What the actual fuck is the fucking point of making changes when they don't make the damnedest bit of difference?
I tried something new a few days ago. I asked for what I wanted.
I fought very hard to get what I needed from the NHS (I think the NHS is fabulous, and would defend it tooth and nail - but there are significant failings in mental health services.) I went to my GP, who referred me to the 'Community Interventions Team'. Initially things went pretty well - I got an appointment with a CPN, who sent me on to a very good psychiatrist, who decided that therapy would be a good idea and that he would also check in with me every now and again. I felt supported and listened to. Towards the end of the allotted therapy (which to be honest just opened old wounds and left me rather frustrated that the main aim was really just to establish what I weigh and attempt to frighten me with a diagnosis I didn't want), it was agreed that I should have a break from it (I agreed with this) and that I could continue to check in with the psychiatrist every few weeks. I pleaded for this, on being told that I was being kicked off back to the GP (I don't have a regular one - it's a group practice with more turnovers than the pastry counter at Sainsburys), and I thought I had managed to advocate a bit for myself here and get what I needed - a bit of consistency. My first appointment with him after the end of therapy rolled around, and I had a phone call a couple of days before asking if I'd mind if it was with a nurse practitioner instead, as Dr N was off. I hesitated, agreed, and made sure I asked if I could see him as well, at a later date. I turned up for the appointment, was made to feel like a total idiotic waste of time (yes yes, no-one can 'make me feel' anything. But the outcome, whether my own doing or not, was that I felt like an idiot and a waste of time, so...whatever.). At the end, I asked very clearly if we could arrange an appointment with Dr N. Was told I'd get an appointment letter in the post.
A week or two later, someone claiming to be my 'Care Co-ordinator' (CC) who I'd never even heard of phoned and suggested going to see her. OK, I thought, I'll jump through the hoops. Met with her, felt it was a total waste of time - having spent half an hour talking about self-esteem issues, how much damage I can do to myself and how I didn't really feel worthy of the space I take up on earth, she looked at me patronisingly and said 'Would you say you're quite hard on yourself?'. I may have goldfished a bit at this point, and immediately realised this was going nowhere. I made it very clear, once again, that I wanted an appointment with the psychiatrist. She was non-committal, saying she'd speak to him about it. I gritted my teeth and explained that this had been agreed between him and my therapist. So I waited a few days, expecting to finally get the letter with an appointment. Nothing. Phoned his office. No record of appointments, can't just make one, he has to ask to see you. 'Oh, sorry, I didn't ask him', from above mentioned CC, 'Why did you want to see him?' I almost gave up at this point, but pushed through and waveringly explained through trying to choke back tears of frustration that I was desperate for some consistency of care. Finally Dr N phoned me and offered me an appointment. At last. It wasn't helpful, but at least it happened.
Fast forward a few weeks. I'd stopped asking for anything again, until CC rang and said she hadn't seen me for a while and would I come for an appointment. Turned up, went through the 'no, nothing's changed in terms of mood/behaviours etc - oh except that I've lost my job and am in an even more fragile emotional state' conversation. CC asks what else I think they can do. I admit the answer is nothing, really. She asks me what I would like to do. I reply that I would like to continue to check in with Dr N every now and again. She says she will talk to him and see what he suggests. Phone call this morning (two weeks later, by the way). 'I've spoken to Dr N, and I think the decision is that we are going to discharge you back to the GP.'
What is the point? Things have changed, admittedly, since I grew a pair and realised that the only way out was to do something a bit radical, and so contacted my former therapist who I had worked so well with, and who, to cut a long story short, offered to help me again in a slightly unorthodox manner. But what if I didn't have that option, or the sense to notice that I was getting nowhere? What if the NHS service really was my lifeline? I shudder to think of how many people have been through something similar and just rolled over and taken it. I would have done, a few months ago.
I guess the lesson is that asking for what you want doesn't always mean you are listened to - but at least I know I did try to get what I needed, and it was not for want of effort that I didn't.
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