Denied assessment by community mental health team

I'm not sure if you meant to reply to me or the original poster. I'm sorted as far as diagnosis goes and I'm getting some decent help from an NHS psychologist at the moment, so my difficulties with the NHS are now sorted, thankfully, as I've plenty of other problems outside that to cope with.

(For what it's worth I live in Yorkshire.)

If you live in an area where the local CCG has an iron-grip on services they may want to control your access to services.

Since 2014 the law was changed for  psychological and developmental issues: you can get your GP to refer you out-of-area to a centre of excellence/expertise where you can get a fair assessment.

The NHS webpages on 'Patient Choice' www.england.nhs.uk/patient-choice/ and this www.nhs.uk/using-the-nhs/about-the-nhs/your-choices-in-the-nhs/  and also http://gplaw.co.uk/chapters/item/28-chapter-11-a-guide-to-the-law-on-patient-choice relates to the law.  You can also look here https://improvement.nhs.uk/home/ for NHS Improvement who will see if you are being treated fairly

Ask for a second opinion if your GP refuses to cooperate: your GP practice should be promoting 'Patient Choice' and the Surgery should have leaflets and help you in a friendly manner. www.england.nhs.uk/patient-choice/elective-care/choice-materials/  ...

Where are you in UK?

If you live in an area where the local CCG has an iron-grip on services they may want to control your access to services.

Since 2014 the law was changed for  psychological and developmental issues: you can get your GP to refer you out-of-area to a centre of excellence/expertise where you can get a fair assessment.

The NHS webpages on 'Patient Choice' www.england.nhs.uk/patient-choice/ and this www.nhs.uk/using-the-nhs/about-the-nhs/your-choices-in-the-nhs/  and also http://gplaw.co.uk/chapters/item/28-chapter-11-a-guide-to-the-law-on-patient-choice relates to the law.  You can also look here https://improvement.nhs.uk/home/ for NHS Improvement who will see if you are being treated fairly

Ask for a second opinion if your GP refuses to cooperate: your GP practice should be promoting 'Patient Choice' and the Surgery should have leaflets and help you in a friendly manner. www.england.nhs.uk/patient-choice/elective-care/choice-materials/  ...

Where are you in UK?

I think that ignorance of the variety of different presentations of autistic people is an issue. I was told by a clinical psychologist about five years ago that I couldn't be autistic because I showed empathy. She wasn't 'thick', but her training had taught her something incorrect and though she would have done more learning since finishing her course as part of continuing professional development it clearly hadn't covered females with autism.

I think a lot of people working in mental health put too much faith in having expert knowledge, rather than listening to the human being in front of them. A dash of humility would go a long way too.

To put it bluntly some mental health professionals are as thick as two short planks when it comes to the possibility of someone being on the autism spectrum. 1975-1984 , 1988-2017 was a psych patient in Essex. Not a sniff of anyone thinking I might be on the spectrum .

Sept 2017 move to Wiltshire . Oct 2018 first appointment . 2 weeks later letter with assessment date  May 2018 given diagnosis of  Asperger's . When it comes to MH  professionals including pdocs we're not always talking about 'Brain of Britain' material .

I had the same thing from the autism assessment team. There were actually things in my notes that did suggest autism, which a therapist found a couple of months after the refusal, when I was assessed for psychological therapies by the same NHS organisation. But I decided to go private for my assessment because although I could have been re-referred I couldn't trust that the service wouldn't be as prejudiced as they'd been when I was referred the first time. I was diagnosed in July after more than a decade of using mental health services that couldn't/wouldn't see my autism as being at the root of my difficulties.

Hi, you could do an online test and take it into your doctor, that's what I did anyway and I also wrote down other factors of why I thought I had it.

You certainly shouldn't feel stupid or rejected; there are lots of replies her and you have had lots from your local support group.

I strongly suggest doing a self test as described and taking the results to your GP, but often there is weeks to wait for an appointment with them!

Let us know how you get on once you’ve digested all the information.

I just watched ‘Spectrum Live’ from the NAS website section looking at getting diagnosed. The NAS helpline was mentioned a couple of times as somewhere to get advice on difficulties with accessing assessments. They discussed different scenarios and had questions from the audience about the diagnosis process. You might find it easier to look at the video then tackle all the overwhelming advice you been given:

https://www.autism.org.uk/about/diagnosis/adults.aspx

Remember you have found the right place to get advice from other people like you; people who understand your situation and can hold your hand (through cyberspace).

 Best wishes x

A quick update..

I have been in contact with a local support group which have put me in a contact with people who are in or have been in my situation. I’ve been given a lot of overwhelming information and it will take me a while to be able to process it all. 
I’ve been told that I shouldn’t give up, for myself, I feel very rejected. It was so hard for me to approach my GP in the first place. I will go back to my GP next week and will keep you all informed.

Thank you so much for all of the replies. I have to admit that receiving the letter has impacted my ability to function. Like I said, I feel stupid and rejected. 

