My experience of the NHS has been awful ...poor psychiatrists, no continuity of care

[frankie]

One good psychiatrist who actually listened , he's moved on now , was replaced by an awful doctor , awaiting another one now as she's been moved on too....no continuity of care and little chance of seeing someone new has been my experience

[Guest OCD_Est.1982]

Unfortunately frankie it seems to be like that across the board in the NHS, but particularly in the mental health department.

I was lucky in the fact that we have a separate hospital here specialising in mental health. Over the years I went through several doctors, some better than others, but eventually ended up being looked after by a really good psychiatrist. He applied to a board to get permission to prescribe me on the high levels of medication I take and put me in contact with an excellent psychiatric nurse who visited me each week. I also had an excellent GP who had looked after me all my life and was extremely understanding.

Then just as I was recovering everything suddenly changed. It was about the time when the government were pushing through the spending cuts. The hospital discharged me as an outpatient and handed my ongoing care over to my GP, as I was much better, which at the time I was fine with.

But a few months later my doctors surgery was sold to a private company, who only employed Locum doctors. My GP left along with all the original doctors and now you are lucky to see the same GP twice. Apparently it doesn't matter when everything is recorded on the system. But every appointment now starts with me explaining how my OCD affects me and each appointment slot is only 8 minutes.

So I'm now going it alone. I get a repeat prescription every month and haven't seen a doctor in 18 months. It's unbelievable how things have deteriorated. A family member of mine was referred to the same hospital only recently. You don't actually see a doctor anymore - they ring you at a set time! They were prescribed some medication and a follow up telephone call was arranged. I was disgusted.

Care in the community was obviously costing too much and was near the top of the list of cuts to be made.

[frankie]

That's disgusting

This government does not care

[Ashley]

Unfortunately frankie it seems to be like that across the board in the NHS, but particularly in the mental health department.

This government does not care

Very sweeping statements, and not ones I would suggest are wholly accurate. Of course there are problems, some NHS services are failing, some government depts are not helping but both the NHS and Labour/Tories/Lib Dems have some fantastic amazing people trying to do their best.

By the sounds of it neither of you have gone down the right avenues, which is where the charity tries to help by making people are of what treatments they need, and the services available.

In terms of OCD treatment I am not sure the approach you describe is one that I would suggest was the right approach to tackle OCD long term (obviously if there are non-OCD issues going on then my comment is redundant).

Seeing a GP or in most cases a CPN is not likely to result in long-term treatment for OCD, because in most cases most GP's and CPNs are not trained to provide CBT for moderate to severe OCD or will be OCD specialists.

The fact is, we can blame the NHS and governments all day long, but at the end of the day we have to become our own therapists that practice therapy on a daily basis, hourly basis initially. Not to get to that point we need help from a CBT therapists to prepare us to be able to work alone and ensure we have the right knowledge and skills to be our own therapists. Some local services can offer that (if you get the right therapist) but more often than not we do need to access a CBT and OCD specialist via the NHS national clinics. Of course there are problems here too in getting the local NHS to agree funding to the national clinics, but not insurmountable problems.

So my advice to both of you is present to your GPs this week, tell them your OCD is still a problem and you would like to be referred to one of the specialist national clinics. There are no guarantees it will work of course, but like they say with the lottery you have to be in it, to win it.

[Guest OCD_Est.1982]

Very sweeping statements, and not ones I would suggest are wholly accurate. Of course there are problems, some NHS services are failing, some government depts are not helping but both the NHS and Labour/Tories/Lib Dems have some fantastic amazing people trying to do their best. By the sounds of it neither of you have gone down the right avenues, which is where the charity tries to help by making people are of what treatments they need, and the services available. In terms of OCD treatment I am not sure the approach you describe is one that I would suggest was the right approach to tackle OCD long term (obviously if there are non-OCD issues going on then my comment is redundant). Seeing a GP or in most cases a CPN is not likely to result in long-term treatment for OCD, because in most cases most GP's and CPNs are not trained to provide CBT for moderate to severe OCD or will be OCD specialists. The fact is, we can blame the NHS and governments all day long, but at the end of the day we have to become our own therapists that practice therapy on a daily basis, hourly basis initially. Not to get to that point we need help from a CBT therapists to prepare us to be able to work alone and ensure we have the right knowledge and skills to be our own therapists. Some local services can offer that (if you get the right therapist) but more often than not we do need to access a CBT and OCD specialist via the NHS national clinics. Of course there are problems here too in getting the local NHS to agree funding to the national clinics, but not insurmountable problems. So my advice to both of you is present to your GPs this week, tell them your OCD is still a problem and you would like to be referred to one of the specialist national clinics. There are no guarantees it will work of course, but like they say with the lottery you have to be in it, to win it.

I disagree. Your argument is too generalised. At a local level it will depend on where you live that will determine the quality of treatment you receive. Every Health Authority differs in its approach to mental health, some are good and some are bad.

Obviously I can only base my opinion on the one that looks after me and after being in the system for 20 years I can definately say that mental health care and availability has seriously deteriorated.

I've even raised this with my conservative MP, but it has fallen on deaf ears. They have also been lead to believe that CBT is a magic cure to every type of mental illness, but it's not. I've seen three different psychologists over the years providing hours of CBT and have learned every coping strategy there is, but it will never erase the OCD completely and therefore using these strategies I battle with my OCD every day.

A course of chemotherapy may cure cancer, but a course of CBT will not cure everyone's OCD. The government needs to wake up to this and that CBT is not going to be a magic pill to solve the welfare budget.

