Mental Illness Treatment and Making a Complaint
As a patient of mental health services many years ago, I had cause to make an official complaint about the treatment I received on two occasions. I approached these complaints in two different ways. Initially I knew nothing of how to complain, and I actually found it all quite distressing at the time. I not only complained because I was dissatisfied, but also because I didn’t want the same things to happen to someone else.
In the last few years, and having had dealings with scores of other mental health service users, I now realize that the large majority have no idea how to complain when they have grievances. This article will explain how to complain,and a few tips from my personal experience. It does not take into account those who are sectioned under The Mental health Act, or those who wish to take legal action.
Why People Don’t Complain
Within the realms of mental health disorders, some people may have periods of paranoia, but certainly the majority will feel vulnerable at times. All service users will feel at their most vulnerable in times of crisis, and it is at this point that there will be the most input from the psychiatric profession.
Medications can be changed or dosages increased, and sometimes a stay in hospital may be necessary. Some people may have dealings with the crisis intervention team also. When a person feels scared and insecure, and they have a bad experience with their care or treatment, they may be dissatisfied and want to complain. This might be about grievances such as:
Reasons for Your Complaint
Were any of the following factors a reason for your complaint
- Lack of compassionate care by professionals
- A feeling that needs have not been met
- Victimization or discrimination by staff
- Care plans not being adhered to
- Safety issues not being addressed
- Disagreement with diagnosis or medications
- Physical, verbal or mental abuse by staff
The reasons people tell me that they don’t complain are:
- Fear of disbelief by those in authority
- Can’t remember dates or names of those involved – cloudy memory of details
- Having to meet up with those in authority to discuss – lack of confidence, self-esteem
- Fear of the complaint being dismissed as unimportant
- Fear that future care and treatment may be compromised
- That it may be pointless
- That they still feel too ill to go through with it
If a person was unhappy with medical treatment, I think they would find it much easier to complain. Mental health service users sometimes lack the support and confidence that other people have, and often feel defeated before they start! You can usually complain up to twelve months after the incident, so there may be time for you to make a better recovery if you have been in crisis and need to complain.
Mental Health Rights and Care
Making a Mental Health Complaint in England UK
All mental health patients should know about the complaints procedure. If you do not know, you can ask for a copy of this from your psychiatrist, community worker or social worker. If you feel unable to ask these people because you do not want to divulge your intent to complain, you can also ask your local MIND charity, which you should be able to find in your phone directory.
MIND is actually a very good place to start when it comes to support in embarking on the complaints procedure. You can tell your story in complete confidence to a worker, either voluntary or permanent staff member, and get a good idea if your complaint is feasible. You will then be advised on what is the best way forwards in your case.
Usually you can ring them and ask to see someone regarding a complaint you wish to make. Otherwise, you can simply drop in and hope someone is available to give you a little one to one time.
This is how I started out on my first complaint. I rang MIND and arranged an appointment to speak to someone in confidence. This particular branch had an advocacy service available to me, although not all branches do. If they don’t they will certainly know of an advocacy service that you can approach.
Advocacy for Complaint Support
With both of my complaints I had the support of an advocate from a local advocacy service. These services are nationally available and can also be found by asking your local community mental health team or Patient Advice Liaison Service (PALS). There are several types of advocates such as voluntary advocate services, or peer advocates (fellow service users or ex service users).
Advocates are there to support you for various reasons, but they can be so valuable when making a complaint about mental health issues. They will want copies of any complaint letters you write, and will initially have at least one meeting with you, sometimes in your home. Their job is not to speak for you, but to be there to assist you should the need arise. They can attend any meetings, and if you are finding it difficult to put a point across, they will help you along. They want you to be happy with proceedings and find a resolution to your complaint. I would advise an advocate for any mental health complaint, as their presence at important resolution meetings feels both supportive and reassuring.