Speaking to your GP about getting referred to an autism specialist might be easier than asking the CMHT to reconsider, as sounds like your GP is being more supportive.

My GP was similarly happy to make a referral for assessment but was uncertain about whether to refer to psychiatry or psychology - he ended up referring me to the CMHT but I was lucky in that the CMHT basically concluded they weren't the right people to make an assessment and passed it on to the appropriate team.

Yes, I fully accept as an NHS worker and service user the NHS is not perfect all of the time...sorry you’ve had a bad experience x

You need to complain and spell out why you need an assessment.

I was under the local MH team and asked four times to be referred for an AS assessment and was told no as there was no way I was autistic. My persistence meant I was eventually referred. I've now known I'm autistic for two years.

If I was in your situation in your letter I'd explain how you meet the DSM 5 criteria - https://mamapineappleblog.wordpress.com/getting-assessed-a-personal-perspective/my-dsm-v-mapping/

I suspect you do not have a good service for autism management in your area and even if diagnosed the service may be poor. 

So consider why you would want to know

Is there a local autism/aspergers self help group

May be try doing the online tests to make the diagnosis yourself

https://community.autism.org.uk/f/miscellaneous-and-chat/1295/online-tests---aq-eq-sq---from-the-arc-website

ItsMyMind said:

CCGs take patient contact seriously and will deal with your enquiry professionally

Unless their approached for a continuing health care assessment...in that case ive heard them get more than one person off the phone in a not very professional manner.  They probably think oh dear someone wants free help and its going to cost us so pass them back to social services to pay for their care (even if there obviously non social related)

Hi

I’ve worked in various parts of the NHS so have a bit of an insight into how some services are ‘commissioned’. I wonder if it would be worth your while contacting your local Clinical Commissioning Group (CCG) and asking to speak to the ‘Lead Commissioner’ or ‘Project Manager/Lead’ for Adult Mental Health. You can then ask specifically if your area has a dedicated service for adult assessment for ASD and what the correct process is for ‘accessing’ it.

There are specific NICE guidelines explaining to CCGs how adult ASD assessment services should be arranged and implemented. There will be a specific ‘referral pathway’ which CCGs should ensure is being followed to make sure patients have equal access and fair treatment.

Once you know the pathway you’ll be in a position to judge whether your GP followed the guidelines, if the service you were referred to was the correct one (doesn’t sound like it was to me) and whether your case has been dealt with correctly.

ASD assessment is a ‘specialised service’ so unless your Community Mental Health Team have a dedicated ASD team (I might be proved wrong but it’s very doubtful they do) they can’t have been the correct service to deal with your referral.

Most ASD assessment services will be commissioned to serve a large population area because it’s so specialised (e.g. where I am there are two commissioned services to deal with adult ASD assessment depending on whether you live in the East or West of the county). The staff required to undertake the assessments are very specialised and need to be clustered together to serve the large area. It sounds like your GP might have innocently assumed the Comm MH Team was the correct service.

Try approaching this from a ‘I’m just checking’ or curiosity point of view rather than having a rant from the off. CCGs take patient contact seriously and will deal with your enquiry professionally - it doesn’t have to be a complaint at this stage.

I recently contacted my local CCG myself to get the correct process so I could pass it onto my Practice as the GP and staff had no clue how to handle my request - it was all done very amicably and now my Practice will know what to do for the next person.

I first went to my GP in July and after all the two-ing and fro-ing I just heard this week (end of Nov) that the referral as been sent to the correct service - that’s my experience as an NHS insider so I hope this gives you a bit of a short cut through NHS processes.

P.S. the reason I’ve put some phrases in inverted commas is because they are all NHS-speak which will mean things to CCG staff

Best wishes

wow great CBT team! Mine was useless, gave me a phone number for the local Autistic society and made me so anxious i had to leave the room and had a meltdown in the toilet. I never went back after that

I was originally diagnosed GAD many many moons ago when I was having a meltdown and hitting my head repeatedly on the wall and flapping my arms. The psych didnt even see me as he was too busy. Ah the NHS lol. Apparently it was one of the workers that relayed my problem to the psych over the phone. As if thats a diagnosis haha. Anyway I believed it until my 2nd huge meltdown (usually in the saftey of my room or a room that no one can see me in) but i was completly over whelmed to the max. It was then thought ah okay maybe ASD but still no diagnosis at that time. 

Someone who knows for sure will be along to confirm but I suspect you were referred to the wrong team? Autism isn't an MH condition and as far as I know MH teams aren't particularly known for spotting it. If you're up for the fight, have you looked at the NICE guidelines?

Thank you so much for that reply, the letter has got me questioning myself!

I’m not going to pass this without a fight. I’ve been dealing with anxiety all of my life! I went through CBT about ten years ago but the staff were awful towards me, one even stating that there was nothing wrong with me, even though I couldn’t get to an appointment without knowing that my other half was waiting in the reception for me! 
Im feeling quite let down, but I want the assessment, I feel it will help me to understand myself a little better.

Im glad you got the right help!