Does the Consultant have to have done some sort of clinical assessment himself?

Mental health
1

Following a failed suicide I am in a mental health facilty, 73 days and counting, and the Consultant wants me to go onto medication that is totally unsuitable for me due to other medical conditions and a severe side effect of it causing suicidal thoughts!  

The consultant has met me twice since admission, both times in meetings with social workers and nursing staff, he has never undertaken a 1 to 1 psychiatric assessment of my condition, of my needs, of my mental health, yet he wants to put me on a tablet that will effectively zombify me!  

Is this ethical?  Can a doctor put you on a treatment regimen without ever having examined you?

For my part I have already informed staff I will refuse any medication prescribed by the consultant, have asked for a second opinion, and whether I can make a complaint. In my entire stay I have been monitored by staff but only had two meetings with doctors both of which were terminated after a few minutes due to mealtimes or other requirements on their time.  

I am worried this doctor will kill me through ignorance of my general health let alone my mental health by prescibing a wholly inappropriate treatment plan.

2

Can I ask what the medication is?

Have you been sectioned if so which section?

Do you feel the medical staff are listening to you.

Have you out your requests for a second opion in writing ( always keep a copy of your letter).

Ask to see the crisis team or you could speak with the organization called MIND. The will advocate for you with all this, they. are very helpful.

This will ease some pressure off you helping you to relax a little maybe.

Keep in touch with everyone x

3

1. Sertraline

2. Voluntary in-patient

3. No

4. Will be doing that formally tomorrow

5. I will ask for help from someone, either an advocate, MIND, or other body they put me in touch with.

I cannot understand how he can make decisions without ever having had a consultation with me!  Surely there is some code of ethics that binds a doctor to having consulted with a patient before making decisions which could affect that patient?

4

If, the reason you say this medication makes you feel sicidal due thaving been given it before, and not because you have 'heard' from other people this is what has happened to them, well, it sounds like he's probably not seen all of your previous medical notes. You could I suppose, also request a second opinion from the Pharmacist who is dispensing this medication. This kind of thing, is something they should be pretty clued-up on, as they have access to reference materials the consultant may not have yet seen. Im certainly not qualified to pass any kind of 'judgement' on his assessment of your situation.

5

The leaflet that comes with it says that it should be used with caution with patients who are diabetic, yep got that, had liver problems, yep had those, and those with suicidal thoughts, well I am here for that reason.  

Also when I asked about cessation issues with the drug I was told there are none, which is a blantant lie.  If they cessation issues are as bad as they are for venlafaxine, 12 weeks of hell, then I for one am not prepared to start on such a tablet.

I have no confidence in this consultant to do anything for me.  The issue of the drug aside my main concern is that I have not had any form of medical assessment from him during my entire stay,  I have not had a full assessment by any psychiatrist during my stay.  I've been in sheer agony with other issues and have begged to be referred to a specialist, all I get is pain relief and no action.

 

6

That is a long time to be in hospital and not have your meds reviewed. Did you take an overdose of meds? There are more meds I'm sure, that you could take that wouldn't have side effects and be safer if taken in larger amounts. It all depends how you tried to take your own life. As I say its a very long time to be in hospital without anything at all. 

7

Hi I am sorry to hear that your having difficulities with your treatment in hospital. We on this forum are not qualified to advise you on medical consultants or prodcedures. There is an organisation called Pals that is usually attached to your GP surgery and maybe the hospital that will listen to your concerns and will be able to advise you. There is another organisation that ( sorry cannot remember name ) that can help with a formal complaint, they will give you an advocate, they will write letters for you on your behalf. Pals will be able to put you in touch with other organisation. Hope this helps. Keep in touch and let people on here know how you are getting on please. 

