"Horrified by NHS Mental Health Services."

About: Armstrong Way (CAMHS) West London Mental Health NHS Trust

(as the patient),

 I have been in the system for six years now. The mental health services has so many excuses as to why they cannot help you. I feel that the vast majority of doctors, psychiatrists and liaison nurses lack empathy, compassion or true insight into mental health conditions and how they effect ones day to day living. I have Borderline personality disorder, Mixed anxiety and depressive disorder, social anxiety and OCD. I have been continually fobbed off from service to service upon entering the adult system. As a child I received the best quality mental health care via CAMHS and I was continually treated with care, dignity, and respect. CAMHS offered immediate help and access to services. They drastically reduced my suicide attempts and helped towards repairing my relationship with my mother and they also offered me coping mechanisms in the form of CBT.

I felt so helped by CAMHS that I felt I no longer needed their services as they helped me to stand on my own two feet.

Unfortunately due to life circumstances my mental health issues began to emerge to the surfaces as I entered into my early adulthood. I think the Adult services are too keen on medication as a form of treatment however it's essentially a dependant suppression of the symptoms that patients face. However they are not treatment options.

 Firstly, I think that within the adult service there are too many teams! In my experience this  means that patients get passed from person to person, service to service, waiting list to waiting. As a child I stayed with one team, CAHMS and they stayed with me consistently and effectively until I was able to cope.

I think the adult services need a serious review. There is also an emphasis on short term treatment teams, might I mention the crisis team whom stay with you for 2-3 weeks of your life when patients may have suffered with mental health issues for years.

It seems to me that instability and unreliability of these services leads patients to repetitive visits to the accident and emergency services, self destructive coping mechanisms and in more saddening circumstances death.

It would be so much easier to paint a picture rather than to cry, become frustrated and complain about a failing system of people unhappy in their jobs. We cannot blame lack of resources or finances, most mental health patients just want someone who cares, has deep insight into their condition and how it affects their day to day living and also some light at the end of the tunnel in terms of treatment. That's more reassuring than being passed around and drugged up.

If you would like to know how it feels to be an NHS mental health patient then please listen with an open mind. Could you imagine a world whereby several people were walking around on the street with their arms cut off and they had clearly bandaged up the wound themselves. A world where cancer patients were sent home from A&E and they had developed more mutations to their cells as they sat in the care of their trusted doctors. Can you imagine a world where people walked on the buses with a head bleeding from the injury of a car crash. However they went to get treated but were told that due to a lack of funding there would be a waiting list of a year to get treated. And although their injury was urgent, life threatening and visibly in a critical state, there was nothing that could be done at present and there was no set date of when something could be done in the future so they should return home and bandage the wound themselves.

A government and national body has the role of classifying 'priority needs'. Internal bleeding if often most times more detrimental.

Sadly the picture I paint is of one that is not of a third world country but it's actually of the United Kingdom NHS mental health services.

Being a mental health patient under the NHS feels like being stuck in a revolving door where the most common form of 'treatment' is that there is no treatment so please accept a sticky plaster that will eventually peal off as its not strong enough to heal your wound, but it 'helps in the mean time of limbo'.

I do hope that this letter is read and appreciated. And I also hope that someone will stand up for the poor people with open wounds that they have bandaged themselves as they were embedded in a system that is clearly falling apart.

Many thanks.

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Response from Fin Larkin, Clinical Director, Access and Urgent Care Service Line, West London Mental Health NHS Trust We have made a change

Dear Ms Lewis,

Thank you for your positive comments about your experiences with our Child and Adolescent Mental Health Services, which have been read by our CAMHS Clinical Director and will be shared with our CAMHS teams. I’m sorry to hear about your negative experiences with our Adult Services.

I agree with you that for too long it has been too complicated for patients and professional colleagues to quickly access the best mental health services for them. For this reason we opened a ‘Single Point of Access’ in April this year. The telephone number is 0300 1234 244. Anybody who would like to access any aspect of our Adult Services can ring this number. General Practitioners can call to discuss a new referral, or a current case. Patients can call directly too. Members of the public who live in our area, but have not yet used our services, are also welcome to call if they are dealing with any mental health issues, or are providing care or support for one of our patients. Our lines are open 24 hours a day, every day, and all calls are answered quickly by our team. We cannot provide confidential information to members of the public over the phone, but we can offer appropriate advice and ensure patients get prompt access to the correct treatment.

I also agree with you that historically there have been too many ‘teams’ for patients to navigate in adult mental health services. One reason for all these teams was evidence that showed a number of benefits to specialising teams. However there has been a cost to this too. There can be a loss of continuity for our patients. Too often they have had to change teams at their point of greatest distress, or they are only getting to know their new team, when they are referred to another one. In addition each interface can lead to another assessment for suitability, which can be a frustrating experience for patients. Although some sensible steps had been taken to reduce these downsides, we decided to reduce these problems by amalgamating some of our teams, and changing their function, to allow better continuity and less interfaces for our patients, particularly when they are in their first phase of illness, or during a particular crisis. For example, in each borough we have recently amalgamated our Assessment Teams and our Crisis Resolution and Home Treatment Teams (CRHTs) into Crisis, Assessment, and Treatment Teams (CATTs). We now have one CATT in each borough, instead of the 8 teams that previously existed. Each CATT offers the assessment, and crisis intervention, functions of the previous teams, as well as up to three months of focussed interventions. We do offer medication, because it is helpful for some of our patients, but it is not offered to all patients, and we also offer all patients a range of psychological and social treatments.

If you would like some help with the particular difficulties you have had with our services it may be helpful for you to contact our Patient Advice and Liaison Service (PALS) on 0800 064 3330 or pals@wlmht.nhs.uk They can talk to you in confidence about your particular circumstances, and they will be able to assist you and advocate on your behalf. West London Mental Health Trust are keen to continuously improve the services that we offer, and are very open to advice and suggestions from all sources.

As a patient who has used our services, your views on what we could do better are very welcome. Our PALS team will be able to tell you about the many opportunities we have for patients to become directly involved in helping to shape and improve our services in your local area, or members of your team that you can meet with to discuss your recent experiences, and options that may be more helpful for you in the future.

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