What is so special about this six week group therapy program that makes them want you do do this first? Is there a personality disorder focus? Is it a particular doctor? How have you done in previous inpatient hospitalizations?

I guess I'm a little torn here...on one hand, I can certainly understand how getting into the right treatment makes all the difference in the world. My daughter was in treatment for years before finally getting the right diagnosis. Once she got it and had the right skills training, everything turned around for her.

On the other hand, I can also possibly see why your clinicians may not want you to be inpatient. I'm not sure what your diagnosis or background may be, but they have found that some people with certain personality disorders actually fare worse in an inpatient setting than they do outpatient, once the initial crisis has passed. They become acclimated to the hospital environment and in some cases, act out in order to show how much they still need to be there. I am in no way saying that is the case with you, just something to consider.

I am not sure how the NHS works, as I am in the US, but is there some way you can get an advocate? Someone who is not a family member or a clinician, who can be there to support you and help you navigate the system? Who can look at your case and be an objective voice to help you and your pdoc come to a better understanding? An advocate could also help you talk to your mother about the insurance issue.

Can you consult with a pdoc at the private hospital to see what they think about the inpatient option? Again, I am unfamiliar with the NHS, so I'm not sure how the private hospitals and the NHS clinicians interact. But could the private pdoc put in an appeal to the NHS?

Sorry if I have more questions than answers. I think this is a very complicated issue and there isn't a simple answer. The six month option may be the NHS's way of getting you out of the inpatient setting to help stabilize you, or it could be a cost-cutting measure. The inpatient stay may nor may not be what is truly best for you. The dedicated DBT program sounds like a good option. Isn't that what the personality disorder team would provide? Not sure why they don't just start you there. I've been in a similar situation, though, where I was denied access to a DBT program because I hadn't been stable long enough. It really didn't make sense to me at the time, but it sort of does now. I was also put into a group therapy program, but it was with a personality disorders focus, so it was still beneficial. It just wasn't the dedicated DBT training. (If it's any consolation, at one time they thought I did have BPD, but I no longer fit the criteria and haven't for years now. It can get better. )

Here's a link that may help. I'm not sure if this is something you are eligible for, but it's worth a look:

http://www.dh.gov.uk/en/Healthcare/M...hAct/DH_091895

I hope you are able to get the care you need.
__________________
I've been scattered I've been shattered
I've been knocked out of the race
But I'll get better
I feel your light upon my face

~Sting, Lithium Sunset


  #4  
Old Jan 23, 2012, 04:43 PM
Anonymous32511
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Thanks for the replys guys - its nice to know you care!

Your both right - it is a tough situation with no clear solutions. The 6 month therapy programme isn't really specific for any disorder, and after going through an assessment for it i didn't really find it intensive enough. On the other hand i agree its not right for someone with my disorder to keep being hospitalised, ive read the stats and i agree it can feed into a certain mind set etc. Im desperate for some form of DBT related treatment though, im a severe self harmer and have real problems with relationships and impulsivity etc. I agree also that its silly not to just give me the right treatment to begin with - the amount of money their wasting by passing me from here to there must be ridiculous. *Sigh* Im just gunna have to ask my mum and hopefully if i broach the subject calmly enough she'll be more receptive to wanting to talk about. I have a big meeting with everyone involved in my care on the 30th, so ill keep u guys updated. Thanks for the advice once again though xx
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gma45
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