Treatment on the NHS for PTSD

Discussion in 'Charities and Welfare' started by themonsstar, Apr 21, 2007.

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  1. I was medically discharged last year with PTSD. Aldershot (Army) Community Mental Health Team referred me to my local CMTH, Surrey & Borders NHS Trust.

    My initial appointment with the civilian psychiatrist was fifteen minutes. At the end of the fifteen minutes session, he told me that he hopes that i get closure on my mental health problems :x .

    Late last year i got a new psychiatrist on each appointment she was late & the excuse was there had been a car crash, she was late 3 times & had 3 car crash's, as she was late each time, i only got 10-20 minutes of the 60 minutes i should have got.

    At each appointment i told them that i was an Ex-Serviceman & in receipt of a War Pension for PTSD, & should get priority service to any of the therapies 'eg' Cognitive Behavioural Therapy (CBT), this made no difference to any of the Dr involved at Surrey Heath CMHT, all i would get back was an eighteen months wating list for CBT.

    I had an appointment yesterday at 11:30am, the Dr, turn up at 12:10 she told me she was sorry & that there had been another car crash!!! I didn't expect any other kind of explanation from this Dr.

    As she is aware that l am ex forces she asked me about my time at Combat Stress, i informed her that the time at Combat Stress was very constructive, She then told me as i was receiving treatment from Combat Stress, She had consulted with the senior consultant, at Surrey Heath CMHT, & she was no-longer going to see me and that it was Combat Stress' problem now.

    I duly informed Dr 'L' that Combat Stress was a charity, and Not part of the NHS, I also asked her what was Surrey Heath's CMHT going to be doing about my mental health problem's, Dr 'L' made it perfectly clear that she was not going to see me again & she is only there to ensure that i was on the correct medication and nothing else.

    The conversation was heated now i informed her of how incompetence & unprofessional that she actually was, & told her to Fcuk Off.

    I now many GP's & Psychiatrists find it very difficult to understand and treat PTSD that i have developed as a result of military action in my past.

    But to say its now up to a Charity to treat my mental health problem's & not my local NHS CMHT is wrong, where do i go now for any treatment, Combat Stress is a charity-only survives on the generosity of the public, as i only receive a 20% War Pension for my PTSD, the Veterans Agency DO NOT assist with any of my treatment at Combat Stress its down to the Army Benevolent Fund (Gulf) another charity to get me the funding for my time at Combat Stress.

    A very disappointed Ex-Forces Veteran
  2. Whilst it sounds a frustrating experience for you, it's probably worth explaining why she may not have wanted to treat you alongside Combat Stress. This is a fairly normal response to any request for therapy where another therapy is already underway, especially if they are similar. The problem is that one sort of therapy can quite easily disrupt the other therapy you are receiving and it's better to have just one lot of therapy happening at any one time. If you stop being involved with Combat Stress (I'm not suggesting you should by any stretch, just making the point) then they may well reconsider. Have you had any input from a CPN, in terms of monitoring?

    There are a good number of conditions where we use services provided by independent sector or charitable bodies, as they have a much more focussed expertise, acquired brain injury (through the Brain Injury Rehabilitation Trust), rehab services for psychiatric patients and psychiatric services for the deaf (RNID) are just three examples of these.

    I don't know the Trust concerned but can speak for my own. It shouldn't necessarily be down to the various benevolent funds to treat your PTSD. All PCTs have different policies but the last one I worked for commissioned a treatment programme at Priory, Ticehurst for an ex soldier with chronic PTSD (in part set up by me as a commissioning manager in mental health). The problem is that 99% of civvy psychiatrists and RMNs have no experience of military life and PTSD caused by service at all (PTSD in military personnel is rarer than you might think and seen rarely within the NHS, most PTSD work done there is the result of sexual abuse as a child. Clearly these are very different.).

    As a result there are VERY few staff who have anything like the expertise to deal with it and therefore the NHS tends to rely on expertise provided by Combat Stress and others. Less severe PTSD symptoms can be looked at with CBT, as you know, but entrenched symptoms are not as simple. There is a good argument for encouraging Combat Stress to contract with the NHS to provide this service, as we understand the value of it! Then it would be a case of being funded by the PCT to go rather than a charitable fund. Whether this happens with any other PCTs I couldn't say.

    If you feel strongly enough that your health needs haven't been met by the trust I would encourage you to make a formal complaint to them.
  3. So if you are in Combat Stress in Feb, for two weeks, then the next time you go back, Sept, what do you do with in between.

    And when you are in Combat stress, you are lucky if you get any more then 2/3 CBT in any two weeks.

    I also did ask my key worker(combat stress) to inform the SBPT CMHT about the therapy i had done there?
  4. That's a difficult one, with no easy answer I'm afraid. Changing therapists can be hard at the best of times as you have to form a new relationship with the new therapist. Often people find that they take a step backwards during this time (may not happen but often does). Continuity of therapist is crucial in doing any psychological work and the CMHT may not have anyone with the skills to carry on the work properly. It is a very specialist field, and as I said earlier we don't make enough formal use of the expertise out there, in my opinion.

