Is this the worst PCT in England?

So, I confirmed my appointment on the 20th January at the complex needs service within the deadline. I spoke to a real person, not voicemail this time, and he said he'd let my contact know. I did ask at the time if it could be brought forward, or if there was any indication that the crisis team from y had made the call they promised to make(!), but apparently it can't and there isn't. Quelle surprise.

Then I got a message on my voicemail at 5pm yesterday saying that I haven't confirmed my appointment, but not to worry because it has to be moved to the 10th February anyway. I tried to call back to say that I had confirmed and although I can make the 10th February I am concerned that's a long way off, but the office closes at 5 so had to leave a voicemail.

Phoned back today to confirm that the message I left yesterday was actually picked up, and apparently it was but I got a bit of an earful for asking if I could see anyone any sooner than the 10th Feb. Never mind.

So I was getting a bit pissed off at everything that's happened with services in both x and y, and started mumbling about the worst PCT in England. It's probably unfair, but I feel that they've been truly dismal. Nothing they've offered has been followed through on, most appointments have been cut short for one reason or another, and when I try to ask for any support at all I'm dismissed and patronised. I left a PCT with the best reputation in London for this. Maybe everyone's right after all, and I shouldn't have bothered trying to move on.

Then, in a truly weird turn of events, I found a voicemail on my phone after an exam today saying that "Doctor [inaudible]'s secretary from [inaudible] got the message from [my local surgery] and will send me an appointment." So I have no idea who they are or what it's for but maybe this represents progress? Or maybe I'm being called in for the obligatory smear test in honour of my twenty-fifth birthday...

Just got a call

The Crisis Team just phoned to tell me that they're worried about me, because I didn't call. I'd never agreed to call, that wasn't the arrangement. I waited for them to call on Christmas Eve., as arranged, and they didn't. Then I waited for them to call on Christmas Day, as arranged, and they didn't. Then I waited for them to call and give me an appointment on Boxing Day, as arranged, and they didn't. So I was a little surprised that I am suddenly told I've worried them by not phoning.

I'm going down later today. Clean start, and all that. I would have said no except that, if anything, I'm feeling a whole lot worse than I was even on the 22nd so I think I need the support.

Just leaving for midnight mass

...and the Crisis Team didn't phone. I don't doubt that it's silly to feel hurt and let down but that's exactly what I feel right now. That and still suicidal, but I'm making my own way around dealing with that by sticking to my original plan to be with people (especially my lovely Girlie) so I can't act anything out.

Up and down like a yo-yo

Today was pretty bad.

So I go to university in town x but I have to spend my holiday at my parents' house in town y. This is not especially unusual for undergraduates (rarer, admittedly for postgraduates) so I would have thought it would be easy enough to understand. I also thought I was pretty lucky because, although they're in different counties and not connected by public transport, x and y are in the same Primary Care Trust (National Health Service local authority). Apparently this doesn't make a difference.

When I phoned them at 11 (under some duress, my mum had to make me do it, I hate feeling like I'm making a fuss) the Crisis Team y had no idea that the psychiatrist from A&E had tried to refer me, and claimed they had no record of a phone call at 8 the night before. Despite that, they agreed to see me at midday so I made my way down there.

After a half hour conversation with two of the nurses, which mostly consisted of telling me off for leaving an area where I had had consistent local health support in order to get on with my life and education rather than remaining in a job I hated for the sake of a thread of support (casting no aspersions on my care co-ordinator, who was brilliant). I just can't do that. I have to go on with my life. One of the nurses also told me that I shouldn't worry about the fact I had a bad time at my first appointment with the complex needs team in x, because "if someone in a shop was rude, you'd still go back". Firstly, that is an appalling analogy. Secondly, no I wouldn't. I have an anxiety disorder and a crippling fear of being disliked. If someone is rude to me, I assume they don't like me and I avoid them at all costs.

I also got a bit annoyed that I was more or less told off for being "emotional", because "that's how you presented to your GP in October". I don't understand why that's not ok? I'm emotional because that's how I am at the moment. I'm a wreck. I don't really leave my room unless it's to go into London because I feel safer there.

Anyway, the rest of the day was spent up-and-down with the Crisis Team. When I left, I had an agreement that we would talk by phone tomorrow and Christmas Day and I'll see them on Boxing Day. The two nurses I saw both agreed that if I feel safer away from home it's not worth changing my plans to be at church on Christmas Eve and Day.

About 20 mins after I'd left, maybe less, when I was with Mum in the supermarket, I had a phone call saying that if they're going to keep me on I need to register as a temporary resident at my parents' surgery so I agreed to that.

I phoned back an hour or so later, just to confirm that I had registered and that seemed to be ok, but almost as soon as I had hung up I got another phone call to say that they won't be able to see me after all, but I can go to my GP if I take another overdose and then maybe they'll see me now I'm on their books.

