Saturday, 6 April 2013

making a start to comparing psychiatric services in Fife and Dundee

Most of my recent carer experience of psychiatric services has been in NE Fife, Stratheden Hospital, since 1995.  I also was a Lomond Ward inpatient myself in 2002 when I went in voluntarily only to be detained for 72hrs and made to take the psychiatric drugs, the anti-psychotic risperidone.  I didn't want to take it for I knew that anti-psychotics would depress me.  It had happened before in 1978 and 1984, when I was a psychiatric inpatient at Hartwoodhill Hospital, Lanarkshire, in the days when grabbing and jagging could be done without having to detain a patient.  And ECT was more commonplace although I managed to resist it.

I knew in 1995 that the care in Lomond Ward for my oldest son wasn't good enough and we complained at the time but to no avail and there were critical incidents that caused us major concerns.  The psychiatric discharge support was minimal, it was more about staying on the psychiatric drugs and remaining in the system.  But my son wanted to recover so I helped him on the journey and recommended getting off the drugs within the year and getting back on with his life.  That's what I had done in previous episodes of psychoses.  He followed my advice and recovered.

In 1999 when my second son experienced a psychosis I made sure to get him out of Fife and back to Dundee where he had been living, and so he went into the Liff Hospital as a psychiatric patient, also again in 2000, then made a recovery and got back on with his life, although still on psychiatric drugs as he was OK about taking them.  In 2005 my third son had a mild psychotic episode and went into Lomond Ward, Stratheden, and has had 3 other inpatient stays since, each one a more traumatic experience because of the dehumanising treatment, poor nursing practice and lack of therapeutic input.

There's something in Fife's psychiatric services that wants to make revolving door patients out of people who experience psychoses or hear voices, and keep them in the system for life.  They tried it on with me in 2002 and it took me 2 years or more to escape, from the prognosis of 'severe and enduring mental illness' and lifelong lithium.  Fife has the most Left Behind patients according to the Mental Welfare Commission report of 2011, on their visits to people with 'severe and enduring mental illness'.  I always think "it could have been me" if I'd lived in Fife back in the day and believed the mantra of mental illness.

My youngest son's 2012 Stratheden Hospital psychiatric inpatient stay was the worst one yet and a year of complaints were not answered to my satisfaction.  It caused me to write in frustration 'don't bother complaining, it's not worth the effort' because of the sense of cover-up and justification of dehumanising 'care' and social work colluding with psychiatric services in the use of restraint, seclusion and forced treatment.  Although I've lived in Cupar, Fife since 1990, my present house for 15 years about a half mile from Stratheden, this last encounter with Fife's psychiatric/mental health services has forced me to consider a move out of the area.  

I am scunnered by the tokenistic involvement of users and carers, the failure to resource mental health services properly and the justification of poor practice and shoddy management.  I organised many events through Peer Support Fife to raise awareness of recovery, peer working, meaningful involvement and the problems of long term psychiatric drug use.  But it will take a major cultural shift for real changes to happen so that recovery is recognised and people with lived experience have a voice, are listened to and can participate as equals at the table.  Until then it's just going to be more of the same in a different wrapping.

And then at the end of 2012 my middle son came back into the country and to Dundee, to live and work, couldn't access any crisis support so we had to get him into Carseview Centre for psychiatric treatment.  It's been three months of engagement with the Dundee psychiatric services, management and practice workers.  Some complaints by me which have been handled quickly and competently.  I've challenged issues as they've arisen and been treated with respect.  A different ball game altogether from my Fife experiences, like night and day.  And yet I'm told that Carseview isn't the best on offer in Scotland.  The postcode lottery of mental health care in Scotland.

I will write more about the specific differences in future blog posts.  About nursing practices, recovery focus, management of patients, therapies on offer, environmental considerations, volunteer involvement, information resources, social worker input.  And the overall experience from the carer point of view and something about the patient's perspective, third party.

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