Saturday, June 16, 2007

Too Little, Too Late

Following on from yesterdays post entitled “Helpless” I would like to continue part of the discussion that followed in the form of a blog post, as I feel that the struggle to access services for people suffering with mental health problems is an important issue which many people may be unaware of.

Catherine said:

“Your post left me feeling sad and empty inside. Recently I have read a lot of posts coming from bloggers saying that the very people that are supposed to help them, aren’t.”
Catherine, the whole situation leaves me feeling sad and empty as well, but also angry. As you have found from reading other blogs, this isn’t an isolated case, and this is an important issue that mental health services need to address.
“Is this just what happens when you cannot fight for yourself? Everyone ignores you?”
The fact that people find it so hard to access services even when they have someone fighting for them suggests to me that there must be people on their own who are not getting help at all. I suppose this could be for a variety of reasons; for a start, people working in mental health aren’t psychic, so unless a person states that they need help no one will know. But I feel that once a person is known to a CMHT they should be provided with an adequate support system, and this is where they are being failed.

This leads me to Slurry’s comment about the CPN.
“I totally understand what you were saying in that post. In regards to “where is the CPN” etc, if it’s not Mon-Fri 9-5 they don’t want to know, even in those hours they probably wouldn’t want to anyhow.”
Slurry, you’re right, the fact that Community Psychiatric Nurses only work Monday–Friday, 9-5 is less than helpful. But the reason why I asked the questions: “Where is this mans Care Co-ordinator? Where is his CPN? Where is his Care Plan?” is because I don’t think he even has any of these things, although he should have.

The problem is that “Service Users” are not made aware of the services available to them or what help they are entitled to, and even the most caring and supportive of families can not demand the services for their relative that they have no knowledge of. This is a problem that Mr Man and I have experienced ourselves; Mr Man was not assigned a CPN until he had been discharged from hospital after his third admission, in which he had been admitted under a section of the Mental Health Act.

So with regards to the man suffering from Bipolar, the question is this: has he been left without this support because the CMHT wrongly assume that his family, with no training, will be able to cope with the responsibility of caring for someone with serious mental health problems? Or - and this is a far worse scenario - are people with mental health problems, including those who live alone, routinely left without an adequate support network from the CMHT until it is deemed impossible to “get away” with it any longer, such as after multiple hospital admissions, or after the person has been hospitalised under a section of the Mental Health Act?

It is my belief that as soon as it becomes apparent that a person is suffering from a serious mental health problem, they should be assigned a Care Co-ordinator, a CPN, and have a Care Plan drawn up. Surely prevention is better than cure? If this man had a CPN regularly calling to see him, I dare say his condition wouldn’t have deteriorated so badly before anyone noticed. If he had a Care Plan, his family would have known exactly what to do and who to call when he reached crisis point.

It makes me so angry that relatives have to fight so damn hard to get help for their sick loved ones, but who will fight for the person with mental health problems who lives alone?

If you want to be depressed even further, please read this article on Mental Nurse, and in particular the article linked to therein.


Slurry said...

Worst case senario sadly, those with servere mental health problems are often left to their own devices, with no imput from agencys such as the cmhts, and only come to the attention of others when things have got so out of control it effects them, very sad, but i know of many people just left to rot by the system.

Mr Mans Wife said...

That's what I suspected.

I may raise these issues next time I go to the "Carers Reference Meeting". Last time I was there I was led to believe that services have improved greatly in the last few years, but this experience over the weekend has shown me that they quite clearly haven’t – although I’m sure I’ll be told that this case is a “one off”.

Mr Mans Wife said...

Sorry - thank you for your comment by the way :)

fire said...

I have been treated for mh problems since i was 18.Between the ages of 18-24 i had a community nurse.
From 26-48 no cpn no care plan no care co ordinator. Contact with mh services was via 5-15 min appts with a pdoc or trainee pdoc every 3-6 months on average.

I am now at 50 getting better help ie
have had care cordinator for last few years(3 0f them as first retired and didn't have second for very long)
I also have care plan but this has not been reviewed for nearly 18 months.

I am also getting one to one via the local mh resource centre.
I am often asked what my goals are as a result of doing the one to one.
It is very hard to answer as so much opportunity has been taken away from me by the years of inadequate help and support.

I am ever fearful that i will be bandoned again.

Mr Mans Wife said...

Fire, it's terrible that you were left to struggle on your own for so long. Did you have any family members to support you during this time?

"Too little, too late" certainly seems appropriate in your case, but I'm glad that you seem to be getting better support now. Remind them that your care plan review is over due though!

Thanks for commenting Fire.

Stephany said...

I am my 19 yr old daughter's full time caregiver, and the last few months she was showing a decline. She has services and I took her there, only to be told 'no appointments available' etc. So I started taking her to 'drop in group'. Then took her for their support to talk to her about taking meds and for encouragement from others besides myself. I was told to leave the building at 5 minutes to 5pm, saying "its too late". Now that she is in the hospital, the same people who didnt give her a minute of their time, call her [she is their client and a legal adult, though living at home, I feel she was not their highest priority]now are telling me she needs more support, and well I want to say, really? Ive been asking for help for months. My biggest concern was what was talked about here--what if she lived alone and didnt have me to drive her there? I almost think she would have had MORE attention from them, and that I was being 'used' as her support, to lighten their caseload. Now they are basically telling me i didnt do enough.


Mr Mans Wife said...

Hi Stephany, welcome to my blog and thanks for commenting.

I've often felt that way too, that carers are expected to be able to do the work of trained mental health professionals, but on a full time basis. I wondered at times whether Mr Man would have got more help if I wasn't there for the CMHT to take for granted, but after seeing and reading other cases I'm not so sure. I'm beginning to think that nobody gets the services they need until their health reaches a point where the CMHT could actually be in trouble for negligence if they don't do something.

Typical that they blame you for their own inadequacies. Maybe in future you should keep a record of all appointments and phone calls so that if something serious should happen you can prove that the negligence was theirs and not your own. I've had to do this before myself.

Thanks again for sharing your experiences. I wish you and your daughter all the best for the future.