Preparing to fight and to keep my peace.
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Thread Starter
Join Date: Oct 2004
Location: uk
Posts: 3,054
Preparing to fight and to keep my peace.
This is long but please read if you have time - I had a hunch I would one day be here and now I am, I could use some support.
Part of me is trying to boost my own confidence, I advocate for a living and always thought I gave the care of family and fought as I would for my own. To the best of my ability I did but the feelings this close to home are different, they make me more fearful when what I really need is confidence, caution and clarity.
Checks.
D wants the help his doctor first suggested, that was my first check - what did he want to do, did he want to fight when now we have at least some help, less qualified but some. He does still want the psychiatric referal.
To check my research, I've rang MIND, the Patients Advice and Liason Service and will ring the advocacy service. Mind put me on to another charity, it was the first time I've seen their website but they are big and reputable (Rethink - national uk mental health charity similar to MIND). This is some of what they have to say about Dual Diagnosis:
Reference - Rethink re Dual Diagnosis
So the site recomended by MIND turns out to offer no difference in suggestions and thoughts to my own research. That's a check, if I'm wrong then I sure as hell ain't alone!
I asked my best mate, she's wiser than me, works in the health system in a walk in center picking up pieces that fall through the health service net. Her views matter to me. She said 'go and do it' very few have the back up, skills or energy but it needs doing.
The next check is to return to his doctor and ask him whether he still feels the original referal was the right one, and that what we've been offered is inadequate - that one will have to wait until Monday!
Plan of action - some completed.
First was to find out what was usually involved in the advocacy process and the process of involving PALS (patient liason). Contacting MIND to get numbers and contacts - some follow up. The process is gruelling, I think hopelessly unfair to expect D to undertake, I can't undertake it without full confidentiality clearence. This is something I've avoided by D always being present but it's something D has wanted me to have for a long time. This is the first time I've considered it except if needed for safety.
IF D'S DOC FEELS WE DO NEED TO GET THE ORIGINAL REFERAL - big IF, then I'll accept formal clearence. D wants me to do it, he said he fixes computers and stuff I scrap with teh system and he wants the best chance for the right help. I'm more than happy it is only doing what D CANNOT do himself.
If the doc agrees to fight I'll ask for a statement from him to that effect in writing. I will also ask for all relevant dates of referal and document hard evidence of life damage while D has waited (lost job, increasing depression, increasing dependance on me, dramatically reducing quality of life, lost confidence etc etc etc).
Then I'll take this information to advocacy and ask their advice/support in dealing with the patient liason service (PALS). I now have the correct number for the PALS which would directly be involved with D's case - it will formalise the process.
My aim would be to formalise a complaint about the wait so far, gain agreement that at the very least if he is re-refered by those who they've passed him to now as well as his doc that they will assess him before refusing treatment.
Best outcome would be that they reconsider and assess him now. To try and achieve that I'll argue against the acedemic logic of their refusal - it might sound arrogant but I think (+his doc) it's so wrong that argument against will be easy. This bit may all be subject to change in accordance with advocacy advice.
Formalising the process of objection increases the proffessional culpability in law, especially when the objection first came from a fellow medic. That information is as much use as a chocolate teapot UNLESS they know we know that.
For me, my peace.
* To accept I can only act to the best of my ability, I can and will get some things wrong, but to keep in mind as long as my actions leave a good footprint then they are good enough.
* To remember all those I deal with are human and not let anger cloud that, to remember they have compassion too, like me they make mistakes, like me they can try again.
* To always keep in mind not to act 'for D' against his will, not to represent him, to empower him to take whatever part he can, and not to lose sight of what he can achieve.
* To keep in mind strong words are when the heart and mouth speak the same language. That's my ace, I know that and maybe they don't. If I want my words to be right my heart must be right and that's why I mustn't let anger take away compassion.
Could my friends here help me watch these things closely and remind me if I forget?
Part of me is trying to boost my own confidence, I advocate for a living and always thought I gave the care of family and fought as I would for my own. To the best of my ability I did but the feelings this close to home are different, they make me more fearful when what I really need is confidence, caution and clarity.
Checks.
D wants the help his doctor first suggested, that was my first check - what did he want to do, did he want to fight when now we have at least some help, less qualified but some. He does still want the psychiatric referal.
To check my research, I've rang MIND, the Patients Advice and Liason Service and will ring the advocacy service. Mind put me on to another charity, it was the first time I've seen their website but they are big and reputable (Rethink - national uk mental health charity similar to MIND). This is some of what they have to say about Dual Diagnosis:
Thirty-seven percent of alcohol abusers and 53% of drug misusers also have at least one serious mental illness.
