Dear Psychiatrist

I’ve adapted and added to this letter which I originally gave to my psychiatrist at the end of October. It’s now more up to date, strongly worded and passionate than the original and thus more in keeping with my thoughts and feelings about my treatment and care.

Dear Psychiatrist,

I would like to clarify a few things. I had marginally improved before our last appointment but not even enough to be able to leave my home more than once a week. I have not improved at all since then. At no point during this period of illness have I improved enough to even consider a month to go back to work let alone implying (as you stated in our last phone call) I’d thought of a start date to return to my position as a Healthcare Assistant on an acute psychiatric ward. When I recover enough to consider working, I will only do so part-time and I will be looking for less stressful positions in retail or offices until I get back to functioning fully. Given that it is still a major struggle for me to leave my home to attend appointments, I don’t think that returning to work will even be a consideration for a number of months.

In future, if I am deemed unsuitable for services that I have been told I will be referred to I would like to be informed of this immediately rather than waiting until the next appointment which could be some weeks or even months away. If treating me is an issue because I am an employee of the NHS Trust then I would like this to be discussed with me. I deserve to have all of the treatment options that any other patient would be offered and if these may cause problems for my future employment then I would like to discuss this rather than not even being informed and having critical decisions about my treatment made without me even knowing.

I would like to be treated with some urgency rather than taking little steps and seeing what happens. As you will have read in my notes and I have said in our appointments, medication does not work well for me. The Pregabalin is reducing some of the intense panic that I often experience and I feel calmer at home but I’m still not able to leave the flat when I would like and am feeling increasingly trapped by this. I am also suffering a huge number of side effects that do not wear off after each dose increase and this is also majorly impacting upon my functioning. I am trying privately funded psychotherapy however, this does not waive my right to therapy on the NHS which I requested in September. 8.5 months is a very long time to be feeling this unwell and money worries due to my inability to work are becoming increasingly severe. I am no longer able to “live life to the full” I’m merely surviving and getting through each day in the hope that I will get better. However, this hope is fast running out as medication options seem to have been exhausted and the only therapy I’ve been offered is group CBT which I can’t possibly attend. I’ve been told by every psychiatrist and psychologist that I’ve seen that I’m not a “typical” patient so surely I need to be given different treatment from typical patients.

Angry doesn’t even cover how I’m currently feeling. I hardly even know how to express what’s going through my mind. I feel so let down and hurt and knowing that the service that’s meant to help me no longer seems to think that’s possible, is very difficult to handle. I keep trying to hold on, to keep hoping and believing that I’ll get better but that’s fast running out. I want to make it very clear that how my life is at the moment is not ok and I’m doing everything in my power to get well but it’s not working. I have little to look forward to and am lonely and unhappy which along with not being able to do all the normal things I was used to is exacerbating my depression which I would like to remind you is not treatable with medication and so I have to take a huge amount of care to keep it under control. I really need proper therapy that will deal with the issues underlying my depression and now anxiety. I am very aware of what a lot of these issues are but I need a trained therapist to teach me how to deal with them because working through them on my own has proved unsuccessful.

I’ve worked in mental health and I know all too well about the pressures staff are under and the effect that governmental cuts are having. However, I’m ill and I deserve treatment, not to be fobbed off with appointments being eked out by spacing them further and further apart and assessments being delayed because I’m deemed “unsuitable” with no explanation of how or why I’ve been given that label. Why do I never get consulted, informed or even explained to about the decisions that are being made about my care? Why is it not discussed with me? Why do so many meetings get held about me where a group of strangers make crucial decisions about my care having never met me, based on the opinions of one man who seems incapable of advocating my best interests? Why do I not feel listened to or heard but rather pacified, silenced and ignored?

I truly hope that this letter will get across to you the severity of my condition and its effect on my life and that following this I’ll be consulted more about my care and offered suitable treatment so that I can finally get my life back and go back to helping others like me. I’ve wanted to work in Mental Healthcare for the last 7 years and desperately want to make a difference but at the moment I can barely leave the house so how can I do that? Please give me the treatment I need so that I can become a success story and not another in a long line of people let down or denied treatment by the NHS. You can help change my life.

From Lucy.


  1. I’m curious, what help are you looking for at this stage? It sounds like you’ve been offered a lot of help already, and if that hasn’t worked, I’m wondering what you’re looking for? I see you’re demanding further support beyond what you’ve already been given, but unless you know what that is I’m not sure what more you want them to do. Like with physical illness, sometimes the NHS does the best it can but not every single person will respond.

    Have they actually asked you what else you’re looking for?


    1. Hi Amelia, just for context, this post was written and published nearly 4 years ago, I’ve now been ill for 4.5 years. The only treatment I was offered was various medications which all unfortunately had no effect or made me worse (I’m no longer on any medication) and group CBT which I’m too ill to attend. The help I was/am wanting is individual therapy to help me work through my issues and finally get my life back. At one point I was told I would be assessed for individual therapy but this was then removed and all I’ve since been offered is to go to groups at a day centre run by people who aren’t trained therapeutically who are in the role I used to work in before getting ill. Again, I’m far too ill to do this as I’m still virtually housebound and suffer from severe social anxiety so this isn’t suitable for me. Apart from that, I’ve just been left to it. I haven’t been seen by my psychiatrist for over 2 years because I’m too ill to attend and he won’t communicate by phone. Earlier this year, after 2 years of no contact, he wrote to me for an update which I replied to (that’s another post on this blog) but they’re still not offering any support. I asked in that letter for any advice of what I could pursue privately as well as an update on what the NHS can offer, if anything, and he didn’t answer that so it appears there’s nothing that can be done until I can attend the art groups I’ve been offered which are groups I used to run at the hospital I worked at. A couple of times in the past they’ve asked what I’m wanting, I’ve been very clear that I need individual therapy, preferably Cognitive Analytic Therapy which I had a number of years ago which helped with blackouts I was having at the time but my Trust won’t offer that, or anything else and they can’t offer anything in my home or remotely and in fact, haven’t offered individual therapy full-stop, just groups run by nursing assistants. I’m very aware of the limitations of the NHS, both with physical and mental health but there are treatments I could be offered that are offered in my Trust and others across the country and they aren’t offering me those so I’m left having to manage and fight this alone which isn’t making much progress. I hope that clarifies things.


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