Got an appointment at the beginning of June

[Amanda_George]

T'was a good job that I read my repeat prescription request form when I started my new box of the AP 'cos it said to make an appointment about my meds and a mental health check with someone called Brad.

I'm assuming that he's a new CPN attached to the surgery as a whole rather than going through the system like I did with Dr Invisible.

I've never had a CPN though and I might be wrong, but let's assume he's a CPN or nurse specialising in mental health.  What should I expect, please?  Should I ask about reducing the dose of the AP slightly while I'm there or will he suggest it without me saying anything, please?  Will he refer me back to my GP about wanting the reduction or will he be able to do it while I'm there?  What sort of things will he ask about or is it just my GP's way of saying "time for you to come off the meds right about now".

Brad was booked up until the first week of June so Steve was thinking that they'd put the request on all MH prescriptions and they'd got there before me.

I know it's a month away and I'm prolly getting in a tizzy over nothing, but I just don't know what to expect!

[Pip]

Try not to worry about the appointment with the CPN as he is there to help.  Obviously he needs to get to know the 'real' Amanda so he will probably want to know more about your day-to-day routine, your short-term and long term aims, your concerns etc.  It's like seeing the nurse or doctor so part of the holistic care of you 

[Amanda_George]

Thank you Pip.  D'you reckon he'd be able to authorise the lowering of my AP or will he tell me to go via my GP please?

[Pip]

I'm not sure if he will be able to authorize that but if the doctor has the final say I'm sure he or she will listen to Brad as CPNs are well trained

[Amanda_George]

Groove and cooly... I just want to try and reduce it as much as possible.  I still need it 'cos I still get paranoid (my warning claxon) but I don't think I've been psychotic since I came out of hospital on the maximum dose.

[Amanda_George]

Can CPNs prescribe short term AD's to help me with the inevitable SAD or do I need to go through my GP with that too please?  What, in simple terms, is a CPN's job please?  Would he be a better person to fill out the mental health side of PIP or is that entirely down to my GP please?  Are the appointments only at the surgery or could he come out to see me if I really couldn't get there?  Will he be able to refer me to more social things around here so that I can start getting to know other MH patients locally?  Should I tell him about this forum so that he can recommend it to others?

What I'm dreading most is for me to go in there, him going "you're coming off the AP and not allowed any more meds or support.  Buh-bye"  then him calling in the next patient.  I know it's very unlikely to happen but that's what I'm most worried about lol   

[Pip]

Can CPNs prescribe short term AD's to help me with the inevitable SAD or do I need to go through my GP with that too please?

 

Google doesn't make it easy to find out information sometimes.  There are prescribers other than doctors such as dentists but I can't find any site that say CPNs can prescribe so you would have to ask.   

What, in simple terms, is a CPN's job please? 

https://www.netdoctor.co.uk/conditions/depression/a638/mental-health-professionals/

Community psychiatric nurses (CPNs)
Role

*  A CPN sees people who are living in the community. This is most often in the person's own home but it can also be in clinics based, for example, in a GP's surgery.
*  CPNs provide support to people through difficult periods of their illness. They may also see patients who are currently well to check everything is going okay and be the first point of contact if the patient starts becoming unwell again.
*  A CPN will help patients with their medication and make sure that the patient understands what they should be taking and when.
*  Because CPNs see patients in their own homes, they also play a valuable role in helping the patient's family and carers understand and cope with the illness.
*  Patients may be referred to CPNs from a number of sources including GPs, psychiatrists and inpatient wards so that the CPN can help the patient's transition from hospital back into the community.
*  CPNs are often a patient's keyworker.

Would he be a better person to fill out the mental health side of PIP or is that entirely down to my GP please?

Yes he probably would be the better person to help with the mental health side of PIP.  Nurses tend to get to know patients better as they have more time or can make the time to get to know the patient better.

Are the appointments only at the surgery or could he come out to see me if I really couldn't get there? 

Yes appointments can be in your home is the short answer 

Will he be able to refer me to more social things around here so that I can start getting to know other MH patients locally? 

I don't know if you have a MIND centre near so if you do you could start going there.  The CPN will be able to tell you if he knows of any appropriate social things you can get involved with.

Should I tell him about this forum so that he can recommend it to others?

Yes you can tell him about this forum and I did get some feedback a few years ago that there was a poster in a doctor's surgery with details of the forum on it. 

What I'm dreading most is for me to go in there, him going "you're coming off the AP and not allowed any more meds or support.  Buh-bye" 

CPNs are there to support people so support is there for as long as you need it.

[Amanda_George]

Thank you so much, Pip.

In the unlikely event that I went head-to-head with my GP over my meds or how I'm feeling, who's side would the CPN be on please?

With the PIP form, would my GP send a report about my physical health and Brad about my mental health or would it just be my GP like it was when they got the form originally?

MIND centres aren't immediately obvious in the centre of Gloucester... what can they help with please?

Is there an official poster I can print off and give to Brad or shall I just give him the URL of the forum when I get there?

I'm doing OK atm, even without the AD, but it's the darker months that I'll really struggle with because of SAD... I don't want to waste his time right now, but he could, potentially, help me over the darker months.  Could I maybe tell him that and ask that I'm kept on file until August/September kinda time?

Thank you so so much, Pip!

[Pip]

Brad is on your side, like doctors and registered general nurses CPNs have a duty of care to their clients.  The only time Brad would speak to an appropriate person is if it were in your best interests such as if you were suicidal or at high risk of self harming.  With meds Brad will have enough qualification to advise and discuss this the same with how you're feeling which is confidential between both of you.

When the PIP form is returned your GP will be asked for relevant medical information such as physical disabilities and mental health.  On the form make sure you put Brad's name in the relevant section and that he is a CPN.  They should then also contact him to get a better picture of your health.

This is the link for MIND https://www.mind.org.uk/ and they can help in different ways including advice on practical stuff we do.

We don't have an official poster so just give Brad the url.  Be honest with Brad for when you need more support and I'm sure he will be able to sort this out     

[Amanda_George]

Thank you so much, Pip.  Since coming off the AD I've been coping even better than when I was on them... no suicidal thoughts and I haven't harmed myself since I've been off them!

I just want to reduce the dose as much as possible while still being sane.  I've already halved the dose and wanna try and take it from the 10mg I'm currently on down to 7.5mg if possible to start with for a while then hopefully down to 5mg after that.

Thank you for letting me know about putting Brad on the PIP form... does he need to agree first though, or is it more like my GP and I just put his details down for whoever asks?

Thank you for the link to MIND... there's a shop the other side of Gloucester, but the nearest support centres are Hereford, Swindon and Wales lol

I'll try and remember to give Brad the URL but I can pretty much guarantee I'll forget what it is thanks to my nerves!  lol  Would you mind if I came up with a basic poster and box of business cards with the forum's details on so that you can maybe send them out to members for their GP surgery/therapy places and stuff?

[Pip]

Yes you can put Brad's name on the form as he is a health professional like your GP.  It wouldn't surprise me if he's done his bit for other people applying for PIP.

[Amanda_George]

Thank you, Pip!  Need to find out his surname and job title first though, I assume lol

[Pip]

Yes it will help