It can be difficult to tell which problem came first. Often the psychiatric problem develops first and in an attempt to feel calmer, more alive, or more cheerful, a person with psychiatric symptoms may drink or use drugs. Doctors call this "self-medication". Frequent self-medication may eventually lead to physical and psychological dependency on alcohol or drugs. If this does, the person then suffers from not just one problem, but two.
Initially, the mental health team will make contact with the person, show them what it has to offer, provide social support, and involve carers and family if appropriate. D was diagnosed with depression in May, raised alcohol problems with his doctor late June, was refered July and has yet had only one letter (yesterday) from the mental health team and been refused by the psychiatric team.
When an initial relationship has formed, mental health workers work to help clients understand the nature of their problems and what can be done about it. At the same time specific counseling skills can be used to help motivate the person into making change. D has had to seek out his own less qualified treatment through an alocohol advisory service. We now have no assigned counsellor and only luck meant our first was qualified and an EX menatl health worker.
Active treatment combines medication to treat the mental illness, education, family involvement and cognitive behaviour therapy. Two important factors to the success of treatment are the development new coping skills and a social network. D's doctor feels his meds may be wrong but changes without support are risky - he knows the psychiatrists are qualified where he isn't but they have refused. D may well have been on the wrong AD's since June. Family (me) has been involved but by D's and the doctors efforts, I onlty recieved support in that due to our first 'lucky break' alcohol counsellor who knew how to do it. D has had nothing to offer new coping skills and his only social network has been me and two of our tenaciously loyal friends.
The final step of treatment is the prevention of relapse. The person is taught to identify situations in which they will become vulnerable to substance misuse and how to deal with these situations. Apparently D must achieve this alone for the psychiatric team to agree to offer the treatment of the first 3 steps!!
When an initial relationship has formed, mental health workers work to help clients understand the nature of their problems and what can be done about it. At the same time specific counseling skills can be used to help motivate the person into making change. D has had to seek out his own less qualified treatment through an alocohol advisory service. We now have no assigned counsellor and only luck meant our first was qualified and an EX menatl health worker.
Active treatment combines medication to treat the mental illness, education, family involvement and cognitive behaviour therapy. Two important factors to the success of treatment are the development new coping skills and a social network. D's doctor feels his meds may be wrong but changes without support are risky - he knows the psychiatrists are qualified where he isn't but they have refused. D may well have been on the wrong AD's since June. Family (me) has been involved but by D's and the doctors efforts, I onlty recieved support in that due to our first 'lucky break' alcohol counsellor who knew how to do it. D has had nothing to offer new coping skills and his only social network has been me and two of our tenaciously loyal friends.
The final step of treatment is the prevention of relapse. The person is taught to identify situations in which they will become vulnerable to substance misuse and how to deal with these situations. Apparently D must achieve this alone for the psychiatric team to agree to offer the treatment of the first 3 steps!!
So the site recomended by MIND turns out to offer no difference in suggestions and thoughts to my own research. That's a check, if I'm wrong then I sure as hell ain't alone!
I asked my best mate, she's wiser than me, works in the health system in a walk in center picking up pieces that fall through the health service net. Her views matter to me. She said 'go and do it' very few have the back up, skills or energy but it needs doing.
The next check is to return to his doctor and ask him whether he still feels the original referal was the right one, and that what we've been offered is inadequate - that one will have to wait until Monday!
Plan of action - some completed.
First was to find out what was usually involved in the advocacy process and the process of involving PALS (patient liason). Contacting MIND to get numbers and contacts - some follow up. The process is gruelling, I think hopelessly unfair to expect D to undertake, I can't undertake it without full confidentiality clearence. This is something I've avoided by D always being present but it's something D has wanted me to have for a long time. This is the first time I've considered it except if needed for safety.
IF D'S DOC FEELS WE DO NEED TO GET THE ORIGINAL REFERAL - big IF, then I'll accept formal clearence. D wants me to do it, he said he fixes computers and stuff I scrap with teh system and he wants the best chance for the right help. I'm more than happy it is only doing what D CANNOT do himself.
If the doc agrees to fight I'll ask for a statement from him to that effect in writing. I will also ask for all relevant dates of referal and document hard evidence of life damage while D has waited (lost job, increasing depression, increasing dependance on me, dramatically reducing quality of life, lost confidence etc etc etc).
Then I'll take this information to advocacy and ask their advice/support in dealing with the patient liason service (PALS). I now have the correct number for the PALS which would directly be involved with D's case - it will formalise the process.
My aim would be to formalise a complaint about the wait so far, gain agreement that at the very least if he is re-refered by those who they've passed him to now as well as his doc that they will assess him before refusing treatment.
Best outcome would be that they reconsider and assess him now. To try and achieve that I'll argue against the acedemic logic of their refusal - it might sound arrogant but I think (+his doc) it's so wrong that argument against will be easy. This bit may all be subject to change in accordance with advocacy advice.