8

As a doctor (not a psychiatrist) and someone who has also had inpatient stays because of depression I can make some general points about what it would be reasonable to expect when admitted to a psychiatric unit, but I obviously can't make any comment about the treatment you are receiving. On admission you should have had an assessment of your situation by a number of health professionals, which should have included a medical assessment. This is usually carried out by a junior doctor rather than the consultant and should include getting information from you about your psychiatric difficulties and your medical background, including ongoing health issues like diabetes. Other professionals (nurses, therapists of various types) will also do assessments, and all this information is shared between members of the team to help work out how best to help you. I don't think there is any requirement for the consultant to see you other than at weekly ward meetings when all the patients on the unit will be discussed. When I was an inpatient I only saw my consultant at those meetings (called various things - ward round, team meeting, review meeting, etc).

It does sound as if communication hasn't been very good, and this is adding to your distress. The other posts include lots of useful information about how to address that. As far as medication is concerned, any decision should be based on thorough discussion between you and the team treating you, addressing your concerns and giving you information that should help you contribute to decisions about what treatment you are given. Sounds like there is a bit of a way to go on that one!

9

Just a last minute thought - can you identify any staff member (nurse, psychologist, therapist) who you feel listens to you and understands what you are going through. They might be able to be a channnel of communication to help you get listened to by the consultant.

10

Dear ericTcat, I hope that you are feeling a little better, I am so sorry to hear of your difficulties.

I too have been sectioned four times into a mental health hospital, has no-one ever told you that as a voluntary in-patient you have the right to leave at any time,

Unless of course you would be in any danger physically or psychologically..

I have similar physical health problems as yourself, I had liver damage, kidney

Damage and I was only two weeks away from a heart attack, but I was put on

Sertraline and it turned my life around....the psychiatrist will have read all your

Notes and the staff will have kept an eye on you twenty four hours a day, if you

Feel however that you are not being listened to, ask straight away for your own

Family doctor and more importantly an independent advocate to come and speak

To you, explain how you feel and ask for them both to attend a ward round....

In the meantime, please try to find a member of staff that you trust, speak to

Them in confidence, also if you have close family get them involved too, but I

Must add after being in the system for very many years they really have your

Welfare at heart..

I wish you all the luck in the world, you will get there, sincere regards Deirdre x

yoo

11

Hi So sorry to hear that you have been sectioned I was in your situation a few weeks ago I had a massive what I can only call a meltdown and really wanted to take my own life, but fortunately for me my wonderful husband took care of me.  Well I say fortunately but on hindsight I now don't think that he should have done, I now think that he should have contacted my psychiatrist and I should have gone into a mental hospital  

Why I can hear you all saying, well over the last 12 months my medication has been changed so many times and I'm if anything getting worse. I was on Venkafaxine then Duloxatine and Busperone then I too was put on Sertraline but oh my goodness the side effects were horrendous so then he decided to put me on Mirtrazapine. From the first pill I thought well I knew actually, that I would definately not tolerate these and they were only 15 mg took these for 5 days and walked around like a zombie. From Saturday the dose was increased to 30mg and I feel like I'm permanently drunk, have fallen several times and cannot walk unaided as I just fall over. Rang the Psychiatrist secretary this morning who then rang me back this evening to tell me to take no more, and hopefully my psych will speak to me tomorrow, but now I'm left with no medication, feeling totally suicudal and just left. 

I know I've waffled on a lot but all I've meant to say was are all psychiatrists the same I feel like he's treated me like a lab rat just palming me off. I told him that I have gained 3 stones in weight over the last 6 months which also makes me feel down but when he gave me the script for Mitrazapine the first thing he said was about weight gain. I really don't know what to do now, I'm thinking about just not going back to see him as I don't have any faith in him. I just hope he sleeps well at night because I cannot remember the last decent nights sleep I had for terrifying nightmares. SORRY rant over. 

12

Hi. How are you?

Are you in hospital voluntarily?

You do have the right to leave but please

take into account You will need suoport when you are back in the outside world.

Do stress to the staff about how you feel.

Your GP can be a source of help and support

Try and speak to the head nurse and explain your concerns.

MIND is an orgsnisation that can be your 

advocate. PALS may be able to help 

Keep your goal in mind and you will win with this.

Do you have your medication or is it dispensef to you?

Keep in touch.

We are all here for you.