Complex Needs Service

[Lily Kym]

Thank you so much for your reply and making me feel like I do matter. It means a lot.

It did feel like a threat when she said it to me, and when I met the group facilitator it felt like I was being put on the spot and asked to commit to it there and then.

Since found out it wouldn't be him, and it wouldn't be the group I met as they have all already started. Just feel like I don't matter to them.

I will try and see GP about it. She tried referring me back to CMHT for Med review when I switched from venlafaxine (psychiatrist prescribed) to mirtazapine. Because I didn't (and still haven't heard back), she's said I need to stay on smaller dose of mirtazapine as she doesn't know if it's right for me. She said I've had pretty much every AD and a few APs over the years

[inmythirties]

You do matter and it makes me feel quite angry that you and others are let down in this way by inflexible service models.
Someone with anorexia wouldn't be told that they couldn't enter ED treatment until she started eating. It is actually the reverse in EDUs where often patients have to drop in their BMI until dangerously ill.
Self harm isn't understood or accepted by mental health services. I find that treatment is better in general health care - A&E, paramedics or GP practice nurses than in mental health which is a bad reflection of the NHS mental health system. Having no cutting contracts doesn't work. My private psychotherapist did the same and I just ended up feeling a failure and once I had harmed it was though I had lost him and the therapy sessions I'd paid thousands for and had little other hope/options. I think it's worse to do that to someone in the NHS as then the service user is blamed for not complying and committing, the fact that someone self harms due to severe emotional distress is lost. It is as though it is seen as an addiction and something that has to stop for you to deserve a place on a programme. Only once outside that system can you see how punitive and unhelpful it all is.
You do need to get what help you can from your GP, get them to re-refer to the CMHT and not give up. If there is no other service for you and the complex needs team won't assist unless you abstain from all self harm (something that is unlikely to succeed) then the GP needs to take this up with the commissioners.
I think I remember from your previous posts that you work? I think that when we do work especially full time it is easier for services to see us as high functioning and not get involved. On one hand they encourage work for all as a recovery outcome, on the other they think once someone is in work then they are fine/have no needs. You need your GP to fight your corner, if your GP is of little help do try someone else from the practice.
If this complex needs service isn't going to accept you then you need to talk to them and your GP about what else. But don't see it as your failure - it is 'the system'. It took me ages to understand that for myself and still I am building a sense of self acceptance and fighting spirit.

[inmythirties]

Also, if you do go into the programme you need to be prepared beforehand for a group therapy model. This often means that everything has to be taken to 'the group', there is no one to one support and you may need to disclose private issues. For some people this can work well, it feels containing and real relationships are formed in helping one another. I think for others who have experienced trauma it can be hard to share more widely than with one person. Any self harm would be challenged by the group, and in a therapeutic community model the group may even be making a decision about what response is applied - eg over suspension due to incidents.
I don't mean to knock a programme I don't know about, every service is different of course and most of all I would want you to get really skilled, therapeutic care. If you feel you need crisis support and some flexibility around meds beyond what they have outlined already though then that needs to be considered. It could be that the group itself would provide the crisis care/members being on call. I would hope the programme isn't all black and white and that if you needed to stay on meds then that could be accommodated. Also there could perhaps be understandable rules around self harm - eg not doing it on the premises, that would make sense to you rather than it being do it in private and you are out of the programme. People entering the programme are individuals and one size doesn't fit all. I hope that once you do get an appointment through the programme is more promising and accommodating than it appears to be right now. You need and deserve the support. You wouldn't be messing up an opportunity, instead the service needs to see how it can best help you - and a good effect of this all working/coming together would be that you didn't feel the need to self harm or take too many meds. You have been brave in agreeing to the referral, seeing what is involved.
By the way,I am sorry if I got it wrong about you working- I may be thinking about someone else's post and am not implying anything about your health status.  Hope that's okay...