written By a helpline volunteer
Why do some people get the right treatment on the NHS while others don’t?
I was thinking about this when I was on the phone to my GP asking for a referral to a specialist OCD service.
For me, the process was easy. I just used all the right medical jargon, sprinkled in a few of my worst OCD anecdotes, dropped my voice an octave and plumped up my accent, and bam! My GP said, “We’ll refer you to wherever you want to go”.
If I had never worked on the helpline at OCD Action, I would have thought that everyone gets this fast-track service. But working for the charity has taught me that this is simply not the case.
Some people end up in the slow lane, crawling towards the right referral one conversation at a time. If this is you, it isn’t your fault, but there are a few things you can keep in mind that may help you get what you are looking for.
So here they are-
My 7 Top Tips for How to Get Your GP to Treat You Like OCD Royalty
Assertiveness
Do Be Assertive
GPs are busy. The NHS is busy. The world right now is busy. When you’re on the call to your GP, they probably have five minutes between appointments. So don’t dawdle and don’t dither. If you want CBT with ERP, tell them. If you know which mental health team you want to see, tell them. If you want one of the medications recommended by the guidelines, tell them. Be polite but firm. Showing your GP that you’ve brushed up on your condition and are knowledgeable about the treatments makes it harder for them to say no.
Don’t Be Passive
Don’t assume that your GP knows anything about OCD. Here at OCD Action, we can tell you everything you need to know about the recommended treatments for OCD. Go into the call armed with information. Knowledge is power.
Professionalism
Do Keep It Professional
OCD is a condition in which you have intrusive thoughts that bring on anxiety, which you get stuck trying to get rid of using compulsions. The treatments for OCD are CBT with ERP and/or medications called SSRIs. There are infinite ways OCD can manifest, but some common themes or compulsions include: body-focused/sensorimotor obsessions, checking, contamination, order/symmetry, Pure-O, relationship, rumination, sexually intrusive thoughts, scrupulosity/religion, thoughts about sexuality/gender, and thoughts of harming others.
Using these buzzwords on the phone shows your GP that you understand your condition and you know what you’re talking about. If your GP doesn’t know much about OCD, you can ask them to look up the terms you have mentioned or to contact OCD Action for clarification.
Don’t Be Emotional
Your GP is there to support you, and the main way they can do this is by making a referral for the right treatment. Do tell your GP that you’ve been struggling and explain how your condition is hampering your everyday life, but try not to get distracted or wound up by the more emotional side of things. Treat the conversation like a business call. A letter with your GP’s signature is what you’re really after.
The OCD Action helpline and support groups can offer a better space to talk about how you are feeling with people who understand and are there to listen.
Preparedness
Do Do Your Homework
Lay the groundwork before calling your GP. If you know which centre you want to go to, speak to them first and find out what they need from your referral. If you want to brush up on the recommended treatments for OCD, speak to OCD Action.
How much better would it be to call your GP and say, “I’ve already spoken to the mental health team and they said that they would be happy to assess me, they just need a letter from my GP”? Or, “I’ve spoken to OCD Action, they said that the only recommended therapy for OCD is CBT with ERP, so that’s what I’m looking for”?
Being one step ahead can get you one step further.
Don’t Skip the Research
Your GP is looking after the health of a hundred different patients. You only need to look after your health. It’s worth researching the treatments for OCD (CBT with ERP and SSRIs) before you make that call, so that you know what you want from your GP before you’re on the line.
Stories
Do Talk Through Your Top 3 OCD Episodes
You’re not being interviewed by Oprah Winfrey. You’re talking to a busy medical professional. Give your GP two or three stories of your worst ever OCD episodes so they have some context about how important it is for you to get the right treatment.
Don’t Give Them Your Life History
If it’s not related to your OCD, then don’t mention it on the call. Your GP will probably ask you lots of questions about how you’ve been feeling and your general mental health, but you don’t need to go into detail when answering those. Imagine that the subject of the call is, “why should the NHS pay for your treatment for OCD?” and focus your responses around answering that question.
Honesty
Do Be Honest
The GP may ask some blunt questions, like “Have you ever considered self-harming?” or “Are you using drugs or alcohol to cope?”. Don’t be embarrassed to answer these questions honestly. They are being asked so that you can be offered the right support.
You don’t need to talk about your intrusive thoughts and compulsions, but your GP needs to know about the impact OCD is having on your life. If your OCD makes you stressed out before every big life event or interferes with your relationships, then say so. Your GP is a doctor, not a mind-reader.
Don’t Evade Questions
The answer to “Does your OCD affect your mood every day?” isn’t, “I don’t know, sometimes.” You probably know all too well how much it impacts you. Tell your GP how you really feel and be specific about what your OCD makes you go through. If it gives you a dull headache, a feeling of lethargy or sleepless nights, tell your GP. This call is for you to explain your symptoms so don’t hold back.
Positivity
Do Explain How You Will Benefit from Treatment
Doctors are driven by a higher cause. They want to feel like they’re helping their patients to recover. They’re not in this game for the money. If you say, “I doubt CBT will help me but that’s what OCD Action has recommended” then it won’t fill your GP with hope. It’s better to say, “My OCD interferes with my day-to-day life, but I know that with the right treatment – CBT with ERP – my symptoms could be significantly reduced, and my life would be so much better as a consequence”. This will make your GP feel good about writing the referral letter, which means they will be more likely to write it.
Don’t Be Pessimistic
Complaining about your failed treatment in the past or how mistreated you’ve felt in your previous misadventures with the NHS will not ingratiate you with your GP. You’re on the same team, not opposing sides. If you’ve had CBT with ERP before and it didn’t work, try to figure out why. It’s ok to say, “I wasn’t ready when I last had therapy, so didn’t engage with the treatment the way I should have, but now, given another chance, I will throw myself into it and I’m sure it will work.” This ability to predict the objections that your GP might raise and give rebuttals before they do is invaluable if you’ve had treatment before. Really work out why this time will be different, and then tell your GP.
Proactivity
Do Make the Call
The NHS exists to provide treatment for everyone in this country who needs it, free at the point of use. If you need treatment, then don’t be shy to ask!
Don’t Forget Your Mental Health Is a Priority
It can sometimes feel like it would be easier to try to manage on your own than to go through all the calling and waiting involved in getting treatment. Therapy isn’t easy, but most people do find that it’s worth it to get back the things that OCD has made difficult or impossible.
Many people who struggle with OCD don’t know that CBT with ERP is available on the NHS, or that medication can really help. Now that you know, you can take steps towards your recovery. If you have OCD, then speak to your GP about the treatments you want to access.
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If you follow these 7 golden rules, then hopefully you won’t need an advocate.
However, if you still run into roadblocks, you can always speak to OCD Action, Mind, Healthwatch, a local community advocacy group, or your MP.