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Ashley

BBC1 - Nadiya: Anxiety and Me

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This is not about OCD, but anxiety related, this preview clip talks about the impact bullying at school had on Nadiya Hussain and her anxiety and panic attacks. This is quite emotional watching this short clip from tonight's programme. Such a brave thing to talk about so publicly. BBC1 tonight from 9pm

It also features our very own Paul Salkovskis.

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I saw her on Loose Women at lunchtime and noticed that it was Paul talking to her.  Worth watching as there are many overlaps between anxiety disorders and I'm sure people could take a lot away from it

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Just watched it! Amazing that her Milton Keynes GP knew about Warneford & was prepared to refer her there immediately. How on earth could her CCG have agreed funding so quickly? Also amazing that she got to see a psychiatrist so easily. 

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It was quite interesting and also highlighting to viewers just how debilitating minor things can be to someone with anxiety disorders.  She talked a little about OCD tendencies which I picked up on (although OCD was not mentioned, I don't think it was OCD).

Her face when Paul through the train trip on her, 'really?' she repeated, you could see the utter shock and horror in her face and the anxiety rising each time she asked 'really?'!  Sweet watching that but also I felt for her at the same time.

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I have mixed feelings. I like Nadiya, I thought she was really honest and brave :) I thought what therapy they showed was good and I thought the things she did were excellent. It also showed how hard it is and how long it takes to recover.

What I didn't like was the fact that Nadiya got the best therapy in the country, yet that was not explained. Therapy for an average sufferer does not look like that at all. I also wish the serotonin claptrap would go where the sun doesn't shine and not feature at all. Talk about medication fine, but leave out the backward theory.

I also think it fell into the similar trap that often happens where mental health problems are 'caused' by an obvious event. Of course this is true for some, but not all, and i think this can make it hard for people who feel they have had no adversity in life. I also feel like the programs at that high school were good but when i was young i definitely wouldn't have spoken up. I needed general psycho-education not one on one. And I wasn't keen on Paul saying anxiety makes you sharp. Yeah, makes you sharp at stuff that stresses you out!

 

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22 hours ago, Gemma7 said:

I have mixed feelings. I like Nadiya, I thought she was really honest and brave :) I thought what therapy they showed was good and I thought the things she did were excellent. It also showed how hard it is and how long it takes to recover.

What I didn't like was the fact that Nadiya got the best therapy in the country, yet that was not explained. Therapy for an average sufferer does not look like that at all. I also wish the serotonin claptrap would go where the sun doesn't shine and not feature at all. Talk about medication fine, but leave out the backward theory.

I also think it fell into the similar trap that often happens where mental health problems are 'caused' by an obvious event. Of course this is true for some, but not all, and i think this can make it hard for people who feel they have had no adversity in life. I also feel like the programs at that high school were good but when i was young i definitely wouldn't have spoken up. I needed general psycho-education not one on one. And I wasn't keen on Paul saying anxiety makes you sharp. Yeah, makes you sharp at stuff that stresses you out!

 

Knowing a bit about the structure of NHS services, and who Paul is, did make me feel keenly aware that the show has been produced with a narrative hook/storytelling element. It does seem rare for someone who, in the course of the narrative, hasn't been involved with services before, should be referred to a specialist centre rather than local IAPT -- although if you're savvy, do your research, and exercise patient choice it's possible. I imagine the team making the show with Nadiya would have helped research the best options. Perhaps the BBC Action Line explains more details about how to access treatment.

It would have been better for me if they'd said who Paul was, and he was consulting for the show to explain how CBT and the diagnostic process works. It felt... intrusive seeing Nadiya in therapy, although I'm also glad they communicated the rawness and how it can be hard work. I'm glad the clips were brief, and I really hope she's continued with therapy and reduced her suffering. 

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I haven’t watched the documentary yet, but I watched some short clips posted on Youtube. I'm not sure what her diagnosis is, but I could definitely relate to my situation. Over the past 15 years, my life has been greatly impacted by panic disorder/agoraphobia. It is often debilitating for me.

