Assertive Outreach: aka the non compliant, disengaged, non attender’s service

I had my first meeting with Gavin, the CMHN at the Assertive Outreach Team this morning. I have since discovered the the AOT is for service users who have been difficult to engage in standard secondary mental health settings. This got me thinking as to whether I am worthy of being referred to the AOT. I am engaged, most of the time, although I have deliberately missed some appointments. My medication compliance was less than useless but I have now realised the error of my ways and take it religiously, and without alcohol. I have been mostly compliant in therapy, apart from the odd temper tantrum and I haven’t always seen eye-to-eye with my key worker/care co-ordinators. I guess I am the sort of person that the AOT was designed for then. The non compliant, unwilling to help themselves, disengaged mental mess of a person. Isn’t it wonderful to be such a no hoper at the tender age of only 23!

Anyway, Gavin is perfectly pleasant even if I didn’t feel totally at ease with him. We talked about the overdose in early July and then the subsequent loitering on a bridge and by the side of the dual carriageway which led to me being admitted. We then talked about my suicide attempt in hospital (of which he said I was the first person he had met who had tried to kill themselves whilst in a psych unit, but that I wasn’t to take that as a compliment). After all the history of the last 6 weeks we went through the standard “how is your mood?”, “how would you rate your concentration?”, “what’s your sleep pattern like?”, “how would you describe your appetite?” questions. Tedious, but I guess they have to be done. I was fairly honest with him, albeit if it was in too much of a jovial tone. I hate myself for putting on the happy, smiling, ‘isn’t life just one big laugh’ mask when faced with mental health professionals. It’s bloody hard to try and convince someone that you do suffer from depressive episodes when you’re sitting there smiling and using humour throughout the session.

I apparently didn’t fool him though as he’s going to contact the CMHT I used to be with in London for my notes and a copy of the emergency assessment in January and see if my notes from Newcastle can be faxed down. Then when he has collated all the information together and had a chance to talk with people who have been involved in my care previously he is going to ring me to let me know what the plan of action is. He thinks I’d benefit from CBT, which I agreed to, and possibly group work, which I didn’t agree to as the idea of group therapy completely freaks me out.

The session was quite positive and yet I left feeling angry and let down. Sometimes I confuse myself so much. I have no idea what I expected out of this morning but I sat for half an hour after the session on a bench fuming internally and rocking. I feel that sometimes even people trying their hardest isn’t enough. I mean what did I want him to say? “You’re fine, go away”; no because that would trigger the borderline fear of abandonment in me. I’m such a fuck up at times.

In other news the side of my fingernail is infected from me chewing at all the hangnails and skin. It isn’t pleasant and I really should have grown out of it by now but it really hurts and is red hot to touch. I shuold go and see a GP but I feel as if my entire life is spent in health centres so I’ll try some iodine solution on it and a dressing and see what it is like in the morning.

On that note I think I’m going to drag my depressed self back into bed where at least I’m out of people’s way and can’t get angry with things. I’m in the mood to start a fight in an empty room at the moment.

Ruth