panpete
Blokes name, birds body.
I do not currently have a CPN or care co-ordinator, but recently, due to suicidal thoughts my GP referred me to Primary Care Liaison Services, where a nurse did a face to face assessment of me
In the interview, she asked me if there was anything else she could do for me.
I stated that it would be really helpful if, when I get my ESA50 form, (reassessment due june 2015) if they could write me a letter of evidence, to put in with my form.
The nurse said that she would be writing up a report after our interview, and I could use that as evidence and that a copy of the report would also go to my GP.
Here is what the letter says:
Thank you for your recent referral for the above lady. She was assessed on 30th September. I enclose a full assessment of Miss ****** with appropriate recommendations, together with a copy of the previous recommendation from my colleague (letter of 14th August which was about my new medication regime)
SITUATION (referrer details, admission detail, presenting complaint, current mental health issues)
Miss ****** attended the appointment promptly. She explained that she has stopped taking mebeverine though advised by my self that any prescribed medication, beneficial for treatment of IBS should be taken on a regular basis. (I now take mebeverine regular) She assured me that she takes all the psycotropic medications regularly and she feels the current regime is beneficial. She did not find Trazodone beneficial at 150mg qds but takes it as 37.5mg qds instead which she feels is more beneficial. She is also prescribed loperamide 2mg OD and propranolol 10mg OD together with the promethazine hydrochloride 25mg BD prn. I advised her that the promethazine can be increased to 50mg BD prn as per the letter dated 14th August from my colleague. She confirmed that she has completely weaned herself off the Diazepam medication and no longer takes quetiapine which she also found ineffective.
Miss ******* had written a few notes for my attention prior to attending the assessment in which she explained that she has felt 'very fragile' all her life and afraid of people and 'trapped' She appears to have a high anxiety state which leaves her unable to make genuine friends, socialise or sometimes venture away from the home unless she takes codeine tablets. She states she has obsessive tendencies around checking plugs, locks and 'unpleasant' smells in the home which includes her owon personal hygiene. She explained that she 'hates this cruel, money-obsessed world' and frequently wishes for her life to end. When enquiring whether she currently felt suicidal, she explained that although she has had a number of plans in the past, due to them possibly not being successful, she has never gone through with anything though does continue to feel she wants her life to end.
Miss ***** has always felt 'repulsed that she is alive' She queried whether she had suffered any abuse other than the physical, mental and emotional as a child but despite have specialised counselling, nothing more has been revealed. She was anxious to delve into this further.
There has been regular illicit drug abuse in teh recent past and other years together with abuse of alcohol (cider). Whilst planning her last suicide attempt, she obtained a number of different medications over the internet. She did not carry out the attempt through fear of it being unsuccessful.
Miss ***** states that she has always had relationship problems and has not partner as this includes problems with intimacy too.
Sleep pattern appears stable to to her prescribed medication. Appetite is variable with nothing eaten on occasions to the other extreme of just eating sweets. She appeared of stable weight for her height.
BACKGROUND (History of presenting complaint, Past medical history, medications, investigations, collateral history, personalsocial/drug history/alcohol intake)
Miss ****** was the youngest of five children livin in the ********* area in the North**** of England. She explained that her home and school life were very hard with physical, mental and emotional abuse by her parents and teachers. She was also bullied in school. She has minimal contact (christmas card) with her remaining family;, her father died in January 2014.
All five children appear to have suffered physical and emotional abuse.
(Appearance, behaviour, rapport, speech, mood, preceptual abnormalities, cognition, physical, attitude)
Miss ******* was cean and well presented though admitted to periods when her self care lapses. She presented with closed body language and minimal eye contact. We developed a good rapport with Miss ****** admitting to 'opening up' about various issues. She rated her current mood (on medication) as 5/10.
There does not appear any evidence of hallucinations nor delusions of any type.
Miss ***** spoke of recently self-harming by cutting her R ****** with a bread knife. She did not require hospital input.
Miss ******* suffers from IBS. She wears glasses.
Miss ****** spoke of certain obsessional traits - repeating statemetns to others, checking plugs, taps, etc, and being very alert to smells.
She then spoke of also having periods of forgetfulness, ie. leaving a candle burning in her home.
Speech was slightly pressured in rate but stable in tone and content. There was no delusional content in her conversation.
Miss ***** felt she would like to be able to contact Primary Care Liaison services. I explained that we are available during times when she feels there is a crisis or she requires advice and at other times after 8pm, there is always someone available to answer the phone from elsewhere. She accepted this stating otherwise she would speak to her counsellor.
SUMMARY
48 year old single lady who has suffers from extreme anxiety for the majority of her life. She queries whether there is some underlying other abuse issue that she has blocked?
Well, I forgot to say loads of important things, one of them being that all my life, I have had rages where I would bang my head on the wall, hit myself etc etc. Has ongoing counselling sessions which have included dealing with abuse previously though nothing has emerged so far.
