Referring yourself to NHS mental health services (non-urgent)

[flotemysost]

Decided to look into NHS counselling/therapy earlier this week - turns out it's far more straightforward than I expected to refer yourself online (so far, and where I live, at least).

I'm booked in for a phone assessment next week - all I know is it should take around 25 minutes, and I need to complete an email questionnaire beforehand, which I haven't yet received. Has anyone else been through a similar process, and would feel comfortable sharing the sort of things to expect (in as much or little detail as you feel OK with, of course)?

I realise the referral process will probably differ depending on what services are available in your area, but ideally I just want to talk to someone one on one, which seems like it could be an available option from the website. I'm not in immediate danger of hurting myself or anyone else, no substance abuse issues etc. so I'm prepared for a long wait potentially, as understandably there are people in far more urgent need of what I'm sure are already stretched resources.

However I'm not sure how much detail I'll need to go into in the phone assessment or what type of things they'll want to know, so any experiences would be hugely appreciated.

Also need to figure out how to explain I'm taking a half hour private phone call at work without making it look like I'm doing a job interview. Although it would be an infallible excuse if that were the case, it's like the equivalent of calling in sick with the shits.

[idunnosomename]

quite frankly i couldn't get seen to until i had a nervous breakdown at work and I was taken directly to A&E where subsequently they put me on a course of CBT

of course work didn't renew my contract after this episode so I moved and haven't managed to get any mental health treatment since.

my advice - people can argue against by all means - but be as negative/extreme as possible. I mean don't flat out lie, but don't hold back on the answers. or they'll just sweep you under the rug.

[Clatty McCutcheon]

I haven't done a phone/online referral, but was referred by my GP last year with some anxiety/low mood issues.

I had a meeting at the clinic rather than a phone consultation but the initial meeting was based around a questionnaire along the lines of:
- your main difficulties/issues and how long have you had them
-what effect your difficulties have on your everyday life
- how do you think these difficulties have arisen?
-what are the things you enjoy in life?
-what are the things you have found most difficult in your life?
-what would you most like to change about yourself?
-how do you think we can help with this?

There'll probably be something along those lines, and probably a CORE 10 questionnaire, where you score questions 0-4 depending on how often you experience certain feelings (if you google CORE-10 you'll get the idea) and get an overall score.  I was only moderately bonkers in the nut, so waited 3 or 4 months for an appointment - probably this is typical, although less than ideal (but that's another thread about NHS funding).  Was worth doing though - helped me greatly.

[Twit 2]

Referred to a laqer and a wank.

[Default to the negative]

Has anyone else been through a similar process, and would feel comfortable sharing the sort of things to expect (in as much or little detail as you feel OK with, of course)?

I wish you luck with it, but be prepared for them striking callously at you. My time with the psychiatric nurse was just a case of me being scowled at, and belittled. He had no sympathy for me. His attitude was: 'Pull your socks up and behave yourself boy.'

[confettiinmyhair]

First of all, a lot of how this goes after the telephone Assessment (in terms of waiting times and treatment options available) will depend what trust you're under and how old you are. If you can afford it, then my advice would be to go private and find your Counselling/Therapy through Psychology Today or the Counselling Directory.

The poster above who advised to stress and sell the negatives is right on the money. At the referral point your case is triaged, a good detailed GP referral can help you access Therapy, little detail in a GP or self referral might see you end up with guided self-help in the form of a workshop or an online course. After the assessment your case will be discussed and a clinical decision what treatment they offer will be made. Now, this can be weighted by organisation pressures such as waitlist times. If you're in an IAPT service then you will be placed on a treatment pathway.

Also, the assessor will base their decision on NICE guidelines, so say you're struggling mostly with anxiety, chances are you won't get given any Counselling. It will almost always be Low Intensity CBT with a Psychological Wellbeing Practitioner or CBT with a Therapist. The NICE Guidelines are available online for you to read.

[a duncandisorderly]

Referred to a laqer and a wank.

a bit flip, that. this is a serious business.

anyway, solvent abuse isn't going to fix anything.

[Dr Rock]

I recently had the half hour phone assessment, was offered either CBT or counselling, chose counselling, told there was a three or four month wait. So I'll just wait then.

[bgmnts]

I'm still waiting for the referral letter from the doctors.

[Dr Rock]

I'm still waiting for the referral letter from the doctors.

