Losing a great CPN when changing catchment area

Topics: Someone who has experienced mental illness, Health professionals, Services, Recovery

I was registered with a GP and I stupidly gave them my new address. I had a letter from them a few days ago informing me that I was no longer in their catchment area and that I had to register somewhere else.

This would be fine, except that CPNs are assigned according to what surgery the patient is registered with.

According to the Islington website, I am not able to register with any GP surgeries that are within Drayton Park's community mental health team (The team that my CPN belongs to, and the team that I am a patient with). I know this because I have rang around, and all have refused me based on my postcode. One ridiculously turned me down because I lived on the wrong side of the road. I am in a new area, Holloway, as opposed to my old one, Highbury.

I am anxious and irritated for a few reasons.
The first is that I am physically only five minutes away from Drayton Park. It is literally around the corner from me, and it's much closer than it was at my old address. I feel like unplugging my monitor with the Islington website burned into it and pointing to Drayton Park from my street. It's there.
However, the worst thing is that I am likely to lose Hannah. And if I can't register with a GP assigned to Drayton Park, I have to move to another CHMT, effectively starting all over again.

I stupidly want to cry over this. I am human, and I don't like everybody. The same applies to the nurses- they are also human, and might not like me. To be blunt, I am neurotic and odd and many people don't like me, far in excess of those who do.
I am the type of person who cannot even be in the same room as someone who I suspect or know dislikes me. It makes me so uncomfortable.   It is partly the reason that I don't have a rip-roaring social life.  It was one of the problems with my previous CPN, Ola. She quite clearly was irritated by me, and we just didn't get on at all. I only continued with treatment because I knew I was being transferred to another borough, and hope springs eternal.
I like Hannah. I like her as a person. She's sarcastic and compassionate, she has similar tastes to me and she nicks my cigarettes when she visits me at home. She makes me laugh. She seems to understand me, and she seems to like me, too. She's done so much for me. She's written countless letters, pulled me out of work, supported all my benefit claims and successful appealed when things didn't go as she wanted them to. Without her, I'd probably be living in a box somewhere, ravingly psychotic. I kept a roof over my head because of her help. She is the reason that I get dressed on a Thursday because I see our meetings as a positive thing, something to work with, something to try and look forward to. She is someone that I trust and probably the second person in the world that I would actively turn to when I need help. I am legendarily awful at reaching out. I don't phone people, I don't text them, I don't e-mail them when I am struggling. I shuffle through it, and I do it alone. Rob, and Hannah, are the only people that I trust enough to call upon when things are getting difficult. If I had still been with Ola, there would be no way that I would ring up and allow the Crisis Team to get involved. She simply would never have known how depressed I felt. I confided nothing in her. She existed to take notes and then dismiss me. That was it. That was the level of our relationship. It was not for lack of trying on either part. We just didn't get on; we were opposite types of people. She had no sense of humour and humour is my ultimate defence mechanism. She questioned superficial things, like my hair dye and clothes, when these things are only part of my fashion and not deeply ingrained psychological markers.

So, depending on where I register, I might be assigned to a new CPN. I might even like them. Hannah is a fantastic CPN, however, and that's rare. I'm in no way demeaning the profession, but she is miles ahead of other CPNs I've met. Hardly anybody is fantastic at their job, whatever it may be. The chances of getting someone as good as her are slim. Slimmer still is the chance that I will actually be able to open up to them. There are people that I have known for years who I don't feel I can confide in. I fear judgment, from everyone, but not Hannah as she's reiterated time and time again to me that she's here to help me and not to judge me. She even giggles as I recall my manic escapades where others turn uncomfortably away or change the subject.

Being switched to another CPN at Drayton Park is the hopeful outcome. What is likely to happen is that I will be transferred from Drayton Park to another CMHT altogether if I cannot register with one of their GPs. Transferred away from the women's crisis centre, transferred away from the Mayflower, and transferred away from Hannah. This means starting again. I have only just been informed that I may be beginning therapy soon. This is almost two years after I was diagnosed with manic depression. Moving CMHT means I am placed at the bottom of a new waiting list. And it might be another two years before I am finally able to start therapy.

I don't want to start again. And as pigheaded as it may be, moving to another CMHT and possibly just not getting on with a new CPN means that I will end up forgoing treatment. Of course, I'll still pick up my prescriptions, but that will be it.
I'm not being melodramatic. I am really, really worried. Hannah had lightly warned me a while back that changing to a GP outside her remit would mean a new CPN.

