Tag Archives: support worker

Dear GP

There is an amazing account on Twitter called Dear GP where people write letters to their GP about their encounters with mental health professionals in the same way mental health professionals write letters about their patients to their GP. You cam visit the website here. I thought I would have my own go at this below after an encounter with a member of staff who is no longer involved with my care.

Dear GP

Today I met with care coordinator P. She was casually dressed in jeans and trainers. She seemed disorientated and unsure about what was happening. She did not know where she had to be and was indecisive of her next steps. She appeared very disorganised and had not booked a room or remembered that she was meant to be attending my psychiatrist appointment.

Before the psychiatrist appointment, P appeared to disappear and it soon became apparent she was making secretive actions with the psychiatrist. She made no eye contact when I entered the room and was distracted and on her phone throughout the appointment.

P made some abstract comments that only just related to the conversation between me and the psychiatrist. She was keen to please the psychiatrist and back up his treatment plan despite knowing the issues with this way forward, which had been discussed previously. P then showed that she had been trying to rid herself of responsibility and discharge herself from my care with no input from myself. This was overruled by the psychiatrist. She seemed disappointed in this course of action and did not make anymore conversation and avoided eye contact for the rest of the appointment.

At the end of the appointment, P decided to arrange another appointment but was inflexible in this leading to no date being set and no forward treatment plan being set.

I thank you for sending P to see me but I think that going forward there may be no working relationship unless her behaviour becomes more open.

Regards

Jo

To share your own experiences feel free to share in the comments or on Twitter, Facebook or Instagram.

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They’re Not All Bad

I realise I’m quite often pretty scathing about mental health professionals but some of them are OK. Some do an amazing job and are let down by their colleagues. Quite often our bad experiences overshadow the good and we get into a negative view of all professionals, which is understandable.

I’ve had a few good experiences with different professionals. The negatives with these professionals only come when they are let down by the system they work within, otherwise they are amazing and make all the difference. When someone is caring and takes time with you it makes you feel valued and has a positive effect.

The first professional I found that was great was my art therapist. This was the first major mental health professional I worked with. At the time she was part of the young person’s service which was part of CAMHS (Child and Adolescent Mental Health Services) and worked with those aged 16-25. I was 20 when I started working with her. She treated me on a level with her. I was training to be a teacher and she treated me like a professional as well as a patient. She didn’t patronise me and went at my pace. Her main work was to get me to communicate and she did well with this but at my pace. She made herself available between sessions if I needed to leave a message or write a letter to help with the next session. She’d talk me through situations. She tried to teach me it wasn’t all my fault and at times I almost believed her. The main thing that sticks with me though is that the young person’s service was disbanded so all over 18 were to be taken on by adult services meaning I’d lose my therapy. However she fought for me and told them it ws totally the wrong time to take it away from me and that she needed to continue her work with me. This led to me having a further 18 months with her. Leaving her was hard and I miss her a lot. I still have the card she gave me at the end of therapy.

Another mental health professional that gave a good impression was a psychiatrist I had in adult services. She is the one that diagnosed me with BPD (Borderline Personality Disorder). She always valued my opinion and explained things when asked. She wasn’t perfect in that she didn’t discuss my diagnosis with me before it appeared on my notes but she was happy to go through it after. She was also a consistent presence for nearly a year before she moved on. This makes a difference.

The next professional who I had a good relationship was a care coordinator of mine, L. L was very proactive in my care and worked hard to get things sorted for me, not only with my mental health but my physical health too, even spending ages on the phone to a hospital trying to sort an appointment for me. She didn’t make me feel like our time was limited, it was always as long as I needed to talk. She took an active role. It was sad when she moved on.

My current care coordinator is also great. She’s not been involved in my care for long but has already shown me how great she is in that she gave me direct contact details for her and allows me to text rather than talk on the phone. She doesn’t mind me messaging between sessions and is quick to reply even if it is to tell me she’ll get back to me properly later. She’s also always on time or early for appointments which makes all the difference. I’ve kind of thrown her in at the deep end with my crisis but she hasn’t made me feel bad about it. I hope we can work together for a while.

Unfortunately these professionals are the exception rather than the rule. It shows as these are four out of many professionals that I have encountered. Hopefully things will improve and we will get more professionals that want to help rather than make us feel like an inconvenience or stigmatise us more. If we can be part of the education of professionals I think it would help them to be more empathetic and understand us more.

Have you had any good experiences? Feel free to share in the comments or on Twitter, Facebook or Instagram.

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Self Harm Etiquette For The Medical Profession

This is a blog post for anyone working in the medical profession. This includes Doctors, GPs, Nurses, Healthcare Assistants, Paramedics, Support Workers, Psychiatrists, Care Coordinators, Psychologists, Pharmacists, Admin staff and Receptionists. Basically anyone who comes into contact with a person who may have self harmed (therefore could also be useful for police officers too).

It has come to my attention that some of the people we want to help us deal with self harm can be some of the least useful with their comments and actions regarding dealing with self harm. Therefore I thought I’d put some tips together specifically for them and any professional that needs to help with self harm.

1. Don’t comment on it in front of other patients

This may sound really obvious. Patient confidentiality is key. Bringing it up in front of other patients without permission is wrong and can cause harm to the person who is self harming, the relationship between patient and professional and possibly even the other patient/s who could hear about it. You never know where this information will go. Unfortunately I know it happens. I’ve seen it happen.

2. Don’t guilt trip us

I’ve had this happen with a former GP. I was told I obviously didn’t love my parents over my self harm. It was awful. I didn’t return for treatment until two years later after a suicide attempt. This isn’t the only impact it can have. Self harm is not a selfish act. It’s a way of trying to keep going. It’s a way of coping. Most people who self harm probably already think about the perceived damage they do to others. To be guilt tripped by a professional is more likely to make the situation worse and even cause the patient to withdraw from seeking help, maybe until it is too late.

