I should turn this into a series of posts. It’s becoming something of a recurring theme, my own little comedy of errors if you will. It frustrates me endlessly, of course, but if you dig a little deeper there is something pathetically amusing about the whole sorry business, in a sort of wry, dark kind of way.
Anyway, here is the latest letter from Mr Director-Person, in response to my correspondence of 11 March. I am very impressed with his wonderfully speedy return on this.
Re Accessing Mental Health Services
Thank you for your letter of 11 March 2010 and I apologise for the delay in replying. As we have acknowledged previously you are correct in your interpretation of the NICE Guidelines in relation to personality disorders. However NICE does not apply automatically in Northern Ireland. Currently a Regional Personality Disorder Group, brought together by the Department of Health, Social Services and Public Safety is considering the Knowledge and Understanding Framework (KUF) as a way forward to developing better services in Northern Ireland.
Locally, a group run by <Mr Twathead>, Head of Mental Health Nursing in our Trust, is working on a plan to improve services for people with personality disorders. This service will support the objectives of the Northern Ireland Strategy for Personality Disorder. The Trust is also in the process of recruiting Personality Disorder Practitioners who will work with community teams to provide a more locally responsive service.
As a Trust we are committed [hahaha!] to user involvement in the planning, delivery and monitoring of our services so we would be grateful if you could get back to us with an expression of interest in helping us develop better services for people with personality disorders – please contact <BitchBrain>, Assistant Director Mental Health Services, <Big Bin>, <phone number blah blah>.
In relation to your own treatment and care, <C> has spoken to <NewVCB> about follow-up sessions. It was agreed that there would be a seamless [*explodes laughing*] transition at that time [<pedantry>at what time? What point of your letter are you referring back to?</pedantry>] to the provision of support from either a community psychiatric nurse or a social worker from the community mental health team. The details of who this will be and the extent of the contact will be negotiated closer to the time of transfer.
Mr Asshole Director-Person Cunt.
One thing that really annoyed me that has no relation to that actual content of the letter was that he addressed me as ‘Mrs <my new surname>’, assuming that any female changing their name must be doing so owing to marriage. My cunting bank did this as well, which send me into a spiralling fury of ranty anti-capitalist rage. What a pile of outdated, presumptuous, misogynistic crap.
Anyhow, this is my proposed response.
Dear Mr Director-Person
Re: Accessing MH Services
Previous correspondence refers. Thank you for your eventual response of 12 May 2010.
I note with interest your willingness to point out that NICE guidelines are not always applicable in this jurisdiction, and that a regional team is “considering” the application of the KUF. I also have taken note of the information that a plan is being “worked on” to develop services in this Trust and that a NI Strategy for PD apparent exists. However, you will recall that in my letter of 11 March, I specifically requested details on how the treatment of the very real challenges faced by Northern Ireland individuals with mental health difficulties (not just personality disorders) is being adequately governed and protected now. I am disappointed to note that you have failed to provide this information.
You may be aware that <NewVCB>, whilst reluctant to continue the tradition inherent in the system of providing stigmatic diagnoses, felt that I am afflicted with a form of complex post-traumatic stress disorder. I would refer you to Trauma and Recovery by Judith Herman and The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization by Onno van der Hart on this subject. As I am sure you are aware, these sources (and many others) quite definitively feel that whilst psychotherapy is a vehicle to recovery, the inadequate provision of same can lead to re-traumatisation. Given your apparent familiarity with my case, I believe that I can fairly reasonably conclude that you will be aware that I am thoroughly re-traumatised thanks to recent work with C.
To that end, I should be grateful if you could clarify the mandate of mental health services within your Trust. Is it your actual goal to discourage healing and indeed bring about psychological damage to ill and traumatised individuals?
In particular, I must question the decision to refer me to a CPN or mental health social worker after my contact with C ceases. I must confess to being amused at your contention that the transition from C to this person would be “seamless” – aside from the fact that it is impossible for you to predict the level of “seamlessness”, and the fact that I am well acquainted with C without any knowledge of his “successor” (and bearing in mind social anxiety is one of my many diagnoses), as yet no one has been able to tell me exactly what such individuals do other than to attempt to encourage their charges to complete day to day activities. C-PTSD and BPD, as you know, require significant psychotherapy, not reminders to undertake simple tasks (which, I might add, are often impossible regardless of external encouragement). Whilst there is arguably a place for such professionals as adjunctive workers involved in a person’s treatment, at present I utterly fail to see how assigning them as the primary contact can be of significant benefit, at least to someone someone such as myself.
On the other hand, I am also aware that certain individuals of these specialisms practice the supposedly panaceatic techniques of cognitive and dialectical behavioural therapy. After my 12 years of being richocheted around your system – and of being forced into the private sector thanks to its failings – I have experience of these “therapies” and feel strongly that not only are they ineffective and patronising, they are indeed offensive. Their practice is in keeping with the victim-blaming culture that seems inherent in psychiatry and allied professions in reference to BPD.
Whilst I accept that the above view is personal and not held by everyone, and that these techniques can have at least temporary usefulness for some sufferers of mental illness, it has been accepted by those involved in my own case that this would not be appropriate for me. I would therefore hope and expect that it is not suggested.
I would, ergo, again enquire as to the relevance of a CPN or SW as opposed to a qualified psychotherapist as my primary case worker.
I would like to convey my sincere thanks to you for inviting me to express interest in your user involvement scheme. I shall be writing to your AD, <BitchBrain>, with said expression forthwith, and look forward to hopefully making a worthwhile contribution to personality disorder services within our Trust.
Thank you for your time.
I whacked this response out on a secluded beach on the Turkish Mediterranean. My God, what a sad, pointless life I lead!
I’m seeking advice on this one because, although I feel my letter is fairly good, it doesn’t ask many direct questions, meaning that Mr D-P can cleverly wriggle out of answers yet again. To this end, I wonder if any of you would like to suggest amendments, additions or direct questions that I could use when writing back to him. As with the last post, all views are most welcome.
Thanks again lovelies. x