"The clinician failed to understand"

About: Nottinghamshire Healthcare NHS Foundation Trust

(as the patient),

Three and a half years ago, I was given the diagnosis of schizo-affective disorder. I was sectioned, and later realised I had been psychotic for nearly 8 years. I had no insight into this when in hospital. The full impact took about 6 months to dawn on me.

This was not my first episode of psychosis, and, in any case, had suffered with depression since my teens. I am now nearly 60. Through experience, I have a great faith in talking therapies as being the long term answer too my mental health issues, and have worked very hard, with the help of counselling, to work towards resolving the psychological issues which lead too my depression and psychosis.

Earlier this year, I was at a meeting where they had a speaker from the local "Social Inclusion and Well-Being Team"-one of the teams offering support to people with mental health issues, in the local Health Care Department. The speaker was an employment specialist, who supports people, like myself, who have had a prolonged period of mental ill health, work towards the possibility of returning to paid employment. I felt I had made progress in my recovery, and felt this was something I wanted to explore-whilst accepting that I had some way to go before paid employment may become a reality. I asked the speaker for his contact details (this was about April this year), and we have been meeting on a regular basis since then. Much of this time has been taken up with the worker concerned, and I, trying to find some unpaid work experience for me, in order that I can update my skills and regain my registration in the field of work I was previously in.

Throughout this time, I have been regularly monitored by my GP for any signs of relapse into my former mental health issues; I have continued to be on medication; and I have seen a counsellor weekly. Though I feel I have made some residual progress, I am aware of the fact that my mental health still has many fragilities, and when stressed, I can still get quite paranoid.

A couple of months ago, the employment specialist said that I would have to be assessed by a clinician at some point, to see if I still met the criteria for input from his team. The worker concerned told me the assessment was nothing to worry about-which I think was a genuine assessment on his part, having see me go through various ups and downs in the last 8 months.

An appointment was made for an OT to visit me at my home, with the employment specialist, to complete that assessment. I prepared myself well for the appointment, which was at 11am one morning. I got up in plenty of time to come round from sleep; do some Yoga and a relaxation (which I do daily); have some breakfast; shower and dress in preparation for the OT/employment specialist coming. Though I, no doubt, had a good sob during the relaxation, by the time the OT arrived I was OK. A general chat ensued (I do not remember the OT asking specific questions, though they may well have), and, after about 45 minutes, the conversation dried up and the OT brought the visit too an end.

During the past 4 weeks, the employment specialist and I have continued to meet and keep in contact-still trying to set up some unpaid work for me to do (as mentioned above). Recently, I met with the employment specialist. He informed me that the OT had given me a "0" score, and hence I did not qualify for a service from the "Social Inclusion and Well-Being Team". It was a Friday, and the full impact of that decision slowly dawned on me over that weekend. I realise the OT had made a decision, on the basis of a one-off visit, which: -

a) Had followed on from a week's holiday, when I had been able to relax a bit, away from the stresses of my life, and with things to take my mind off my troubles so I could switch off a bit

b)Took no account of the fact that, generally, I can be in quite distressed states most days. (The employment specialist told me he had told the OT that if they had seen me 2 weeks previously, they would have seen me in a very different state. His input made no difference, which he also feels unhappy about, as well as the cluster score the OT gave me)

c)That I had prepared myself not to be too "down in the dumps" and be able to speak clearly to them by the way I had got myself together that morning. (I even told the OT that I had decided to write a log of my own life history, so I could see my situation from the outside in. I said it had been extremely enlightening an experience, but very painful. I said that this process not only involved me understanding the past, but also see how some people in my life-most notably family members-were still operating in ways that had contributed too me becoming ill in the first place, in some instances going back to childhood. This made no difference. I wonder if some people in their position have insight into how painful a process such a recovery is?

As you can see, I am very unhappy with the decision. It has been made on the basis of a "snap-shot" which I no way reflects the reality of my life in general. It took me 3 hours that morning to get to the point whereby I could speak with some degree of coherence to the OT.

Earlier this week, I asked the employment specialist if there was any system of appeal against the decision the OT had made. The employment specialist was uncertain about this.

I told the employment specialist I had posted stories on Patient Opinion before, and asked if he felt there would be any mileage in me raising the issues in a story and see if anyone who may read this can give me any advise as to any appeals process I may use to challenge the decision of the OT. Hence, this posting.

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Response from Tracey Taylor, Service Manager, Community and Residential Services (South), Nottinghamshire Healthcare NHS Trust

Hello Sheelee

I have just read your story; I am sorry you feel that you have not been listened too and that a snapshot decision has been made about you.

If you would like to discuss this further please give me a call on 0115 955 5358, or you can email me on tracey.taylor@nottshc.nhs.uk.

thank you, Tracey

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