"Let's Talk Wellbeing? Not good for our wellbeing!"

About: Let’s Talk Well Being ( IAPT) – Nottinghamshire

(as a carer),

As a sufferer of chronic depression myself, I was all too aware when my partner (and carer) started showing signs of this debilitating illness. His list of physical ailments was growing longer and his mood started to wane. He began self-harming in my presence when he became frustrated with himself and was self-deprecating. He would talk about going out to drive his car under a lorry on the motorway because he didn't care any more. At this point I became very worried. He’d got himself dug deep down in a hole and I couldn't coax him back. Reluctantly, he attended an appointment to see a GP regarding palpitations. At the appointment I also brought up the fact that he’d been suffering from low mood and could he possibly benefit from someone to talk to? The GP agreed to refer him to the Let’s Talk – Wellbeing service.

When the letter arrived from Let’s Talk - Wellbeing, my partner was very disheartened. Upon reading the letter myself, I was taken aback by the wording – cold and clinical. I'm presuming it was a standard letter sent out to all patients who are referred to the service? The first paragraph stated, “Please take the time to read the enclosed leaflet, which outlines what we are able to offer. ” There was no leaflet enclosed! The letter stated that demand for face-to-face appointments was a limited resource. The final paragraph read, “We would encourage you to read the leaflet and contact us upon receipt of this letter if you wish to be seen, as demand is high. However, if we do not hear from you within two weeks from the date of this letter, we will assume that you do not wish to be seen at this time and will discharge you. ” I can assure you that when feeling at rock bottom, with suicidal ideation and no self-worth, the last thing you want to do is fight for help. If it hadn't been for me fighting to get some help for my partner, he would have just given up. The wording of the letter gave the impression that we were wasting Let’s Talk – Wellbeing’s time. I have to wonder about all the people who are on their own, suffering from depression, who don’t have someone to fight their corner for them, and just give up. I want to speak up for all these people.

With my encouragement, my partner did contact the service. He tried to make an appointment for an initial telephone assessment but as he works shifts he only has one or two weeks’ rota times at any given point. He agreed a tentative appointment date and said he would contact the service again to either reaffirm or cancel the appointment once he had his work rota. Subsequently, he contacted the service to say he would be working that day and so could he rearrange the appointment. As he was scheduled a day off work the following Tuesday, he was told to ring the service first thing that morning. A few days following this telephone call, a further letter was received reading, “As you were unable to attend your last scheduled appointment and to date we have received no contact from you. We write to confirm that if we do not hear from you within 14 days from the date of this letter we shall assume you no longer require our service and we will discharge you accordingly.” At this point he read the letter and was livid, throwing the letter down in desperation. He was frustrated as he had already contacted the service and cancelled the appointment. I picked up the letter and rang the service straight away to complain. I was connected to a senior administrator who was very apologetic. She said that she had spoken to my partner when he cancelled the appointment and that she had explained to him that he would receive a further letter to keep him in the system. I asked if she had warned him what the letter was to entail as it quite clearly stated, “As you were unable to attend your last scheduled appointment and to date we have received no contact from you. We write to confirm that if we do not hear from you within 14 days from the date of this letter we shall assume you no longer require our service and we will discharge you accordingly”. The letter upset him greatly as it was not factual. I explained that the whole experience with Let’s Talk – Wellbeing service was, in my eyes, diabolical. How many more people who have received these poorly-worded letters have slipped through the net because they thought they were being a burden on the health service with its “limited resources”?

My partner was offered a cancellation later that morning for a telephone assessment which he took up.

It certainly feels that whoever composed these letters has no understanding whatsoever of the problems encountered through depression. I would urge the service to be warm and welcoming with their words and not make people feel intimidated and unworthy of help. Vulnerable people need encouragement to get help, not be frightened into submission by isolating themselves.

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Response from Mick Collins, Clinical Lead , Let's Talk Well-Being Bassettlaw, Nottinghamshire Healthcare NHS Trust

Responding on behalf of the service manager Helen Simpson.

Thank you for taking the time to write on the patient opinion site. It is only through feedback that we can strive to improve and develop the service. As a result of your posting we will be reviewing our letters with the assistance of the Involvement Team. Many thanks for taking the time to share this story with others and I hope any future communication with the service will be positive.

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