Formalising the process of objection increases the proffessional culpability in law, especially when the objection first came from a fellow medic. That information is as much use as a chocolate teapot UNLESS they know we know that.
For me, my peace.
* To accept I can only act to the best of my ability, I can and will get some things wrong, but to keep in mind as long as my actions leave a good footprint then they are good enough.
* To remember all those I deal with are human and not let anger cloud that, to remember they have compassion too, like me they make mistakes, like me they can try again.
* To always keep in mind not to act 'for D' against his will, not to represent him, to empower him to take whatever part he can, and not to lose sight of what he can achieve.
* To keep in mind strong words are when the heart and mouth speak the same language. That's my ace, I know that and maybe they don't. If I want my words to be right my heart must be right and that's why I mustn't let anger take away compassion.
Could my friends here help me watch these things closely and remind me if I forget?
Member
Join Date: May 2004
Location: England
Posts: 3,410
I think that is a wonderful, carefully thought out plan. As you know, I have felt very strongly about this for a long time and I know that I would be doing the same if I were in your shoes. Perhaps my opinion is slightly clouded as I lost a dear friend 3 years ago through NHS incompetence (imo), and I of course have no recourse about it.
I am here to support you and be with you every step of the way.
I am here to support you and be with you every step of the way.
Member
Thread Starter
Join Date: Oct 2004
Location: uk
Posts: 3,054
Thanks minnie!! Thanks for nudging me to MIND too, it was a fantastic resource to begin knowing who to contact. Just help keep me in line too - I'll need it when I get all hot and bothered!
Last night I went for a coffee with my best mate. She spends day after day patching up those who should be better looked after, she often uses her role to provide those first proffessional objections to the care they recieve. It's about pieces of information needed to make another proffessional aware of legal culpability (legal blame).
The first information is the doctors clinical assessment, the second is to have research supporting that opinion. But that is worthless if no losses can be shown - to show incompetance you also have to show the result of the incompetance. If all those have been raised with the psychiatric team it adds legal weight if they are shown to have acted wrongly - they will know that. Like my freind says, if a fellow nurse or patient raises an objection it 'removes' the 'get out clause' of acting 'to the best of my knowledge at the time'. Proffessional responsibility relies on an unwritten rule - 'are my actions justifiable with the information I had? have I filled the requirements of my proffession?'
The part D cannot do is the cost and that's vital, without consequence you have no cause to suggest actions can be shown to be wrong. D is just about getting to the stage where he can, with support, if asked the right way, tell his own doctor he's struggling to get outside again. That's a world away from using that information to persaude people trying to show it is not their fault but his. D is just about getting (with all the above) to the stage he can tell his doctor sometimes he can't see the point of anything anymore, again to do that with a stranger is different. D is struggling with feeling ashamed not to be working, BUT that he's lost his job is an important life indicator. D is desperate to have a chance of making new friends, he can only just about say to me how worried he gets even posting on a forum (but he is trying). The fact he is almost entirely socially excluded now is a life consequence. His contact with the outside world deminishes week by week.
He's attended every appointment, was honest from the start with his doc, reading the above recomendations for dual diagnosis from Rethink - I realised how phenomenal his effort has been - what's been achieved from what they suggest has directly come from his openess and efforts. Even the support I've offered would have been redundant and stupid unless it had been wanted or without the level of co-operation D has shown with those working with him and me.
Last night I went for a coffee with my best mate. She spends day after day patching up those who should be better looked after, she often uses her role to provide those first proffessional objections to the care they recieve. It's about pieces of information needed to make another proffessional aware of legal culpability (legal blame).
The first information is the doctors clinical assessment, the second is to have research supporting that opinion. But that is worthless if no losses can be shown - to show incompetance you also have to show the result of the incompetance. If all those have been raised with the psychiatric team it adds legal weight if they are shown to have acted wrongly - they will know that. Like my freind says, if a fellow nurse or patient raises an objection it 'removes' the 'get out clause' of acting 'to the best of my knowledge at the time'. Proffessional responsibility relies on an unwritten rule - 'are my actions justifiable with the information I had? have I filled the requirements of my proffession?'
The part D cannot do is the cost and that's vital, without consequence you have no cause to suggest actions can be shown to be wrong. D is just about getting to the stage where he can, with support, if asked the right way, tell his own doctor he's struggling to get outside again. That's a world away from using that information to persaude people trying to show it is not their fault but his. D is just about getting (with all the above) to the stage he can tell his doctor sometimes he can't see the point of anything anymore, again to do that with a stranger is different. D is struggling with feeling ashamed not to be working, BUT that he's lost his job is an important life indicator. D is desperate to have a chance of making new friends, he can only just about say to me how worried he gets even posting on a forum (but he is trying). The fact he is almost entirely socially excluded now is a life consequence. His contact with the outside world deminishes week by week.
