"Discharged out of the blue"

I was discharged from psychiatry without any consultation despite my psychiatrist promising me they would give me an appointment 3 months later at my last appointment. I had mentioned to them how my last psychiatrist would keep telling me that my next appointment would be in 3 months but I would always have to chase it up via phone, ending up with my appointments being more like every 4 months and they had said they would book my appointment straight away to avoid this happening. 

My discharge letter was incredibly generic, had some apologies about services being full and case reviews being done and had nothing about why I was being discharged. It made no reference to my status waiting for anxiety management or occupational therapy so I had to phone and get this clarified myself. 

My discharge letter was dated about 2 months before I received it. I had phoned regarding my concern that I hadn't had an appointment in over 3 months and the next commutation I got from Livilands was the discharge letter. Clearly it hadn't been sent to me when I was actually discharged and they instead only sent it out when I enquired about it.

Discharge had not been discussed with me at any point and I wasn't given any advice for further care beyond going to see my GP. Upon discussing this situation with my GP they were absolutely outraged that Livilands had done this, they looked through my notes and seemed to think I had been discharged prematurely as the notes talked about waiting for me to finish anxiety management before doing anything else. As discharge hadn't been discussed with me there was no obvious criteria for which I had been discharged. My condition had clearly been gradually declining while I languished on waiting lists for years without any significant help and it was at this point they chose to discharge me.

Another concern was that at my last psychiatry appointment the doctor took me off the anti-psychotics that I had been on for some time. This was a very significant medication change and I would've very much appreciated a follow up medication review appointment because sending me back to the GP, who will not deal with the kinds of psychiatric medication I have been taking, is simply not good enough. It honestly feels quite negligent to not follow me up on this, when I started the medication I had to have an ECG done and my weight taken and this was not followed up on when I stopped the medication despite me feeling significant problems with weight gain.

Being discharged out of the blue was incredibly detrimental to my mental health. I felt let down and discarded. Not to mention the fact that I had told my psychiatrist at my last appointment that I was potentially facing homelessness and that I felt my condition was declining due to not being offered very much in the way of mental health services for years. Fortunately the council managed to save me from homelessness but since the discharge decision was made without even checking on my current situation (they hadn't seen me in months) there was clearly no way for them to know that and they didn't bother to check before discharging me. The decision to discharge me was based on maybe a handful of contact appointments they'd had with me in the past year, during which discharge was not brought up a single time. I had absolutely no idea what I was meant to be doing after my discharge and I still don't.

Naturally, I complained about this as it felt like such an egregious breach of their duty of care. The response I received back is honestly quite jarring as I feel it shows such poor self-reflection on the part of Livilands. They stand by their decision to discharge me, saying that this would be an appropriate decision as ongoing support [would be] provided through the group programme. They go on to say that this group starts in May 2024. It is genuinely astounding that they think this is a justification and I can't even get my head around it. I have had literally zero communication from any mental health services since I was discharged, apart from when I've phoned them myself to enquire about whether I'm even on their waiting list.

I feel it makes absolutely no sense to discharge me because I may potentially have group support in a year's time. Add to that the fact that after being sent the discharge later I wasn't even aware of whether I was still on the waiting list for this group, and the only conclusion I can come to is that they are being dishonest and trying to cover themselves. If, as I suspect and can deduct from the information available, I was discharged because the services are too full and they need to get rid of some patients then they shouldn't be trying to make up a clinical reason. If the decision to discharge me was clinical in nature, it would've been done after assessing my current condition, not what my condition was the last time I had an appointment, which was months before they made the decision. You discharged me without even being aware of what my current condition was - this is clearly negligent, in my view.

I got the generic staff are sorry apology in the letter which obviously means less than nothing to me. Something is clearly systemically wrong at Livilands as I've been under their care for maybe half a decade and there have been many times I've felt like they haven't treated me with basic compassion; this is just another example. To add to that their waiting lists are ridiculously long for everything (years), they barely offer any variety of services or day services and they have a revolving door of psychiatrists and locums. This is actually the second time I've been discharged without consultation form them and I'm fed up.