Any advice gratefully recieved!!!

[Kate]

Hi,

I'm posting on behalf of my brother (with his permission).

He's 31 and has had severe depression and anxiety for the last 12 or so years and finds it near impossible to leave the house, except to go to the local shops. He is a very intelligent and caring person, who wants to get better - but seemingly, there's no one there to support him with this.


To cut a very long story short.... he had a psychiatrist probably about 7 years ago for the first time, after only receiving support form his GP. The psychiatrists most helpful suggestion was for him to go and get a job as this would give him self esteem. At about the same time, the CPN's (who visited once) best advice or should that be order... was for him to open the curtains and then discharged him. As I’m sure people will appreciate, this really damaged him, made him lose all faith in getting help and made him feel even worse about himself etc. He understandably didn’t go back to psychiatric services for years.

He has now been seeing psychiatrist now for 2 years (which considering the way he was treated last time, I’m very proud of). This took an extraordinary amount of effort and courage. The first one was really supportive and referred him for CBT (even though he wanted talking therapy, but better than nothing)... but has now changed to one that is very off hand, only seems to care about his med's and is very unsupportive.

He had to wait 2 years for CBT. He had three sessions and was discharged for being 'too ill'. She was setting him goals like going out to socialise.... going to the pub... which for someone who can sometimes not leave his room let alone the house, seems highly unrealistic. When he tried to explain this to her, saying he felt like he was failing and could he have goals that were more realistic and achievable, she said "well if you don't want to do this, there's no point in you coming.... you're too ill for this... go away and make yourself better then we can try again" and discharged him.

Hmmm.. wasn’t the point of the CBT to try and support him to feel better?? If he could do this on his own, then he wouldn’t be there in the first place.

Anyway!!

know he's in the position again of being let down by services after building up the confidence to go back - and they've just snatched that away from him. In his words - this was his last and only hope - and now they've taken it away. He’s still waiting (after 2 years) for a CPN.... has been told if he wants talking therapy it will be another 2 yr wait and then he will only get 8 sessions. he feels in netweena rock and a hard place - he's trying so hard to seek help, and gets turned away or let down every time.

I’m going with him to his next psychiatrist appointment to discuss this with him, before the possibility of putting in a complaint.

I just wondered a couple of things...does anyone have any advice on what we can do? And also.... what is the current mental health policy that services are working too? I’d really like to read up before the appointment so I know where we stand in terms of service provision and what they should be providing etc.

Thanks
Kate

 

[yakuza]

Hi Kate and

It sounds like your brother has had a very difficult time.

You may find this site (royal college of psychiatrists) very helpful:

http://www.rcpsych.ac.uk/mentalhealthinformation.aspx

Good luck with everything

 

[Yellowcoaching]

Hi Kate,

That sounds pretty frustrating.
I think your brother had it right when he said he wanted to set goals that would be realistic for him so he could feel a sense of achievement rather than failure. Seems like common sense to me and I would have tried that rather than discharge as an immediate response!

I'm not sure where you stand in terms of what you can do to get better treatment from his mental health team but to support him I would think that setting those goals are a really good idea.

The format I use (I'm a coach so I don't usually set these for those as ill as your brother but be guided by him as a rule for this and you can't really go
too far as it's him setting the pace) is SMART goals

S= specific : be detailed about what you're going to do, so "have a shower each day" is more effective than "Take better care of myself"

M= measurable, you need to know when you've achieved something, so make sure you'll know when you've done good

A= attractive, the more you want to do something the more motivated you'll be

R= realistic : this is where it went wrong for your brother, small steps will still get you to the same place as a great leap recovery is not a race!

T= time framed, when do you plan to get things done by, if you know that you have a target and can ask for support and motivation from others.

Hope that helps a little.

Best of luck getting more support for your brother, try not to exhaust yourself and take care of YOU too.

 

[Michael]

Hi Kate
You could end with of lot of information and suggestions to what your brother should do. Has he ever read any of the threads here on the forum, he may find someone who he could 'click' with and start the long journey for just discussing how he sees himself.
This Forum has opened a very big door for me, I'm not saying I'm like your brother or anyone else, but what I can say is that there a lot of little things that I have read and put together to suit how I am at that time - and that has what has helped me.
The support you are giving your brother is nothing short of brilliant and I want to say thank you, it is hard, my wife tells me it is all the time, but she has helped me to help myself. Sometimes I need a lot of help, some times I just need a kick up the backside. What does your brother say or thinks he wants - to start!

Michael

 

[Kate]

Thanks so much for all you replies, comments and suggestions!! It's so nice to be speaking to people who are on the same side!!

i've emailed my brother to let him know all the kind things you have said - i know he'll be really touched - hopefully he'll come onto the forum himself.

Thanks again

Kate

 

[nickh]

Oh damn damn damn (I would use much stronger language but for forum etiquette). This horrifies me, Kate and confirms my prejudices about some current psychiatric practise. I have had some experience of the type of thing your brother has experienced but not to nearly the same extent. It reminded me of all my worst experiences in the Mental Health System.

OK. CBT - although undoubtedly beneficial for a number of people - does NOT work for everyone. For some people - like me ,and by the sound of it your brother - it can be positively harmful (in my case its crude application brought on a terrible bout of depression). It is NOT the only talking therapy, and, again for some people - I am one, another kind of talking therapy is essential. In my case that was basically psycho-analysis (though its called something else nowadays usually ).

Talking therapies are like medicines - they work in different ways for different people, and as with medicines the wrong talking therapy can bring on an adverse reaction. If this happens then you should definitely immediately seek medical advice. The problem is that while if you do this with a medicine you will be immediately represcribed with a new medicine. in the case of talking therapies the options available within the NHS are often limited, and even worse there are now some doctors who mistakenly believe that CBT is universally applicable.

OK all this is really to explain that I recognise the situation that your brother is in. It took me many years to obtain the right kind of talking therapy and although as I say I never had as bad experiences as your brother I know what you are talking about.

What to do? Well he has one great advantage. You . (just as I only got by cos I have a fantastic partner). It is a question of badgering, complaining then badgering and complaining again. An ill person cannot do this but you can. There should be other talking therapies available. You can demand to see your brother's GP and psychiatrist. There should be a PALS (Patient Advice and Liaison Service) in your area to whom you can complain about your brother's treatment. I won't pretend any of this is easy. Mental Health Services - and especially talking therapies - are woefully underfunded and underresourced. But with determination you can do it. So that's my recommendation...

B...Badger
C...Complain

.

Your brother's a lucky guy to have you. The very best of luck and let us know how you get on.

Nick.