    2/3 sessions of CBT in two weeks is about all most people can take. Therapy, as I'm sure I don't need to tell you, can be very hard for the client and a weekly session is plenty, with homework inbetween times. More probably wouldn't have much more benefit.

    People we've funded through Combat Stress and others tend to have a care co-ordinator from the CMHT who can monitor their mental health (often a mental health social worker to avoid the issues above) and I would have thought they might have have considered that for you (can't comment any further on that as not my trust and I don't know what they have or haven't done).
  5. My hubby ( now ex services) waited 6 weeks for initial appointment. In November he received a 2hour appointment where by we were told we are looking at severe PTSD. It is May and we are still awaiting another follow up appointment, which we are informed might be early July if we are lucky as they dont give set amounts of sessions- you can go every week if you want till you feel 'better'! We did consider private, but having already had a 2hour session pouring out your deepest fears and nightmares, he decided he would wait rather than go through that again. ( we were initially told about a 4month wait) Great system eh? lets hope the NHS gets better once the sessions actually start.I live in hope! It must be bad enough if your the one living with PTSD but it doesnt get any easier for the family either.
    Anyone else finding treatment the same?
    Trying to stay strong enough to cope,
  6. As a soldier still serving and having a son who's just joined up the problems you have faced/still facing worries me. I hope everything goes well for you all and your families and hope something can be taken from the experiences you are facing to change things for the better. Im not an expert like phycobabble but the bits I can understand would also do what he/she says and put in complaints about your treatment and also highlight the frustrations to higher up the medical chain.
    I hope everything can sort itself out so you can start living a normal life again. :D
  7. I did put a complaint in to them as well as Derek Twigg, & my local MP, SBPT did say they have not had a copy of the complaint, so i sent it again, they have phone me up to let me now that somone will be getting to me soon. I've had nothing from Derek Twigg MP, but my local MP is also on the case.
  8. Although usually against all this hype - contact the sun (ask for someone who wants your story and negotiate some payment) drop the nhs trust in the poo. It does move things!

    Remember the story about the 2 army guys waiting for their pensions after a med discharge? Well, the poo that it made fly was unbelievable - in the end it was all fast-tracked!
  9. I've had two letters back from the NHS, 1 from deputy complaints manager, saying that they have instigated an investigation. And the other is from a Psychologist for an assessment appointment, so hopefully I could be moving forward.
  10. In situations like this it can be very helpful to pay to go private, even if it's just for one session with a psychiatrist.

    I had a mate who waited over 2 years to see an NHS psychiatrist. Technically, he was on a waiting list to get onto a consultant's waiting list so his wait didn't impact on the hospital's waiting time statistics (i.e. the hospital didn't give a toss about how long he had been waiting).

    At the end of his tether, he paid £150 for a one hour session with a (moonlighting NHS) psychiatrist at the local private hospital.

    The psychiatrist determined that my mate had been misdiagnosed by his GP and that the GP was prescribing the wrong medication. He also wrote to my mate's GP stating that my mate was suicidal.

    The result of this was an immediate appointment with a psychiatric registrar who prescribed appropriate medication that brought him back from the edge. £150 well spent.

    NHS psychiatry is in an even bigger mess than the rest of the NHS. You need to be a bit devious if you want the treatment you've been paying for all of your working life.
  11. I was sorry to read about the sad experiences of themonsstar and I have a few comments to make.

    Although it may seem as though making a formal comlaint against a health Trust is a reliable way to produce quick results, it can be counter productive, in my experience. Firstly, with the best will in the world, it is difficult not to be defensive and cautious if you are trying to build a therapeutic relationship with someone who is known to be a complainant or may be litigious. Trust needs to be established on both sides; psychological therapy isn't something that the client is a passive recipient of. It's a partnership. Once established, it might be possible for someone o be angry with their therapist, but if people's backs are up to start with, it will be an uphill struggle.

    The same caution would apply to complaining to the tabloid press. Of course papers like the Sun are a gaping maw that gobbles up traumatised people and spits them out when something more tasty is brought to the table...again, this is nearly always counterproductive as far as the psychological health of the individual making the complaint is concerned.

    Thirdly, if someone does manage to get a quick appointment, assessment or even starts therapy by way of complaining, this is a knee-jerk reaction by Trust executives who don't much care what the impact may be beyond getting them out of a fix and avoiding litigation. What actually happens is that this results in a great deal of time involved in the complaint response which might have been spent treating people and an appointment given which should by rights have gone to another person waiting patiently on the list. So, although most of the health staff you see will behave perfectly professionally towards you, they may well resent this kind of queue jumping. I'm not suggesting that themonsstar did this, as it sounds as if he was particularly unlucky with NHS treatment he is entitled to, but some MPs do.

