Shockingly poor service from a Community Mental Health Team

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I live in the UK and from 2010-2012 I was under the care of my local Community Mental Health Team. In the UK, every city and most towns have one of these CMHTs, which are usually led by a psychiatrist and also include psychologists, community psychiatric nurses, social workers, support workers, etc. They are run by the NHS (National Health Service) and their work is free of charge for UK residents, though one can only access them if referred by a GP or other suitably qualified health professional. The CMHT deals specifically in providing community-based care (regular home visits, outpatient appointments, medication prescription and monitoring, etc.) for people with “complex” mental health needs, so a lot of their patients are people with schizophrenia or other psychotic conditions.

I was diagnosed with “Unspecified Psychotic Illness” which I believe would today be called “Schizophrenia, Unspecified.” Anyway, in 2012 I was discharged due to things improving a great deal and I was basically in remission between then and September of this year, 2020.

This time around things are even worse and more serious in terms of my symptoms and so I was referred again to the CMHT but as I’d moved to a different city a few years ago this is a different CMHT. Today I had my first appointment with them, a telephone assessment that lasted just over one hour. The woman who did it didn’t tell me her role or job title and I didn’t think to ask but there’s no way she was a psychiatrist or psychologist or nurse. She was very incompetent in every way but the most alarming thing was that despite me answering her questions and explaining about hearing unpleasant voices every day and other “classical schizophrenic” symptoms, she strongly implied that the only help I would be offered would be a support worker (who she said would not be psychiatrically qualified) to help me with my shopping! And even that was a maybe, as she also inferred that I might not be offered any help.

There was no mention of diagnosis, medication, coping strategies, or of seeing a psychiatrist, psychologist, community psychiatric nurse, or counsellor. But she said she would give feedback to the rest of the team and that I’ll be contacted in around 1-2 weeks to be told exactly what support they will offer me. This is very different to my 2010 experience, where I swiftly saw a psychiatrist, got a diagnosis and antipsychotic medication, and started receiving home visits from a nurse.

So if anyone else here is in the UK and under the care of a CMHT I’d like to hear your experience. Today’s appointment was so disheartening and concerning in its incompetence and lack of treating my situation seriously that later in the day I wrote an email about it to them, as it would be a disaster if they genuinely don’t offer me any psychiatric assistance despite my being in the middle of a serious breakdown!

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@firemonkey @Naarai might have some insight.

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My CMHT was amazing. From 2016 to 2019. Generally speaking.

That sounds worrying what you have described. Yea you are doing the right thing by speaking up about it.

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I find the CMHT can be a bit hit or miss. My local team isn’t great including the psychiatrist who at best is incompetent and worst neglectful. Best of luck @Rivka

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IMO there’s a post code lottery as to quality of mental health care in the UK. @Rivka your situation is unfortunately the opposite of mine. , It might be worth getting in contact with

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Thank you @firemonkey - that information you’ve shared has helped me find the PALS contact details for my local NHS Trust, whose auspices my CMHT comes under. I’ll wait and see what happens in response to the email I’ve already sent the CMHT and also what support they end up actually offering me…and then, if needed, I’ll get in touch with the patient advice/liaison people.

I am in London by the way and for some reason I expected the London CMHTs to be very good but I suppose they are in fact even more overstretched than the rest of the country, due to having so many more people to deal with.

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You’ve got it backwards. Generally you’re shocked when the service isn’t poor.

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I think that they are taking rather aggressive stance on everyone who is recipient of social welfare in UK/EU (so at least that’s what I’ve heard from someone a while ago). I won’t go into the details because I don’t know if the information that person provided me is accurate.

The default aggressive stance in psychiatry I think it’s because there are excessive cases of hypochondriacs and individuals who are trying claim benefits that perhaps otherwise not always would qualify for it. I suspect that the default aggressive stance is the norm in psychiatry field nowadays. The nurse who spoke with you is a very good example of it. Acting like a trained assassin is her job, and I’m sorry to hear that you had to experience that. The feeling is mutual.

I was once denied referral by a general practitioner to visit psychiatrist. I told the GP about my symptoms and that I was homeless living on streets, also suicidal, and having some sort of psychotic symptoms. I said to him that I needed to see psychiatrist because I was actually going bonkers. The GP told me that there is nothing wrong with me and that he won’t be giving me any referral.

Later my situation has spiraled down and I ended up with an emergency admission anyway. So the GP did failed at the basic task. I only asked to a referral to be checked by psychiatrist.

I won’t bore you with the details. It’s very unfortunate that they’ve been unhelpful towards you. I hope that you get the help you need very soon.

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My understanding is that you get seen by someone (a psychologist I believe) and they gather data on you, then they take that data to a team and then they decide what you get.

I would be surprised if they dont give you an appointment with a psychiatrist soon to review your meds.

I understand you felt like the person you spoke with didnt feel that helpful, and perhaps she was rude/impolite to you, but unfortunately they dont make the policy. What dictates how much resources CMHTs have is the government and the tories don’t give a toss.

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I’m glad I’m not under CMHT. I’m under intellectual disability services which are brilliant.

I go to the CMHT depot clinic for my monthly injection, seen by one of the CMHT nurses. I have been going with my support staff every month for 7 years because I have anxiety and intellect disabilities. Somethings depending on what nurse they can be horrible to me so I like to to may staff with me, never had a problem, with this before,. During Covid they now say only two people are allowed in the clinic room. A nurse was very sharp with me to the point I refused to go in to appointment when I wanted my support worked in with me. I told my community nurse and he said they have to make reasonable accommodations under the Equality act 2010. I’m worried I’m going to get more grief from them.