So that was pretty shit and my parents decided to get involved. I wasn't particularly keen, but couldn't stop them from getting the number and calling so they went ahead and did so. After about 30 minutes of circular argument Dad managed to get them to agree to go back to the original plan, so I'll talk to them by phone over the next two days and see someone on Boxing Day. Don't know when they'll phone but I made it clear when I intend to be travelling, and even offered to go by in the morning if they'd rather see me in person but they said no after all that fuss.

I don't know how much I want to engage with a team of people who don't give a shit but it's only fair to give them a chance, right?

(On the plus side, had to keep an appointment with my parents' surgery in order to maintain the temporary registration, and they were pleasant enough, so if I do have to go back that wouldn't be awful.)

Back in accident and emergency

I was in London today, at the library, and it occurred to me that it would be easier to go to my old GP in Islington than to try and see someone where I'm staying with me parents. So I made a temporary resident appointment and popped in because I'm worried things have been on the decline recently.

I had been worried about seeing anyone at all, and trying to avoid it, but after agonising about it at a friend of mine agreed with her that I would go, and that I would take their advice (after all, if you aren't prepared to take advice you shouldn't ask for it...), but the advice was to go straight to A&E at UCH and ask for the duty psychiatrist.

I've managed to never go to A&E on my own before, so I was pretty nervy but there was no one around. In the end I did go and managed to explain to the receptionist what I needed. Triage was pretty easy. 4pm on the Tuesday before Christmas turns out not to be the busiest time to show up in hospital, thankfully.

The duty psychiatrist saw me at about 5 and she was really nice, worked really hard to understand what was going on, where I'm living when and why, etc. She wanted to admit me at first, but I wasn't keen so she said if she could find my local crisis team (UCH isn't in my local PCT) and get them to agree to see me, then I could go.

So, after a two-hour discussion with her and an hour waiting for her to arrange everything with my local Crisis Team, I'm finally home and under orders to phone the local crisis team if I hadn't heard anything by ten. For some reason I'm nervous. It's not like I've not done this before but I'm nervous. I'm relieved I didn't have to be admitted and surprised that I was taken so seriously. After all, I showed up without having done any major harm to myself. Last time I was at UCH I had taken a fairly large overdose (or two, one in the evening and one in the morning) and all I got from the duty psychiatrist was the following interview:
"Do you feel safe at home?"
"Not really."
"Are you alone a lot?"
"Yes."
"Are you likely to try again if we let you go?"
"Well, I don't feel any better, so I might."
"OK, well I can't see any reason to keep you here...."

So I suppose today was a positive experience, as much as these things ever can be.

Not a good appointment

Since I've been at university, my GP and my former care co-ordinator have both been trying to get me some contact with the local CMHT (Community Mental Health Team) to set up an appointment with a care co-ordinator there. This is currently not happening and no amount of suggesting it might be important (as I am currently without care) is making it happen.

Instead, I have been referred to the laughingly euphemistic "Complex Needs" service. I accepted and confirmed the appointment as instructed (left a voicemail that wasn't returned and also sent an email). I was really impressed with the appointment letter they sent me, which contained detailed directions through the health service complex to the right building and an outline of how to gain admission.

Sadly, the reality was somewhat different. It was snowing over most of England today, and the south was badly hit. I arrived for my 2:30 appointment in the middle of a snow storm, and reception was closed. A helpful note on the door suggested I ring the buzzer for my appointment. I did, and no one answered, but I was 10 minutes early so I waited.

At 2:30, I rang the buzzer again. Again, it rang inside the building but wasn't answered. Gave it a few minutes, tried again. And a third time. Then a nice person from the next door building stuck their head out and said they'd tried to phone the complex needs team but no one was answering. Now, I know from experience that appearing not to show up for an appointment (for whatever reason) pushes you right back down the pile and mental health waiting lists are unpredictable things. So I waited some more. At 2:55, just as I was about to give up, a member of staff walked out of the building. I explained the situation, and she let me in and found a colleague of hers to help. He then found the woman I was due to see and she came to find me.

It didn't get much better from there. Firstly, she kept calling me Rachel (which is not even close to being my name), and then she told me that she did call reception but because no one answered the phone she assumed I hadn't shown up. Not especially logical, but she wasn't to know I was stranded outside.

The appointment itself then didn't go too well. I had filled in a detailed questionnaire, which she mis-read and barely gave me a right of reply. She ended up concluding the following:
1) I haven't self harmed since I arrived at university
I self-harm daily, often more than once in a day
2) It is easy to get to my university town, x, from my home town, y
I don't drive and there is no public transport between the two.
3) Despite that, I shouldn't bother coming back for appointments during the six-week vacation...
????
4)...because I am safe at home
I feel least safe at home


So, although I tried to interject and explain where her assumptions were wrong, I failed. So that was perhaps the worst appointment I've been to since the Austrian psychiatrist who told me (aged 17) that I'm gay because I don't feel attractive enough to be straight....