I do agree that CBT is definately needed in the treatment for OCD, but I think the results it can provide get over inflated and raise vulnerable people's expectations that it will be the answer to their prayers. Like I said I've had 3 courses of CBT because I've relapsed twice. Most of my friends at the self help group I attend have had similar experiences.

If you hype up the NHS and CBT to unrealistic expectations, then people who have never had a course could be disappointed by thinking it will rid them of OCD and could end up feeling worse for it. By all means have goals to strive for, but all the doctors that I've seen have reiterated the importance of having realistic expectations.

[Ashley]

Your argument is too generalised. At a local level it will depend on where you live that will determine the quality of treatment you receive.

I've seen three different psychologists over the years providing hours of CBT and have learned every coping strategy there is, but it will never erase the OCD completely and therefore using these strategies I battle with my OCD every day.

Absolutely, and that is why I referenced the national specialist clinics, but even then a new fresh approach to treatment you experienced in the past may work next time.

We published a story of a man in his 80s who had multiple visits to the Maudsley over 60 years of suffering with OCD. The last time he went he saw a new therapist, and they had about 6-monrhs of therapy and he is now pretty much OCD free after 60-years.

a course of CBT will not cure everyone's OCD. The government needs to wake up to this and that CBT is not going to be a magic pill to solve the welfare budget.

I do agree that CBT is definately needed in the treatment for OCD, but I think the results it can provide get over inflated and raise vulnerable people's expectations that it will be the answer to their prayers

I accept that, I believe the quantity (IAPT) over quality is a huge issue, and one we are trying to highlight. But, right now CBT is the best treatment we have for OCD. Just because it did not work in the past, does not mean it can't work in the future. As sufferers, we have to keep trying.

[Guest OCD_Est.1982]

Absolutely, and that is why I referenced the national specialist clinics, but even then a new fresh approach to treatment you experienced in the past may work next time.We published a story of a man in his 80s who had multiple visits to the Maudsley over 60 years of suffering with OCD. The last time he went he saw a new therapist, and they had about 6-monrhs of therapy and he is now pretty much OCD free after 60-years.I accept that, I believe the quantity (IAPT) over quality is a huge issue, and one we are trying to highlight. But, right now CBT is the best treatment we have for OCD. Just because it did not work in the past, does not mean it can't work in the future. As sufferers, we have to keep trying.

Ive been a patient at the Maudsley in London, but the cost of train fares and the stress of the journey there each week made the therapy unsustainable. My case was put before a board to approve my referral. I doubt they will consider me again and I was told you were limited on how many CBT courses the NHS will offer you. My last one was less than 2 years ago, so I doubt I'd be eligible for another any time soon.

[Ashley]

Ive been a patient at the Maudsley in London, but the cost of train fares and the stress of the journey there each week made the therapy unsustainable. My case was put before a board to approve my referral. I doubt they will consider me again and I was told you were limited on how many CBT courses the NHS will offer you. My last one was less than 2 years ago, so I doubt I'd be eligible for another any time soon.

Where in the UK are you? There is also a specialist clinic in Bristol now led by Professor Salkovskis add his team. If you wish to access a national clinic I would be happy to try and help you access it, it's something I do for other patients. I usually get them there, it just depends how long it takes.

[Guest OCD_Est.1982]

Bristol is over two hours away by car, but unfortunately I'm unable to drive.

[snowbear]

I've seen three different psychologists over the years providing hours of CBT and have learned every coping strategy there is, but it will never erase the OCD completely and therefore using these strategies I battle with my OCD every day.

I think the results it can provide get over inflated and raise vulnerable people's expectations that it will be the answer to their prayers.

There's a difference between learning coping strategies to use in the short term management of OCD and changing your thinking so OCD doesn't manifest any more. Changing your thinking is key, but only begins when the person is ready to hear the advice. Then it takes time to apply it and persistence of application to achieve long term results.

This process of learning new ways to think means improvements and relapses are par for the course - who said they weren't? I'm pretty certain none of your therapists ever suggested you'd never have symptoms again after a course of CBT.

I think it's fair to say that people's expectations of OCD treatment are often unrealistic without blaming that on the hyping up of CBT. They expect a magic bullet that stops unwanted and intrusive thoughts from occurring like a painkiller takes away a headache.

Being faced with the reality of therapy is a challenge too far for some people. It's hard work; learning to deal with intrusive thoughts in more healthy and adaptive ways, learning to live with uncertainty, coping with relapses, trying to change the faulty thought processes which underpin the OCD. How long it takes to change thinking patterns varies with the individual.

People are disappointed to find CBT is designed to equip them to manage themselves and it's up to them to apply the techniques. It's a surprise to many to discover therapists don't treat your OCD, they teach you how to treat yourself.

The system isn't perfect and it does fail at times, but I think a lot of people blame therapists, the system, or the CBT itself for failing them when they have struggled to apply the CBT techniques and don't see results.

It can take several courses of CBT for what you're being told to all 'sink in'. That's nobody's fault - not the person with OCD, not the therapist, not the therapy, not the health care system. It's just how it is because we're human. It takes time to learn new things and it can take even longer to learn new ways of thinking.

If you can't access a specialist clinic just keep plugging away with local CBT courses. Treat each one as a new start, ears open, see what new things you learn. For most people there comes a point where they are able to apply the CBT techniques successfully and then they look back and wonder why something so simple didn't work first time around! Unfortunately, nobody knows the answer to that.