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Am I Being Unreasonable About Text-Only Communication with CMHT? (Seeking Advice!)

Deleted User

Hey everyone, thanks again for the lovely welcomes! As I hinted in my intro, I've hit a bit of a wall with the Community Mental Health Team (CMHT) and could really use some collective wisdom.

To recap: I was referred to the CMHT for mental health support. My autism and selective mutism mean I really struggle with face-to-face appointments (especially in busy city environments) and having strangers in my safe home space. I explained this, and they offered a few options, but none that truly accommodate my communication needs.

My preference, as highlighted in my autism diagnosis report, is to communicate via text/email. It's the only way I can really process and express myself without becoming overwhelmed and non-verbal.

Their latest response, however, was pretty disheartening. They said they couldn't offer an initial assessment with "written communication only." They reiterated their standard options (F2F, video call, phone) and basically said if I can't commit to those, they can't proceed. They did mention discussing whether a "service specific to ASD support" would be better placed for me.

Honestly, I feel quite upset and like I'm being pushed away from mainstream mental health support, despite my genuine need for help. It feels like they're trying to shunt me to a specialist service, which might not even offer the crisis support or other interventions I might need, rather than making reasonable adjustments themselves.

I've just sent them a detailed email, referencing my autism diagnosis report (which explicitly recommends text/email communication) and even the NHS England guidance (B1800) that states mainstream services should be accessible to autistic adults and offer text/email options for contact. I also copied PALS.

Now I'm left wondering: Am I being unreasonable here? Should I just try to force myself into one of their standard options, even though I know it will be incredibly distressing and likely unproductive? Or should I continue pushing for text-only communication, given that it's clearly stated as a necessary accommodation in my diagnosis and in NHS guidance?

Has anyone else faced this kind of pushback from mainstream mental health services? Any advice on how to navigate this, or what to expect next? I'm trying not to give up, but this is really draining.

Thanks for listening!

Oh and please feel free to tell me if I am being unreasonable here, I value your opinion on this, all love and respect!

TheQuietOak

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  • I can share my experiences.

    At work I am often encouraged to communicate in person, usually by Teams with my managers. If I am trying to explain my difficulties I prefer to put it in writing as it gives me time to work out what I want to say as in person I tend to stall for the right words.

    In respect of NHS services. When I had a period of burnout I spoke to a lovely lady at our surgery who is a mental health nurse. She did a referral for assessment for autism but did say she couldn't advise on this as she is not trained in this area.

    I had a similar experience when speaking to a nurse from Occupational Health who said she could not advise on reasonable adjustments for autism as my employer did not subscribe to the service provided for this.

    From my experience, if they can't offer what you need would it be helpful to ask about the specialist service with autism experience?

  • in reply to Homebird

    Thanks for the reply. Honestly I think they could offer me what I need if they choose to, I think they just don't want to make any changes to how they normally operate. It would be great if there was a specialist service which could help me but I think what they mean by that is a service designed for people who need social care or telling me to look at particular websites, as far as I am aware none of these services offer crisis care and I do feel that the CMHT should be supporting everyone including autistic people and people with communication difficulties. They haven't suggested any alternatives yet, just an ultimatum to fit in or be refused help. I do appreciate your reply and comments thank you. I need some time to have a think about this.

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  • in reply to Homebird

    Thanks for the reply. Honestly I think they could offer me what I need if they choose to, I think they just don't want to make any changes to how they normally operate. It would be great if there was a specialist service which could help me but I think what they mean by that is a service designed for people who need social care or telling me to look at particular websites, as far as I am aware none of these services offer crisis care and I do feel that the CMHT should be supporting everyone including autistic people and people with communication difficulties. They haven't suggested any alternatives yet, just an ultimatum to fit in or be refused help. I do appreciate your reply and comments thank you. I need some time to have a think about this.

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