Friends, Family & Carers Forum

[perseverer]

My heart goes out to psychiatrists. It is one of the toughest, most emotionally draining jobs in the world. It requires many years of study to do Medicine and then Psychiatry. It takes a person who is very dedicated, intelligent and grounded to be able to do it. Mental health patients do not always or even often recover. There are varying degrees of how well they can adjust to living in society. Some, with help, can live relatively normal family lives, keep a home and hold a job with intermittent periods of illness. But many others are too ill to have any semblance of normality in their lives. For psychiatrists, it must be heartbreaking to devote years of treatment to such people only to see continuously worsening illness.

That being so, how much worse is it for the poor patient. A gigantic shadow hangs over their lives. They see their friends doing things they feel they can never do. If only they could wake up each morning, see the sunshine and feel that it's great to be alive. But they don't. They wake up with a feeling of crushing and crescendoing gloom. They know their day is going to be full of painful struggle, even to do the most basic things like get out of bed and have a shower. Their minds are full of terrifying, confusing or conflicting thoughts that they cannot control. They are scared out of their wits. Sometimes the world around them feels extremely threatening - even colours are out to get them. Each step is a stammer of determination to try. But they feel defeated and hopeless every step of the way. They are a prey to addictions because even the most fleeting and momentary pleasure is a distraction from their tormenting inner turmoil. Then they hate themselves for being addicts.

For the chronically mentally ill person life is a series of crises. Their lives are chaotic and out of control. They see only too clearly how devastating their illness is on those around them. Their parents have no freedom; their siblings are neglected. The system gets sick of them, because ultimately, it does not have the answers. The mentally ill patient feels totally fed up with himself for causing all this trouble. It seems to him that the world would be better off without him. He sees no hope for his own future, just continuing torment. He becomes suicidal.

The public health system is limited. Our local hospital does not even have a resident psychiatrist. They have a psychiatric ward with enough beds for 25 patients. When my son developed catatonia some years ago and lost he ability to walk, he was not put in the psyche ward, he was put on the general ward. The psyche ward is reserved for the suicidal.

All the patients here are very ill. Most are schizophrenic, so on top of being depressed and suicidal they are also delusional and very confused and disjointed in their thinking. To voluntarily choose to go on this ward and be with these people says something about what the patient is going through. They are saying not only that unless they are restrained and observed continuously around the clock they will end their lives and break their parents' hearts, they are also saying that ONLY this environment can restrain their terrible addictions and maybe, just maybe help them on the road to recovery. So it should be seen as a big deal to any treating psychiatrist when a patient comes through the public system with a view to being admitted to the psyche ward.

With all this in mind, I need to comment on yesterday's psyche consult with Dr S. This is the doctor who said to my son last week, "What you need is a good boot up the backside." It did not surprise me to see him standing in front of my son yesterday with his hands on his hips saying, "You do realise that one day Mum and Dad won't be there and you will have to stand on your own two feet." It seems to me that this doctor feels strongly that my son OUGHT to have made a substantial recovery. Certainly he was regarding our voluntary 14 hour wait to see him as an attention seeking exercise. After ascertaining the rest of the family's mental health problems he even accused me of not giving my son enough attention and that is why he keeps wanting to come to hospital.

Dr S, there is something I would like to say to you. Remember why you became a psychiatrist in the first place. You wanted to help people. But you will never help them until you understand them. I bet you have done a lot of good for a lot of people. And if you are honest with yourself, you must admit that you have patients who never really seem to recover; they are just too ill with many complex and intertwining difficulties. But you have provided for such patients a network of support in which they feel they have someone to talk to who at least understands what they are going through. For someone like my son whose whole life is a nightmare, this is at least one last little light of comfort.

So when things seem hopeless and you feel you need to blame the patient or blame the parents, try to bury those feelings and remember that the least you can do is be compassionate. If you do nothing more than hold my son's hand and say, "Listen mate, I know you are going through hell, but we are here to care and support you in any way we can", you will at least be doing something caring and it could actually give my son a feeling of hope, that maybe suicidal ideation will be on  hold for another week or two. Thank you for giving us your card and saying we can call you any time and you will come and see us in our home. THAT was the best thing you did.

[JellyBean]

 Hi @perseverer, 

Thank you for your beautifully worded insight in to the relationship between psychiatrist and patient and the reminder of why people get into the helping professions and to not lose sight of that core motivation. And the value of compassion and truly listening to someone, without filters or judgement. 

Thank you also for the reminder that individuals exist within a family who often require support and inclusion also. 

