"I don't have anywhere safe to go"

About: Camden and Islington NHS Foundation Trust / Crisis resolution

(as the patient),

Written with advocacy support:

I cant work with the crisis team, I find them unreliable and they don't provide women workers and tell you to go to A&E. They also refuse to work with me and I dont feel safe with them. I don't have a community team because I get very very scared of mental health services.

Because there is a complaint about them the crisis team tell the GP that if I want any help or if am acutely mentally ill I have to have a mental health act assessment which means they come and see if to detain you and lock you up. it is very frightening so I stay away from the gp. The crisis team also tell the gp to call the police to do a 'safe and well' check so the police often come. So I feel like a criminal when I have never been violent. This is wrong. They should have beeter crisis services. Many people I know and my advocate knows can not get help from camden crisis teams.

why isnt there somewhere that is not nhs that I can go to and just stay until I feel better? I have just come out of hospital again in a different area to this Trust as the police detained me on a section out of area and then the hospital admitted me. But because C&I have discharged me and there is a complaint C&I crisis teams tell police and other hospitals that they dont offer follow up. So I have been admitted 2 times in last 7 months including once abroad and I never get any help after.

They have policies that are about supporting people but if they cant/wont work with you or you are too scared then they say no we wont help

the police records show many times the police have contacted the Trust for help and been told no. And the Trust has rarely told my gp of these contacts so even the support I am meant to get doesnt happen as the gp doesnt know if I am at risk

mental health services frighten me so much. I would rathe be dead than ask them for help again. everything feels so aggressive and threat to me. I have nowhere safe to go. I am a burden to my family as carers and they have never had help and feel C&I are very unsafe

there is no hope with these people they always claim they are right and that they listen but they dont

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Response from Camden and Islington NHS Foundation Trust

Dear endsigns

It is extremely distressing to hear what you have to say. No one should be worried about contacting us, let alone of being "locked up" as you describe, and feel they have nowhere to go.

I can categorically say that we don't advise GPs or others not to help someone, no matter how difficult a patient is. Of course, if someone is a physical threat to our staff then we must take precautions, but it seems that this is not the case at all.

It is difficult for us to help you if we don't know who you are. So please do get in touch with feedback@candi.nhs.uk, and quote this case. I promise you there won't be any negative repercussions to your care, and our staff will do their utmost to help you.

However, in case you don't get back in touch, then I will ensure the relevant teams reply to your original post, but the response may be fairly generic as we don't know who you are, but I hope it will reassure you that you do have somewhere safe to go.

Thank you for getting in touch


Response from Camden and Islington NHS Foundation Trust


Crisis Resolution Teams

Our ref: AC/15/Q1/37

Dear endsigns

Thank you very much for taking the time to put in writing your concerns regarding care under Camden & Islington NHS Foundation Trust. I do appreciate that you wish to remain anonymous, however as we are unaware of your identity we are unable to feedback to you as detailed a response as we would normally provide.

In order to address your concerns the response below has been written by the team leader for South Camden Crisis Team, on the basis that your main concerns within your post pertain mostly to this service.

To address each point as follows:

1. The South Camden crisis team do not provide female workers.

There is a mixture of males and females within the team. Whenever possible, should there be a request for one gender only, the team will always endeavour to provide this whenever possible. The team have an alert mechanism to highlight this so team members are aware before a visit is allocated. Due to the team having a relatively even split of male and female staff, this request can be met almost all of the time. During the hours of 21.00hrs and 08.00hrs however the Camden crisis service has one staff member based at A&E. As a result of only one staff member working during these hours, this of course does significantly increase the possibility of a request for service user contact with a specific gender not being met. As a result of this a system has been developed to allow the opportunity for a male or female service user to speak to a member of staff in one of the crisis houses.

2. The South Camden Crisis Team tells service users to go to the casualty department.

The South Camden Crisis Team has been set up to allow more resources within the community to minimise the need to direct a service user to the casualty department. A crisis team worker will make a judgement as to whether the level of need amounts to a decision to direct the service user to casualty as opposed to the team themselves managing the presenting need. This is of course a judgement call and the team manager needs to keep a close eye, as to whether team members are making the most appropriate judgements. Should you feel that you have been diverted from the crisis team inappropriately then the team manager would like to talk to you in order to gain more information with a view to improving the judgment calls within this area of care.

3. “If you are acutely unwell you must have a mental health act assessment.”

This is actually true but only on certain levels. The Crisis Teams within the trust endeavour to manage mental health crises within the service user’s home environment as much as possible. The determination as to whether Crisis Team or Mental Health Act Assessment is the most appropriate is made mostly on the grounds of risk and behavior. This can be risk to oneself or risk to others. Again if you feel that you have experienced care within our service that amounts to an incorrect decision you are welcome to discuss the matter with the South Camden Crisis Team Manager.

4. The Crisis Team telling the GP to do a police welfare check.

Yes this is true; the South Camden Crisis Team do occasionally ask the police to do a welfare check. The decision to ask the police to do this is again based on grounds of risk of the service user to self. The crisis team normally in the first instance attempt to make contact with the service user before asking the police to do so. The timing of making this request is based on levels of immediate concerns. You mentioned that you feel like a criminal when a welfare check is requested. I am sorry that this service has led to you feeling this way, however the mental health services have always worked closely with the police with health matters and will only request this when it is truly needed. I suppose the main thing to say here is that the police deal with a whole range of issues beyond crime.

5. “Why can’t I get non-NHS care”

In relation to the Crisis Team service, yes this is indeed only in the NHS. The Camden and Islington NHS Foundation Trust only really access private mental health services when an inpatient NHS bed is unavailable. Upon saying this, the Trust strive to provide all services within Trust in-patient sites wherever possible.

6. The Camden and Islington Trust did not offer follow-up.

The Crisis Team often arrange follow-up care in a whole variety of circumstances; however we would need more detail of your particular circumstances in order to provide a full answer to your question in relation to this. The minimum would always include a discharge letter back to the G.P.

I am sorry that you feel that the Camden and Islington NHS Foundation Trust particularly in relation to the South Camden Crisis Team have provided care in which you have a need to raise several areas of concern. The team manager of the South Camden Crisis Team would be pleased to be able to talk to you on the phone with a view to rectifying any gaps in the service which potentially lead to a service user feeling dissatisfied. You can contact them directly on 020-3317-6850.

You can also contact the Foundation Trust’s Advice and Complaints Service on 020 3317 7102 or write to them at complaints@candi.nhs.uk or freepost address;

Advice and Complaints Service Camden and Islington NHS Foundation Trust FREEPOST (LON 12613) – FIRST CLASS London NW1 0YT