He's attended every appointment, was honest from the start with his doc, reading the above recomendations for dual diagnosis from Rethink - I realised how phenomenal his effort has been - what's been achieved from what they suggest has directly come from his openess and efforts. Even the support I've offered would have been redundant and stupid unless it had been wanted or without the level of co-operation D has shown with those working with him and me.
Alcohol is a cruel mistress!!!
Join Date: Jun 2005
Location: crownpoint newyork
Posts: 820
Hi Equus, I am sorry you are going through this. I not real aware of how the system works over in england but it does sound like D has been going to alot of different therapists. I know I would prefer to talk to one good one that I could trust and establish a bond with. I can see why you are frustrated. I like the serenity prayer maybe it would help you. You seem to be a great wife you really loves her husband, I admire how your supporting him. Keep up the good work and keep your chin up. With love, Kerry
Searching and tripping
Join Date: Sep 2004
Location: Back in my head
Posts: 1,194
It's pretty obvious that your plan was well formatted. Nothing off the top of the head here. How can I forget this one. You taught me about this through your posts. Remember the old saying..."if at first you don't succeed, try try again."
(((((((((((((Equus))))))))))))
To remember all those I deal with are human and not let anger cloud that, to remember they have compassion too, like me they make mistakes, like me they can try again.
(((((((((((((Equus))))))))))))
Member
Thread Starter
Join Date: Oct 2004
Location: uk
Posts: 3,054
Thanks reader, and Kathy yep - that is a good old saying!!
I've got brain strain today so thankfully all this is on hold now till the docs on monday.
Thankfully too it's FRIDAY!!! Yipeeeeee!! At work I'm having to blend and analyse legislation for private fostering, fostering, and the legal requirements for foster placement of looked after children. Then rewrite the info in child friendly form so that they know what they need to know - all this before a campaign to advertise Soc. Serv's need to be informed of private fostering arrangments (giving your kid to a friend to care for). The fun bit is we've just found a nasty loophole which means a child's status would get very complicated in a particulalr (and quite likely) circumstance change.
As per FF'ing usual the fostering team have misread the bloody legislation and think they can do what they can't!!
Rant over - back to writing up and hometime soon!!
I've got brain strain today so thankfully all this is on hold now till the docs on monday.
Thankfully too it's FRIDAY!!! Yipeeeeee!! At work I'm having to blend and analyse legislation for private fostering, fostering, and the legal requirements for foster placement of looked after children. Then rewrite the info in child friendly form so that they know what they need to know - all this before a campaign to advertise Soc. Serv's need to be informed of private fostering arrangments (giving your kid to a friend to care for). The fun bit is we've just found a nasty loophole which means a child's status would get very complicated in a particulalr (and quite likely) circumstance change.
As per FF'ing usual the fostering team have misread the bloody legislation and think they can do what they can't!!
Rant over - back to writing up and hometime soon!!
Occasional poor taste poster
Join Date: Jul 2005
Posts: 2,542
I know one thing for sure! I would NOT want to debate w/ Equus over who's right and who's wrong about ANYTHING, much less very complicated rules & regulations of a very complicated medical system. There's no doubt in my mind you will go in prepared! Your best mate giving you inside information!! Knowing you and the research you have put into this! Go get'em tiger! D is a very lucky man.
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Thread Starter
Join Date: Oct 2004
Location: uk
Posts: 3,054
I know one thing for sure! I would NOT want to debate w/ Equus over who's right and who's wrong about ANYTHING,
Thanks yous!!!
I'm home from work and AM NOT reading fostering leg over the weekend! I've already wandered round the auction rooms on my way back, put my feet up, watched Michael Palin in the Himalayas (love it!!), come for a squiz here and feel loved up from SR!!
AND...... Been reading 5 sheets of A4 D has done on his APAS excercises!!! It's fantastic - the BEST I've seen him do!
Life is good, I think I'm ready and from here on what will be will be.
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Thread Starter
Join Date: Oct 2004
Location: uk
Posts: 3,054
Originally Posted by cwohio
how i feel after reading an equus post....
(that would be me poking my brain to see if it's actually working!)
D is so lucky to have such a tenacious woman as his partner in life!!!!
(that would be me poking my brain to see if it's actually working!)
D is so lucky to have such a tenacious woman as his partner in life!!!!
Member
Join Date: Dec 2004
Location: Chicago, IL
Posts: 2,333
Equus...you must be exhausted!!! You put so much effort into everything you do.
My week had been so incredibly simple and wonderful (waiting for the other shoe to fall...bad codie) that I can't even image all the strength you muster up.
I hope you get some relazation this weekend, you desserve it.
My week had been so incredibly simple and wonderful (waiting for the other shoe to fall...bad codie) that I can't even image all the strength you muster up.
I hope you get some relazation this weekend, you desserve it.
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