The Student Room Group

CMHT are saying I can't discharge myself from their care

I want to discharge myself from the CMHT as I don't require their help or services anymore but my care-coordinator is saying that it's not as simple as just discharging yourself, I can't discharge myself without approval from my consultant psychiatrist.

She said if I try to discharge myself by refusing to engage with them it will look poorly on me and could reinforce their belief that I lack the insight to make rational decisions and I'm at risk, which could prompt an AMHP visit to my home.

Why is she threatening me like this? I'm pretty sure it's illegal to compel me to continue attending appointments and she's just trying to scare me into continuing with their treatment plan.

They're acting like I'm sectioned in hospital or something... It's my choice if I want their help or not and I do not want it. I have an appointment coming up soon where the consultant psychiatrist is going to talk to me about why I want to leave etc.

Should I just not go to it and ignore all communication from them so they discharge me for non engagement?

They are wasting time, people and resources on me instead of spending those resources on someone who's actually sick and needs / wants help.

It's so ridiculous.

Reply 1

It is likely that a consultant psychiatrist is a better judge than you are of your state of mental health. You cannot be compelled to attend appointments or follow advice, but if doctors consider that you are a danger to yourself or others they could take steps to have you detained for assessment or treatment.

The team is trying to help you.

Reply 2

Original post by Stiffy Byng
It is likely that a consultant psychiatrist is a better judge than you are of your state of mental health. You cannot be compelled to attend appointments or follow advice, but if doctors consider that you are a danger to yourself or others they could take steps to have you detained for assessment or treatment.
The team is trying to help you.

I know they're trying to help me but I don't actually need any help. And that's not me being stubborn or rude, I'm just not unwell. It's like a doctor asking you to use a pair of crutches that you don't need. The doctor is just looking out for you but your leg is fine so you don't need the crutches.

I have been attending for long enough but now I no longer require help.

Reply 3

Original post by evident-moonshin
I know they're trying to help me but I don't actually need any help. And that's not me being stubborn or rude, I'm just not unwell. It's like a doctor asking you to use a pair of crutches that you don't need. The doctor is just looking out for you but your leg is fine so you don't need the crutches.
I have been attending for long enough but now I no longer require help.

Put it this way: are you qualified to diagnose whether or not you have cancer? If not, why do you think that you are qualified to diagnose your mental health?

Reply 4

Original post by Stiffy Byng
Put it this way: are you qualified to diagnose whether or not you have cancer? If not, why do you think that you are qualified to diagnose your mental health?

I'm not trying to diagnose my mental health. I'm saying that I don't require the help / services of the CMHT anymore. Let's say you go through a traumatic experience and decide to take up therapy to help you through it. Once you come out the other side and are doing well, there's no need to continue going to therapy anymore.

It's literally the exact same situation.
(edited 1 month ago)

Reply 5

Original post by evident-moonshin
I'm not trying to diagnose my mental health. I'm saying that I don't require the help / services of the CMHT anymore. Let's say you go through a traumatic experience and decide to take up therapy to help you through it. Once you come out the other side and are doing well, there's no need to continue going to therapy anymore.
It's literally the exact same situation.

I have yet to work in any CMHTS which wasnt actively trying to discharge people (even when they needed specialist help), so do find it highly unusual that they would be trying to keep you coming even if you didnt want to.

You may be an outlier, and if so ask for a case review and discharge plan alongside your support networks. As has already been queried, when we are really struggling with our mental health we may not be fully cognistant of the extent of our difficulties as we may get so used to feeling or thinking this way, and thus may struggle to fully realise we need help. Its right not to rush into decisions regardless, and a formal review does sound like a good option.

Greg
(edited 1 month ago)

Reply 6

Original post by evident-moonshin
I'm not trying to diagnose my mental health. I'm saying that I don't require the help / services of the CMHT anymore. Let's say you go through a traumatic experience and decide to take up therapy to help you through it. Once you come out the other side and are doing well, there's no need to continue going to therapy anymore.
It's literally the exact same situation.

Diagnosing your mental health is exactly what you are doing. Lack of insight into the existence of mental illness can be an obstacle to recovery.


No NHS organisation deliberately wastes resources. The team's professional judgment is that you still need help.

Reply 7

Option 1 : Go to the appointment and simply explain yourself.

Option 2 : Stop taking calls or emails claiming that you know better and vaguely implying some sort of conspiracy.

Reply 8

Original post by Stiffy Byng
Diagnosing your mental health is exactly what you are doing. Lack of insight into the existence of mental illness can be an obstacle to recovery.
No NHS organisation deliberately wastes resources. The team's professional judgment is that you still need help.

You're just like the CMHT, you think that because someone no longer feels the need for any further help, they must be lacking insight and therefore are unwell.

Reply 9

Original post by StriderHort
Option 1 : Go to the appointment and simply explain yourself.
Option 2 : Stop taking calls or emails claiming that you know better and vaguely implying some sort of conspiracy.

