Luck of the draw

Is the quality of care received by psychiatric service users subject to a postcode lottery? Overall I would not complain about the quality of psychiatric care I have experienced over the past 10 years. But different approaches from psychiatric teams in various parts of my home city have left me wondering whether my personal development could have been supported more.

I was so keen to carry on with a “normal” life after recovering in a psychiatric ward from my first psychotic breakdown that I pushed all memory of depression and psychosis to the back of my mind. I thoroughly relied on the idea that a chemical imbalance had been corrected by “miracle” psychiatric drugs and all I had to do was continue taking them.

However, having had two relapses since 1995 – the most recent of which occurred last summer – I’ve come to the conclusion that a little more work needs to be done on my psychological state than simply popping pills.

When my first request for cognitive behavioural therapy after my first relapse was greeted with the enquiry “what for?” by my community psychiatric nurse, I felt discouraged.

At the start of that relapse my former psychiatrist said my illness would be “treated aggressively”. Although I wasn’t sure what to make of this, I foolishly harboured the hope that it meant a talking treatment and a detailed and thorough analysis of my depressive and psychotic symptoms. In the event, it just meant a change of antidepressant and a lot more anti-psychotics.

Although I was extremely relieved when the drugs proved effective once more, I still felt disappointed not to be able to discuss the contents of my confused mind with my consultant.

Only after my most recent relapse did I feel my new psychiatrist was showing any interest in my take on my symptoms, and allowing me more than two minutes to discuss them. I had moved to a different area of the city and my GP had chased up a first referral to a new resource centre after I had burst into tears in his surgery. I was very distressed and was therefore thankful when my new consultant took the time to listen.

For the first time I have established a meaningful dialogue with my psychiatrist and have finally been given a referral to a psychologist.

I’m left unsure as to whether it takes a few breakdowns over an extended period to merit the attention of a therapist, or whether I’ve simply been lucky in my current placement and found an understanding team.

Psychiatric service users are more than a set of neurological chemical reactions. My current consultant certainly seems to take into account personal matters in treating the whole person as holistically as an over-stretched and underfunded system can allow.

If I hadn’t had to move home I might still be waiting for a humanistic intervention that would never materialise.

Helen Waddell uses mental health services and is a mental health volunteer