Friday, 14 September 2012

Are medical services in danger of a breakdown?

Recently I have had personal experience that mental health services that were difficult enough to access before the economic recession are now even harder for more minor conditions to access due to increasing demand. The demand has increased as a result of the people losing jobs, their homes, or indeed being under even more pressure at work as they try to cover the work of two or more people because of those job losses. 

This can only serve to fuel paranoia for the mentally ill further and increase the severity and intensity of episodes. I am deeply concerned that cuts to staffing and resources will lead to zero preventative and recovery care so that the only people who will be gain help will be those who are suicidal or those with long term and severe conditions. If that were to be allowed to continue then severe episodes would escalate in number, cost in time, medication and resources would have an even more profound effect on not just the economy and society as a whole but on everyone (25% of the population) who is affected by mental illness at whatever level.

It was bad enough a few years ago for me when I had to wait over 18 months for psychotherapy after losing my Mum for the type of counselling that I needed when we weren't in a recession, heaven knows what it is like for people now that we are in the middle of one. That therapy not only helped me to adjust to my loss but went much further, it helped me to unravel many long standing knots and get rid of most of my demons. It transformed me from a person who feared the world to one that could see, appreciate, engage in and adore all that was good and healthy in it. Fortunately for me my GP at the time was excellent and he would see me every week if need be while I was waiting for that psychotherapy. Sadly he's retired now, and I have not found finding any in the practice that would do the same - nearly all of them have been dismissive of me.

What can we do while on the waiting list for the services we need? Are medical professionals now thinking that if they ignore people with symptoms of anxiety, stress and depression for long enough that they and their symptoms will conveniently go away? I have had instances of a GP slamming a door on me for asking for help; reception staff laughing at me when I called in a state of desperation trying to get through to another GP who had promised to call me hours earlier but hadn't done so. I appreciate they may have had an emergency and had been called to an even more urgent case, but couldn't the receptionist have told me that instead of laughing?

The struggles of the medical profession

The suicide rate among the medical profession is alarming high. Outside mental health teams few have any in depth knowledge of mental health conditions. This is totally understandable given how long it takes to train anyone in any type of health care. The amount  of knowledge your GP is expected to have and be trained in is vast which is precisely why it does take years of training. However I do vehemently believe that a couple of sessions on active listening skills (the starting point for counsellors in their training) would benefit not only all medical professionals but all their patients too. It could even time and costs in the long run simply by helping the whole service become more efficient in its communication.

In my experience people who suffer mental illness feel isolated, misunderstood or alienated or in some way don't feel happy because they don't feel they fit in with everyone else - they often don't feel able to or welcome to. Some are ill because they don't want to at all. Listening skills are vital at the outset to determine what help anyone needs. Be aware though, that just as that is true of patients of all kinds, so it holds true of medical professionals too.

Disaster Management

At 7.30pm on 18th November 1987 a fire broke out at King's Cross Station in London. All the emergency services rallied and were involved in helping to contain the fire and save lives that they could. Afterwards only Fire and Police personnel were automatically offered counselling services for what they had witnessed and had to deal with. Nothing was similarly on offer for the Ambulance crews involved unless they pushed for it. It may be over two decades ago and you may think that that never happens any more, but I'm afraid it still does although hopefully not as much. It seems to take a long time for people to learn from any disaster situation probably due to the shock and complexity of them. 

Analysis reports following the terrorist bombings of 7th July 2005 found that radio communications were still not what they should have been despite the best efforts to improve things after the King's Cross Fire. We have no hope of identifying ways to improve things before many a disaster as often they simply don't occur to us beforehand. Afterwards though I feel we should be doing better by now to insure lessons learnt are probably implemented.

Among the many people who suffer from mental illness are people who work in highly stressful and distressing roles. What is perhaps most shocking of all is how medical professionals themselves get dismissed and talked down to by their former colleagues when they themselves suffer from mental illness. For example I know of a psychologist who suffers from Bipolar who was told that they were "just having another episode so take the tablets and go away." It transpired that the psychologist had good reason to have an drop in mood due to a life changing event that would be stressful for anyone. They weren't working at the time because of the situation they were in - they had done the responsible thing and stopped work. But when they needed help of the kind they provided when working none was forthcoming in a form that was supportive.

Dangerous assumptions
There is an inherent danger in assuming that people with long standing mental health histories have those conditions as a result of their DNA and genetics; that it is down to their physiology and metabolism alone. That simply cannot be true in my opinion because no one is ever without an environment in which to exist in. As a former counsellor of mine said, people diagnosed with schizophrenia, bipolar or any other form of mental illness still have the ordinary stresses and strains, and at times traumas of normal living to contend with. Why is it then that so often such situations and circumstances are not taken into account as a possible trigger for an episode of ill health as they would be for anyone without such a label? 

Along with anybody, people with bipolar have relatives that die or have accidents, they move home, get divorced, get made redundant, they have children that get diagnosed with terminal illnesses etc etc. Perhaps in some cases it would be more productive for them to have access to the same counselling services as anyone else for such events instead of automatically being thought of as severely ill and in need of hospitalisation. 