I really like the approach of Dr. Salkovskis. I’m sure it’s because of his background with OCD, but he really focused on her safety behaviors in the clip that I watched (as well as the House of Agoraphobics documentary several years ago).  Compulsions are always discussed in relation to OCD, but it's actually somewhat rare to hear safety behaviors mentioned when it comes to panic disorder and agoraphobia.

Most agoraphobics that I’ve talked with do numerous safety behaviors, which are basically the equivalent of compulsion in OCD. They are done in an attempt to prevent or monitor for the next panic attack or to make sure that there is a way to escape if the next panic attack happens. Checking pulse is a common one, but I actually have a few more elaborate safety behaviors as well. I’ve never understood why stopping these behaviors didn't play a bigger role for therapy for panic disorder/agoraphobia. I know this is an OCD forum, but I wanted to know if  anyone had an opinion on this?

Edited by mw321

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I watched this yesterday. It was very brave of Nadiya to open up about her anxiety on national TV. It sounds like she really went through it during her childhood. Bullying is really such a shocking and disgusting behaviour. 

I think there were OCD tendencies such as the magical thinking around saying her family names before going to sleep as a child however I am sure if OCD was also at play then it would have been mentioned by Prof Salkovskis. 

I agree it maybe was a tad misleading in the type of therapy Nadiya received i.e getting to be seen by someone of Prof Salkovskis standing, I know some people have waited an awful long time - over a year on some occasions to access therapy and its generally someone in your local IAPT provider.. If the programme could have explained that waiting times do vary an awful lot depending on where you live. - Very much a postcode lottery. 

I think any programme - well produced and thoughtfully done about mental illness can only be a good thing, people such as Nadiya do have a platform that many of us don't to raise awareness. 

I also watched the David Harewood documentary, this was again very brave of him talking about his psychosis in his younger days. A well produced programme and again hats off to David for his openness and honesty.

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9 hours ago, Avo said:

I also watched the David Harewood documentary, this was again very brave of him talking about his psychosis in his younger days. A well produced programme and again hats off to David for his openness and honesty.

I just watched this. Having had psychosis I found this a bit of a tear jerker.

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On 20/05/2019 at 14:48, Avo said:

I agree it maybe was a tad misleading in the type of therapy Nadiya received i.e getting to be seen by someone of Prof Salkovskis standing, I know some people have waited an awful long time - over a year on some occasions to access therapy and its generally someone in your local IAPT provider.. If the programme could have explained that waiting times do vary an awful lot depending on where you live. - Very much a postcode lottery. 

I think any programme - well produced and thoughtfully done about mental illness can only be a good thing, people such as Nadiya do have a platform that many of us don't to raise awareness. 

I think that last part is crucial in recognising how Nadiya could have got treatment so promptly. The NHS and the BBC/show producers may have valued its awareness-raising potential, demonstrating good CBT. The specialist centre in Oxford has only recently opened its doors for referrals, and it says on their website there's no waiting times at the moment apart from administrative ones. So theoretically, at this point, anyone could be referred and seen relatively promptly. I don't know if you could request it through patient choice from your GP, and I imagine getting your Clinical Commissioning Group to agree to fund the referral (if you haven't exhausted local resources first) could be tricky... Any ideas, @Ashley?

I only know about the above because I've been through the mill of local CBT (through my GP, then CMHT, then private, then IAPT) and so have had grounds to request a referral to another specialist centre, CADAT, through the NHS Highly Specialised Service. I've had to research it to convince my CMHT to make the referral. The charities (OCD-UK and OCD Action) have really good resources explaining the NICE guidelines and referral routes, but I can imagine if it's people's first time using services it can be bewildering to know what to do for the best. People shouldn't have to go so far afield to access appropriate treatment, or wait as long as they are.

