"The entire experience has actually really upset me"

About: Ealing / Assessment Team

(as the patient),

When I arrived the people didn't seem to be aware that I had an appointment, although they had confirmed it a few days prior, and were unable to locate the correct information and I had to call the Referral Team myself in order to confirm it.

When I finally got to my appointment (45 mins after it was due to start) I was sat in someone's office with 3 people who stared at me like a zoo animal. 2 were psychiatrists (I was told that one was observing the other but they ended up taking over most of the appointment) and someone whose job title was a 3 letter acronym, which was never explained to me (who did not speak a single word during the hour I was there).

The first psychiatrist asked me lots of very broad questions and I had to ask to clarify a lot. There was no easing in to the conversation and one of the first things I was asked, was 'why are you here? ' My mental health is something I have discussed with about 4 people ever so perhaps asking me really bluntly in a roomful of strangers was not the best way of getting me to open up. My answers to a lot of the banal, but probably mandatory questions, were probably a bit snappy because I wasn't particularly impressed with the entire process. If any of the people in the room had read any of the referral notes from either my GP or the initial assessment team I would be very surprised as they gave no indication of it at any point.

After the first psychiatrist has finished asking me about what my parents do for a living the second psychiatrist indicated they wanted to take over and actually ask some questions about my mental health problems, however during the appointment I was asked several times about the voices I was hearing or if I heard voices or saw visions. I made it pretty clear that I had never heard any voices or seen any visions, but they seemed determined to trick me into admitting it or getting me to say I had. I was genuinely concerned that they had decided on a diagnosis and was just trying to shoe-horn me into fitting into it. Part of my mental health problems included going into disassociative states where I can't recall what has happened during them, I was told that my descriptions of these were vague and pressed me to answer questions about them. I found it rather distressing as the reason I was there was due to the fact that I am experiencing these 'blank-outs' and to be told that I am vague while describing them was not exactly helpful for my state of mind.

I had no problems with anxiety before I went to this appointment but the entire experience has actually really upset me. I am concerned about my mental health, but I think I will have to be asked to be referred to another team as I found the entire experience to be distressing and I don't think I could work with this team.

Whilst discussing if I could return to work, I stated that I wanted to do so soon. They questioned whether I was up to it, but gave no suggestions or recommendations and were fairly unhelpful on the subject. It has lead to me questioning whether I am ready to go back, with no doctor's opinion and just my own self doubt (which I did not go into the meeting with).

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Response from Vishal Jugessur, CRHT Manager, West London Mental Health NHS Trust We are preparing to make a change

Dear Sir/Madam,

I would like to apologise for the service you have received from my team and I agree with you that this must not have been a very good experience at all. It is unacceptable that you had to wait for 45 minutes for your appointment, when we encouraged our service users to be on time for their appointments.

I would also like to apologise that you were not asked for your permission for other professionals to be present in your assessment. From your description, I can only think that they would have been medical, nursing or social work students. Whilst it is important for our students to learn and have hands on experience, this has to be done with our service users' expressed consent. You should have been asked for your permission for them to be present.

I have informed my team of your concerns and I plan to discuss this further with the whole team at our next clinical improvement group. Without knowing more information or knowing who the clinicians are, I am unable to discuss the situation with them. We absolutely want to learn from instances where we could have been better and hence I would invite you to contact our PALS to give more information for me to look into this further.

Thank you for taking time to providing your feedback and once again, I do apologise your experience was not positive.

Thank you,

Vishal Jugessur

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Response from Vishal Jugessur, CRHT Manager, West London Mental Health NHS Trust

Dear upset and unimpressed,

As stated, I discussed your case with my team today and looking at the information you have given, we believe that the appointment in question took place with another team within the service. The professional who did your initial assessment in the team here was able to confirm this, looking at the information you have given.

We carried out your initial assessment and made a referral for you to be seen. This said, the principles discussed in my initial response still stand. I will contact the team concerned and inform them of your concerns.

Thank you,

Vishal Jugessur

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