Performance Indicators in the NHS - Just one example

If waiting times are being manipulated in order to create a different impression from reality, I agree it’s deceitful and potentially harmful for patients.

My GP referred me to mental health services over two years ago. I received a standardised response on partially headed paper and three leaflets. The letter heading showed the name of the Health Trust to which my GP had referred me, but no address or contact details and the letter wasn’t signed. The text was very blurry (a photocopy of a photocopy X multiple).

The text said that I should contact one of the agencies named in the enclosed leaflets. These were voluntary agencies and charities. I contacted all three agencies. Two had closed several years earlier, but a very nice man at the third agency telephoned me and said they weren’t set up to deal with me as they dealt only with victims of certain types of trauma. He was furious with the Trust and he said that I and others in the past had been referred to him because the Trust couldn’t do its job and it couldn’t be bothered to deal politely and properly with people. The man hadn’t even received a courtesy call from the Trust.

Some time later, my GP received a letter saying that I hadn’t engaged with the Health Trust service and that I had been discharged. That was untrue. I did my best to follow this up but everybody I spoke to passed the buck and told me different stories. It’s really shocking because it feels like an assault on my character, it’s lies and I’m powerless.

It sounds like by not putting down any contact details they pretty much guaranteed they could say you hadn't engaged with them, as they didn't give you any means to. Anywhere method of keeping the books clear, it wouldn't surprise me if the manager gets a bonus for that.

I hope you have managed to find something since, support seems to be so thin on the ground.

I contacted the clinic that my GP had referred me to but they said they didn’t know of anything about my referral or the letter.I suppose that could be, but somebody sent that letter.

I received around 6 or 8 weeks counselling at the GP surgery.  The counsellor picked up that I could be ASD which ultimately lead to the GP’s referral and diagnosis, so that was a good result. I could really do with something further.

I didn’t mean to make you cry; I hoped it helped though and I’m glad you said.
If anything needs to change to help you, I hope that can happen too.

You are very kind (I cried a little when I read this, probably as I'd had a bit of a wretched day this week).

Cinnabar_wing said:

Anytime I've been to the doctors, they just make you feel you shouldn't have come, and I wouldn't trust talking to them about mental health issues. (I almost called them this week for something but didn't, I'm terrible at self care, much easier to look after everyone else!)

I know what you mean about feeling you shouldn’t have gone to the doctor. Sometimes the “bedside manner” leaves a lot to be desired. The doctors in my GP surgery are generally good, but there is one who isn’t so I avoid them. I bet you are one of the least demanding patients a doctor could have. You are definitely very caring towards lots of people here but you deserve also to be caring toward yourself. I think they way the NHS is at the moment, patients need to be persistent when it comes to making their doctor realise what they are experiencing. 

What the NHS says it offers and what happens in practice are two different things. 

It's incredible that they just kept trying to 'cure' something you weren't diagnosed with (OCD), and shows how blind professionals can be to not consider if it could have been something else (autism). Also if the standard approach wasn't working, it should have been on them to try a different approach, rather than just claim you weren't engaging (which sounds like someone not turning up or refusing to speak). I'd be upset about that too so you are fully justified! It's like if a drug doesn't work, the doctor would try prescribe something else instead, not say your body isn't engaging so they won't help you.

It just doesn't make a lot of sense to me really the way they handle mental health, it's like treatment is all lumped in as one 'mental health' banner. Imagine they did that with the body, 'oh we treated you for a broken foot before, now you say you've broken arm, I'm afraid you've already used up all your time with radiology so you can't get it x-rayed. 

I will confess I've never dealt with nhs mental health services myself so sorry for Sam inaccuracies, I tend to avoid going to the doctors like the plague for any reason. Anytime I've been to the doctors, they just make you feel you shouldn't have come, and I wouldn't trust talking to them about mental health issues. (I almost called them this week for something but didn't, I'm terrible at self care, much easier to look after everyone else!)

I think though if you do feel you need something from the doctor and they don't listen, you have to keep going until they believe you. I can't follow my own advice, but I know others with things like abdominal pain had to do that as they kept getting written off as 'female pain'. It took a long time for them to get surgery to help.

Even 16 sessions isn't enough time to deal with complex issues and my memories of NHS counselling were that you had a 45 minute session, which isn't long enough either. I've had counselling clients that are just begining to trust after 6 or 8 sessions, people who've suffered serious trauma don't give thier trust lightly or easily, I'd actually hesitate to start counselling at all if the sessions were so limited, it could very easily stir up a lot of stuff that you then have nowhere to go with, leaving in as bad a place or even worse than before.

