Sunday, 27 January 2013

problems with psychiatric system self regulation and second opinions

As long as we have self regulation of the psychiatric system then there will be human rights issues behind closed/locked doors.  It stands to reason.  Psychiatrists shouldn't be left to keep an eye on other psychiatrists.  This doesn't make sense.  It's too much responsibility that is open to abuse.

I'm also thinking about the situation when in a psychiatric ward, detained, and having to get a second opinion, by another psychiatrist.  I've not found this helpful.  In one case the other psychiatrist was worse than the original one.  Suggesting depot injections or new psychotropic drugs that haven't been trialled effectively.  Just as well that I was there to keep an eye on things.

And when I checked on this 'second opinion' psychiatrist I found out that he was on psychiatric drug committees in the area where he practised.  So a conflict of interests and even maybe personal gain financially?  We can't be too vigilant when it comes to psychiatric drugs.  They alter brain chemicals and can cause physical side effects and permanent disability if taken long term.  

Therefore for any watchdog organisation or independent overseer I think there have to be people from disciplines and backgrounds who aren't psychiatrists and preferably people in management positions with lived or personal experience of mental health issues.  Who are prepared to admit to this and not be ashamed.  Or be in fear of the stigma that goes with psychiatric diagnoses and labelling.

1978 was my first foray into the psychiatric system, as a patient in Hartwoodhill Hospital, Lanarkshire, when I and was grabbed and jagged with anti-psychotics.  My prior experience of visiting my mother in a locked psychiatric ward in 1970 had prepared me for the experience.  I knew what I didn't want and this foreknowledge helped me resist the ECT. 

I also knew that I didn't want to be on the psychiatric drugs, at that time chlorpromazine, for any longer than a year.  And so I worked towards coming off the psych drugs in that timescale.  It wasn't easy for the drugs took away my decision making abilities but I had my sons to look after so I managed it.  And did the same after a similar postnatal episode in 1984.

My 2002 menopausal episode took longer than a year, to get off the drugs, because of the cocktail, of anti-psychotic, anti-depressant and (so-called) mood stabiliser - risperidone, venlafaxine and lithium.  All combining to take away my personhood and personality.  But eventually I got up out of the slough of despond and got back on with my life.  The drugs didn't work for me and I don't want any more of them so have written this in my advance statement.


  1. Dear Chrys,
    I am thinking about psychiatric drugs in a similar way and I supported my daughter in her decision to wean herself off Abilify some time ago.
    However I see quite often that people diagnosed with schizophrenia make different decisions - that's OK, because I believe that everybody is entitled to their own decisions about their own lives.
    The thing is that once somebody is taking drugs he/she feels often entitled to pressurize others to do the same!
    Here is an example, a post from Schizophrenia.comSupport Forums I read on a daily basis:
    ''Medication is the foundation of long-term recovery. You won't ever recover from this illness if you consistently refuse to let medical professionals help you establish that foundation for future recovery. You can suffer a little over the short term, or for your entire life by resisting treatment. Your choice''

    So take your meds. Or else.

    I wonder why people don't just let other to decide for themselves. Are they so anxious/angry taking drugs meekly for years, suffering side effects etc. that they think'oh,no, I don't want the other sufferer to have it better'?
    I know that 25% people who suffered psychosis will have only one episode in their lifetime and they won't need ANY drugs.
    Why at least the 'first episode sufferers' are not given a chance to recover without drugs or being given drugs only for a short period of their psychotic shock?
    And yes, I agree that psychiatrists shouldn't be left to keep an eye on other psychiatrists!
    I was working as a teacher and witnessed many times teachers supporting other teachers' opinions in a false sense of 'camaraderie' and 'being in it together'.

    1. Thanks for commenting, I agree with what you say. People should have the choice but somehow from the psychiatric side it seems to be all about risk.

      However I do think that even in the present system we can choose, eventually, to taper and come off all the psych drugs but it is not easy, in fact can be very difficult. And many folk will do it without letting on. I remember a critical psychiatrist saying this.

      I've never liked the psych drugs, they don't suit me. So the choice always for me was to come off them as soon as I could. Psychiatrists usually don't help with this but I did have a community psychiatrist back in 1985 who was OK about me tapering and coming off, this was in Lanarkshire. Haven't had any others since in Scotland of the same persuasion. I think they are feart to speak out, the psychiatrists that is.

    2. Dear Chrys,
      sorry for not signing my first post in this thread, it's me again, Zofia.
      I think that diagnosed people who decide to wean themselves off drugs should be supported by their doctors! they shouldn't be left without any support let alone frightened by professionals, it's not good for anybody to be frightened or threatened especially when unwell!
      Now let me cite some wise words of a doctor who is 'pro-drugs' so to say, his name is E. Fuller Torrey and I am reading his book 'Surviving Schizophrenia'( third edition.
      On page 202 he tells us :
      ''I had one patient, for example, who definitely was impotent when he took antypsychotic drugs and who became acutely psychotic whenever he did not. He was faced with a painful dilemma; the role of the physician in such cases should be to outline the choices and consequences as clearly as possible and then support the person's choice.'

      Can't agree more, Dr Fuller Torrey! Now, with so much understanding for the impotent man let's try to be equally understanding towards old women, old men, young women, everybody! Let's support the people's choice!

      It's not like that now and some patients although entitled to their choices are left to their own devices. Even worse-they are bullied.

      Zofia, Dunfermline

    3. Well said Zofia! Of course Dr Torrey, being a man, would have more empathy with his impotent male patient. Maybe not so easy for him to identify with a woman, old or young. Meanwhile us women give birth to men then bring them up, also have had some contact with them prior to this. I think it gives us some advantage.