Experience of Psychiatric Medicine

Question 1:
What is the best way of reducing stress?

Response: Those present suggested relaxation, exercise, and sleep. It is important to keep occupied, read a book, watch football, play football, but try to avoid sitting alone at home doing nothing. Avoid alcohol. One client, aged 37, suggested he was too old to play football, and the response was that one is never too old for exercise, or to be active.

Question 2:
The client has been receiving Modecate injections for 15 years. For the last 7 years the dosage and frequency has remained the same but the patient feels the dosage has never been reviewed. How often should treatment be reviewed and what is the procedure for reviewing medication?

Response:
Clients thought they should be seen by a consultant every 6 months, and their medication reviewed every 6 months.
Another client thought it wrong to be on medication long term, and patients and consultants should work towards coming off medication.
Patients should be offered a broader range of treatments including counselling or psychotherapy. This should be offered before patients go into crisis.
It was pointed out that coming off medication can cause a relapse.
After a patient comes out of a crisis, why is it not policy to slowly reduce medication with an aim to taking them off altogether?

Question 3:
It is two years since the client’s last breakdown. She was taking 6mg of Risperdal and this was reviewed every 4 months. The dosage was reduced from 6mg to 4mg, and she is now on 3mg. However one of the side affects is that she has put on weight. Can anything be done about this?

Response:
Several people raised issues of side affects.

Question 4:
A client, aged 65+, taking Epilim and Prozac, asked if anybody else was taking Epilim. He has been attending the day centre for many years and he has not met anyone else who has been prescribed with Epilim.

Response:
No other clients were prescribed Epilim. However a carer said her son had been prescribed Epilim, and she believed it to be a drug for the treatment of epilepsy. It was questioned why drugs for epilepsy were being prescribed.

Question 5:
A client has been taking ?Lostril for 15 years and it has adversely affected her liver and kidneys. Her medication has been changed to Cipromil and reduced from 100mg to 20mg, however she feels like a zombie, is extremely tired and can’t do anything for herself.

Response:
Another client responded that she had the same symptoms after being prescribed a high dosage of a drug and that she took herself off that medication. Her GP/consultant was not pleased, but sometimes it is up to patients to do something for themselves. It seems that only then will they be considered.

Question 6:
A client despaired of the fact that her GP did not listen to her. There should be a two-way dialogue between the GP and the patient, but the GP never considered what she had to say. The patient knows how they are feeling yet they are not consulted. She described doctors as trying to kill their patients with their drugs.

Response:
Several identified with this point. Many clients did not think their GPs and consultants treated them with respect, and truly listened to what they had to say.
Clients understand that GPs and consultants have limited time, but they also felt that their own time was wasted, sometimes by several trips to the GP for repeat prescriptions.
Why can’t mental health patients be treated more humanely?

Question 7:
A client takes 500 mg of Epilim at night and 300mg in the day. Is this a lot?

Question 8:
How do you cope with depression?

Response:
Going to the centre regularly was helpful. Being alone and isolated makes depression and illness worse.

Question 9:
A client asked if it was possible to get insurance against mental health? One can insure different parts of the body, against a broken arm or leg etc, can you insure against mental illness?

Question 10:
A client has spent 31 years in and out of mental hospitals. In Africa, she believes, the medicines given to patients by a witchdoctor are natural, but the drugs in western medicine are produced chemically and drug companies profit from them. She does not trust doctors. Last time she was in hospital she was given sleeping tablets at night, and sleeping tablets during the day. That cannot be right. She was later told by the consultant that she should not have been on the tablets in the day.

Question 11:
A carer has a son who has been suffering from schizophrenia for 12 years. He has had four changes to his medication. At the moment he is on Sodium and has problems in the late afternoons. He takes a tablet in the morning and another in the afternoon. What can be done to balance his day? The tablets are too big for him to swallow and have to be broken up. Is this a problem? He has terrible side affects and won’t travel anywhere, he won’t go on the bus. Is there anything that can be done about the side affects?

