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Will Psychiatrist discharge my wife affect benefit

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13 years 10 months ago #19676 by Snowbird
Hi. I would really appreciate your advice.

My wife has a long standing history of depression, agoraphobia, panic attacks and severe anxiety. I am at home as her main carer. My wife has been under the care of community mental health and seen psychiatrists regularly for the past 24 years. However due to her having social anxieties (and not being able to attend group sessions etc) her present psychiatrist has decided to discharge her with absolutely no mental health support for the future.

She rarely sees her GP as she is terrified of going. Her psychiatrist says there's nothing more the community mental health team can do for her and says that the mental health services operate on a basis of only seeing patients they can "actively help". The Psychiatrist said it's all to do with budgets and lack of money. They have also refused to allocate her a CPN.

My wife has no friends and I am her only support, without these psychiatrist appointments she will no longer have anyone outside the home to talk to.

My wife is on long term medications for her mental health, (Quetiapine, Venlafaxine, Clonazepam and Trazodone).

My wife had an ATOS medical two years ago (they came out and did a home visit) and was found excempt from PCA on the basis of mental health. She was also awarded DLA (lower rate care and mobility). The DLA was awarded on the basis of her being under community mental health; her regular appointments with the Psychiatrist would likely have helped her be excempt from PCA for the last 14 years. Also when the GP wrote to ATOS asking for a home visit medical due to my wife's agoraphobia the GP was able then to state that my wife was seeing a Psychiatrist and severe enough to be under the care of community mental health. The next time this comes up my wife's GP will not be able to state this as she will no longer be under the care of community mental health despite being just as ill. Will she still be eligible for a home visit? She isn't well enough to travel to a medical.

Now that my wife is being discharged from community mental health (despite the fact that she still feels she desperately needs their support and remains on heavy doses of anti psychotic medication, antidepressents and anti anxiety meds), do you think that my wife's case will be looked on less sympathetically by the Job Centre and ATOS?

She is due an IB50 and possibly a medical soon (the last one was 26 months ago and she usually gets the IB50 forms every two years), she is in a very anxious state and worries that being discharged by the Psychiatrist might be looked on as "getting better" by ATOS when in fact the opposite is true (community mental health feel they can no longer help her). Does she need to be under the Psychiatrist to be exempt from PCA or would ocassional visits to the GP hold as much weight with ATOS as hospital visits to a Psychiatrist? I would imagine that it won't look as good on the paperwork and forms now that she can no longer list hospital appointments. I want to reassure her as she is making herself sick with worry, but I can't (which is why I am seeking your opinion). Even on her DLA award letter two years ago it stated that they got their information "from the hospital".

On top of all the worry about how it will look to ATOS / Job Centre that she is no longer seeing her Psychiatrist, I'm really worried about her general state of mind due to the fact that she will no longer have anyone to talk to. She already felt isolated but this could be the straw that breaks the camels back for her. I'm so worried about how this has affected my wife that I'm watching her like a hawk incase she does something silly. She has a history of attempted suicide.


In addition to mental health problems for which she has had support throughout the last 24 years, my wife also has an underactive thyroid, asthma, eczema and adrenal insufficiency. She is taking Hydrocortisone and Fludrocortisone for her adrenal insufficiency and any shock or extra stress could send her into a crisis. Also we're fairly certain she has Aspergers as she has a very severe social disability and our son has Autism; community mental health said that the professionals don't have the resources to formally diagnose Aspergers in our area.

Please could you give us some advice on whether or not you think that being dishcharged from community psychology will affect my wife's claim for incapacity benefit and exemption from PCA? It just seems that it has been an intrecate part of things in the past.

Are there others here who have been through similar experiences with community mental health withdrawing their support and regular appointments?

Snow

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13 years 10 months ago #19679 by Jeff1
Hi snow, I am not a qualified adviser but is there no one at the GPs surgery you could have a word with the practice manager, or have you any local organisations like MIND. They may be able to get you help. I know this is only very scant information but iy may well be wirth a try your GPs may be able to write to the local PCT.(primary care trust) sorry i cant be of any further assisstance. Good Luck

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13 years 10 months ago #19680 by jenniferb
Hi

I don't know what the answers are but here are my thoughts-

The psyciatrist has to write to the GP explaining when and why they discharged a patient. I would expect this letter would explain why your wife was discharged (treatment resistant MH problems) and confirm the continuing severity of the diagnosis and impact on her life as well as a prognosis (whether this is likely to get better or not).

So could you ask the GP for a copy of this letter? If the psuchiatrist hasn't made it crystal clear, you could ask your GP to write to the psychiatrist and ask for more information. Perhaps that would allay some of your fears.

Another thing to remember is a lot of people are failing MH medicals because the ATOS doctor makes their own diagnosis based on seeing a person for an hour or less, and doesn't look at the medical info from GPs, psychiatrists etc. As your wife passed the last medical, assuming (as you say) she is the same as last time then it is reasonable to assume they will manage to correctly notice her problems as they have already managed to once!

