A unifying idea for psychiatric self help

This Blog is an invitation to discuss the predicament facing a person who feels, insurmountable and inescapable problems, total inability to act except to curl up cry and shake, fetal position with voluntary inertia. Day and night hallucinations with or without medication are common. Some relief can be obtained, assuming communication is possible through those few who have mastered their problems and can sometimes empathize and advise from their experience.

Help is often designed to fragment the problem, chipping away at issues that the health services has no staff or equipment to attempt alleviation. For many of us lifelong medication is needed and I have no problem with that if carefully and frequently reviewed by a good psychiatrist. GPs are often forced in the UK to the desperate step of prescribing drugs to render the patient unconscious until more appropriate care can be found; due to paucity of qualified mental care facility available this may be up to 6 months. GPs are neither trained to diagnose psychiatric illness, to understand the side effects of long term usage or to recognise signs of a patient reacting negatively. Death, despair and suicide follow.

There is comprehensive coverage of the psychoactive drugs on wikipedia at antidepressant list and these are all linked into wikipedia pages on depression and insomnia very well . There are, of course many other learned books and journals that both GP and patient should FULLY absorb building up a matrix of what works well for a specific patient and set of drugs, at what dose and at what time of day.

In my own case little consistent improvement was visible which led my GP at the time to prescribe a potentially lethal cocktail by adding oxycontin in high doses to the list alongside all the other depressants and SSRIs she was dishing out liberally.

Fortunately a drug induced coma led to many of the drugs doses being simply evacuated by over worked E&A staff pushing as much water and sterile solid though me.

As an absolute accident I missed two whole sets of medication in a row and found that I remained depressed, as expected, but was able to walk unaided, talk coherently and, vitally, from that point on formally refused any further medication from the amateurs employed as GPs at our surgery

9 months on I am, of course, unemployable having been ill for over a year but I read prodigiously and get plenty of exercise.

It really does pay to do your own research, checking with online qualified psychiatrists from time to time. If I had paid to get the treatment that I have needed we would now be a house-less, penniless grown up family of four all reliant on my pension.

At least we saved our marriage (just) and a very degraded relationship with the children who are now 23 and 26 but still at home thanks to the recession.

The other observation I would make at the "talking therapies" supported by Rethink and the governmant may cut costs and waiting lists by using cheap unqualified staff and they will work for those who do not have a clinical depression due to imbalanced brain chemistry or neural activity. For those of us with clinical depression talking does no good and, for me, is harmful.

Please do share your thoughts with me and I will help if I can (via private message if requested)

A word of warning - it is easy for the psychiatrically ill to seriously damage all those around them. This is especially the case where the patient is disruptive, violent or delirious.

The growing youtube collection of videos relating to depression may help those readers who do not understand why someone who is clinically depressed cannot "snap out of it". Brain dysfunction can defeat the strongest will.

Regulation fit for the target

In 2005 the National Audit Office published a report on the complexity of the benefits system http://www.nao.org.uk/idoc.ashx?docId=CEB51B1D-07A8-45B7-8F85-C472333F34D0&version=-1

What is apparent is that the complexity is inversely proportionate to the ability of the potential recipient to unravel it.

This applies to every aspect of "special needs" provision. As social services are cut back there is very little chance of a special needs person encountering a state provided advocate and even less chance that they will be able to obtain what care remains in the system on their own.

Special needs of all kinds stand out as an area where opaque regulations minimise state liability to care. The situation is made worse by a typical case involving contact with more than 30 organisations each with their own waiting list, budgets and forms.

One way to deal with this is to establish a public advocacy service as a single point of contact for the special needs client whether they are seeking eduction, employment, housing or just social interaction. That way the advocates could learn the existing mass of regulations and connections between responsible bodies. This is rather like relying on a trained human to answer call centre queries using a plethora of unconnected information systems rather than trying to design a new system that replaces the trained human.

The other way is to wish publicly that it was easier but plan to gently deposit the problem on a remote back burner.

It would be nice to see anything positive to promote stable special needs communities in which groups of individuals could live with, perhaps, one advocate and a collection of special needs people who could work together to compensate for each other's disabilities.

I encountered only one such community in the course of a search lasting more than 20 years and that was the Redhill College run by the RNIB with a funding contribution from the government education budget. Sadly that is now gone as a result of the education contribution being withdrawn on the basis that funding ought to be awarded only to institutions that teach mainstream qualifications rather than skills for life. http://www.facebook.com/#!/group.php?gid=117965814884402