What must never happen is for anyone involved in healthcare to assume that one answer or set of treatments suits all. Every individual on the planet is exactly that - individual. It follows then that every individual will require different levels of support at different times according to their life experiences.

This year I had to resort to emptying all my cupboards to find out of date prescribed medication as I had reached a point of crisis due to stressful events that were happening. In effect I self prescribed and ended up taking more that I had ever done on that particular medication. I was lucky not to have died. I had to resort to such a drastic measure because my GP wouldn't listen to me over what I needed, hadn't bothered to look through my notes as to what had helped me in the past at a time of crisis and didn't keep their promises to get back to me over the course of a week. Nor would they give me access to a mental health team to talk to who have my full history. Instead they kept prescribing me medications that they were used to, none of which helped, all of which made my condition and moods worse. I refuse to be treated as a lab rat - end of. The result of which was a total lack of trust in them for anything to do with my health.

If you find yourself in a similar situation I suggest you complain to the local Primary Care Trust (PCT) to help get your transferred to a better practice. You can also write to the Lancet, your MP and the British Medical Association. 

Courtesy of some contacts of mine I was able to contact the mental health team direct only to find that no one would talk to me unless and until my GP referred me.

I have since heard of several instances of people being driven to suicide attempts while asking for a similar level of help i.e. a preventative level of support. All I needed at the time was someone to advise me, guide me and prescribe what had worked before. I am now looking for a better GP and a different practice and will not stop that search until I have found one. In the meantime though find avoiding my current GP adn the practice infinitely less stressful. Mental Health Charities are far better and knowledgeable it seems. I sincerely hope that the government will fund healthcare at the point of need to increase access to such services to prevent such instances happening to anyone else as if they don't it could easily result in an increase in wholly preventable suicides from both patients and medical professionals alike. 

I strongly feel that anyone in the medical profession should be suspended from work if they are found wanting in their ability to listen and not return to work until they have either been retrained or successfully benefited from counselling services themselves. If they don't they could end up being responsible for the death and suffering of others which rather defeats the purpose of their intentions for entering the profession and jeopardises their own health into the bargain.

The good news for me is that little bit of self-administered prescribed drug intervention gave me the ability to adjust to the events that had thrown me into a state of crisis. Fortunately I was already seeing a counsellor. My counsellor was extremely concerned that without that medication I might not be here today and highlighted I was that extremely lucky that the pills I took have not had any lasting detrimental effects - some medication can lead to all manner of nasty things happening which is precisely why we need doctors to prescribe them. 

In a crisis my brain doesn't produce the right mix of chemicals; just as a diabetic might need insulin, so I need my medication too. Not having access to the tablets I need can only result in my condition deteriorating. Luckily I am already in less need of those particular tablets as the events that triggered the crisis have largely been resolved, so I am back on track working toward coming off all medication as the last psychiatrist I saw over a year ago advised. I won't rush at it because I am waiting for a time when circumstances are favourable to do so, but I will never assume that I might not be in need of them again.    

Time for changes to happen
This is the year that the Time to Change campaign has taken off in mainstream media, where programmes like Channel 4's 'World's Maddest Job Interview' have proved that people with mental health histories can be the best choice for employment instead of the worst. This is the year that the Paralympics have proved beyond all reasonable doubt that is possible to overcome disability, prejudice, disadvantage and adversity of all kinds and make dreams and aspirations come true. It is also the year where cuts in funding are crippling and risking the lives of so many though too, even mental health charities have suffered from them at a time when demand if anything is only set to increase. 

Surely we have reached an age of maturity to make those cuts impossible by now. Surely we can and will do more to improve matters to prevent and reduce suffering. I hope so as I am fully aware that my experiences of the bad side of mental health care services are far from unique. 

I would remind readers of just how many lives have been saved though because of the astonishing positive changes that have occurred in the care of those who have been mentally ill over the last 50 years. When and where it is working it is literally performing miracles everyday. I hope such wonderful work will be built upon instead of being hampered once again to that often times odious commodity known as money. I mean would you like untrained volunteers to take over? I know I wouldn't.

1 comment:

  1. I am fully aware that I've raise big issues and big questions with this post and that many may not like it, however I have never claimed to know or have all the answers. Nor have I ever claimed to be ever have been right. I am only sharing my thoughts, highlighting the problems and what has happened to have helped me.

    Only by raising such things can we hope to to get ever closer to preventing the darkest of our days. I hope collectively we will one day we will fine those elusive and at times, seemingly impossible answers. Hang in there please, as I am, then at least none of us need to fight alone.

    By hanging on, we at least stand a chance of happiness. I do not rule out that for some the safety valve of a survival instinct may be what's at their illness. Every time I think that, I weep and feel guilty for making it this far. Maybe though, if I or anyone can find the path through it will help us all to.

    Remember, we are never alone.

    Next blog then, as I originally intended this one to be... the Pros and Cons of Competition.


Due to threatening behaviour, comments are now for members only.

Note: only a member of this blog may post a comment.