3. Don’t mimick self harm behaviour

Again this is something I have encountered and not just with one professional but many. It seems some can’t bear to say the words “self harm” and so use actions like using their hand to mimick cutting across an arm. Not only is this not clear communication, it can be triggering. It is a difficult topic but it is one that needs to be dealt with sensitively and professionally. Yes you do need to ask, but please use words rather than miming actions.

4. Be careful with what you say

Most professionals are careful with what they say. They think before they speak and take into account the individuals situation. That’s great if they know the patient. However without continuity of care, which is heavily missing in places, you may not know details or you may just be someone that only encounters someone briefly so has no background information to draw on. This means being careful with what you say. I’ve heard things that concern me. They may be useful for some but I can also see them as potentially inflammatory to the wrong person. I’ve heard “you’re scars look cool”, “just use your faith” and “what would your family think?” as common phrases among others. Let’s work backwards, the last comment can easily be seen as a possible guilt trip but it can also cause some negative emotions to surface, particularly if there is friction within the family. The middle comment is also dangerous as some people don’t have a faith and this may be because of trauma or abuse. It can also suggest unless you have a relationship with a god, you can’t be helped. The first statement may be the most troubling though. You’re reinforcing the behaviour. Yes self harm shouldn’t be something people feel ashamed of, but it shouldn’t be highly celebrated either.

5. Don’t judge or use stereotypes

Some professionals have a preexisting picture of what a person who self harms is. They may see them as frustrating and a drain on resources. They may see it as attention seeking. These stereotypes tend to grow over time within a staff member. I can see how hard it must be to treat someone who seems to be causing their own suffering. But it is a symptom of an illness. It is like an addiction. It is hard once you have started to stop. It can feel like all you have in the world at that time. It is a sign of distress. Being compassionate, non judgemental and just kind to the patient goes a long way. It can help the person to keep accessing help. Doing the opposite could push people away and leave them in dangerous situations.

6. Don’t compare us to other patients who have self harmed

Every person is going through their own unique experience with mental illness and self harm. Self harm is self harm. So it may not be as deep or as “bad” as someone else you have treated, but to that person the pain they feel inside is probably just as intense and unbearable. Hearing that we aren’t as serious as someone else because it doesn’t reach a certain level is heartbreaking and can have a negative impact. It can cause us to try and do more damage. It makes us think we aren’t good enough or that we don’t deserve help. Everyone, whatever level of self harm they present with, deserves support and compassion.

7. Don’t use the terms “superficial” or “attention seeking”

I hate the term superficial when it’s used to describe my self harm. It makes me feel like a rubbish self harmer and that I need to harm worse or more. It can encourage the behaviour and make things worse. The same can be said about the term attention seeking as it can drive the behaviour underground and prevent people getting help.

Those are just a few helpful hints for medical professionals. It might not be a regular thing you encounter but it is always useful to know how to help someone who self harms.

If you have any tips you wish professionals knew then feel free to use the comments or Twitter, Facebook or Instagram.

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Mental Health Professionals

This is a post about the different professionals involved in my mental health care. I aim to discuss a bit about what each of them do and my relationships and experiences with them. There are many different professions in mental health care and it can be confusing to know what they do.

1. My GP – I thought I would cover this role first as its normally the first port of call for anyone struggling with their mental health. They can offer advice and medication, as well as referring you on to get help from other professionals. My GPs have on the whole been great. I see two who deal with everything and have been really supportive in getting me the right care. Sometimes it takes a while to find a good GP in the practice; the ones I see now were not the first I approached about my mental health, but keep trying as there are great GPs out there who can act as your advocate.

2. Psychiatrist – This is a doctor of the mind. Mine is involved in prescribing medication and referring me for other treatments and services, such as therapy. I have seen many different psychiatrists over the years, some great, some appalling. Getting one who listens to you and respects your opinion is amazing and can make all the difference. I currently see a different one each time I go which makes continuity of care hard.

3. Care coordinator – A care coordinator can be any mental health professional and is usually the main point of contact for support. They also sort out your care plan under the care plan approach (CPA). I’m on my second care coordinator after my first left. Neither of mine has actually really made the time to sit down with me yet and discuss my care plan. I hope this changes as I feel I need their support.

4. Support worker – These are people who support you in different ways, from being a point of contact with services to getting you involved in activities. Me and my support worker don’t always see eye to eye but she has been my regular contact with the mental health team and sees me on a weekly basis (usually, she is currently off sick) to check in with how I am doing and to trouble shoot any problems.

5. Psychologist – A psychologist is different to a psychiatrist. A psychologist offers talking therapies in order to treat mental illnesses. They have nothing to do with medication. I am currently going through the process of getting an assessment and hopefully starting therapy, and it will be my psychologist who facilitates this all. In the past when I had art therapy I had a great psychologist who really understood me and respected the way I work. I hope this will be the case again.

6. Crisis team – A crisis team is there to support you when you are particularly unwell and treat you outside of hospital. They will often see you every day for a short period of time. Although they are not currently involved in my care I thought it was important to include them as they do play an important role in keeping people safe in crisis times. I have seen them a number of times with varying responses, unfortunately not all good. Some people find them frustrating.

So there you have the professionals that are, or have been, involved in my mental health care. There are other professionals that work in mental health but I haven’t had contact with them. Please feel free to share your experiences of different professionals in the comments. It may also be different if you live outside the UK. For more information on mental health professionals check out the Mind website.

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