"I felt my discharge was abrupt and unsupportive"

About: Leeds and York Partnership NHS Foundation Trust / Adult mental health

(as the patient),

I went off sick from work with anxiety and depression. After 2 months I was in very bad way. I was asked if I wanted to go to the day centre. I went for about 10 days and found it very helpful. All but one of my workers were always kind and helpful.

However, on the day of my discharge, I sat in a room with 3 psychiatrists who told me I should give up work and claim benefits. My CPN was not at the meeting, I do not have a carer and the keyworker who was present was too busy to see me afterwards as she was involved in the review meetings and was quite curt with me.

I felt despondent at being told I should give up work and was very worried about my future on benefits in the current economic situation. I could have done with some support then and there and someone to talk through things.

In the end my retired parents travelled 200 miles to see me the following week so I at least had some support then. I also saw the CPN 5 days after discharge. She was rather surprised at what had happened and had NOT been given a copy of my discharge summary.

On the day I was discharged I would have expected the CPN to be there and it would have been good to have some contact with a keyworker immediately afterwards. I hope this is not common practice.

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Response from Leeds and York Partnership NHS Foundation Trust We are preparing to make a change

Dear Caroline, Thank you for taking the time to make us aware of your experience. It is always valuable to receive feedback about our services but obviously unfortunate that your experience was below that which you should expect. I am Guy Brookes, Consultant Psychiatrist and Associate Medical Director at Leeds Partnerships NHS Foundation Trust. From your description it seems that you were attending one of our Acute Community Services. It is a pity that having found the service to be so helpful whilst there, you felt that on leaving that you had little support and that your needs and worries were not properly considered. I apologise for this as it clearly caused you and your family a lot of upset. I am glad your parents were able to travel to be with you, but it is disappointing that you felt you had to look so far for support on your discharge. At the Trust we work within the Care Programme Approach which is a framework designed to ensure that all your needs (including finances, accommodation, education or employment) are carefully considered and acted upon. You should be centrally involved in the process of managing and agreeing your care plan as should your community nurse. In this instance it seems that the process may not have been satisfactorily followed. For example, it is certainly usual for your care co-ordinator or community nurse to be present at all your CPA meetings. Furthermore we do acknowledge that discharge from a particular service (although a positive indicator of recovery) can often provoke anxiety, and so we try to ensure that any transition to a different service or level of support is as smooth as possible. It is also clear that the prospect of being unable to work is a concern for you. It might be that the professionals involved in your care had good reason for suggesting that you should not return. However, given your views it could be useful for us to support you in reviewing this. Your community nurse along with other organisations can help you explore this as it can otherwise be a daunting prospect. Here at the Trust we are aware that education, volunteering or employment can be hugely important to someone’s recovery. I am therefore pleased to be able to say that we are currently involved in a project with Leeds University to develop an employment support model for the Trust. We are also in the process of embedding ‘Vocational Leads’ within our Community Mental Health Teams, and having floating ‘Employment Specialists’ available to service users in the community. These individuals are trained in supporting people to remain in employment, or to access education, training and volunteering or employment opportunities, including any impact this may have on benefits. Therefore even though you may feel that this aspect of your life was not given enough consideration at the time, I can assure you that we are actively working to increase the support we can offer in this area. It is difficult for me to give you a satisfactorily detailed response as, understandably, in a public forum such as this you do not want to give out personal information. However, this is something that we wish to and should help you with. Could I suggest that in order to ensure we are giving you the right kind of support now and are helping you in the right way, you could either talk to your community nurse about your concerns or contact our Patient Advice and Liaison Service (PALS) on freephone 0800 052 5790 or by e-mail to pals@leedspft.nhs.uk, who can help you to make certain that your needs are being met. Kind regards, Dr Guy Brookes Associate Medical Director Adult Mental Health Leeds Partnerships NHS Foundation Trust