- The Advocacy Letter
- Victories and Failures: Updates on *Those* Letters
- Hilariously and Predictably Shite Response Letter from the Trust
- Latest Letter to the Trust, With a Giant Helping of ‘Screw You!’
- Latest in the Ongoing Me v NHS Saga – MORE ADVICE NEEDED!
- Revised Letter to Mr Director-Person
- Dear Mr Member of Parliament…
In response to this. See also this update. I have corrected a few minors errors in the author’s writing and have, as you will see, provided (italicised) annotated notes of the most rational and considered variety. *cough*
—
Dear Pandora
Advocacy in Accessing Mental Health Services
Thank you for your letter dated 17 December 2009 about accessing our mental health services. I am glad to note that you have developed a good therapeutic relationship with the clinical psychologist involved in your treatment[,] but am sorry that our services have not met your expectations. [My "expectations"? My "expec-fucking-tations"? No, you miserable old bellend, they are not my "expectations". They are my fucking needs and requirements!]
I have received feedback from Dr C J confirming that he saw you for the first [time] on the 19 February 2009 and [that] after three assessment interviews an agreed treatment plan was drawn up that offered weekly treatment appointments and also an assurance that an end to therapy would be identified well in advance of a contracted completion. Dr J [he is not Dr fucking J! He is C! I don't care if this is an official fucking letter. He is fucking C!] agreed with your view that some modest gains had been made during your contact with psychological services [aren't I the fucking lucky one]. He also recognised the complexity of your difficulties and so sought additional input in the form of a referral in May 2009 to [Old]VCB, Consultant Psychiatrist [that should have gone through months beforehand, after a referral from my fucking GP. Useless twats]. I understand that you continue to be seen by the psychiatric team [yes, after more upheaval, and when they can be bothered, which is really rather infrequently].
At the time of your letter Dr J [FUCK] had made the offer of 24 additional appointments, which would bring your contact with him to an end at about the first week in June 2010, a treatment duration of about 16 months [actually, that is incorrect. There will be 59 sessions, three of which were assessments, and four of which will be to end the process. This gives an exact total of 52 therapy-specific sessions, which surely even in your clearly deficient brain equals a total of 12 months. Fuck you.]. Dr J [fuck fuck fuck] expressed the hope that within these sessions, which would span approximately six months [my God, I would never have realised], [that] further work could be done that would help towards resolving, dealing with or managing your ongoing mental health difficulties.
It is clear that you have a good knowledge of the NICE guideline[s] on the treatment and management of borderline personality disorder [Hmm. You are telling me that I know something that I know. That was a productive use of your secretary's typing time]. Overall as the guidance states, the evidence base for individual psychological therapies in the treatment of borderline personality disorder is “relatively poor”. Specifically, however[,] it recommends that brief therapies (under three months) should not be used. Much of the guidance relates to provision within a specialist Personality Disorder Service. The availability of twice weekly sessions, group psychotherapies and integrated team treatments [what the fuck?] are [sic] largely to be found within those highly specialist services [oh really, I had no idea Mr Director Important Person, thanks for clarifying].
The <Trust in question> does not have such a service [aha, and that's clearly the fault of the patient. Nevermind the NICE guidelines saying in the absence of such a "service" that adequate generic therapy should be used. Fuck you again], although we, along with all other local Trusts, are involved in the development of a regional approach to Personality Disorder services across Northern Ireland [wowee, I'm so profoundly impressed] and have recently interviewed for two specialist workers [two? A whole TWO? That's extraordinary! Congratulations sir!]. Therefore we are planning to develop our services to people with personality disorders [I therefore assume that I can take this letter as confirmation that these "services" will be fully accessible by me...?].
As you state it is important that clients have access to a full range of mental health services appropriate to their needs. We try [and fail] to ensure that needs are assessed in a collaborative way [hahahahahahahahahaha!!!!!] that involves both clients and mental health professionals [well, then. That has been an epic fail!]. I would encourage you [who the fuck do you think you are, my father? Fuck you in triplicate] to discuss these matters with the two professionals that you currently attend [yeah, because I haven't done that already. Fuck you x4]. The Crisis Team provides mental health assessment and support outside 9am to 5pm hours in the working week, and can be accessed if appropriate through the out of hours primary care service [well, fuck me sideways with a broomstick. I had no idea what the Crisis Team did, thanks for providing me with a lit pathway to therapeutic enlightenment. Fuck you mark five].
Dr J [FUUUUUCK!!!] has confirmed that you have continued to attend his sessions following the writing of your letter [what was I meant to do? Fuck a goat? Oh wait, that's exactly what I was meant to do, right? "The bitch is borderline, so she must be non-compliant with treatment and will instead go out and fuck anything to temporarily fulfill her emotional voids"]. I would hope [oh would you really?] that despite their finite nature you could still use the upcoming sessions to make progress.