Question 12:
I have been on medication for 8 years. The trigger for my illness was bereavement, and problems with my children. The source is no longer in my life and I would like to come off medication. There seems to be no plans to wean anyone off medication. Why not?

Question 13:
Another carer’s son had been prescribed Risperidone, but was now on Olanzapine. She has tried to look into the drugs and it seems these two are the same? Is that correct? Her son is living in Woodford and there is not a good racial mix in that area. She has asked for him to be moved to a different area but nothing has happened. Her son had problems before being diagnosed with schizophrenia. They do not address these problems. He has also been prescribed Epilim, as mentioned earlier, and when I looked into the drug it is prescribed for epileptic fits. He doesn’t have fits. Patients need someone to support them and look after their case. My son wets himself. He doesn’t know he is doing it. He’s not coping. The police picked him up in the middle of the night, walking to my house and now he is in Goodmayes. He is ill and can’t help himself.

Response:
Carers and clients want more information about medication.
Why is there so little support?
Why are black people treated differently? It was felt that even in the Borough of Waltham Forest with a high percentage of ethnic minorities, cultural differences were not taken into consideration.
It was discussed that although several GPs and consultants are from ethnic minorities, their medical training is very Eurocentric.
It is different for ethnic minorities. They do not get enough sun and sunlight, and often live on their own in cramped conditions, in bedsits. Their lives are unnatural. The food they eat is not natural to their system.
Another client argued that mental health care in Britain was often better than in African countries. She had a cousin with mental illness who was kept in a small room and his food was thrown on the ground before him.
This treatment was blamed on a lack of funds and a phobia within the community about mental illness. If you suffer from mental illness your life is over, and people are sometimes kept chained up. This treatment is awful.

Question 14:
A carers son was taken into hospital. He didn’t want an injection and in a struggle the doctor was hit. This resulted in a summons to court, and he was put on probation. My son is not well, and he broke his probation because of his medical situation. I am in the process of trying to get his case out of the courts.

Response:
Carers and clients would like to know how the penal system communicates with medical professionals. When is a psychiatrist called in? At what stage do they get involved? Why don’t they communicate sooner with the penal system?
It is thought that sometimes the medical professionals do not want to get involved?

Question 15:
A client recounted that she was asked to telephone the Home Treatment Team if she felt she was going into a crisis. She did ring them, and they did respond, and because of this she didn’t have to go into hospital.

Response:
Other clients asked how they get in touch with the Home Treatment Team.
Some had been told about the team at the hospital.
This service is only available in the south of the borough, and therefore only covers about a third of the borough. Why isn’t this available across the borough?
BPMHA gave out cards with Home Treatment Team information.

Question 16:
A carer explained that her husband had suffered for 39 years. At the moment he gets up very early, but is not suffering the side affects of dribbling. She points out that it is very difficult for carers and that they have very little or no support. And she asks why is it so difficult to get the balance of medication right?

Response:
Carers and clients alike would like a response to this question?

Question 17:
Why are the mentally ill treated so violently by the police and the medical profession? Is it necessary to use such violence in order to control behaviour? And after incidents caused through mental health, why are they then stigmatised?

Response:
A few clients had been treated violently by police. One remarked that he thought he was going to die.
Several described receiving injections as violating, and the manner in which they were injected as violent.
A client described how it involved 12 people to give her an injection, and she perceives this to be extremely embarrassing. Further embarrassment is caused when you find yourself naked in a room when you wake up.
Another client described her experience of not wanting an injection. It took four people to hold her down, but she said they were apologetic afterwards.
The violence was perceived to be mental as well as physical, especially when patients feel they are not listened to.
A carer described how her son was stigmatised after he hit a doctor. When the police came they stood on his hands. His son no longer has a GP, and he cannot get an appointment anywhere.

Question 18:
A client described problems with communication between the consultant and the GP, both when she was discharged from hospital and after check-ups. What can be done to improve this communication?

Response:
Several clients experienced problems.