Also remembering the courage it can take for someone to ask for help and to remember to be respectful, responsive and empathic always.

[southerncross]

Thankyou perseverer for such an insightful and well worded post.

You have left me personally feeling not so much alone now with my internal contradiction's of feeling both grateful and yet really frustrated at the same time with our daughters treatment team and her newly diagnosed condition in the public health system.

While I really do feel that the people who choose this line of work and dedicate a large portion of their lives towards their training and qualifications really do deeply care about what they do, I also feel that they might just develop callouses over time and become immune to the overall personal hurt and suffering that they see on a daily basis. Not that they don't care, but that they need to do so on a personal individual level to survive the never ending onslaught of cases that they see over time.

I might be rationalising all this to myself as our first introduction to this whole new frontier (for us) of psychiatric care was only a few short weeks ago, but in that time our daughter has physically assaulted, spat on, thrown coffee at, verbally abused/insulted just about all of her carer's in one way or another.

At the same time, despite numerous phone calls and requests when visiting to see her senior Doctors we have been repeatedly told that they were not available to talk to at this point in time and any real information gleaned from her duty nurses was so vague as to be useless to us to know what was actually going on with her.

In over three weeks since her admission in a deep psychosis, we have had exactly one single meeting with her treating Doctors lasting 45 minutes and a couple of phone calls lasting literally minutes, our most informative discussion came about with a duty nurse who had just came back on shift after three weeks off and who had been caring for our daughter for only ten hours when we met.

I guess the internal conflict comes with us knowing our loved one as an individual, someone we love and who we actually know as a person, while on the other hand that person we love and know is passed over into the care of professionals who see them as a patient, a case, a file, a workload rather than a member of their family.

perseverer I have a number of Dr. S' I would like to personally say something to as well right now, if not grab them by the shoulders and shake them as I say it . I really do get that they have an enormously hard job, but "BUT", it is one that they have personally chosen to do as well. If the callouses become callousness or contempt, then it is time to find something else to do.

Sorry if this comes across as a bit harsh on such people, but last night I had my daughter's duty nurse in the psychitric intensive care ward tell me that " At least she is still alive, so I suppose that is a good thing". Still trying to get my head around that.

[perseverer]

Thank you for your reply, @southerncross, and also for sharing your own story in the forum. There are many kinds of unacceptable behaviour in hospitals - physical and verbal abuse of the patients are two. You and I both know that some treating mental health professional are downright abusive. The consequences of such ineptitude for our helpless, vulnerable children are great. This kind of abusiveness to the most vulnerable members of society has to stop and you and I and carers like us are the ones who have to speak out and complain and hopefully make it stop.

I was consciously polite in my wording. My son's last psychiatrist was like the mental health worker who told you your daughter was just a bit depressed. He told my son he is not psychotic and took him off his anti-psychotic medication he had been on for years to treat catatonia. When my son had to see him following a police complaint because he had called them thinking people were trying to break into our house, he said I will prescribe an anti-psychotic and see you in three weeks. A couple of hours later, my son went missing in the Bunyip State Park, thinking he was being chased by the Antichrist. He was out there for three days and two nights and no-one had any idea of where he was. He could have died out there. That psychiatrist had a breakdown and hasn't worked since, to the best of my knowledge. 

My son has had mental health problems all his life and his treatment is peppered with a large number of therapists, several of whom we colloquially refer to as arrogant pr*#$s. Dr S is the latest. But he is currently working in the system and we might be dependent on his good grace to get emergency help when we next need it. So I did not want to create unnecessary antagonism.

Just for the record, our son has private health insurance and is well known in the private system as well as the public system. In my opinion, the public system is better than the private. Inadequate as it is, there are more checks and controls going on than in the private, and greater exposure to different psychiatrists. The private system is more comfortable for the patient, but also more dangerous, in my opinion. One hospital my son was repeatedly admitted to had suicides by the same method every time my son was there, and in spite of that the means of doing it was never removed. But I can understand why someone else might have a completely different perspective, especially as the private system has a greater reliance on group therapy.

When dealing with complaints, and I have had many over the years, I have found two ways of effecting action. 1. Write to the relevant Minister. 2. Speak to the Ombudsman. I have even had personal apologies from the hospital and the doctor.

Meanwhile, you are your daughter's best advocate and you need to go out and bat for her. All the best.

[Shaz51]

Hello @perseverer, @southerncross

how are you today ?? is it getting cooler where you live xx

love to hear from you , hope you are ok

[Former-Member]

@No3Sister

This is a short but insightful thread.