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I have spoken to Paul about this. If I am understanding correctly, initially the BBC approached Prof Salkovskis last year, long before the new Oxford clinic was confirmed and they wanted him to work with Nadiya privately, which of course Paul doesn't do.   Paul believed in the project to raise awareness, so agreed to see Nadiya and be filmed in his own time, provided the referral went through a NHS route. I am not sure if the CCG were actually charged as the clinic didn't exist when the filming took part. Paul didn't receive anything for taking part, other than a BBC supplied sandwich for lunch one day!   

Obviously I agree they should have made it clearer during the programme that the treatment route is not usually that easy or straight forward. However, I don't think that takes away from a very moving journey that Nadiya allowed to be filmed.

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8 hours ago, Ashley said:

I have spoken to Paul about this. If I am understanding correctly, initially the BBC approached Prof Salkovskis last year, long before the new Oxford clinic was confirmed and they wanted him to work with Nadiya privately, which of course Paul doesn't do.   Paul believed in the project to raise awareness, so agreed to see Nadiya and be filmed in his own time, provided the referral went through a NHS route. I am not sure if the CCG were actually charged as the clinic didn't exist when the filming took part. Paul didn't receive anything for taking part, other than a BBC supplied sandwich for lunch one day!   

Obviously I agree they should have made it clearer during the programme that the treatment route is not usually that easy or straight forward. However, I don't think that takes away from a very moving journey that Nadiya allowed to be filmed.

I was more wondering whether you'd heard what the waiting times were like/how referrals are going for the new clinic, since it could be helpful for members! It is interesting to hear how these documentaries are created though. Paul's principles are solid and admirable, and Nadiya is just downright amazing.

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10 hours ago, Ashley said:

the referral went through a NHS route. I am not sure if the CCG were actually charged as the clinic didn't exist

Since when / how is a GP referral to a clinic which doesn't exist an NHS route?

Since when did the NHS legal framework allow for the prioritisation of the treatment of celebrities to promote "awareness"?

Edited by seekingERPnorthwest

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11 hours ago, Raffles said:

I was more wondering whether you'd heard what the waiting times were like/how referrals are going for the new clinic, since it could be helpful for members! It is interesting to hear how these documentaries are created though. Paul's principles are solid and admirable, and Nadiya is just downright amazing.

There's been quite a few CCG referrals from across the country already apparently, but waiting time is still non existent at the moment.  So funded referrals should be seen more or less within couple of weeks.  

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12 hours ago, Ashley said:

There's been quite a few CCG referrals from across the country already apparently, but waiting time is still non existent at the moment.  So funded referrals should be seen more or less within couple of weeks.  

Do you know how feasible it is to get referred through patient choice? It's not as simple as just asking when you see your GP - your local CCG still have to sign off/fund it? 

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Hi Raffles, patient choice is your legal right, provided it is for your first outpatient appointment in a new episode of care. Get your GP to state this explicitly in the referral. Your CCG has to authorise funding for assessment. If, following assessment, treatment is recommended, CCG would also have to authorise funding for that.

It is designed to be simple, but not surprisingly the opposite is the case because they will take forever, rummage through your medical notes & give you some reason why you can't go there. Which is ******** so you have to play hell with them / get your MP involved / get NHS Improvement to tell commissioners how to do their job properly.

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12 hours ago, Raffles said:

Do you know how feasible it is to get referred through patient choice? It's not as simple as just asking when you see your GP - your local CCG still have to sign off/fund it? 

 

9 hours ago, seekingERPnorthwest said:

patient choice is your legal right, provided it is for your first outpatient appointment in a new episode of care.

SEN is partly right. 

My understanding is technically (see note below) patient choice only applies to the same level of treatment level you have been referred for.  i.e. You are referred to IAPT, your right to choose can only apply to an IAPT service, you can not step yourself up to secondary care.  The same with secondary care, if I am referred to secondary care here in Derbyshire, I would implement my right to choose for the secondary care in Nottingham which I know is better.  But I can not use right to choose to step myself up from secondary care to Oxford.

But, because the CADAT / SLaM clinic have their own IAPT and secondary care teams, that's how I managed to get a patient choice referral to CADAT.  

