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

TheQuietOak

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

Parents

  • It doesn’t sound like you’re being unreasonable, but I’m curious how that email will be received. My thought is that while you might be reasonable in fighting for a text/email solution, you might be out of luck with this provider.

    If you do end up conceding and taking up their services in person, I’d recommend via video call. Some video call services have chat options, so you might be able to conduct that meeting with mostly text responses. Kind of just depends on what service they use.

  • in reply to profdanger

    Thanks, sometimes I need some processing time so chatting in a video call would be hard but they won't even accept that. I also think I might be out of luck here too, even if they do back down I'm not convinced that they will be able to help me, in fact I think there a good chance that they will make things worse. Thanks for the input thought, I appreciate it.

  • in reply to TheQuietOak

    I'd go back to your GP and explain it to them and see if they can refer you to ASC specific support, but in my experience don't be surprised if they don't listen either, I spent 20 mins explaining to one of our local ones how I struggle with tech, don't have a smart phone and can only do really basic stuff, I was told that I could join a video dicussion which is their standard introduction and were amazed when I told them I couldn't do it as I lacked the equipment and the the knowlege of how to do so.

    Is there someway you could make a room in your home OK for an outsder to come into? Like putting blankets or throws on the sofa and chairs, so as when the visitor has lef they can immediatley be taken off and washed?

    If these written options were in your report then I think you do have a case for insisting on it, maybe writing to your MP or someone could help? 

  • in reply to TheCatWoman

    Thanks for your reply, sometimes people just assume everyone is tech savvy and has access to modern phones etc. I wish I could easily go back to my GP, for me it's something that is very difficult. I think it's really hard for people to understand selective mutism, most people just don't get it they think I'm choosing not to speak or I'm shy or maybe just stupid. Thanks again for your reply.

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  • in reply to TheCatWoman

    Thanks for your reply, sometimes people just assume everyone is tech savvy and has access to modern phones etc. I wish I could easily go back to my GP, for me it's something that is very difficult. I think it's really hard for people to understand selective mutism, most people just don't get it they think I'm choosing not to speak or I'm shy or maybe just stupid. Thanks again for your reply.

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