You can refer yourself

https://www.nhs.uk/conditions/stress-anxiety-depression/free-therapy-or-counselling/

[Zetetic]

Not everywhere. That's an England-only website for a start. (Unhelpfully, the NHS in England have claimed "nhs.uk" as their own.) And bgmnts doesn't live in England.

[Incandenza]

https://www.bacp.co.uk/
To find a therapist more specific for what you need. - paid though.

[Zetetic]

Echoing some of the things above, it might be worth thinking about, and maybe even writing down, what has prompted you to seek help and what you hope will be different after this. (If that's not too distressing.)

Means you don't feel that you have to make sure that you remember everything important, or remember to say it, off the top of your head.

[Zetetic]

There'll probably be something along those lines, and probably a CORE 10 questionnaire,

Out of interest, were your experiences in Scotland?

[Dr Rock]

Not everywhere. That's an England-only website for a start. (Unhelpfully, the NHS in England have claimed "nhs.uk" as their own.) And bgmnts doesn't live in England.

Sorry didn't know that. Maybe it will be helpful for anyone who does live in England.

[flotemysost]

Thanks all for the advice so far, that's really helpful, and I'm very sorry to hear about the negative experiences some of you have had.

Clatty McCutcheon, that's along the lines of what I expected - I've already made a mental note of the main points I want to stress and the ways it's affecting my life, but I'll make sure I get across the most negative/destructive things.

confettiinmyhair, thanks for the detail on the triage process - as I haven't gone via my GP I'll make sure I go into as much detail as possible.

I have thought about looking into finding a BACP accredited therapist - someone I work with (who also lives near me) is currently seeing someone who she highly recommends, but she (the therapist) ain't cheap, and I don't know soon I'd be able to find a slot, although I'm very lucky in that my workplace is pretty open to flexible working (so leaving early on one day of the week if I make up the hours elsewhere could be an option, for example). I could maybe afford it once I get a bit more organised with my finances and cut back massively on unnecessary stuff... it seems ridiculous as something like this should be a priority really.

If in doubt I shall pass on the laqer and wank referral.

[a duncandisorderly]

I have thought about looking into finding a BACP accredited therapist

this is exactly the area of therapy my other half is studying to get into (OU course, though obviously that's only the theory component) just as soon as she can escapes the evil empire she currently works for. she also does tarot readings as an online service, though she stresses that these are a form of therapy, using the cards to trigger openings in the dialogue rather than for clairvoyance or anything like that.

hope you find someone sympathetic.

[Zetetic]

I've already made a mental note

Just to reiterate - consider making this an actual note to refer back to.

[Blue Jam]

CaB Mental Illness Thread #756787555, yaaaaay

I have recurring bouts of depression and every few years I get on the ol' Prozac and that sorts me right out. Except this time it hasn't... After being on it for six months this time I have finally experienced the dreaded "Prozac poop-out" and it's now doing fuck-all for me. I'm absolutely gutted as it was the nice, clean, side-effect-free drug that always worked for me and I was a lucky bugger to have that lifeline and now I haven't got it anymore. Arses...

Been told by my GP to wean myself off Prozac over two weeks before starting on Venlafaxine. Stopped the Prozac altogether as it was doing fuck-all anyway, maybe that's a bad idea and I know that as a neuroscience nerd I'm a bad patient but fuck it, I feel fine and I want to get it out of my system and try the Venlafaxine ASAP. Bricking it a bit about starting the Venlafaxine but I'm told it may be good for my anxiety so I'll give it a go. I don't have any particular anxiety disorder, I've just always been a very stressy Type A kind of person and I'm fucking sick of it to be honest.

Anyway, I have also been referred to Beating The Blues, the NHS's online CBT course. I have never found talking therapy that useful because for me it just seems to consist of dredging up old memories and I find that just makes me cry rather than solving anything, so I'll give it a go. I have always been prone to repetitive negative thought patterns and I'm sick of that too and would like to sort it out. Will report back.

In the meantime, has anyone been on Venlafaxine before? It sounds a bit more hardcore than Prozac and I'm a bit scared. Any advice would be greatly appreciated, cheers.

[Clatty McCutcheon]

Out of interest, were your experiences in Scotland?

Yes, under one of the larger regional NHS health boards in Scotland.

[Zetetic]

I asked because the CORE-OM tools aren't so common elsewhere. For example IAPT services in England will tend to use the GAD-7 and PHQ9 (amongst others) to screen for anxiety and depression, and measure change.