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I had no support for ages as I used to hide everything from people, because I was ■■■■ scared of being locked up for being crazy. I knew something was up, but I chose to hide it to protect myself - however it always got to the point that I would lose control

When I was 17, they left me in the care of the youth offending team as I had a 12 month community rehabilitation order. The CMHT in 2004 was pretty much non-existent. I think I saw a psychiatrist once, and after two years I stopped the medication.

Fast forward to 2011-12, I again was left for a very long time psychotic, and I scared the ■■■■ out of the University counselling team and again I saw a psychiatrist, and got given Risperidone and Olanzapine and sent on my way

In 2013 I stopped taking the pills, and had a major relapse and was sent from A&E back to my home town’s mental hospital. When I got discharged to CMHT, I discharged myself after two weeks as I hated the attention. Again, I wanted to keep things to myself, and being pensioned off on benefits was never going to happen, as I was adamant that I needed to work to keep busy. They were in the process of getting me supported housing before I told them where to go.

in 2015 I realised the meds (Olanzapine 20mg) which I had been left on that dose for two years with no follow up had caused me to put on 35 kilos. Safe to say I went ape ■■■■, and quit cold turkey. I learned about this illness - mainly from this site, as for those two years I just took the pills and had not developed any insight into my illness until this point, two years after a diagnosis of paranoid Schizophrenia.

in 2016 we tried 3 meds, and I relapsed twice until we found that latuda helped me. I got discharged as soon as my symptoms were under control. I was very angry with the OT who was my care coordinator, as she betrayed me. Lifetime illness & part time care was unbelievable!

2017 I got akathisia, and I ended up quitting meds again, and back in the hospital. After I got released, the CMHT phoned me, and it was the OT who discharged me, so I told her where to go.

a few months later I had another relapse and this time I agreed to stay with the CMHT.

It worked well as a psychiatrist took interest in me, and he was the one who I first met when I was 16/17. He got me therapy (Which was ■■■■■■■ ■■■■) and we found Amisulpride which has kept me stable since 2018.

Since the CMHT have got me on PIP, Universal Credit capacity to work thing (I don’t understand this) and employment support services. My care coordinator now gets things done even though he doesn’t really listen.

Oh yeah, and seeing as I have been in services on and off for 16 years, it took them until 2020 May to diagnose me with Autism and anxiety.

Sorry for the long post. I wanted to let you know what I have been through with the CMHT as it has it’s problems.

I do have a new psychiatrist who seems very good. He actually has called me off spec several times over the last few months, as I have been getting agitated, and causing some problems messing with my meds.

I meet him for the first time in person on the 2nd Nov.

Anyways, I will stop there. If you have any questions about what I have posted, feel free to ask

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@Joker No need to apologise for the length of your post; I appreciated it and found it interesting. I hope to eventually get their help in finding some sort of supported housing, as one of the factors in my relapse is loud building work (drills, hammers, goodness knows what else) that’s been going on just the other side of my wall for literally half a decade, minus a few periods of a few months during which the work stopped. It’s been busier and louder than ever this year and the building manager of that property doesn’t know when they may finish. I’ve no idea what type of building reconstruction takes five years, including five years of daily hammering and drilling in one and the same room. It’s literally driving me insane (though there are other factors and triggers as well) and I have no easy way to escape from it. It’s 8am to 5pm Monday to Friday and 8am to around 2pm on Saturdays. I bought a white noise machine which I switch on in the mornings when they start, so that I can continue sleeping (I need a lot of sleep) but even the white noise machine at full volume plus ear plugs doesn’t usually drown it all out, so I’m increasingly sleep deprived as well as assaulted by horrible noise, plus there are other builders who have been working on some scaffolding that’s directly outside my window for the past three months…and during the summer there were also builders working in my building, directly outside my door, for a month or two…so the feeling of intrusion and persecution from all this has been hellish. So we’ll just have to wait and see what happens with my CMHT.

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@Rivka I moved into supported housing 10 years ago and it’s truly the best decision I made. I was really isolated in my past bungalow but now I’m not lonely anymore, with a great group of people who I regard as friends and we have 24/7 staff so always somebody around to talk to and company.

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Welcome @Rivka! I’m in the US so I can’t help you navigate the mental health field in the UK, but I’m glad you found the forum. Hopefully you get the help you need

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@Joker

I liked reading your past story. From another British person prospective, I think this is important that it’s written on here as there really isn’t many of us British around so it’s nice to read other people stories, glad things are going good with you’re pdoc.

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deleted as past is past. I wanted to you read my past exprenances @Joker but feel ashamed of the past, I live a clean life now. I only deleted it as I post my photos on here and have paranoia.

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I had referral orders, supervision orders and finally a rehabilitation order that got me off drugs between 12 and 17 years old. It took a particular drugs worker who wanted to help from the YOT, and I owe my life now to that man

Unfortunately I did spend a month in Feltham YOI when I was 17 as I was psychotic in court and I was trying to convince the magistrate judge that I was being ‘groomed’ to be a terrorist for al-queada.

She was not impressed and clearly had no understanding of psychosis. I got given a 12 month sentence, but the crown court judge over turned it on appeal after a month of being there and sent me to a community hospital. I was in the mental health ward, so I was a bit safer, but that was a really dangerous place.

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Can you delete this message, sorry to be a pain, past is the past and have new life now.

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@Ninjastar @anon4362788 I can only delete 1 of the replies to Bobbily can you remove the other quoting a deleted post?

Thanks