psychiatrist referrals

Thank you so much for your kind words x

You must do what you need to keep yourself safe. The fact that you have reached out now suggests that you do see a future in which things could be much improved.

Good luck. I genuinely hope the appointment goes well and that you get the support you need. Try not to forget that you understand yourself and your needs better than anyone else does.

Thank you for being so honest about your experiences. I've tried medication twice and I'm willing to try again, just not carry on trying for years without success like so many people seem to end up doing. I'm just very sceptical that medication will make any difference, not least on hearing the experiences of others, and the long term nature of my issues. I don't think I could cope with any form of therapy though because life has taught me to be scared of trying to be positive and I don't think there is any coming back from there which is partly why I guess I just wanted to try discussing my issues with a psychiatrist.

Thank you for a very insightful (if depressing!) and interesting response. I'm glad you've found what works for you. Unfortunately in my case, I have avoided the medical profession for many years in trying to deal with long term depression and other issues such as emotional dysregulation but circumstances have escalated these issues to having regular dark thoughts to the point I don't feel like I have any other option.

I can understand why contact with MH services is triggering for you. I've had multiple referrals declined too and it is truly devastating to have the courage to reach out for help and have yet another door slammed in your face.

Even when you do manage to get to see someone then sadly MH services are woefully inadequate when it comes to supporting autistic adults. They simply do not have the training to understand autism and how to adapt the support they offer. The approaches they take can often leave the autistic person worse and left feeling inadequate and blamed for not trying or not engaging. Unless this particular psychiatrist is an autism 'specialist' then I fear you are being set up for yet another disappointment.

They would rather blame the patient than accept that their approach is wrong or that they have failed to make the adjustments needed to make the service accessible. In my experience they are more interested in the score on those checklists they get you to fill out each session. If they don't think those are going to improve you get discharged and left without any support.

There is an interesting document here on how the services are supposed to support autistic people and what improvements need to be made. It's perhaps worth you referring to that, when requesting what reasonable adjustments you might need to make the support accessible and useful for you.

https://www.england.nhs.uk/long-read/meeting-the-needs-of-autistic-adults-in-mental-health-services/

Personally I've found my mental health has improved since I stopped engaging with them and started embracing my autism more.

You don't need to be 100% sure that you'll feel okay in 2 years, you just have to make it clear that you're willing to try. If you're at the point where you feel like it's just a never ending pit of despair and you're feeling suicidal, you have very little to lose. If being slow to understand the things that are explained is an issue, make sure you tell them that.

But all the treatments they can try rely on you to meet them halfway. If you're not willing to do your best then not discharging you would be a waste of your time and theirs.

Like personally, I'm not sure I see myself ever fully recovering, but I fight like hell in that direction anyway because there's always a chance and at the very least I'll be able to say that I did what I could if I end up gone in 10 years. 

I get what you say about wanting help -I'm an only child so whilst I have elderly parents to think about, I am concerned about acting on the thoughts I have been having, so I do genuinely want help to that extent, I just don't have in it me to believe anything is going to help. It just makes you feel even more despairing that MH people, who I thought are meant to be experienced in these things, either just don't grasp that or perhaps given the stretched resources, it is easier to give up on the likes of me. Needless to say, the more distressed I get through talking to the MH services, the worse the negativity kicks in, plus I am genuinely slow to understand things anyway which just adds to the cycle of despair and distress.

thanks but I'm afraid the psychiatrist is feeling like the last option now, and yes, I'm not realistic that is going to help in any way

I think it's standard to receive a copy of the letter they send to your GP (and generally preferable because it lets you know what their plans are going forward) but I'm sure you could specifically ask not to be sent it. When I don't feel okay enough to read those things, I just leave it. I get that it's sometimes not as easy as "then don't read it", but you can try.

If you react negatively and in a way that seems confrontational to their suggestions, I wonder if that is potentially responsible for the declined referrals? If they aren't getting the impression that you really want their help and to get better, you're right that there's not that much they can do (aside from involuntary treatment if you cross a line and are seen as an immediate danger to yourself or others). 

Yeh I don’t agree with that at all. No one is beyond help in my opinion. I mean what do they expect you to do? I wouldn’t go overboard worrying about a psychiatrist rejecting you anyway. There isn’t much they do to be honest all they do is prescribe the same drugs a GP would prescribe anyway which is just antidepressants. Other than that they might refer you for therapy but that’s it. Psychiatrists have the power to do other things like prescribe much more powerful antidepressants that most people have never heard of that were invented way back in the 1950s. But they don’t even do that most of the time because there’s too many side effects. So they just follow protocols and guidelines that your GP follows anyway which is again just prescribing SSRI’s. I really don’t get how it all works it’s very strange. I would say in my opinion the main thing that sets a psychiatrist apart from a GP is that a psychiatrist has the power to diagnose psychiatric conditions but that’s about it. Please don’t bother yourself too much if you don’t get access to a psychiatrist trust me I don’t think there’s much to be sad about with regards to that. Try other things like working on your self esteem and eating a healthy diet. There’s lots of other stuff out there. Don’t give up hope I am rooting for you