(I've been pushing CORE-OM for years here, not in Eng or Scot, because they're better tools for measuring change while being properly Free. Getting psychologists etc to give up their favourites tools is not easy though, if you don't have a government pushing it, particularly if they've spent huge amounts of cash over the years on Beck Inventories and the like.)

[Zetetic]

I have never found talking therapy that useful because for me it just seems to consist of dredging up old memories and I find that just makes me cry rather than solving anything, so I'll give it a go.

Interesting how these things go - England's IAPT services have frequently had a kicking for being too CBT and skills-focused and not prepared to engage with people's experiences of trauma.

(I have to admit that my inclination is to the view that actually rehearsing trauma should generally be expected to be damaging than helpful... But of course this is all probably terribly variable from person-to-person.)

[Clatty McCutcheon]

To be honest, I completed the CORE-10 questionnaire as part of the initial assessment (which I got pretty quickly) but it wasn't referred to in the course of the actual sessions.  The psychologist I saw wrote up a formulation based on the information I gave in the first 2 or 3 sessions, and proceeded from there.

(for the uninitiated, see https://en.wikipedia.org/wiki/Clinical_formulation )

[Zetetic]

I think they're more useful in aggregate (understand services' demand, if services are helping men as much as women, etc.) than for informing an individual's care, which probably a fundamental problem with any reductive categorisation or measurement. (Hence formulation, I guess...)

[flotemysost]

CaB Mental Illness Thread #756787555, yaaaaay

Ha, I know, I'm sorry to add to the litany of woes - I did try to do a search on here before starting this thread but it doesn't work for me for some reason. Obviously I've looked at the NHS website, BACP, Mind etc. but any discussion of similar topics I've seen on here before have always seemed practical, sensitive, frank and good humoured so I really appreciate everyone's comments.

Sorry to hear about your experiences anyway Blue Jam, I hope things work out for you.

[Noonling]

In the meantime, has anyone been on Venlafaxine before? It sounds a bit more hardcore than Prozac and I'm a bit scared. Any advice would be greatly appreciated, cheers.

You are me. Was on and off fluoextine for years, then seemed to stop working.  Been on venlafaxine for about 9 months.

Can only speak for myself, but I also found no side effects for prozac, venlafaxine is another matter... Started with night sweats, those have gone away but it's given me general anxiety (usually not remotely anxious), restlessness, possibly nausea  (not sure if that's caused by something else as it's only started in the last two months), and on the normal 75mg my resting heartrate went up to 95+. One day it was 101 when I had just been sitting up in bed doing pretty much nothing all day. Gone down to 37.5mg for the moment, but I might try going back to Prozac. Ive also heard its one of he worst for if you miss a dose, though i havent experienced that. It has helped with low mood, though it hasn't helped with mental imagery like Prozac did. I certainly notice the effect of it on my energy levels more, but it's often a kinda restless, frustrating energy. It's annoying being at this crossroads, not knowing what to do with medication and being nervous to switch things up in case my functionality goes down and I struggle with my new-ish job.

So...good luck! I honestly can't imagine it helping someone with anxiety, though I guess everyone responds to things differently.

[imitationleather]

Missing a dose on Vnlafaxine is fucking horrendous. I missed two doses recently and I was out for the count. Could barely stand up.

The side effects were bad when I started taking it, and would come back when I increased my dose, but eventually they settled down and all round I feel mentally better than I can really ever remember being. So it has worked for me.

The first couple of months are rough, though. There's no getting away from that.

[Cuellar]

Currently banging shit loads of venlafaxine - remember getting quite sweaty (I think, it's been a while since I started), feeling a bit jittery. A little bit like being hungover having not eaten enough and probably still being a bit pissed. It settled down relatively quickly though. I soon got it paired with mirtazipine at night and THAT fucked me hard for a day or two. Could barely keep my eyes open at work, hungry all the time, barely conscious. That went after a day or two too, but I had big intense dreams for a few weeks and again sweaty nights.

I started on venlafaxine tablets which tasted foul, really bitter, but now on capsules which are much better.

[imitationleather]

I started on venlafaxine tablets which tasted foul, really bitter

Quite. Swallowing them without enough water and getting a bit caught in your throat is a taste sensation alright.

[Pancake]

I went though this, ended up doing a bit of talking therapy which was useless but she sent me some PDFs of studies which were much more helpful so I knocked it on the head and never looked back, literally just the studies that she probably read herself to get her diploma or something. I had irrational fears so was calmed by the voice of expertise.