However the Oxford clinic is a tertiary care service only, so unless you are referred by a local NHS service to a tertiary care team, you couldn't implement 'right to choose' to Oxford.  So for example a simple GP referral to Oxford wouldn't count, unless it could be shown you have exhausted all other local options and mental health staff agreed it was the next option, but at that point, the chances are the CCG would agree and fund it anyway.

NOTE: But, not all NHS bodies fully understand 'right to choose' for mental health, so I have seen some people try their luck and ask the GP to implement right to choose even though technically they are not eligible to do so and it's been approved by a local CCG.  Always worth a try :)

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9 hours ago, seekingERPnorthwest said:

Hi Raffles, patient choice is your legal right, provided it is for your first outpatient appointment in a new episode of care. Get your GP to state this explicitly in the referral. Your CCG has to authorise funding for assessment. If, following assessment, treatment is recommended, CCG would also have to authorise funding for that.

It is designed to be simple, but not surprisingly the opposite is the case because they will take forever, rummage through your medical notes & give you some reason why you can't go there. Which is ******** so you have to play hell with them / get your MP involved / get NHS Improvement to tell commissioners how to do their job properly.

It really shouldn't have to be so convoluted to receive appropriate treatment. I've seen your posts about your experience - the system needs radical improvement so these things don't happen. Hope your current CBT+ERP is helping.

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35 minutes ago, Ashley said:

My understanding is technically (see note below) patient choice only applies to the same level of treatment level you have been referred for.  So because the CADAT / SLaM clinic have their own IAPT and secondary care teams, that's how I managed to get a patient choice referral to CADAT.  

However the Oxford clinic is a tertiary care service only, so unless you are referred by a local NHS service to a tertiary care team, you couldn't implement 'right to choose' to Oxford.  So for example a simple GP referral to Oxford wouldn't count, unless it could be shown you have exhausted all other local options and mental health staff agreed it was the next option, but at that point, the chances are the CCG would agree and fund it anyway.

NOTE: But, not all NHS bodies fully understand 'right to choose' for mental health, so I have seen some people try their luck and ask the GP to implement right to choose even though technically they are not eligible to do so and it's been approved by a local CCG.  Always worth a try :)

I hadn't appreciated the Oxford clinic is tertiary. Thank you for explaining things, Ashley.

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8 hours ago, Ashley said:

unless you are referred by a local NHS service to a tertiary care team, you couldn't implement 'right to choose' to Oxford.  So for example a simple GP referral to Oxford wouldn't count, unless it could be shown you have exhausted all other local options and mental health staff agreed 

...which makes Anxiety and Me all the more misleading, as Nadiya said she was referred straight from her GP to Oxford, and hadn't previously been using local mental health services. Shame on the BBC and the Trust which allowed this seemingly fake / sham referral.

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I'm sorry that you feel misled seekingERPnorthwest. I wasn't involved in any way shape or form with the programme, I only knew about it a week before but I know Paul well, so I feel I can say that I don't believe he or Nadiya would purposely intend to mislead. I truly believe both were honestly involved with good intentions, to help explore anxiety and how people can be helped. I believe the programme did that, which can only be a positive for many people suffering in silence.

The fact is, patients can be referred to the Oxford clinic now, so that part is not misleading at all, although I accept the programme did make the route clear, but I don't believe it was a deliberate mislead or fake or sham. But I accept that is your belief and I am sorry you feel that.

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Thanks so much, Ashley. I suffered in silence until 2002. Since then I have been trying to get help for my mental health. The NICE Guidelines for OCD were written in 2005. I was diagnosed in 2007. CBT "with ERP" is recommended by NICE. It took until YESTERDAY for the NHS to help me with my first ever exposure - i.e. 17 years!!! (I need to change my user name!).

So I feel strongly that breaking the silence is not enough - we need to do so much more than this. I will get in touch with the BBC's director for factual programming. Thanks for the discussion.

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