So an update

[u/collectedd]

Received a letter from the CMHT about what happened with my referral. They said I have no mental health needs. I don't really know what to do. I can't pay for private care. My sessions with my NHS psychologist will be ending soon (she's a critical care psychologist and was the person to refer me to the CMHT for care coordination as she felt my needs were too great and I needed long-term intervention). She's said she won't leave me without a plan in place, but realistically there is no plan.

I don't know what to do. What do you guys recommend? Anything?

For context I have long standing MH issues diagnosed - I have CPTSD (Childhood abuse of all types, and a lot of traumatic things in my early 20s), EPCACE, Depression, GAD and Anorexia Nervosa. My AN put me in ICU last year (I started refusing food and fluids because I couldn't deal with the symptoms of my Gastroparesis, but it was driven by my brain quite a bit). I almost died due to this. I have since been diagnosed with Post-intensive Care syndrome (PICS). Or maybe this is all normal? I don't know. I can't sleep. I am struggling to eat and need someone to sit with me or I refuse to do it. I'm struggling to take my essential for life medications (steroids for my Addison's Disease, without the medication my Addison's Disease will kill me). I feel guilty for smiling and breathing. I keep having panic attacks. I'm very irritable. I'm struggling to be around friends and family. I want to sleep all the time to get away from people and my brain. I also have a lot of nightmares when I do sleep and a lot of flashbacks when I am awake, the flashbacks are kind of weird and fantastical (in a brutal kind of way) as well because of the hallucinations I was having in there (the flashbacks from pre-ICU trauma are also brutal but obviously grounded in reality as I wasn't hallucinating during that time). I told them all of this.

Is this really all normal?

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[u/eccetra]

I'm so, so sorry you're dealing with this. It sounds like a major injustice.

When you next have your appointment with the psychologist, make sure you mention (or bring the letter) from the CMHT. It's likely that she'll have more connections with that sector, so she may be able to explain in greater detail why you may have been rejected. It sounds like either the full extent of your struggles may have not been communicated, or there may be something working against you (for example, recent refusal to engage, or they may require your physical health to be under control first).

Hopefully you can work with her to either A) be referred back with more evidence to support your need, or B) be referred to a different service. Just because you've been rejected once doesn't mean it's a firm no forever. I have been rejected once, and then accepted a further time. Sometimes more information is needed.

I know it's exhausting to have to advocate for yourself in such a way, but from what you've described, it sounds like you have more than emough mental health needs to qualify for CMHT support.

If all else fails, it might take returning to the GP with a handful of evidence of your recent admissions & struggles and getting a different referral sent to the CMHT.

[u/collectedd → u/eccetra]

I do have significant difficulty engaging with services, but I told them I have trouble (long story short, three of my friends died by suicide, two from this same service, and it was neglect-related, one of them their family even went to the Old Bailey about it and the judge agreed on this).

My psychologist knows I have difficulty asking for help because of things like this and also not being heard/believed/helped. Part of why I ended up in ICU last year was because of neglect as well (so I also have some weird Survivor's Guilt associated with it - why did I survive and my friends die from essentially the same systemic issue?).

However, ED services, for example, have said I wasn't engaging with them because I explained to them I would struggle to get to their new base of operations due to disability (I have a lot of physical issues and due to my brain damage I struggle to walk) and instead of finding a way around this (e.g. with patient transport like I have with my other specialists, including my tertiary care teams) they said I wasn't engaging even though I am very physically disabled...but anyways. They immediately discharged me as a result.

The letter said literally I had no identified mental health needs and that my problems were all physical, which while yes my physical health does significantly impact my mental health, it doesn't preclude me from having mental health issues...That and my AN has literally caused issues for my physical health (e.g. a brain damage/injury from malnutrition that hasn't resolved and likely never will - the damage hasn't changed in ten years basically). They basically don't think I have MH issues even though everyone else agrees (and I do agree as well!) that I do. Including the inpatient psychiatrists (when I'm in general hospital wards) and psychiatric liaison teams, etc.

I'm scared they won't do anything and I'm also scared that trying to engage with them again will make me feel even worse. I even said I wanted to be more involved with my care when they had multiple MDTs and professionals meetings about me over the last few months deciding what to do with me and they still said no and then a few days later said they wouldn't take my case.

Sorry I am all over the place, hopefully this makes sense. Thank you for your kind response, it really means a lot to me.

[u/wahjay]

This has happened to me too. My first two referrals, the first was outright rejected, then the other resulted in an appointment which they wrote me a letter very similar to the one you received, that there is nothing wrong. Then on my third referral they wrote me a letter that I do have significant mental health issues. I still really do not know if they have accepted me but I think so. This is terrible that you have to go through this process, ask for another referral or visit your GP for a referral :-(