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Alex Williams is a volunteer and a mental health service user.

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 Last month my community psychiatric nurse (CPN) was withdrawn from my support package following a care programme approach (CPA) review.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 well.


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 helped me.

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.