They’ve been in the news, mostly focusing on in patient care. Whilst this does need highlighting I’d like to have a rant about out patient services, or the complete and utter lack of them.
I’ve never been in in patient care, I was threatened with it once as a teenager but I can barely remember those years and ironically I wasn’t really crazy then (they saw my M.E/CFS as psychological, so I was sent to the psychiatrist from hell), they just thought I was and now I am actually going crazy everyone seems much less keen to actually treat my craziness.
My experience of outpatient care can be mostly described in one word :
constituting a minimum: a minimal mode of transportation.
barely adequate or the least possible: minimal care.
No 2 specifically.
I was formally diagnosed with depression (as opposed to the false it’s not M.E it’s depression mess from my teens) about 5 or 6 years ago. In those 5 or 6 years I’ve been on about 3 different anti-depressants, none of which have really worked and some of which have sent me crazier, or just not worked at all. My doubts and queries about my medication have rarely been given an answer beyond the monosyllabic, I have felt for the last year or so that my latest medication, venlafaxine (which has had the dosage raised again and again, like all the others) is leaving me emotionally dulled and deadened to the extent that it is starting to add to my depression symptoms. All I’ve been told is I am not well enough to consider lowering the dose as I am still ‘very depressed’. I need to be ‘more stable’. It’s like talking to a brick wall.
I have been referred to psychotherapy twice. The first time was useless. I had 16 sessions of CBT which I didn’t find very helpful and when I came to the end of my allotted 16 sessions I was told that was it regardless of the fact I was still as depressed as ever. It took me about 2 years to get referred for a second time; with one memorable false start of referred for counselling at my GP’s surgery only to be told a few weeks later I wasn’t eligible as I was seeing a psychiatrist and was thus too ill. That counselling wasn’t for ‘people as depressed as me’. After asking the psychiatrist and GP about 20000000 times again the psychiatrist (not my regular guy, interesting) referred me to some ‘improving access to talking therapies’ thing. About 6 months or more after I got that referral I had my first appointment. It seems like it’s CBT again, which I have told everyone I didn’t find helpful. Though on the plus side the guy seems nicer than the other one and said there were other options available should I need them.
My appointments with the psychiatrist last about 5 minutes on average, I say I’m still depressed, go over my feelings, say when I was hurt myself or felt suicidal it all gets noted down and nothing happens. I raise the odd question it gets ignored or I just get told to go away. I had one good one hour or so session about 5 years ago where I went over things in depth, but no more since as it was an introductory type thingy-ma-bob.
I am just given pills and sent away. I am not getting better, if anything I am getting worse. No one seems to care.
Beyond mostly ineffectual pills or short courses of CBT it seems there is nothing anyone can offer me.
The treatment I found most helpful, when I thought I might be getting somewhere was when I saw a clinical psychologist, I had more than one long session where I could talk in depth (one hour is woefully inadequate for a long history of ‘shitty stuff that fucked you up’) but that was arranged through university and I graduated last year.
I feel pretty much left to get on with it on my own.
It’d be nice to have someone who listens to me and my concerns, to not be fobbed off with more pills that don’t seem to bloody work; it’s the same pattern over and over. I get a bit better, it fades, the dose gets raised with little or no improvement till I plateau or even get worse, I can’t go any higher on the dosage so my medication gets changed and it starts all over again, or I just get stuck asking questions and being ignored. Not to mention the good few months of the horror that is withdrawal and changing over of anti-depressants , which I why I won’t just stop taking them as I am often tempted too, it’s too fucking hard to come off them without doing it properly, If I miss even a day or two I go ‘cold turkey’ (or more accurately hot, sweaty, dizzy, nauseous, headachy and roller coaster emotion turkey).
I spend more time starting at the fish in the waiting room than getting anything that can be described as ‘care’.