"Provision of CBT to OCD sufferer by East & Mid Devon DAS"

About: Devon Partnership NHS Trust / Clinical psychology

(as a relative),

This applies to all of the DPT where there is absolutely no fit for purpose service provision for people who have severe obsessive compulsive disorder (OCD) anxiety, who need services in addition to the selective serotonin reuptake inhibitors (SSRI) medication they are already on. There seems to be no regular, consistent and extended programmes (up to 2 years+) of CBT. NICE CG31 in relation to OCD says "Each PCT, mental healthcare trust and children's trust that provides mental health services should have access to a specialist OCD/body dysmorphic disorder (BDD) multidisciplinary team offering age appropriate care. This team would perform the following functions: increase the skills of mental health professionals in the assessment and evidence-based treatment of people with OCD or BDD, provide high-quality advice, understand family and developmental needs, and, when appropriate, conduct expert assessment and specialist cognitive, behavioural and pharmacological treatment".

But where is it? Where is the ready access to specialist CBT? It is impossible from DPT website to identify clearly any of the DPT service provision at all: what there is from Board level down to it's workings on the ground, the clinicians, the teams, the pathways, the options available to an OCD sufferer, and who is responsible at each level.

This feedback relates to someone who has struggled with blood/germ/contamination OCD for approaching 30 years. Anything that looks like blood triggers extreme anxiety, leading often to spells of deep depression and thoughts of suicide at their blackest moments. These triggers can be anywhere, but have often been found at local GP surgery, hospitals etc by their very nature. This person cannot therefore freely attend consultation/clinics/sessions in those locations, because their OCD make it near-impossible/difficult to do.

Their anxiety is also severely triggered if DPT staff or others from GP/Hospital or other settings where blood is common, are likely to attend their own house. Interaction needs therefore to be at independent locations, or ones where blood is not commonly around. Their condition is well known and reported by them to DPT consultants/therapists and the like, yet for someone who needs hi-intensity CBT over extended periods, they were apparently sidelined into the low-intensity DAS service. Over 8 months DAS in Tiverton managed to only give them 3 sessions. Follow up appointments were scheduled by the service (without any consultation whatsoever) at times that were not suitable for their patient ie childcare/school needs. Worse still they randomly arrived via the post, which for the patient, represents an extreme OCD trigger, as they had routinely experienced blood stained deliveries.

Last session was some time ago and despite repeated calls into East & Mid Devon DAS have always been met by promises that a Therapist will call, but never seems to do. In one week 3 calls in with promise of call back when admin leader returned. Yet no call back ever, not even now, even despite the patient explaining last week to admin that their OCD was very much worsened as a results of the absence of any continued CBT.

East & Mid Devon DAS and DPT are not routinely monitoring (audio) calls into DAS administration departments (who have absolutely no understanding of OCD) to pick up service users who are near-falling into crisis. The patient's much worsened OCD is being caused and exacerbated by DAS and it's lack of any satisfactory response. This to me is maltreatment of the service user, it is like corporate/institutional neglect & abuse of a potentially vulnerable adult. They need fully effective hi intensity OCD anxiety CBT in a community setting. DPT have let my relative and my family down.

Rest assured this whole account is being given to the Care Quality Commission.

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Response from Peter Leggatt, Head of Communications, Devon Partnership NHS Trust

Thank you for your feedback. We are very sorry that you are unhappy about the service that your family member has received.

We would like to do everything we can to address your concerns. Our PALS team can be contacted at dpn-tr.pals@nhs.net or on 0800 0730741 and they will be happy to help.

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