Are they still offering CBT as the cure-all?

Cinnabar_wing said:

They don't do that with physical medicine. Imagine how absurd that would be 'oh that rash came back, sorry we treated you for it already.'

I have a copy letter from my GP, from years before the incident I described in my OP, which states that all psychological intervention and medication has been futile. Perhaps my poor mental health is being treated as equivalent to a long term physical disability with no cure. I agree it feels absurd, especially when there are things out there that could help, but the government isn’t interested in improving mental health services. 

Perhaps if the NHS psychologist hadn’t given me 40 weeks psychotherapy for OCD (7 years ago), I might be in a different situation (The psychiatrist had referred me to them for depression and anxiety). My GP later said that I was never diagnosed with OCD and I understand now that my ‘strange rituals’, to quote my GP, are actually repetitive behaviours which I enjoy or use if I’m stressed, and they do not cause me distress in the way OCD behaviours might.

So the NHS psychologist took it upon themselves to incorrectly tell me I was OCD when they didn’t have the authority to diagnose me, and that detail was left off my hospital records. Five years later I hear “I didn’t engage with the service” (not true). No wonder there is a mental health crisis with the nation!

Cinnabar_wing said:

They don't do that with physical medicine. Imagine how absurd that would be 'oh that rash came back, sorry we treated you for it already.'

I have a copy letter from my GP, from years before the incident I described in my OP, which states that all psychological intervention and medication has been futile. Perhaps my poor mental health is being treated as equivalent to a long term physical disability with no cure. I agree it feels absurd, especially when there are things out there that could help, but the government isn’t interested in improving mental health services. 

Perhaps if the NHS psychologist hadn’t given me 40 weeks psychotherapy for OCD (7 years ago), I might be in a different situation (The psychiatrist had referred me to them for depression and anxiety). My GP later said that I was never diagnosed with OCD and I understand now that my ‘strange rituals’, to quote my GP, are actually repetitive behaviours which I enjoy or use if I’m stressed, and they do not cause me distress in the way OCD behaviours might.

So the NHS psychologist took it upon themselves to incorrectly tell me I was OCD when they didn’t have the authority to diagnose me, and that detail was left off my hospital records. Five years later I hear “I didn’t engage with the service” (not true). No wonder there is a mental health crisis with the nation!

I didn’t mean to make you cry; I hoped it helped though and I’m glad you said.
If anything needs to change to help you, I hope that can happen too.

You are very kind (I cried a little when I read this, probably as I'd had a bit of a wretched day this week).

Cinnabar_wing said:

Anytime I've been to the doctors, they just make you feel you shouldn't have come, and I wouldn't trust talking to them about mental health issues. (I almost called them this week for something but didn't, I'm terrible at self care, much easier to look after everyone else!)

I know what you mean about feeling you shouldn’t have gone to the doctor. Sometimes the “bedside manner” leaves a lot to be desired. The doctors in my GP surgery are generally good, but there is one who isn’t so I avoid them. I bet you are one of the least demanding patients a doctor could have. You are definitely very caring towards lots of people here but you deserve also to be caring toward yourself. I think they way the NHS is at the moment, patients need to be persistent when it comes to making their doctor realise what they are experiencing. 

What the NHS says it offers and what happens in practice are two different things. 

It's incredible that they just kept trying to 'cure' something you weren't diagnosed with (OCD), and shows how blind professionals can be to not consider if it could have been something else (autism). Also if the standard approach wasn't working, it should have been on them to try a different approach, rather than just claim you weren't engaging (which sounds like someone not turning up or refusing to speak). I'd be upset about that too so you are fully justified! It's like if a drug doesn't work, the doctor would try prescribe something else instead, not say your body isn't engaging so they won't help you.

It just doesn't make a lot of sense to me really the way they handle mental health, it's like treatment is all lumped in as one 'mental health' banner. Imagine they did that with the body, 'oh we treated you for a broken foot before, now you say you've broken arm, I'm afraid you've already used up all your time with radiology so you can't get it x-rayed. 

I will confess I've never dealt with nhs mental health services myself so sorry for Sam inaccuracies, I tend to avoid going to the doctors like the plague for any reason. Anytime I've been to the doctors, they just make you feel you shouldn't have come, and I wouldn't trust talking to them about mental health issues. (I almost called them this week for something but didn't, I'm terrible at self care, much easier to look after everyone else!)

I think though if you do feel you need something from the doctor and they don't listen, you have to keep going until they believe you. I can't follow my own advice, but I know others with things like abdominal pain had to do that as they kept getting written off as 'female pain'. It took a long time for them to get surgery to help.