It must be very worrying and difficult for both of you so I hope these suggestions help.

Ginge

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  • originaldave
13 years 10 months ago #19682 by originaldave
many consultants are now doing this to save money, it should have no affect she still has her problems and has she medication ? she also has 24 years of medical records

in fact the fact they say she cant be helped (no one says she is better) helps her case for an indefinate award next time she has a DLA review

you say dla was awarded because

"the care of community mental health and seen psychiatrists regularly for the past 24 years. "

thats not correct she gets it because of her health problems and help needed because of what she canr manage IMO

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13 years 10 months ago #19687 by Snowbird
Thanks for your thoughts on this. I sort of saw how the scenario could be interpreted in more than one way.

On one hand I feared if she is discharged it could be assumed that she no longer needs support and therefore her condition disregarded, despite still living with all the anxieties, fears and panic attacks on a daily basis.

On the other side I wondered if the fact that they are saying there is nothing else they can do to help her, and if they write a letter to the GP to that effect, should reinforce the fact that this condition remains with no resolve in the forseeable future.

She will also be on the current medications and I cannot personally see when she can discontinue them anytime soon.

Thanks again and any other comments or suggestions are appreciated.

Snow

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  • goldensyrup
13 years 10 months ago #19693 by goldensyrup
Hello, I moved to Spain in 1996. I have suffered, like your wife, with Extreme Anxiety Disorder, Clinical Depression, Panic Attacks and now Bipolar.

I take meds everyday, I take Xanax (benzo) for my anxiety, Sertralina (anti-depressent) and Lamictal for Bipolar.

I have had these disorders for the last 20 years (I am now 43).

When I lived in Uk I had lots of outside help, like Cognative Behavioural Therapy, Psychologits and Psychatrists, a brilliant GP and also attended Relaxiation classes.

I have been in receipt of Long-Term Incapacity Benefit since 1996. The last review medical I went to was 5 years ago in when I was living in UK. I went with my mother, I had a massive panic attack, started being sick in the doctors sink, turned on his fan, opened his windows, and paced the floor, and could hardly breath. He told my mother to take me home. I was literally in there for 4 minutes. I reguested a copy of the report he had written and his diagnosis was "severe mental health disorder".

I have now applied for DLA from Spain in Feb 2008, but have been turned down due to not being in the uk for 26/52 weeks. I am having a nightmare with the DWP, this has made my condition much worse, and I have to admit that I take one more Xanax (there the ones for anxiety that you disolve under your tongue), because my anxiety is getting worse and my depression with all the worry.

My case is surposed to be going to appeal, and I am still waiting a Tribunal date.

Since moving to Spain I have developed Bipolar and have been refered to a psychatrist by my GP, who by the way are both private and I have had to take out private health insurance. I have used this letter for evidence of my medical condition and for my DLA appeal I asked my psychatrist to write me a letter in English. This I have received and he has mentioned on the letter that "Lisa is not having a good response to the Bipolar medication", he has not given up on me yet and has changed my medication. I see him once a month.

My Long-Term Incapacity Benefit review is due at the end of July 2010. So I will be using this letter as evidence plus various other letter from GP.

I telephoned the IB department and have been assured that I do not have to go back to UK for medical, which is good, because there is no way on this earth I will fly again, due to a bad panic attack from Spain to UK. All that will happen is a questionnaire will be sent to my GP, I have asked her to let me know when she receives it so I can fill it in with her, as she does not have my full medical history (but I made sure I got my doctor in the UK to make me copies of all my medical records).

I know this is not quite the same problem that your wife is having, but like I read in a previous post, if the Psychatrist states that he can not help your wife further, he may mean that she is unresponsive to the meds she is on. which is a weird kind of way is a good thing and she should not worry about not seeing him anymore and her condition is long-term, like mine.

I know exactly how your wife is feeling, her illness is exactly the same as mine and mine is nearly a long. I hope you get things sorted out. Thankfully I will not have to attend medical or work-shops and I will not be changed over to ESA for the foreseeable future.

If your wife ever wants to talk to someone who knows what she is going through I can give her my direct email address, or I can talk with her on here. Let me know if she would like a friend. I know I live in Spain, but I also donĀ“t have many friends, just 2 kids and a dog, and also my carer has becom my friend.

Sorry this reply is so long, but try and tell her to worry. I know it is hard for her not to worry, look what happened to me I worried about my DLA claim for over 2 years and ended up with Bipolar and no DLA. I hope my appeal date will be soon, but I do not know of anyone else who has applied for DLA after moving to Spain and has been successful. I shall have to wait, wait, wait and wait a little longer to see whats happens.

Wish your wife all the best and I am sorry that this post has turned out so long, but she is not alone :)

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