The Therapy Diaries 5 | Long Waits and Too Many Assessments

After a bit of a break, The Therapy Diaries is back! While we’re coming up to my most recent brush with my local mental health service, I felt that I wanted to do a post around the journey that led up to it, as it was certainly a stressful one. Of course, my previous experience of CBT back before I went to uni involved a wait, but it certainly was nowhere near as long as the one I’m going to talk to you about today.

Disclaimer – I am not a mental health professional in any way, so any recommendations are based on my own personal experiences. If you are concerned about yours or a loved one’s mental health you should seek support from the links below. I will include links to further information at the end of this post should you wish to find out more about each type of therapy, but please bear in mind that this post is based on my own experience so will more likely differ from everyone else’s. In addition, I’m looking back over the last 10+ years in some cases, so some procedures mentioned may be different to what they are now. The following is based on my own personal experience with local mental health services in my area between 2014 and 2017. All views are my own.

2014

It’s clear that prior to this point, I was having some issues with my mental health. However, following a nasty bout of what turned out to be food poisoning, I started to become more and more obsessed with germs and illness. I was experiencing severe health anxiety relating to other things too – one thing in particular was cervical cancer. Because at this point I was too young to be invited for my cervical screening, I spent months convincing myself that I was going to be one of those women who had it before the age of 25. Around September 2014, I plucked up the courage to see my GP, who suggested I make an appointment with the surgery’s counselling service. I was surprised that it was that easy. During the first week of October, I had my first appointment, where I was given the PHQ-9 and GAD-7 questionnaire. The PHQ-9 is a tool used in the assessment of depression, while the GAD-7 is used to measure anxiety. I was already well familiar with both of these by this point. She advised me that this was purely just an assessment, but that I would benefit from CBT. I could have six sessions of CBT with the community mental health service, but there was a pretty long wait.

2015

Following a disastrous Christmas that was full of anxiety and illness, I had my first ‘official’ CBT appointment with the community mental health team in January. My scores were a lot higher than my previous appointment, and it had been documented on my record that I was experiencing regular obsessional thoughts. So, it was advised that I get referred to the Wiltshire IAPT service for more specialist intervention. However, saying that it was a long wait was an understatement. In context, I saw the community MH team in January, and was referred for assessment. Said assessment didn’t happen until early the following year. 

Now, as you may remember, my mental health took a further dive thanks to the fact I was planning my wedding. After yet another instance of me going to her house in tears because this person’s child had a sickness bug and I was worried they’d have another one by the time they came to the wedding, my Mum convinced me to try hypnotherapy – just to help with the wedding anxiety if nothing else. This was paid for privately, and at £50 a session, it wasn’t ideal while having to fork out for a wedding. I wrote about my experience of hypnotherapy in my last Therapy Diaries post, so do check it out if you’d like to find out more!

2016

I packed in the hypnotherapy just after the wedding, as it was clear it was no longer working for me. 

Early 2016, I had my first appointment at the nearby psychiatric hospital – another assessment. It went horrifically wrong. My Mum came with me for this one, and when we were called in by the mental health worker, it soon became clear that this particular pairing wasn’t going to work. I appreciate that not everyone wants to be coddled, but she seemed to have a complete lack of compassion. It was weird, because she seemed to go from one extreme to the other – at the start of the session, she was blunt, but there was a sudden shift halfway through. She suddenly started speaking to me like I was a child, and if there’s one thing I can’t stand, it’s being patronised. I’m aware I look about twelve, but that in no way means you get to speak to me like a child mate. I was given the PHQ-9 and GAD-7 again, as well the Obsessive Compulsive Inventory (OCI), which not surprisingly, I scored rather highly on.

I was informed that because of my high scores, I would be better off being referred for high-intensity CBT. However, it would be a wait of around 12-16 weeks. While I left the hospital feeling frustrated and in all honesty, a bit humiliated, I was still relieved that things had started moving.

Cut to May, and we’d still heard nothing. By this point, things were getting a lot worse – after a severe breakdown over some ants in my garden (don’t ask), my Mum dragged my 24 year old ass to the doctors again, insisting she came in with me. This time, we saw a lovely locum doctor, clearly fresh out of medical school (NGL he was rather good looking). Despite previous ones flinging self help leaflets at me, this particular doctor was understanding, kind, and he actually listened to me. He prescribed me 50mg of Sertraline and said he would enquire about what was happening with IAPT. On the medication front, I feel I should point out that I’d been offered it many times before, but for various reasons I refused it. By this point, I was exhausted and I didn’t give a shit anymore, so I happily trotted out of the surgery with a prescription.

Late September, it happened – I finally was offered an appointment. Unfortunately, it was for another assessment. Wtf?! This time though, things went much better. While my score on the OCI was now at 120 (the cut off being 40), I genuinely felt like this was going to be it. Following a few more questions, it was established I could have up to 21 sessions of high intensity CBT, where we’d focus on the OCD mainly, while doing some minor work on the emetophobia (which had seemed to have taken a backseat over the last few months). I ended up having my first official session in October 2016.

Thoughts

I’m sure I’m not the only one who will have had this sort of experience with mental health services. It’s incredibly sad and frustrating to be told that you’re not sick enough to get the help you need quicker. It was something I was told on numerous occasions – “your scores are high, but they’re not high enough for us to consider immediate intervention” – and it feels almost insulting. I’m sure there were people out there who undoubtedly were much sicker than me and who needed the help more – but the fact that resources are so limited that it’s at this point is incredibly sad and really not okay. During one of the waiting periods, my Mum called the service to get an update on what was going on (because at 24 I was still incapable of making a phone call myself), again to be essentially told that my issues weren’t severe enough for me to go to the top of the list, despite the fact my hands were bleeding from the constant hand washing. My Mum – rather angry and frustrated at the whole thing – got a bit lairy and said “So if my daughter was suicidal, you’d help her, would you?” and the response was “Well, essentially, yes.” I can’t even.

I don’t want to slate the NHS, especially not now – it’s something that we are incredibly lucky to have here in the UK, and it’s something that many other countries don’t have access to. However, like many other services within it, mental health is one that’s highly neglected, and something needs to be done about it. 

Have you had a similar experience? Let me know in the comments.

Additional Support and Information

The following contact details are based within the UK. If you live outside of the UK and need mental health support, CALM has a list of international organisations that you can get in touch with. 

Samaritans

Free, confidential mental health support available 24 hours a day, 365 days a year. Call from the UK for free on 116 123. 

Childline

Free, confidential support from trained counsellors for anyone under the age of 19. Call from the UK for free on 0800 1111.

Mind

Mental health support and information. Use this page if you are in need of urgent help.

CALM (Campaign Against Living Miserably)

Free and confidential crisis support available 7 days a week, from 5pm till midnight. Call from the UK on 0800 58 58 58 or use the free webchat.

References

PHQ-9/GAD-7- https://www.efficacy.org.uk/therapy/phq-9-and-gad-7/

OCI – http://www.veale.co.uk/wp-content/uploads/2010/10/Obeessive-Compulsive-Inventory-OCI.pdf 

Featured image by FWStudio on Pexels.