Independent Mental Health Advocacy
How to Start a Complaint
Complaining Directly to The Source of the Treatment
We are told that we should first take up a complaint at local level, and this can be directly to the body you are complaining about or the health trust in your area. Complaining directly to the psychiatric hospital, the crisis intervention team or community services, or whoever is applicable for the ill treatment is usually seen as an informal complaint. If the complaint is about treatment as an in-patient, your letter should be sent to the manager of that hospital or unit. If t is about crisis intervention, then you should seek out the person who manages that also. There is always someone who manages each individual service. A phone call to the service can ascertain who it is you should be writing to.
Type your letter if possible and make at least three copies. Try not to waffle, but stick to the facts of what it is you are unhappy with and why. Make sure the date, your full name, address and telephone number is included.
Try to state dates as much as possible and be prepared to name the staff/professional involved. The more information you can give, the easier it will be for the manager to follow up. Hand deliver the complaint letter if possible, or send recorded delivery.
You should get a phone call or letter confirming that the letter has been received as I did. This should be within several days. Resolution on this level should not take too long; mine took around six weeks. You may be asked specifically what you consider a resolution should be, and then be told roughly how long it will take to handle the complaint.
The complaint directly to the cause of my dissatisfaction didn’t work well for me. At first I was told if I couldn’t remember exact dates it might prove difficult to investigate. Mental health patients in a crisis don’t usually write everything down! I couldn’t remember a vital person’s name either and that didn’t help.
I found that the points raised were brushed over somewhat, with a vague apology over the telephone from the manager on behalf of others. I needed to know professionals had learned something from this; that I had proved flaws in my treatment had been acknowledged and acted upon. My advocate agreed entirely, but I did not have the mental energy to pursue it.
If you are not satisfied with the resolution, you can go a step higher and make a more formal complaint as I did the second time.
Mental health system problem - critical account of injustice
Complain to NHS Primary Care Trust
Another way of starting a complaint on local level is by writing directly to your local primary care trust (PCT) the address of which you can find here.
My complaint took around four months to reach a resolution by this route, but as I was determined to reach my desired outcome, I asked for my mental health records first in order to obtain concrete facts. I actually found reading my mental health notes quite stressful, and a stark reminder as to how poorly I had been.
You can ask to see your records for a certain time frame by telephoning your local PCT, and this may incur a charge of around ten pounds. To have copies of your records will be more expensive; anything up to fifty pounds. I would advise you to access your records because it does help with dates, and jogs your memory about the issues in complaint.
Have you Made a Formal Complaint?
Have you made a complaint about mental health service treatment or care?
Making a complaint to the PCT is handled in much the same way as complaining to the local manager. Communication is made by both letter and telephone calls, but the outcome of the investigation into your complaint will certainly be summed up in a letter.
I asked for a meeting with the staff involved and a doctor I was complaining about, along with my advocate and the director of mental health services.
It was a daring move on my part, but I had learned from my past mistakes. The doctor left the meeting because of an urgent call halfway through, and one member of staff from the hospital had gone on holiday (I wasn’t told prior to the meeting). Despite this the results were good. Because of my complaint, I was assured that things would change and retraining the staff on the basis of my complaint would follow. A few days later I also got an outline about how these changes would be pursued, and an apology from all concerned.
Taking a Complaint to an Ombudsman
If you are still dissatisfied with the outcome, you can ask an ombudsman to look into your complaint. Ombudsmen are not connected to the NHS and will form an impartial investigation. If they find that there has been bad conduct on those providing your care, they will recommend that action is taken and changes made where applicable.
MIND - Support for Mental Health Issues
- Mind, the mental health charity | Mind
We’re here to make sure anyone with a mental health problem has somewhere to turn for advice and support.
Advice on Making a Complaint
- Make sure you have an advocate as soon as you know you want to complain
- Look at, or get copies of your records to help you write your letter
- Ask if you can also take along a good friend or family member to any complaint meetings (perhaps a member of staff from MIND may be able to attend)
- Don’t expect much more than an apology on local resolution, anything more is a plus
- Don’t be afraid to say what changes you would like to see and why
- Make another formal complaint if you feel there are any repercussions
If you don’t speak out, the same things may happen to someone else!