Mental Health Assessors think I pose a risk

[Saz]

For my 'false memory' x

[Steven_in_the_clouds]

This is all wrong on so many levels. I hope it gets sorted out soon Paul. I hope Ashley can help. Isn't there someone else in the office who can help in his absence? Firstly, why have they broken confidentiality to inform this 'safeguarding' team. Secondly, didn't you mention that this was anxiety and list your other obsessive fears in the past? It's pretty obvious reading your posts that you have OCD. If they weren't sure they should have consulted a clinical psychologist and/or psychiatrist. It seems awful to me that it is now impossible in many areas to see anyone qualified and instead they wheel out newly 'qualified' graduates who have six months training. Sooner or later, the only option for decent treatment will be private for mental health in the UK, which is sad.

Anyway I'm sure that this will be resolved. Stay strong and if I were you, I'd get my GP involved and ask to be referred urgently to a psychiatrist or clinical psychologist and say how much this episode has upset you and damaged your confidence.

[taurean]

For my 'false memory' x

Hi Saz.

This is another example of your OCD scanning for something (to connect with your fear) then making an unwanted mental (neural) connection to your false memory.

Remember, I get these negative OCD connections too, but by seeing what its doing and not playing along and believing in that connection, I am now much better.

So that is what to do - worth noting that down.

All the best xxx

Paul keep the faith you have been wrongly treated through others' ignorance .

Roy

Edited July 30, 2015 by taurean

[Ashley]

Hi Paul,

Caramoole asked me to take a look at this thread for you. The situation you describe is sadly not unusual, and is actually why we spent thousands of pounds last year to setup a professionals OCD conference to highlight this very issue. Very few IAPT workers bothered attending, but we are going to keep trying to work on training health professionals ourselves (should not be our job, be so be it). We are actually hopefully doing something positive to highlight it with a film crew in the very near future (fingers crossed) (so if anyone had issues like this and would be willing to share their story on camera (we will blank people out to protect their identity please let me know).

But back to your situation Paul, obviously I can not guarantee being able to make this all go away overnight, but the offer is there should you wish me to help simply email me ashley@ocduk.org or PM me on here and I will give you my number and you are welcome to call me. I will do all I can to resolve this situation sooner, rather than later for you.

Out of interest you are listed as South Yorkshire on the forum, do you mind if I ask exactly where, and the name of the IAPT provider that you first saw where the lady didn't seem to understand?

Wishing you well,

Ashley

[Ashley]

What is important is others reading this are not alarmed by Paul's story, whilst it is not uncommon, it is not common either, many health professionals do recognise this to be OCD. For those due to go to a therapist we put together this special GP/Therapist 'Ice breaker' to try and help people in this situation - http://www.ocduk.org/sites/default/files/OCDIceBreaker-Harm.pdf

[Caramoole]

Firstly, why have they broken confidentiality to inform this 'safeguarding' team

Confidentiality can (and should) be broken where there is considered a real risk. The problem lies in the person carrying out the risk assessment, and this can't be carried out effectively where the assessor doesn't have the full knowledge of the disorder and mistakes a very common obsession/fear with a real risk.

instead they wheel out newly 'qualified' graduates who have six months training

In fairness, they haven't only had six months training, they've done a three year degree course BUT they are not trained in OCD as a disorder, except for the most basic knowledge. The same is true of Psychiatric Nurses. One of our former Admins was a very skilled, professional and extremely knowledgeable Psychiatric Nurse and I remember discussing how much training they had had specifically on OCD, it was none.......and yet CPN's seem to be given the front line role often, even with quite a lot of control over decision making.

I'm not suggesting that practitioners or Nurses don't have a vital and important role in treatment but I feel that it's very much a case of using them for the numbers game, to be seen to be doing something because there aren't enough Psychologists available.

I self referred through IAPT a couple of years back, the young woman was very nice and very good...or would have been to someone suffering from anxiety alone or panic....but when it came to OCD her knowledge was scant, very basic and I probably knew 10,000% more than she did. For me it was a futile process and most of our meetings ended up discussing OCD and how it can affect people.....I also discussed at length with her the very process (and it's failings) of their risk assessment/reporting process and how it was failing people because of their misunderstanding of the disorder, just as has happened to Paul. I do feel she may have actually learned something and hopefully it prompted her to investigate and expand her own awareness.

The thing with these service providers is that they offer help on about three levels. The initial assessment is often telephone based and takes the form of a questionnaire but then most are referred for the first, basic level of help with a well-being practitioner....rather than the third level which can be with a Psychologist and I don't feel that generally the practitioners have sufficient knowledge to help as effectively as one would expect.

[Steven_in_the_clouds]

Personally it seems very odd to me that CPNs and IAPT workers are not specifically trained in OCD when it is one of the most common mental illnesses. Especially if it is their responsibility to triage and refer people. The relevant information could be explained in a day. Could the charity have any influence on their training syllabus?