Treatment is a depressing experience. It is depressing to take medication and depressing to be ill. It is depressing to know that you need this help when for years you became accustomed to being mad, to being alone. I went from being someone who resolutely refused help to someone who gradually, very gradually, began to accept it. But the shame I feel for it is horrible.

Having someone that you like on your side makes so much difference. It has taken me six years to receive competent medical care after being fobbed off by chancers and neglected by lazy staff. It has taken me six years to find one person that understands what I am going through and understands how I feel, how I feel when I'm ill and how I feel about the medication that is changing me, and not always for the better. That I am disconnected and disjointed, and that I don't feel like the same kinetic, lively, tempestuous person that I had known myself to be my whole life. That I feel flat, dull, boring, unremarkable and untalented. I was warned about this, of course, at the very beginning. That I may well feel far lesser than I did. And I do.

I will talk to Hannah when I see her on Thursday and make the case that I don't think it's a good idea to change CPNs or CMHTs. I don't want to say, "I need you", to go into arm waving detail about how she has helped me, and how I am so afraid of an unfamiliar room, of dealing with yet more disinterested and jaded staff, and how I just don't think I'll carry on if that happens. I don't want to say I'm dependent. I'm not. It just makes it easier, so much easier, to continue with treatment to have someone who cares. I never wanted to be someone who became emotionally attached to their caregivers. She's just doing her job. But after such a long time of being nodded at, belittled and dismissed, it made such a difference. I don't think the outcome will be good.

I don't want to start again. It has taken six, almost seven years from my first contact with mental health services to get this far.   As utterly reliant on medication as I am, at least I finally accepted I had an illness.  I stayed in this borough for a reason, and that reason was Hannah.

Comments

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1. At 03:35 PM on 10 November 2008 lauren wrote:

Moving

Hi, Just by chance came by this website and blogs. Why did you have to move knowing that you have found a great support in your CPN? Suppose that does not really help with you dealing with a major change and shift. I had to move and register with a new GP. I found it really hard to understand their different systems. The last GP surgery was more of a community surgery and the current one is a large one with 2 other GP practices. I was in dire way and they did not have my notes, so I was just told to hang on. In the end I just never went back and am not on any medication. My sister will throw me out soon and then I will be homeless, and that is when I know I will have to try and go back to the GP for help.
2. At 02:12 PM on 06 November 2008 Leigh wrote:

New job

Similarly to the lady above, I have never written a blog comment before in my life, but I have an interview next wk to be not quite a CPN but a support worker for the early intervention team in my area, so I came across this website whilst trying to do some research, I read your blog and it made me think...If I get this job I really really really hope I can do as good a job as Hannah did and I hope I have the type of relationship with my clients that you and her had. Good luck with your new CPN. x
3. At 08:29 PM on 13 August 2008 hindia wrote:

a loss

Seaneen, i have never posted a blog anywhere ever in my life before but after reading your entry i just felt utterly compelled to do so. It is like you have summed up succinctly everything i feel. I too have moved house and made the mistake of telling my GP about this. After many painful years of concealing my illness, 18 months ago i confessed to my GP and slowly built up to confiding in her many things that i have never talked about before. 3 weeks ago she made an urgent mental health referral and it was then that everything began to unravel. As a result of this it became apparant that i was no longer in the correct catchment area and the gp sent a message (via her receptionist) that i was no longer able to be a patient at the practice. I felt abandoned and betrayed. Then the crisis team became involved and things went from bad to worse. I too am somebody who does not open up to people. As i was incredibly wary of them and felt so unable to "engage" with them, they went on to threaten me with sectioning and have since sent the police round to search my house (as they said they were concerned for my safety). I now feel unable to register with a new gp and feel more isolated and pessimistic than ever. Seaneen, i really do hope you manage to sort out a way in which Hannah can remain involved with you. The rational part of me would like to encourage you to be open to the possibility of building a positive and supportive relationship with a new CPN - it may take several attempts and lots of time but it might just be worth taking the risk?
4. At 03:50 PM on 11 July 2008 Dennise wrote:

life

Hi Seaneen Life is a roller-coaster of ups and downs, mental illness is debilitating, angry and relentless but you can find good support. Like every aspect of life there is good and bad, some people provide a good service, For better a word, and some just disappoint us with their lack of empathy and understanding, but that is where on good days we can make good decisions, hold on to the encouraging thoughts that Hannah came along after a not so pleasant or successful experience with the first CPN . You have the right to the best care and support. Fight for what is right for you, it is out there. Just remember that when life becomes difficult, step back,a setback isn't a relapse it is just a blip. New people and friends are waiting round the next corner for you to meet. it is an inevitable part of life and thankfully provides us with our future. Look forward to all those new people you are going to meet.

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