Should I discontinue treatment with my CMHC/ACT?

I’m in assertive community treatment at my regions state mental health center. Right now I have a case manager, a DBT therapist (we just resumed DBT yesterday), and a pdoc who all get together once a week to discuss a client’s situation so that’s pretty cool.

But I’m kinda fed up because I’ve been with this team for over two years and I don’t think I’ve made any progress. My pdoc atttributes everything to psychosis when a very reputable dr in a psych ward in Boston that did a thorough evaluation and checked in with everyone throughout the day said it’s not even psychosis it’s DID/CPTSD and a part that fronts frequently with a hyperthymic temperament that may or may not be associated with bipolar/mania. But every time I complain about lack of concentration, losing time, overwhelming emotions my pdoc thinks it’s the schizoaffective I don’t have and wants to fck with my meds when right now they’re working wonderfully imo.

What do I do to get out of this CMHC/ACT? I’m pretty much homeless so I was thinking when I don’t have any more treatment of going back to Boston and trying to get a treatment team there while looking for housing programs hopefully with a case manager from the area. Does this seem like a good plan? I’m chronically suicidal so I’d probably go back to the same unit I was at and asking them to help me get set up with services or do you think that’s overkill and there’s another way that might take longer but doesn’t involve IP?

Sorry if this is long or all over the place.

Edit: I’ve talked to three friends all who say I should go to the ER after I get kicked out of here because I am in perpetual crisis depending on whos fronting it can get dangerous and they’re worried I’m gonna make another attempt. I just don’t know if I should go to the one where they know me well and will let me stay and might be able to find housing and will keep me until I have a place to go (this hospital is in southern NH and is ok) or if I should go back to Boston and see if they can set me up with good specialists in the area, but that would be difficult because I have NH medicaid but also Medicare and I generally do not spend much time near the NH/MA border but there’s a train from the border to Boston I could take and virtual options now.

Idk lm just having trouble figuring out an optimal path but I do know a different path is needed.

This is extremely difficult post to respond to on a forum because you are asking which root to take. Either choice has significant impacts on your life, so you want to make sure it's the best decision.

I'd say, given you are

So, I wouldn't give up on any therapies you currently have going; however, if you are indeed , then you should go to your nearest emergency centre.

As for later and the possibility of moving to Boston, could you have a very good social worker who could get some of the crucially important questions answered, such as insurance coverage, place to live, and disability payments so you can buy food? Your basic needs have to be met.

Sometime in the future, ask your current team about a social worker or try contacting HeyPeers - Where Peers and Support Groups Connect to see whether they could suggest someone, perhaps in the Boston area.

You need a good social worker who can navigate the system and advocate for you.

I will say this: maybe the diagnosis is less important that the treatment protocol. You say that your currents meds are working well, but that your current pdoc in NH wants to change you meds. You need to sit down and discuss why it is that you think the current meds are working... or maybe they're not really, as you're "chronically All this needs to be addressed with your current team.

I was diagnosed did too and it was a zebra diagnosis by a zebra doctor. I agree that the diagnosis is the least important aspect. Doctors diagnose difficult cases with what they are most familiar with. Turned out I needed to be taken off half my meds.

I’d not cut loose any connections and go impulsively to another state without some backup in place. Use the case manager you have to make connections to a dissociative unit if that’s what you want to pursue. But tell your pdoc that you think the meds you are on now are working, what you need is stable housing and long term therapy. In my case the social worker worked with my insurance to send me out of state to a dissociative unit. But that didn’t resolve the housing issue. It wasn’t until I got my sec 8 and had stable housing that I was able to make progress. I did it with a good therapist who knew nothing about DID but did great elective therapy. So my 2 cents is keep harping on housing. Don’t discount what you have which is a bird in hand for two in the bush.

I mean right now where I'm at I have no services so....
no PCP, no pdoc, no T, no case manager.

I'm starting to work with the lady that runs the shelter though on finding housing.

Oh, dear. Do you have access to your medication? I hope this woman can help. Stable housing is so important. Once you get that the rest will fall into place.

Nope! When I feel revved up or can't sleep I take half a seroquel that I have saved up because it was PRN, but when I'm out, I'm out...other than that, no meds.

You need a plan that includes getting your meds.

Based on your other posts, it looks like you should go to emergency.

Will you do that?

You need treatment and help with housing, food, insurance, meds....

I’d have to second that. Go to ER, a psych ER to get medication

In Boston the bridge clinic/cmhc for emergency psych care but I believe you need Massachusetts Medicaid. They do intake and then you see a psychiatrist within the week. It's a walk in clinic. Also look into RAFT Boston for housing assistance. I would really go to the closet psych ER for medication.

Wtf is a “psych ER”?

They're either ERs with a psych department or an actual ER dedicated to psych only.

It’s a ER for psychiatric only. There may not be any where you are. They are a specialist care. In Austin Texas there was only one psych ER in the whole city. They had psychological people on hand, a pdoc, psychologists, social workers It used to be a separate building but just before I left they merged it with one of the regular ERs with beds available for one or two nights. Mostly they are only available In big cities. I don’t know how big the place is your at but it might not be an option. I also think they may have closed some during the pandemic.

Yeah we don't have any in NH. I tried googling "Psych ER in NH" and then "psych ER in MA" and I couldn't find anything closer than the Boston area. So, I guess if I really wanted meds I could spend $50 on a taxi or uber to Lowell, spend $13.25 on a train to Boston, wander around trying to find this ******* place because Boston's a fking mess, and then wait forever and explain everything to get the script, and then spend another ~$65 to get back. I don't think it's worth spending 15% of all the money I have in the world just to TRAVEL to get some meds when I wouldn't even want to go back to the doses I was on right away.