People with OCD are by their nature anxious, so I have no doubt that this thread will scare people off getting help. Perhaps they are right -- no one wants to be labelled as something they are not. Equally, such things occurring create a lot of stigma for sufferers as they are being conflated with the worst thing possible.

It also makes recovery harder. I have come on leaps and bounds since initial diagnosis about ten years ago. I'm generally in good shape and OCD does not play a major part in my life most of the time. However, stories like this make me angry and set me back (temporarily). Among other fears over the years, I used to have similar fears as Paul. They no longer affect me but they did and occurrences like this make me feel shameful that I did, when I shouldn't because I was just suffering from a common illness. What if I am mistaken for something bad because of past fears?

I should say that I've been in IAPT myself in the past and because I live in South London (near CADAT) received an excellent service where I was seen by a high intensity worker straight away who did understand OCD and was a clinical psychologist. But it seems that many areas are far worse. Also, I already had OCD diagnosed so I knew what to ask for. I don't know what I would have done ten years ago if I'd been greeted with Paul's reception when I first presented. I was already in crisis at that point and it might have tipped me over the edge!

[gingerbreadgirl]

I had a poor experience with Iapt, too.

[Steven_in_the_clouds]

Also -- looking at their website, a "psychological wellbeing practitioner" only needs 45 days training and does not need a psychology degree. I don't think it is three years. See page 9: http://www.iapt.nhs.uk/silo/files/psychological-wellbeing-practitioners--best-practice-guide.pdf

However, irrespective of their ability to treat people, they should at least be able to recognise common mental health conditions before as Polar Bear says "pressing the panic button". Then they can get someone with the correct knowledge to take it forward.

[gingerbreadgirl]

I would just say that pwp posts in iapt are fantastically competitive and require a great deal of relevant experience and training to get, in practice even if not in theory (I know this because I applied once) - I don't think it's fair to brandish them as unqualified and I do think they provide a useful service, but in this case clearly the process was absolutely dire and Paul has been put through an awful experience for no reason, it is completely unacceptable.

[Caramoole]

Sorry Steve re the training.......my IAPT states that all their PWP are graduates but in truth that means they have to be a graduate to undergo training. Only 45 days training is even worse

[Caramoole]

I don't think it's fair to brandish them as unqualified and I do think they provide a useful service

Yes, they do....particularly in respect of anxiety, panic disorder, mild/moderate depression etc. Indeed if all people presenting with these things for the first time were seen promptly and offered support in this way, many could avert a lifetime of suffering because it becomes entrenched.

BUT if they have the responsibility to assess and make these judgements it has to come from a solid and thorough understanding of the condition. In the experience I had this was not the case, the young woman simply did not have that level of understanding. That to me is dangerous and unacceptable

[Ashley]

Personally it seems very odd to me that CPNs and IAPT workers are not specifically trained in OCD when it is one of the most common mental illnesses.

They are (or should be) but the problem is that initial training is just 1 or sometimes 2 days on OCD. Here in Kent some IAPT workers came to us to give them a bit more support and training because they only got 1.5 days, the problem is not all IAPT workers are conscientious as those in Kent. In other areas, like Liverpool our own Catherine as put on OCD training days each year through her employers MerseyCare. In Nottingham Nottinghamshire healthcare have done a lot too. So not everywhere is bad, but there are huge issues nationally that we can not ignore.

In this case, and all the similar cases the local services have ignored the NICE guidelines for OCD, which state health professionals should:

“Consult mental health professional with specific expertise in OCD if uncertain about risks associated with intrusive sexual, aggressive or death-related thoughts. (These themes are common in OCD and are often misinterpreted as indicating risk.)”

In some respects it is not the IAPT worker themselves that is at fault, it is their supervision that is at fault too.

Rest assured all, I have spoken at length to Catherine again today and we will invest time and money to ensure Paul's story becomes an infrequent and rare story.

[gingerbreadgirl]

Yes, they do....particularly in respect of anxiety, panic disorder, mild/moderate depression etc. Indeed if all people presenting with these things for the first time were seen promptly and offered support in this way, many could avert a lifetime of suffering because it becomes entrenched.

BUT if they have the responsibility to assess and make these judgements it has to come from a solid and thorough understanding of the condition. In the experience I had this was not the cause, the young woman simply did not have that level of understanding. That to me is dangerous and unacceptable

I agree, my experience was pretty useless as well.

[Ashley]

I often clash with health professionals about my views of IAPT. In theory it was a fantastic idea, but in practice it became quantity over quality to decrease waiting times. My personal view is it was messed up from day one when the initial IAPT contracts were put out to tender to any provider, I am not sure who decided that (Labour government at the time), it if was the DoH, NHS England or the government themselves. Cheap tenders meant services run with minimum of therapist's (patients getting just 6 sessions of CBT in some cases then discharged). I also think having primary care and secondary care services run by different providers is unhelpful too, which is the case in many parts of the country, although in Liverpool MerseyCare just won the IAPT contract from the previous commercial provider, so in my opinion that is good news.