Poor concordance with medication - advised of the benefits to take regularly as advised.
Continues to attend MIND and ********** drop in groups.
Information provided on ******** (counselling service for abuse) which miss ****** was interested in contacting.
RECOMMENDATION
1. Information provided on ****** abuse related local counselling service. - patient to contact service by email. (*I did contact this organisation after the assessment, but this organisation advised that as I cannot remember any abuse, they felt it was not the right service for me)
2. Copy of letter dated 14th August to be forwarded to patient as requested (*now received)
3. PCLS to enquire about referral for Asperger's assessment.
4. PAtient advised to take all prescribed medications as advised. If not felt beneficial after a few weeks, to discuss situation again with her GP.
5. PAtient to be discharged back to care of GP.
Should you feel your level of distress has increased significantly at any point after we have met, I suggested the following contacts could be helpful.
In the first instance please contact your GP for advice.
If you feel the need to talk, samaritans provide a 24 hour a day, 365 day a year servicve. Their contact number is 0845 909090
The emergency Duty service (EDS) is teh social work crisis service provided by ****** council outside normal office hours, at night and over the weekends and bank holidays. This service is provided to help with personal or family problems that have reached a crisis at these times. Their contact number is 0845 *******
The ******* mental health partnership has a trust switchboard which will offer advice and support on ***************
The MIND infoline is open weekdays from 9am - 6pm on 0300 123 3393. This provides information and advice on a range of issues around mental health problems.
Yours sincerely
*************
I got the letter this morning, and although it says that I recently cut myself with a bread knife, because I failed to tell her that I have had self harm 'tantrums of rage' all my life, and sometimes feel unsafe from myself, this did not appear on the letter.
Also, I have realdifficulty with stress and pressure of any type and when under pressure or stress, cannot think straight and make lots of errors.
I phoned them today, and a lady said that she would get the nurse who interviewed me to phone me on Monday.
I plan to tell her about the life-long self harm issues and the difficulties with stress and pressure on Monday, and ask her if she could put this in the letter.
I'm not sure what the nurse will do and I have some questions please?
I want to know that if the nurse refuses to add these things to the letter, do you think it will be adequate as evidence in its current state?
also
If the nurse does add to the letter, and states that I forgot to tell her about the life-long self harm (as opposed to the one isolated incident) and the inability to cope under pressure, will the fact that I forgot these important things look a bit unconvincing to the ESA assessors?
thanks
In the interview, she asked me if there was anything else she could do for me.
I stated that it would be really helpful if, when I get my ESA50 form, (reassessment due june 2015) if they could write me a letter of evidence, to put in with my form.
The nurse said that she would be writing up a report after our interview, and I could use that as evidence and that a copy of the report would also go to my GP.
Here is what the letter says:
Thank you for your recent referral for the above lady. She was assessed on 30th September. I enclose a full assessment of Miss ****** with appropriate recommendations, together with a copy of the previous recommendation from my colleague (letter of 14th August which was about my new medication regime)
SITUATION (referrer details, admission detail, presenting complaint, current mental health issues)
Miss ****** attended the appointment promptly. She explained that she has stopped taking mebeverine though advised by my self that any prescribed medication, beneficial for treatment of IBS should be taken on a regular basis. (I now take mebeverine regular) She assured me that she takes all the psycotropic medications regularly and she feels the current regime is beneficial. She did not find Trazodone beneficial at 150mg qds but takes it as 37.5mg qds instead which she feels is more beneficial. She is also prescribed loperamide 2mg OD and propranolol 10mg OD together with the promethazine hydrochloride 25mg BD prn. I advised her that the promethazine can be increased to 50mg BD prn as per the letter dated 14th August from my colleague. She confirmed that she has completely weaned herself off the Diazepam medication and no longer takes quetiapine which she also found ineffective.
Miss ******* had written a few notes for my attention prior to attending the assessment in which she explained that she has felt 'very fragile' all her life and afraid of people and 'trapped' She appears to have a high anxiety state which leaves her unable to make genuine friends, socialise or sometimes venture away from the home unless she takes codeine tablets. She states she has obsessive tendencies around checking plugs, locks and 'unpleasant' smells in the home which includes her owon personal hygiene. She explained that she 'hates this cruel, money-obsessed world' and frequently wishes for her life to end. When enquiring whether she currently felt suicidal, she explained that although she has had a number of plans in the past, due to them possibly not being successful, she has never gone through with anything though does continue to feel she wants her life to end.
Miss ***** has always felt 'repulsed that she is alive' She queried whether she had suffered any abuse other than the physical, mental and emotional as a child but despite have specialised counselling, nothing more has been revealed. She was anxious to delve into this further.
