I’m ill, which means I need to access mental health services, which in turn makes me more ill. Oh the sweet irony of NHS mental health care.
I write this in my GP’s waiting room having just had an encounter that was almost as unpleasant for the doctor as it was for me.
As ever, whenever I deal with authorities I find myself trapped in some kind of hideous Catch 22 in which the people with the most power have the least intellect.
I turned up for a routine appointment to review my mental health. I explained that things had got worse and please could I have some more diazepam. After a lecture from my somewhat-new-and-inexperienced GP on how addictive it was, I explained that I understood that but my choice was currently to take medication to control how I was feeling, or chuck myself under a bus. I am dealing with the lesser of two evils here.
I also asked for one of my prescriptions to be changed from three times daily to ‘as required’, as I’ve been instructed by the crisis house to which I am hoping to be admitted this afternoon that they can’t administer more medication than prescribed.
There followed the most ludicrous and cyclical conversation, in which the doctor repeatedly told me that she couldn’t give me any more tablets. I explained I did not want any more tablets, I had plenty. I wanted her to change the prescription from TDS (three times daily) to PRN (as required). She couldn’t give me any more tablets, she repeated. I DON’T NEED ANY MORE TABLETS I repeated.
No word of a lie, this conversation went round in circles at least four times before she informed me that my psychiatrist would have to agree to this, but she was too busy to contact him today. The crisis house would have to phone the surgery, speak to the duty officer, ask them to phone my psychiatrist (who, as a consultant, is not easy to get hold of at the best of times).
I expressed the view that this was not good patient care, and would likely leave me in a situation of extreme distress with no access to medication for a period of days until contact could be made with the appropriate people.
She refused to budge from this point, so, knowing that I would have to explain this situation to the assessment team at the crisis house, I asked to record her reiterating her position, and turned on my phone.
At this point she left the surgery and did not return. Instead, her senior colleague returned and informed me that she was very upset.
He asked me to stop recording and said he would end the consultation unless I did so, so I agreed I would do so provided he would give me a written account of our consultation to take away with me. On this basis, I quit the record.
He then agreed to contact my psychiatrist today and to phone me and let me know the outcome.
I thanked him. I explained that I was sorry that his colleague was upset but pointed out that I thought it showed skewed priorities that he was asking me to empathise with her.
I was a patient who had presented in the midst of a mental health crisis and has asked for a course of help that would prevent causing me further distress. When that was denied to me I asked for evidence because I knew that I would have to progress this battle with other authorities in the health trust. At no point did I raise my voice or be impolite; what I did do was give a frank account of being unlawfully detained by the trust last year and explained why I felt the need to cover myself from all angles in interaction with mental health services. The other crime I seemingly committed was of having an understanding of my rights and of prescribing guidelines on controlled substances.