Yours sincerely
Abject Twatfeatured Spetum-Faced Tosspot
Director of Mental Health and Disability Services
—
So. He has succeeded in providing me with:
- A chronology of events. Woohoo. Obviously the stupid mental couldn’t possibly know that she saw these individuals, nevermind know in which order she saw them, even less what they said! Particularly when she’s an immature, manipulative borderline freak. So thank you, Mr Important Director Person, you have made my life and mental health treatment complete!
- A commentary on the fact that I know what I know. A tremendously useful and productive use of his time and mine; after all, I couldn’t know what I already know unless he told me, could I?
- Um…that’s about it.
Altogether an epic success, I’m sure you’ll agree.
The letter is dated 17 February (how it took him two months to compose the above I’ll never know) and it actually arrived at Mum’s house a good while ago. I made her read it down the phone to me, so I was aware of its content, but I only collected it the other day, and had (until now) refused to look at it. I thought that due to its high degree of pointlessness and its utter failure to assuage my concerns, that it would upset me considerably. After all, this is about the cessation of my relationship with C, which is an incredibly traumatic thing to contemplate.
However, when C asked about it this morning (blog to follow – big update on the beard!), I somewhat surprisingly found myself wryly amused as I reported a redacted version of its contents to him. Therefore I’ve come home and written it up and am pleased to say that I still find it amusing rather than upsetting, probably because it doesn’t actually say anything. OK, there’s maybe six or seven hundred words there, but it doesn’t actually – at any juncture – make any salient points at all. It is a vacuum of a letter. It is a nothing. Empty space seems full relative to this page of black and white nonsense. I’m glad it was printed on both sides of the sheet as I would have hated to see any more wood senselessly wasted on something so fruitless and silly.
Given the amount of money this moron is paid, I should really be rather angry, as well as disappointed and lost as to what to do next. Instead, fair play to him, as he’s given me a laugh…and, in fact, some hope. If someone with such poor (written) oratorical skills and an intellect clearly directly comparable to that of an earthworm can rise to such a lofty position within a large organisation, then my dream job is surely still within my reach.
In conclusion…FUCK YOU ONCE MORE, Mr Director Wankface Important Daft Person!
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Way to get the anger out! Whoop (for you) but am completely with you on how crappy this letter is. Urgh, mental health services suck, so sorry
Thanks hun. I don’t know if I’m finished with this yet or not; there’s more tricks up my sleeves, but I’m not sure to what extent I can be arsed to proceed. We’ll see. Take care x
Complete crap. Sorry to hear
Thanks Kate
The way you write has me rofl. But…what a pathetic letter. He may as well have said “Erm, I have no clue what to do or how to respond to your valid argument, so I’m just gonna jot down a few names and dates and that can be my reply” ?!?! What an f-ing loser, I mean, really that is pathetic. I’m sorry you’ve got that and I know how these shit letters can make you feel. HUGS xxxx
Exactly! Stupid twatbag. I would love for him to somehow happen upon this blog and see how everybody thinks he’s a wanker
Thanks for the hugs hun – right back at you. xxx
That is *ridiculous*. I am *so very angry* on your behalf … what a complete waste of words and A4 that was! They seem to think that by sending a salutory letter stating the bleeding obvious that you’ll just ‘go away quietly’. Well don’t. Bang on more drums m’dear. This cannot be the end of it.
I’d be constructing something along these lines:
Dear Waste-Of-Space-Spending-Tax-Payers’-Money-On-Frappucinos-And-Carrot-Cake,
Thank you for your reply of 17th February. It is with great disappointment that I note your acceptance of the fact that you are unable to meet the requirements of the recently published NICE Guidelines with respect to the treatment of Personality Disorders. As you may be aware, in December 2007 the Dept of Health and Ministry of Justice commissioned the development of a national framework to support people to work more effectively with personality disorder. The new National Knowledge and Understanding Framekwork (KUF) development work builds upon the aspirations articulated within the policy guidance documents “No longer a Diagnosis of Exclusion and Breaking the Cycle of Rejection” published in 2003. The key goal is to improve service user experience through developing the capabilities, skills and knowledge of the multi agency workforces in Health, Social Care and Criminal Justice who are dealing with the challenges of personality disorder.