I will go and explain myself but if they insist for my to continue under their care I'm just going to cease all contact. If people don't even believe me when I tell them I'm doing well then that isn't a healthy relationship to have anyway.
This previous thread has some relevant background.

Reply 11

Original post by greg tony
I have yet to work in any CMHTS which wasnt actively trying to discharge people (even when they needed specialist help), so do find it highly unusual that they would be trying to keep you coming even if you didnt want to.
You may be an outlier, and if so ask for a case review and discharge plan alongside your support networks. As has already been queried, when we are really struggling with our mental health we may not be fully cognistant of the extent of our difficulties as we may get so used to feeling or thinking this way, and thus may struggle to fully realise we need help. Its right not to rush into decisions regardless, and a formal review does sound like a good option.
Greg

What is your role within the CMHTS?

What can I do to prove to my psychiatrist that I am not unwell and therefore do not need any further help?
Original post by evident-moonshin
I want to discharge myself from the CMHT as I don't require their help or services anymore but my care-coordinator is saying that it's not as simple as just discharging yourself, I can't discharge myself without approval from my consultant psychiatrist.
She said if I try to discharge myself by refusing to engage with them it will look poorly on me and could reinforce their belief that I lack the insight to make rational decisions and I'm at risk, which could prompt an AMHP visit to my home.
Why is she threatening me like this? I'm pretty sure it's illegal to compel me to continue attending appointments and she's just trying to scare me into continuing with their treatment plan.
They're acting like I'm sectioned in hospital or something... It's my choice if I want their help or not and I do not want it. I have an appointment coming up soon where the consultant psychiatrist is going to talk to me about why I want to leave etc.
Should I just not go to it and ignore all communication from them so they discharge me for non engagement?
They are wasting time, people and resources on me instead of spending those resources on someone who's actually sick and needs / wants help.
It's so ridiculous.

It feels like you want to have more autonomy around your support. We can hear you are feeling like you no longer need the support of your CMHT, but maybe there is a compromise? We wonder if the support you are accessing could evolve. Your care- co-ordinator has concerns around you just ending their support, there will be a reason behind that advice, because right now the support they offer is limited due to demand on the service. Is it possible to have a calm, considered conversation around your support and what it could look like if it was decreased?

Reply 13

Original post by Papyrus Hopeline
It feels like you want to have more autonomy around your support. We can hear you are feeling like you no longer need the support of your CMHT, but maybe there is a compromise? We wonder if the support you are accessing could evolve. Your care- co-ordinator has concerns around you just ending their support, there will be a reason behind that advice, because right now the support they offer is limited due to demand on the service. Is it possible to have a calm, considered conversation around your support and what it could look like if it was decreased?

I have since had my meeting with the psychiatrist and they said they're not prepared to discharge me but if I want to discharge myself I'm free to do that. So that's the decision I decided to go with.

They did try and talk me into remaining with the CMHT but at the end of the day it's my decision and I have the capacity to make that decision. Also with me leaving it will free up a spot for someone who actually needs and wants their help so all around it's a good outcome.

Reply 14

Original post by evident-moonshin
I want to discharge myself from the CMHT as I don't require their help or services anymore but my care-coordinator is saying that it's not as simple as just discharging yourself, I can't discharge myself without approval from my consultant psychiatrist.
She said if I try to discharge myself by refusing to engage with them it will look poorly on me and could reinforce their belief that I lack the insight to make rational decisions and I'm at risk, which could prompt an AMHP visit to my home.
Why is she threatening me like this? I'm pretty sure it's illegal to compel me to continue attending appointments and she's just trying to scare me into continuing with their treatment plan.
They're acting like I'm sectioned in hospital or something... It's my choice if I want their help or not and I do not want it. I have an appointment coming up soon where the consultant psychiatrist is going to talk to me about why I want to leave etc.
Should I just not go to it and ignore all communication from them so they discharge me for non engagement?
They are wasting time, people and resources on me instead of spending those resources on someone who's actually sick and needs / wants help.
It's so ridiculous.


Same here. I'm not engaging with my CPN or taking my medication properly anyways because my CPN is useless anyway and for some reason when I ask the doctor to titrate me off medication The crisis team puts the block on him stopping him in his tracks.

Reply 15

Original post by evident-moonshin
I have since had my meeting with the psychiatrist and they said they're not prepared to discharge me but if I want to discharge myself I'm free to do that. So that's the decision I decided to go with.
They did try and talk me into remaining with the CMHT but at the end of the day it's my decision and I have the capacity to make that decision. Also with me leaving it will free up a spot for someone who actually needs and wants their help so all around it's a good outcome.

I recommend you check the disengagement policy on the NHS website so you're aware of the facts in case you do decide to disengage like me? I won't recommend it. It's not the best decision, but unfortunately, mental Health services are perpetuated by negative experiences like mine. So in other words I will decide to do it and be defined to the end.

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