    And whatever may be the general impression given by the tabloids, there is absolutely no NHS directive that says that military or ex military patients should have preferential treatment. NHS staff have a problem with military patients who behave as though they should have priority. Well, my personal jury is out on that one, but there you are..I'm only stating what I have heard people saying.

    Fourthly, lobbying the government in these ways isn't going to make psychological therapy come any quicker. the Government and the NHS are already aware of two things: 1 - this therapy is effective and 2 - there is a shortage of it, hence the waiting lists. Many more therapists are being trained although I personally have concerns that the expertise of therapists will become dilute if there is another knee-jerk response which involves training people to do CBT without a rigorous academic selection and decent levels of clinical supervision. Traumatised military pesonnel are entitled to properly expert input, not watered down or quack input.

    Please be very cautious about following up therapy sites advertised at the bottom of these sites by Google. And also be careful about checking the professional qualifications of any private therapists. Lots of letters after their name doesn't mean zip. can be a member of 10 organistions and a Master Practitioner of 10 different therapies, but they could still be quack therapies and quack organisations. If they're not a psychologist or psychiatrist, they should be recognised by the BABCP, the BPS or similar. They may be well intentioned and caring but if my son were a traumatised soldier I would not be sending him to NLP, energy therapies or, for that matter, to an in-patient regime of group therapy for a couple of weeks. I'm sorry if some may think I'm sniffy about this, but to me it's the same as someone unqualified taking out your appendix.

    Take my word for it - the NHS is not going to be funding anything other than CBT for the foreseeable future and after Gordon Brown becomes PM, the NHS will make a U turn on funding treatments from the private sector.
    BTW I am an NHS professional who has worked with military patients as well as with a wide range of other NHS patients, so clearly I do have an angle and an agenda like anyone else, but at least it is an informed opinion, I hope.

    Sorry this turned into a bit of an essay..
  12. I have no advice to offer you, unlike some self-styled experts on here.

    Good luck on your journey. I wish you well.
  13. And whatever may be the general impression given by the tabloids, there is absolutely no NHS directive that says that military or ex military patients should have preferential treatment. NHS staff have a problem with military patients who behave as though they should have priority. Well, my personal jury is out on that one, but there you are..I'm only stating what I have heard people saying.

    I feel that you need to re-look at your NHS Guidelines HSG(97)31. Priority Treatment For War Pensioners. To help you its called a (Health Service Guideline) which re-iterates YOUR RIGHT to have priority treatment provided by your NHS provider. This is an ACT OF Parliament stretching back to 1953.

    Exacutive summary

    These guidelines abvise health authorities and trusts of an extension of the definition of the term "War Pensioner" to cover people who were injured or disabled as a result of service in the armed forces.

    A War Pensioner has previously been classified as someone who has a pension or who had a gratuity for disablement caused by armed service. This includes merchant seamen & civilians who receive pensions for wartime injuries.

    In 1953 hospitals run by the Ministry of pensions for the treatment of war pensioners were transferred to the NHS. The Government gave an undertaking that there would be priority examination & treatment for war pensioners in NHS hospitals for the condition or conditions for which the war pensioners received a pension or gratuity.

    NHS hospitals should give priority to war pensioners, both as out-patients & in-patients, for examination or treatment which relates to the condition(unless there is emergency case or another case demands clinical priority).

    Referrals for treatment sould make it clear that the patient is a war pensioner.

    War pensioner can use the NHS complains system to resolve any alleged breakdowns in the arrangements for priority treatment.

    Chief executives of health authorities & trusts should ensure that general practitioners & relevant hospital (maybe your not one) staff are advised of the definition of a war pensioner & are reminded of the arrangements for priority treatment of War Pensioners.

    So from me to you, you say you are a NHS Professional, A PROFESSIONAL nows there job, do-you now yours
  14. Hi Themonsstar
    In answer to your last question - clearly not. :oops:

    I've done my homework now (as befits a professional!!- by
    means of Google, where all the best pros go) and I stand corrected.


    I wonder why it is that, despite CEOs having been reminded to cascade the relevant info back in 2002, I don't remember seeing anything? It must be because I was too busy to read yet another email from Trust HQ and I will remember to read them all from now on. Or is it because that reminder never came?

    I'm still a bit unclear about whether those veterans compensated under the more recent scheme (as opposed to those prior to April 2005 in receipt of war disablement pension) have the same priority entitlements. What's your view?
    Normally compensation is awarded so that people may pay for any treatment they need, rather than going to NHS. And how would you find out on what basis the pension was awarded?

    As I'm a newcomer, I'm hoping to get the same level of courtesy as I get on other message boards, but i fully accept that perhaps these forums are rough arenas and that you have to expect a bit of buffeting, hostility and sarcasm. Is this the famous military culture we civilians are always being told we don't understand?

    I married into a service family .. maybe I still don't understand it after 30 years!
  15. Maybelline,

    Which NHS trust do you work for? Following themensstars' post above i did a little searching and found a few relevant links. Two of these links are for NHS Trust guidlines, specifically mentioning HSG(97)31.

    See this thread.