Aria is in her late forties and has anxiety and PTSD linked to incidents of domestic abuse in her past. She receives support with her mental health from a psychiatrist and her Community Mental Health Team (CMHT). Aria reported that going out into the community is now much more difficult for her as there was a long period where she wasn’t doing this due to the Covid-19 restrictions. Aria also finds phone calls particularly difficult as her anxiety causes her to forget what she wants to say. She finds talking to professionals on the phone particularly stressful.

Aria had requested advocacy support to find out what was happening about a referral for Psychotherapy, at a specific clinic.

Aria had met with a psychotherapist once, but was experiencing a delay to the start of regular therapy. This coincided with a planned and necessary house move. The mental health teams supporting Aria were concerned that it would be too stressful to move house, and engage effectively with the Psychotherapy. Aria agreed to this, but following her house move, she has had difficulty communicating with the CMHT to organise the restart of her psychotherapy.

Louise, a POhWER advocate supported Aria with a number of three-way phone calls to request a re-referral through her psychiatrist’s secretary. Aria didn’t receive any response from these calls, so after discussing the options with her, it was agreed that Louise would support her to approach PALS (Patient Advice and Liaison Service).

Louise contacted PALS via email and copied Aria in so that she was part of the emails. PALS made contact with the clinical team, who explained that no re-referral had been made as Aria was due to be moved to another CMHT as Aria was now out of area for her previous CMHT and that they would need to re-refer her for Psychotherapy.

Aria was also advised that she could speak to her psychiatrist about this at her next appointment.  Louise discussed Aria’s options with her, which included helping her to make a formal complaint about the delay in accessing treatment and supporting Aria at her next appointment. Aria decided that she wanted advocacy support at her next scheduled phone appointment.

Louise arranged a visit to Aria’s home with another advocate to provide in person support at the phone appointment. Prior to the appointment, Louise made a list of issues that Aria wanted to mention, which included a re-referral to Psychotherapy. Aria also wanted to increase her medication dosage due to impact of noise from neighbouring building work.

Aria explained to her psychiatrist that her PTSD has been worse recently. Her psychiatrist offered some general advice. Aria became frustrated and indicated that she wanted Louise to step in. Louise intervened to explain the impact that noise from building work in the flat above had been having on Aria’s mental health. This enabled Aria to explain further and then ask her psychiatrist about increasing her medication frequency, which was agreed to.

Louise also supported Aria to ask about her referral to Psychotherapy and transfer to another CMHT. Her psychiatrist agreed to speak to Psychotherapy about re-referring to their service. It was confirmed that Aria would be transferred to another CMHT, although a specific timescale couldn’t be given. After the call Aria said “Thanks again for your help, it really, really helped you being there."

Afterwards Aria spoke with her GP. Her GP said that she would not be able to prescribe any more of the medication that had been agreed in the appointment with the psychiatrist. Aria was upset and frustrated about this. Louise supported Aria to contact her CMHT and leave a message to request a prescription. As a result, a prescription for a six month supply of medication was arranged for Aria. Aria was really grateful and said “How great is that? I felt heard and supported and most importantly trusted to look after myself."

Aria asked Louise to support on several occasions where she faced hurdles in communication with the CMHT and their appointment processes, which had not run smoothly, causing Aria some concern as she felt her mental health was getting worse again and she was on her own. She finally received a letter for an appointment four months after her original request.

Aria was contacted by the Psychotherapy service and then accepted into one of their therapeutic groups. Aria said that receiving this news had made a real difference to her mental wellbeing as she now feels she has support and people that are there for her.

Louise is still involved in supporting Aria to communicate with her new CMHT and psychiatrist about her ongoing medication and treatment.