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    Thread: When to refer to a Psychiatrist?

    1. #1

      Default When to refer to a Psychiatrist?

      New to this, so hope I'm in the right place.My daughter has been diagnosed with depression and anxiety,following Dysthmia. She's been seeing her G.P who's excellent, but after two lots of drugs with little or no effect and CBT he seems to be possibly suggesting that we're almost reaching the end of treatment.
      My daughter feels that she always puts up a good show but is in truth feeling terrible. At what point would or should a G.P. suggest seeing a Psychiatrist?

    2. #2
      Senior Member maxitab's Avatar
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      He ought to have done so immediately!

      Oh, sorry, welcome to the forum!

      GP's are not trained and have a poor grasp of the intricacies of mental health difficulties. You are entitled to be referred to the Community Mental Health Team or a Psychiatrist, or both.These people are trained to make a diagnosis, and will make a proper assessment. Ask for this and if there is a problem ask to see another GP.
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      Senior Member pentagram's Avatar
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      you should encourage your daughter to drop her acting, saying as you do that "she always puts up a good show" who to? hopefully not to her GP or the CBT T cos since they mostly can't read minds she has to prove she is depressed, and like maxitab says your GP should not be trying to sort out the problem using A/Ts in the first instance and should have got your daughter referred to someone who knows what they are doing.

      I recently started a course of CBT which was going to be limited to 10-12 sessions, I am now on my 14th and is now open ended. It has been extended because I have been honest with how bad I am feeling.

    4. #4

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      Thankyou for your replies. I agree that my daughter needs to be upfront, yes she does put on a good show for the GP most of the time and I suppose to a certain extent to us as she doesn't want to worry us, it's difficult when you are a person who likes to be seen to cope. I have told her that we can look after ourselves and this is about her and getting her better.
      I am going to phone her GP as she has exams at present and can't see him any time soon, I will discuss with him how serious, the situation is and that she doesn't feel there's been any improvement in fact quite the opposite, because it's been a year she has less faith that she's going to get better.He's an excellent GP in most ways but I as well as her definetly got the feeling that he was almost saying we've done what we can which obviously we don't believe.
      I will ask if he'll refer her.
      I just wanted to know would we be asking to be referred to a Psychiatrist or Mental Health Team. Don't have any idea really.Thanks again.

    5. #5
      Senior Member lulubelle's Avatar
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      Hi Phicia,

      Do you mind me asking what the GP has prescribed? I would say that you would like to be referred to a psychiatrisy, they then usually put you with the CMHT- thats my expeerience of it in London.

      Lu
      I ask for patience to deal with stupid people and the courage to tolerate their ignorance, because lord knows if i ask for strength, I will beat them to death

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      Super Moderator pepecat's Avatar
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      I"m also surprised they haven't referred your daughter sooner. It's an endless source of curiosity to me as to how the different referral processes work in different parts of the country - even in the same city! It seems to vary hugely, and you'd have thought it would be the same for everyone - not everyone getting referred to a psych, obviously, but at least an 'order' to things, like gp-mental health nurse - mental health team - psychiatrist etc..... something like that.
      I was referred by my gp to the practice mental health nurse, who saw me for about 15 mins, by which point she'd made up her mind i should be referred to a psychiatrist, and that was that.

    7. #7
      Administrator calypso's Avatar
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      May I suggest you post on the Depression Forum next time, as you will find a whole range of people there. Not that you haven't here of course. xx
      "I am She who e're the world was formed, was Rhea, Binah Ge. I am the soundless, boundless bitter sea from whom life welled eternally. Isis in heaven, on Earth Persephone, Levanah of the waves and Hecate. All these am I and all these are seen in me." Dion Fortune.

    8. #8

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      Well I thought I'd take up this thread again. We have been very disappointed. My daughter was referrred to a Mental Health Team, they saw her for an hour, although my daughter says they didn't ask anything about her current symptoms more her previous history. She had a letter yesterday, saying they thought she should go for some exploratory councelling and they wished her luck and thanked her for coming and that was that.
      The only thing that has kept my daughter from going completely under is the fact she thought at last someone was going to really be able to support her and she now feels she has nothing to hold on to.
      I have suggested she asks to see a copy of the report that was taken and goes to see her GP again to see about a re-referral. I don't know if any of these things are possible but I had to give her something to focus on.
      I'd really appreciate some advice about what we can do. I am so worried about her.

    9. #9
      Super Moderator keepsafe's Avatar
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      Yes she should go back to the g.p. and insist she needs some help, maybe they will then refer to psychological therapies, she should at least get offered some c.b.t. but the waiting lists are long. I would definitely get back in touch with the g.p. though.

      KS
      'But I don’t want to go among mad people,' Alice remarked.
      'Oh, you can’t help that,' said the Cat. 'We’re all mad here. I’m mad. You’re mad.'
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    10. #10

      Default Update on my daughter's care for Depression

      Hi, I wanted to just bring things up to date for comment. Since writing last, ,my daughter was referred to The Mental Health Team. She had an hour long appt which she felt, focused very much on her family and friends and very little about her and the effects of her illness.
      Anyway we really felt that we might actually start getting somewhere now she was going to be under the care of people specifically trained in Mental Health, so you can imagine our dismay when she got a letter saying she should go for counselling and nit return to them for care. The Gp's referral letter had specifically asked for help and suggestions with medication and he told us they hadn't suggested anything or even discussed it. If counselling was all she needed, we and our GP could have sorted that out. Well as the GP wasn't happy with the response, he suggested he would write to them again and ask for a review.
      My daughter then got a letter saying to ring them, which she did after much encouragement, as she hates talking on the phone and I was sat there watching as she agreed to everything they said. As I knew she would.

      I'm afraid to say I couldn't stand by. I rang the woman back (who had basically said she should find a good counsellor). Well my conversation went something like this, "people with depression, lack motivation, aren't you taking a risk that your advise won't be acted on. This woman had been advised by the GP and my daugher had mentioned to her, that she did think about suicide. It all seemed to me, to hinge on the person taking charge and seeking out help for themselves. I understand this idea perfectly, but I asked what if the person isn't ready or suffers from other problems such as social anxiety which might prevent her seeking help, or simply because she just too depressed to do it. What makes these people think that when she's at her most depressed and she doesn't bother eating, she's going to bother to seek out counselling. She also said that it wasn't likely that the Psychiatrist would be any better in prescribing drugs than our GP!! I find this very hard to believe.

      All in all, we weren't happy. The plan the social worker has suggested is that we could ask for a rereferral from the GP, or my daughter needs to play a more active roll in her care. I did say that we thought that's what she was doing by asking to be referred to them in the first place, but that fell on deaf ears.

      I suppose all we wanted was a light at the end of the tunnel, someone just pointing the way with a little nudge and support, but it seems that unless you're able to really take matters into your own hands you're going to be left to flounder!

      Does anyone have anything to say to help us feel all's not lost?

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