Mental health services cause more distress than they solve

My journey seeking psychological support since my own life-threatening illness and the resulting death of my son earlier this year can best be described as a farce.

Today’s psychiatrist appointment was extraordinary, even by the standards that have previously been set, with the doctor bringing religion into the conversation, and refusing to write a repeat prescription for antidepressants for fear of getting in to trouble for spending the budget. Yes, seriously.

For the benefit of anyone who hasn’t been following my story, in February this year I was diagnosed with the rare, life-threatening pregnancy complications pre-eclampsia and HELLP syndrome when I was just 24 weeks’ pregnant. My son Hugo had to be delivered to save both our lives. Hugo fought incredibly hard for 35 days – he was just too small, and premature. I am heartbroken at the loss of my much-wanted, much-loved baby.

In June, I was diagnosed with post-traumatic stress disorder (PTSD), anxiety and depression. I have been referred for psychotherapy, and have received six sessions of formal counselling from a specialist pregnancy loss charity, Petals (that I had to source myself). My experiences with mental health services have been previously outlined in this post, and this post.

Mental health services in Bedford, where I live are provided by an organisation called SEPT, who describe themselves as “one of the most successful Foundation Trusts in the country providing integrated care including mental health, learning disability, social care and community services.” Local psychiatric services are provided in a wing of Bedford Hospital.

Today I had an appointment at noon. This was the third different psychiatrist I have seen since June. She introduced herself with her back to me while walking down the corridor on the way to her consultation room, so it was lucky I have her name written on my appointment card as I didn’t catch it.

On arriving in the room, I was invited to sit. While looking at the notes, not at me, she asked me how I was and I explained I was feeling a little low and teary thanks to a virus, on top of everything else. She then asked me how I was getting on with my medication – the dosage had been doubled at my last appointment, and I was struggling with the side-effects. I was told they would calm down after a while – fair enough.

What I really need, however is psychotherapy to help me deal with the underlying trauma. I was originally informed back in June the referral would take up to six months because it is oversubscribed, but this doctor told me it would take up to a year. Naturally, I expressed my frustration – the doctor said I would be better off going private. The same doctors provide private and NHS services, meaning it is likely in their interests to keep the NHS waiting list long. While I said working in the NHS I recognised how silly the system can be, I wasn’t really interested in a political debate.

What I really want is help to get better. She suggested I call the the Samaritans. I didn’t realise they offer counselling support for all sorts of reasons, not just those who are suicidal – but why should patients constantly have to seek their own support, and from so many sources? We deserve consistency of care.

Then I started to feel teary and said how much I miss Hugo. The doctor turned to me and said “God will give you another baby”, and said what happened to me is common. I could tell from her countenance that she meant to be kind, but bringing God into it was wholly inappropriate. If God is so generous with babies, why did my last pregnancy nearly kill me, and my baby die as a result?

Furthermore, what happened to me is not common – HELLP syndrome is, thankfully, very rare, as I told her. She looked at me quizzically and asked what it was, so I told her. She replied asking if that’s what affected Hugo, so I told her that technically yes, but the syndrome affected me meaning Hugo had to be born prematurely, which caused his death. To be fair, she is a psychiatrist and not an obstetrician, meaning not knowing about a very rare pregnancy condition is forgivable – but to so obviously not have not read my notes beforehand is unacceptable. That insensitivity could have been avoided with a quick Google search to learn more about HELLP syndrome.

Then followed a conversation about what could be done to prevent it happening again in another pregnancy – there is nothing that can prevent it – and I was told to ‘keep positive’. Again, this was meant kindly, but how on earth can I ‘keep positive’ about another pregnancy when I have not received adequate support to help me overcome the trauma of the last one?

She retorted by saying that psychiatrists are ‘overwhelmed’ by patients from all specialities, and each specialty should have their own counsellors like, for example, Macmillan do for cancer patients. I agree, but her opinion on that does precisely nothing to help me.

To conclude the appointment, the doctor confirmed that she would try to expedite the psychotherapy appointment, which I thanked her for.

We agreed I would persevere with the medication. I’ve run out of medication of that dosage, so I asked for another prescription – the psychiatrists on my other appointments have done so with no problem. The doctor said my GP had been made aware, so I could get another prescription from them. Yes I could, but as I explained, that would mean making an appointment with them, making another trip, etc etc, – and I was there then. She reluctantly got her prescription pad out of her bag but then hesitated and told me that she would get in trouble for writing the prescription because it would come out of her department’s budget.

I was flabbergasted, and asked her why exactly she felt the need to tell me about her department’s budgetary concerns, which is 100% irrelevant to a patient. In response, she raised her voice and kept  repeating about not wanting to get in trouble , and that I should go to my GP.

It was not like I was asking for something I do not need, or some revolutionary new treatment costing thousands of pounds that would have caused her strife with her manager. Telling me she was unable to give me a prescription on those grounds was spineless and lazy. To raise her voice as well was unacceptable.

At that, being frustrated at the whole appointment being a waste of time I said “For fuck’s sake”, picked up my coat and left, slamming the door as hard as I could behind me. To the best of my knowledge, no attempt was made to follow me to check I was ok.

I was not ok. I was in floods of tears and hyperventilating.

I make no apology for my language. Angry outbursts are a key symptom of PTSD – surely a senior mental health care professional would do everything they could to prevent one by being kind, compassionate and understanding – not arguing with a patient.

I am utterly furious and distraught at the way I was spoken to at the appointment today.

In addition, outside that busy hospital, people paused to gawp at the crazy sobbing woman but not one stopped to check I was ok. Shame on you, shame on you all.

The biggest shame, however, is on the consistent failure to prioritise mental health services. I know the NHS is bursting at the seams, but things have to change – the current situation is intolerable.

While the mental health system in general is in disarray, this issue is specifically with the services provided by SEPT. This post will form the basis of a formal complaint that I am also sending to them today.