It is my understanding that the absence of a “specialist Personality Disorder Service” as you put it, is precisely the issue with respect to my complaint. Were such a Service in place, I would not have been ricocheted around the system in such an unproductive manner, being unable to make use of the brief and fragmented services offered as they have been fraught with such tension during the process. As you have indicated that such a Service is something that you are “planning to develop”, I would request the following:
1. A timeline of when such a Service will become available
2. My ability to input as a current Service User on the development of the Service as it progresses
3. What systems will be put in place following the termination of my therapy for my support until this new Service is available
As you can appreciate, living with Personality Disorder is an incredibly difficult task at the best of times, and having to navigate my way through the mire of Services (or lack thereof) has only caused to worsen my condition, rendering the past year’s therapy almost entirely futile as I am now *more* stressed as I have been at the mercy of a “Trust without such Specialist Services”.
I would ask for your immediate attention to this important issue, and ask that you fully include me in any future planning for these new Services, and how I will be supported by your Trust in the interim.
Yours sincerely,
Rightly-Pissed-Off-And-Deservedly-So-Now-Make-Me-A-Freakin-Latte
IMHO
xx
I cannot beat that comment, it is excellent. Copy and paste that.
Yep, it was pretty brilliant
Pan, can I just second this. Girl, Interrupted’s response is perfect and will piss this twat up no end. You go girls!!!
Kate
It almost doesn’t matter anymore whether or not this succeeds in continuing my sessions with C; it’s now about fucking the system and pisding the bastards right the fuck off
I think this letter will more than achieve that 
x
You, my dear, are a letter-writing genius.
I don’t know how much fight I have left in me. But you’re right, the letter was exactly intended to be a “I’ve replied, now back down and go away” response, and that isn’t acceptable. I’ll maybe respond with your template to scare him if nothing else. Or I may respond with your template with the full intention of pursuing the matter with the zeal that I originally possessed when I started this complaint. I’ll have to think about it and have a long discussion with A.
I don’t exactly know to what extent HSC Trusts here in Norn Iron are similar to PCTs in Britain. I assume the guidelines and whatnot are similar, though. Fuckface, as the post makes clear, did refer to my familiarity with NICE, so I assume that it’s applicable.
But I love your letter whatever happens next. You should be a fecking speech-writer, my love.
Take care and hugs <3 xxx
Absolutely – take your time to consider your next (if any) move. It’s only worth fighting if you have fight left in you, and that is true even if there is only 3% of you left that can. My concern is that you have come this far and it would be appalling for this to be the end of the game … they win, you by default end up losing. It simply isn’t good enough to be palmed off like that, and if you do decide to write back to them you know you have the full support of each and every person that reads this lovely blog.
They’ve given you enough of a kicking. Time the tables were turned …
Love you <3 xx
No, no, you’re right. You’re absolutely right.
Fuck them! It’s not even about C-no C anymore. It’s about being fucked about for 12 years with absolutely no adequate care whatsoever, beyond what C has tried to provide in the shitty limited timeframe he’s been allowed.
He told me this morning that he felt my crusade had been “helpful to psychological services” and had helped raise inter-departmental “awareness of the shortcomings” of mental health care in my Trust. To me, reading between the lines, it sounds like the timeframe that he claimed to have decided upon was only decided by him in the most technical of senses. It sounds like his managers were telling him to palm off the difficult, disruptive borderline mental freak, as they’ve got better things to do.
So you’re right. Up their arses. I will send it.
Lots of love xxxxx
Hurrah!
We’re all here for you darlin, just let us know how we can be of help – remember you’re not alone in this at all … draw our our communal strength when you feel like giving up.
Bring on the system~smashing!
xx
Thank you.
<3 <3 <3 ad infinitum
xxx
Too many people (in my humble opinion) simply accept what they are presented with, tolerate it, and let things become the “norm…”, thus letting too many other people simply get away with delivering poor, inadequate, and in some cases blatantly unsuitable “service”…
Mental Health services in my experience are rarely given feedback, challenged, or even questioned by us users, and without users driving change, these things are unlikely to change for the better. Staying silent creates a lottery, and is choosing to leave things to chance.
Well done on making a noise. For what it’s worth, I think that crappy reply most definitely deserves a muscular response! Go get ‘em!
You’re absolutely right Lou; shoddy service is peddled to people on the NHS and because it’s ‘free’ of sorts, many seem to accept it. When complaints do occur, they fail at the first hurdle because some bland, meaningless crap like this is meant to satiate the complainant.
I was going to let it lie, but you and the others are all right – they win, and after all my efforts, I lose…and so do other/future patients.
At the end of the day, even if it doesn’t work, it’ll annoy the miserable old bastard, and that’s satisfying in and of itself
Thanks for commenting, great to see you here! Take care x
Am pleased I found you Pandora – your blog especially has been a great insight for me, and am somewhat reassured by lots of stuff that you have written about !
Catch you soon !
