Uniformity within mental health trusts

I am under the Early Intervention in Psychosis team in Walsall, which is part of the Dudley and Walsall Mental Health trust. Despite being the same trust, Dudley and Walsall operate very differently,

This first came to my attention in my most recent hospital admission, where I spent 7 weeks in Bushey Fields Hospital in Dudley. Not only is the daily routine different but I  also noticed that most of the patients had Borderline Personality Disorder (BPD) and that a lot of them were having Dialectical Behaviour Therapy (DBT). DBT isn’t something that is offered in Walsall. I have asked a few times about DBT and I’ve just been told that they don’t offer it however they do it in Dudley. Only problem is, you have to be a Dudley patient to receive the help. You would think this would be a service that would be open to the whole trust.

I was speaking to my CPN about the differences in the trust when I saw her last week. She told me that they are looking into having DBT services in Walsall, however they are trying to get the funding at the moment, so it could take years before anything is put into place. She also told me that doctors in Walsall are very reluctant to diagnose people with BPD because they simply don’t know how to handle the patients who are diagnosed. They also fear that a lot of people would kick off if they were told about their diagnosis. Instead, they sit on the idea for years, without telling the patient, until it gets to a point where the behaviours and unhealthy coping mechanisms are ingrained into them and by the time they do get a diagnosis years down the line, it’s very difficult to treat.

This lead me to wonder why I got diagnosed. Apparently, my psychiatrist had mentioned it a few times before anything was mentioned to me. I often think that if I hadn’t have mentioned it to him and questioned whether or not I have it myself, I would still not have had a diagnosis and would still be clueless as to why my medication for bipolar isn’t helping.

The only bad thing about having a diagnosis is that there are limited treatment options in Walsall. The only thing that is available is a 20 week STEPPS programme which is group training rather than therapy. You get taught skills and have homework but there’s no opportunity within the group to talk about how you’re getting on with the skills or how you’re feeling. This has to be done with your CPN or support worker. I was all up for doing the STEPPS programme until I researched it more. I don’t want to be taught skills without having any help in place if I’m struggling. At least with DBT, you are offered support along the way.

So this is my question. Should there be more uniformity within mental health trusts? I’m not sure if this is the same for any other mental health trust but surely all areas that are covered should have equal opportunities and work ethics.

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