Community Mental Health Team won't see me.

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Community Mental Health Team won't see me.

Postby babooshka2002 » Tue Nov 23, 2010 9:01 am

(x-posted from my Facebook)

Had a call from the occupational therapist about half an hour ago.

She'd referred me to the community mental health team, as i said before. They've sent her a letter back saying they won't help me as they don't feel I have a mental health condition. They may be right - the dyspraxic tendencies, the executive function issues, the hypotonia - these are all neurological problems, not mental health conditions, though I think one could make a good case that having these undiagnosed neurological conditions most of one's life could cause mental health problems. But they aren't like schizophrenia and bipolar disorder, both conditions which they would look after. Though I'd say that is debatable - we know so little about the brain that it would be entirely possible, in my view, for those conditions to be caused by underlying differences in brain structure, which would make them neurological in origin. And what is the difference betwen neurology and psychiatry anyway? A interesting question.

Anyway, essentially, they've said, "not our jurisdiction, officer - not our problem".

Mairi the OT is most annoyed. She said she was rather irritated and confused as to why they rejected me. I can see it from their point of view though - they have to limit the sorts of patients they can see. They place things into boxes and they can only see people in *this* box, not all those other boxes. I wonder what happens to the other people with neurological disorders like me though. Who looks after them? I'm certainly not the only one. I have an unpleasant feeling that many of them fall through the cracks and can't get any support, like me before my incessant pestering paid off. There are no services that I know of, like a community mental health team, that deal with people in the neurological box - not unless they are also mentally retarded, in which case they fall into another box and are dealt with by learning disabilities services. And people who have neurological problems caused by traumatic brain injuries, some of which are quite similar to the problems I have - they fit into yet another box and are dealt with my traumatic brain injury people. There isn't anything for adults with developmental neurological problems.

Mairi has sent a more strongly worded letter back asking them to reconsider and sending them what I wrote about what she calls my compulsive behaviours - the pulling my toenails off etc - to try to convince them that I do have a mental health issue. If they still say no, she says she will be writing to my GP to ask him what he thinks they should do next, because she thinks I need more support than just her and if the CMT fails she doesn't know what to do.

Meanwhile, she's also written to Dr Duffey, neurologist, and asked for him to see me again. I'm not entirely sure why since I don't know what could be gained from it, but I'm hapy to see him again - he's very cool and doesn't mind me arguing with him, which is fun. I'll also be able to apologise to him for being so very militant about dyspraxia, given that I've been tested for it and not been shown to have it - not by the current criteria anyway. I'm sure I would have been diagnosed with it if I had been assessed as a child - they used different tests then.
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Re: Community Mental Health Team won't see me.

Postby parnassus » Thu Dec 02, 2010 11:15 pm

I think the chief difference between neurological disorders and psychiatric illnesses is that neurological disorders are all about cognitive functions - language, auditory processing, spatial perception, etc. Mental illness is more about emotional problems that can sometimes cause behavioural issues as well. They might well be neurological in origin, but they are still qualitatively different from conditions like dyslexia and dyspraxia. Having spatial difficulties that stop you fromg getting across the road safely is not the same as seeing a monster hiding beneath your bedside cupboard, although both arguably fall under the category of 'perceptual abnormality'. The treatment they require is completely different, which is why I don't think it makes much sense to try and place dyspraxia alongside schizophrenia.

I am treated by the CMHT because of my difficulties with anxiety and eating. My experience with dyspraxia and AS played a big part in why I developed these problems, so dyspraxia and AS come up quite frequently in appointments, as you would expect. But the main purpose of my treatment is not to deal with dyspraxia, but to help me improve my eating and manage anxiety - a clearly defined goal that is connected to mental health. I can't really tell from your post what kind of service you were hoping your CMHT would provide for you. Therapy of some sort? Medication to help manage psychiatric symptoms? If that's the case, your OT needs to make clear what your psychiatric symptoms are (toenail-pulling, etc.) and refer you specifically for help with those. It might be useful for the CMHT to know about your dyspraxia to help them devise a treatment plan for any mental health issues, especially if your dyspraxia has been a big factor in why those problems developed, but I doubt they will be able to offer any treatment to help with dyspraxic symptoms in and of themselves.

When I needed help with independent living skills I was referred to the occupational therapy team at a unit which usually deals with stroke patients. There is some flexibility in who can use a particular service (bearing in mind that many stroke patients carry a dyspraxia/apraxia diagnosis). But you already have an OT, so this info probably isn't very helpful. What exactly is it that you need the help with?
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