Alex Williams is a volunteer and a mental health service
As a service user any change in support can have a significant
impact on my life. Last month my community psychiatric nurse (CPN)
was withdrawn from my support package following a care programme
approach (CPA) review. The professionals present felt that I had
been seeing my CPN for a long time and it would be good to change
workers due to my continued self-harm.
The decision left me distraught. It felt like bereavement. I had
built up a good rapport with my CPN and felt that she was genuinely
concerned about me and proud of my achievements. When I struggled
most she had enough faith for both of us that I would pull through.
She was dynamic and worked in a person-centred way. I have no
family in my area so she was, along with my support worker, my main
source of support.
My depression worsened. I overdosed on painkillers twice. I asked
to go on to the psychiatric ward and discharged myself soon after
admission. I didn’t feel any safer there and staff weren’t
available. I felt that I couldn’t start again with another worker.
I’ve since realised that I will lose out if I withdraw from
services now. My voluntary work provided me with stability through
a difficult time. My support worker listened to my feelings of
disappointment. She is an advocate for me in trying to get other
support put in place.
I disagree with anyone who says that my feelings on losing my CPN
were solely due to my mental health problems. When you have worked
with a professional for a long time an attachment does exist. And
when you feel better you rely less on their intervention. I had
hoped my CPN would see me until I was closer to recovery; then it
would have been a shared journey and given her satisfaction as
So what would have made the change easier? Being in the room when
decisions were made at the CPA review would have helped – I was
waiting outside for 30 minutes. A planned rather than sudden change
would have been far better. Seeing someone over the following weeks
– the new worker has not been allocated yet – would also have
I did see the community mental health team manager. She said that
workers would be rotated in future so it is unlikely I will see the
same person long-term. This worries me since I want continuity of
care. I am able to see my CPN as a one-off to thank her for her
input. Social care staff need to be aware that changing staff can
be difficult for users, be sensitive to this and offer increased
support. I am grateful for the time I’ve had working with my CPN
because it helped me gain insight through psychodynamic work and I
learned to trust someone.