Lou
Thanks Lou! I really appreciate you saying that; it’s always really nice to hear that the blog has some use
Thanks again, take care of yourself xxx
Firstly well done on actually writing the letter and expressing how you felt. Secondly, what an absolutely useless reply. I also have quite an uncertain future with the mental health services because I live in a rural area where we have the CMHT and that is about it. There are no out of hours crisis teams or people to see on a weekend. Mental illness here only lasts Monday-Friday 9-5pm apparently. If you have a crisis outwith office hours they kindly send you 2 hours away to the most rundown psychiatric hospital you have ever seen. Really helpful for people like myself with agoraphobia. I can see that dickwad is trying to reassure you that there are “other support services available” but sadly he seemed to totally miss the point about continuation of your therapy. Totally agree with Girl Interrupted’s comment you should send that back to him! Clearly he was just trying to fill his A4 sheet with some random words and useless information so he can mark on a little sheet somewhere that a reply was issued. Grr.
Thanks hun
I’m disgusted to hear about the pathetic provision of services in your Trust. Two hours to the psychiatric hospital?! And a shit one at that? That’s absolutely pathetic. I’m so sorry you and others in the region are being let down like that
I totally agree that Knobend here completely missed my point – whether he deliberately overlooked it or whether he was just too pigshit thick to understand my original correspondence is unclear. As I was saying above, I feel like I’ve got very little fight left in me as regards this, but on the other hand, it would be ridiculous to let these bastards get away with what they’re doing. I will probably cut and paste GI’s letter, therefore
Cock – there was something else I wanted to say but I’ve completely forgotten what it was. Bloody Venlafaxine screws with my memory. Anyway thanks BG, appreciate your kind words and support
Take care xxx
I loved your additions it made me smile. Shame the letter didn’t actually say anything useful. I think you are right not to let them get away with just a bland letter. Chase them, Girl Interrupted’s reply was excellent i wonder how they would react to it being sent in it’s entirerity i’d like to be a fly on the wall.
Thanks hun
As I said to Lou above, even if the new letter fails, at least I’ll have the satisfaction of knowing that it will have pissed this idiot off…therefore I too would give almost anything to be a fly on the wall when he receives it. Mwhahahaha!
At the end of the day they can’t be allowed to palm people off in this inane fashion any longer. Wankers.
Take care x
SI, I don’t know how the funding works in your area (since I am in Canada) but from your experiences….geesh…I’m really glad I can afford to pay for services because I couldn’t go through your experiences with trying to get appropriate care.
Thanks Sanity. It is a bloody nightmare. I could (and probably ultimately will have to) go private, but the difficulty is, aside from the difficulty in financing it, I already have the requisite therapeutic relationship required for progressive work, after after 12 years within both the private and public systems, I’ve not experienced that before. So it’ll be difficult to find that again
Pandora:
Only 2 specialist workers in the proposed Personality Disorders trust?
To meet the need, there should be – at a bare mininum – 20 to 25. Then after some years they can train and so on.
(There should also be substansive seed funding and it should be recurrent).
The point is, more people should have more access to someone like C (or a therapist/psychiatrist/psychologist who they have a rapport with) and for longer.
Meanwhile, here’s something very much like this while you think of writing a letter. It was released on the 22nd February of this year.
Mental Health Promotion in Northern Ireland: has lots of addresses and networks
And even I saw the letter came on your first anniversary with C.
Adelaide, you are absolutely spot-on. The fact that the fact they’re hiring a pathetic two people was reported in the letter as if it was something for which I should be grateful, but we are talking about a fairly large demographical and geographic area, so how they think this is remotely adequate is completely beyond me.
This is brilliant. Thanks for finding that
I’ll be bringing the included points into my response!
Take care x
Typical spout of crap from the NHS! What a lot of utter bollocks!
Thanks Alison – they should be bloody ashamed of themselves! I know it’s meant to be ‘free’, but seriously – it’s also meant to be a service, and in that it’s failing remarkably
I don’t think I’ve read such a wryly funny or intelligent blog. Congratulations; it’s fantastic. Although I neither work nor am treated in the mental health sphere, this has held my interest (intently) and made me laugh and splutter aloud on more than one occasion. P.S. C sounds like a bloody saint, or at least a man very good at his job.
I don’t know what to say. Thank you! I’m really chuffed. It’s always very heartening to know people take anything from my writing, never mind entertainment and laughter
Thanks very much Leroy, I really appreciate it!
C and I have had our differences over the months certainly, but ultimately I agree; he’s good at what he does. He also finds this particular situation frustrating I think; he wants to help, but the budgetary constraints and lack of resources are conspiring against him. Basically it’s a nightmare for all concerned
Anyway, thanks again – please feel free to comment any time, I’d love to hear from you
Pan x
Using GirlInterrupted’s template, I have composed the letter. Let the battle commence. Mwhahahahahaha!!!
Result!
Very very proud of you for doing it … can’t wait for the response
<3 xx