There has been regular illicit drug abuse in teh recent past and other years together with abuse of alcohol (cider). Whilst planning her last suicide attempt, she obtained a number of different medications over the internet. She did not carry out the attempt through fear of it being unsuccessful.
Miss ***** states that she has always had relationship problems and has not partner as this includes problems with intimacy too.
Sleep pattern appears stable to to her prescribed medication. Appetite is variable with nothing eaten on occasions to the other extreme of just eating sweets. She appeared of stable weight for her height.
BACKGROUND (History of presenting complaint, Past medical history, medications, investigations, collateral history, personalsocial/drug history/alcohol intake)
Miss ****** was the youngest of five children livin in the ********* area in the North**** of England. She explained that her home and school life were very hard with physical, mental and emotional abuse by her parents and teachers. She was also bullied in school. She has minimal contact (christmas card) with her remaining family;, her father died in January 2014.
All five children appear to have suffered physical and emotional abuse.
(Appearance, behaviour, rapport, speech, mood, preceptual abnormalities, cognition, physical, attitude)
Miss ******* was cean and well presented though admitted to periods when her self care lapses. She presented with closed body language and minimal eye contact. We developed a good rapport with Miss ****** admitting to 'opening up' about various issues. She rated her current mood (on medication) as 5/10.
There does not appear any evidence of hallucinations nor delusions of any type.
Miss ***** spoke of recently self-harming by cutting her R ****** with a bread knife. She did not require hospital input.
Miss ******* suffers from IBS. She wears glasses.
Miss ****** spoke of certain obsessional traits - repeating statemetns to others, checking plugs, taps, etc, and being very alert to smells.
She then spoke of also having periods of forgetfulness, ie. leaving a candle burning in her home.
Speech was slightly pressured in rate but stable in tone and content. There was no delusional content in her conversation.
Miss ***** felt she would like to be able to contact Primary Care Liaison services. I explained that we are available during times when she feels there is a crisis or she requires advice and at other times after 8pm, there is always someone available to answer the phone from elsewhere. She accepted this stating otherwise she would speak to her counsellor.
SUMMARY
48 year old single lady who has suffers from extreme anxiety for the majority of her life. She queries whether there is some underlying other abuse issue that she has blocked?
Well, I forgot to say loads of important things, one of them being that all my life, I have had rages where I would bang my head on the wall, hit myself etc etc. Has ongoing counselling sessions which have included dealing with abuse previously though nothing has emerged so far.
Poor concordance with medication - advised of the benefits to take regularly as advised.
Continues to attend MIND and ********** drop in groups.
Information provided on ******** (counselling service for abuse) which miss ****** was interested in contacting.
RECOMMENDATION
1. Information provided on ****** abuse related local counselling service. - patient to contact service by email. (*I did contact this organisation after the assessment, but this organisation advised that as I cannot remember any abuse, they felt it was not the right service for me)
2. Copy of letter dated 14th August to be forwarded to patient as requested (*now received)
3. PCLS to enquire about referral for Asperger's assessment.
4. PAtient advised to take all prescribed medications as advised. If not felt beneficial after a few weeks, to discuss situation again with her GP.
5. PAtient to be discharged back to care of GP.
Should you feel your level of distress has increased significantly at any point after we have met, I suggested the following contacts could be helpful.
In the first instance please contact your GP for advice.
If you feel the need to talk, samaritans provide a 24 hour a day, 365 day a year servicve. Their contact number is 0845 909090
The emergency Duty service (EDS) is teh social work crisis service provided by ****** council outside normal office hours, at night and over the weekends and bank holidays. This service is provided to help with personal or family problems that have reached a crisis at these times. Their contact number is 0845 *******
The ******* mental health partnership has a trust switchboard which will offer advice and support on ***************
The MIND infoline is open weekdays from 9am - 6pm on 0300 123 3393. This provides information and advice on a range of issues around mental health problems.
Yours sincerely
*************
I got the letter this morning, and although it says that I recently cut myself with a bread knife, because I failed to tell her that I have had self harm 'tantrums of rage' all my life, and sometimes feel unsafe from myself, this did not appear on the letter.
Also, I have realdifficulty with stress and pressure of any type and when under pressure or stress, cannot think straight and make lots of errors.
I phoned them today, and a lady said that she would get the nurse who interviewed me to phone me on Monday.
I plan to tell her about the life-long self harm issues and the difficulties with stress and pressure on Monday, and ask her if she could put this in the letter.
I'm not sure what the nurse will do and I have some questions please?
I want to know that if the nurse refuses to add these things to the letter, do you think it will be adequate as evidence in its current state?
also
If the nurse does add to the letter, and states that I forgot to tell her about the life-long self harm (as opposed to the one isolated incident) and the inability to cope under pressure, will the fact that I forgot these important things look a bit unconvincing to the ESA assessors?
thanks
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