[Steven_in_the_clouds]

Yes - in Lambeth and Lewisham, the nhs run IAPT and it seems fairly seamless with the secondary care services. In fact the IAPT was so good that I had no need of secondary care. It would be good if they could export that model elsewhere. (I am aware that this is exceptional). If they did it well nationally, it would pay for itself. I am able to work and live a full life. And I pay lots of taxes and have a relatively senior managerial job. If ten years ago, I had been greeted with this rubbish, then my career may never have got started and would cost the state and I would be spending my whole time worrying. Anyway getting off topic and I hope Paul's situation is resolved asap.

[Caramoole]

Anyway getting off topic and I hope Paul's situation is resolved asap.

And so say all of us. I'm sure it will be resolved, it's just so sad that someone has to experience this sort of angst at all.

[Legend]

I'm very very saddened , especially after what I went through 10 odd years ago, I thought things like this would cease to happen

I think if a person/therapist\cpn is unsure they shouldn't automatically makes knee jerk assumption of the sufferer ,they should automatically seek a second opinion !!

This practice has to stop before someone takes there life

[LizzyHoy]

Like the others I'm sorry and angered that you have had this experience. Even a moderate amount of knowledge should be enough to recognise this as OCD - as is apparent from the reactions on the forum, no one is phased when someone mentions those types of thoughts, because we know it's a common form of OCD.

Regarding IAPT - having a Psychology degree doesn't actually teach you much about mental health. I have a degree in Psychology and a Masters degree in Cognitive Neuroscience, and I think I was only taught one module on mental health altogether. Most of what I know about mental health is through my own experience and research. From a personal perspective I think I just missed the introduction of IAPT, I finished my only truly successful course of CBT around the start of 2013, when the services were becoming too stretched to offer in depth support to people with severe anxiety conditions (I believe I got in just in time, before they had to start turning people with anxiety/depression away).

[Guest Paul92]

Thank you for all the posts and your messages. I've only just got home from work, and I just feel shattered, and fed up.

I need to have a real think what I am going to do next.

In honesty, I wish I could just drop the whole thing and get back to my life. I can live comfortably enough. I just want that back. I have genuinely no desire to continue with the NHS, or indeed any sort of program at the moment. It's only when you are in this position that you realise how well you was actually doing on your own.

I can't ring the guy I saw up though and tell him I don't want to continue. He told me the other day that if I hadn't attended the appointment then he would have had to have gone further with the safeguarding team. As I said, we seemed to leave the appointment on good terms, but how can I trust them? How do I know what is happening now?

I'm scared about challenging them too. Because they could twist anything I said in order not to look stupid. It's in black and white afterall that I told him that I get feelings of attraction that feel so real, they could use that to any length.

Ashley, thank you for your email, I will reply as soon as I can. It's been a hectic few days, and I need to gather my thoughts.

Thanks again

[Caramoole]

Because they could twist anything I said in order not to look stupid. It's in black and white afterall that I told him that I get feelings of attraction that feel so real, they could use that to any length.

Paul, OCD thoughts and feelings DO feel real. Any therapist worth their salt should know that. And if they're unsure there are National Guidelines which they have breached and failed to utilise.

Work with Ashley on this and it will all be sorted out in the end.

[Guest Otloz]

This sounds like a terrible situation and reminds me of a time I was very falsely misdiagnosed by a therapist specialized in sexuality. I had another therapist at the time, but my obsessing lead me to question his expertise. Anyway, the problem was resolved by getting help from a very understanding and professional psychiatrist.

I could be branded a pedophile or something terrible by ignorant people, if they had a look at my internet history, but this is just a typical paranoia response. I've learnt to just trust the expertise of qualified psychiatrists or real therapists.

This situation will get resolved. You've been mistreated!

Edited July 31, 2015 by Otloz

[Guest jemima74]

Okay, after reading what you have gone through Paul92, I am becoming increasingly worried that this kind of treatment will happen to me. I have very similar intrusive thoughts which are always sexual abuse based and am currently waiting to see a psychologist through IAPT. I'm hoping and praying that when I finally get to see them and explain my problems that they won't automatically assume that I pose a risk like they did with you. Especially seeing as I was abused myself as a child and it seems common thinking amongst those supposedly in the know about sex offenders, that if someone was abused themselves then that automatically makes them prime molester material. This mindset makes me so mad, it's outdated and doesn't take into account the many millions of people who have suffered horrific childhood abuse and turned out okay.

I really hope I get someone who is knowledgeable about OCD and especially this kind. I wish you all the best Paul92 and hope that you can get this sorted.