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2 comments:
Hi Helen,
Saw the post and was sorry to hear you're still struggling to get the support you need, I hadn't realised, sorry.
I asked my friend who is a Clinical Psychologist in the South West and she said this:
"Unfortunately your friend's situation is typical of people all over the UK and things seem to be getting worse despite the governments well meaning 'increased access to psychological therapies' scheme. I would be asking a few questions, is your friend waiting for CBT at the G.Ps (primary care), in which case could her and her partner have a conversation with the G.P about referral through to secondary care (the community mental health team). Even though therapy might not be more forthcoming your friend would at least have a care coordinator (a person who gets to know you really well and helps you plan your care- usually a nurse or social worker).
Your friend could also look up their local CMHT on the Internet and see if they take self referrals. I would expect that if your friend stressed her suicidal feelings (I hate to give this advice but make this bit really really clear) and her chronic low mood that she would meet the criteria for a CMHT. I think MIND is a great idea, and would also look around to see if there are other sources of support in the voluntary sector. In terms of treatment for personality disorder/low mood your friend is right that DBT is a very good option, this is available on the NHS but through secondary care (the CMHT).
There are self-help guides etc out there, the MIND website have the most comprehensive collection of information and self- help material I've seen. Your friend could get hold of the Dialectical Behaviour Therapy Skills Workbook (Matthew McKay) which is on amazon and introduces some of the principles she could try, but the relationship with a grounding, helpful care team is really important so I think pursuing this too might be a good idea.
The most important thing is to know that the lack of services is not a reflection of how important your friends life is, though that is exactly how it feels when you're banging your head off a wall. The key is to make very clear the risk she is in, and be familiar with what options should be available- the NICE guidelines (google NICE borderline personality disorder) are a good place to start with this,
Hope this is helpful, feel free to forward this if you want to."
I'm posting this publicly in case it's of use to anyone else but if you want to remove the comment, please do.
Good luck and keep an eye out for that cheese under the fridge*! x
Hannah
* That's a hyperbole and a half joke in case that just confuses the crap out of this well meaning message.
Hi Hannah,
Thanks for asking for your friend's advice and for passing on what she says - it's all really helpful.
I have been referred to our CMHT (our area doesn't accept self-referrals) and tried ringing them once ... it went to an answerphone message telling me to contact another service if it was urgent (Samaritans, emergency GP or 111) and finished by asking me to please not leave a message! I should try again really but it takes a lot of energy to make the call and it was pretty crushing when I couldn't even leave a message but I need to get into the system so I'll try again when I feel up to it. :)
The difficult part is that on days when I have the energy to deal with getting help it feels like there's nothing wrong with me and I'd be making a fuss over nothing. And on the days when I need help I have almost no inclination to ask for it. I need to write a big reminder note for myself: "Even though you feel better today you are still unwell, get help you ninnymuggin!"
The DBT workbook sounds good - although I know that my executive functioning skills make it unlikely that I'd work through it well on my own.
I will keep on reaching for that sliver of dust-covered cheese with every fibre of my being though :)
Helen x