Wednesday, April 12, 2006

He must be ill....

So says the close relative of a patient hospitalised after an overdose. It's the third this year, and they are getting more serious at each attempt. The family have tried pulling out all the stops when they get the call, followed by a more standoffish response, followed by "Tough Love". None of it makes a difference.

Booze is a big part of the problem... that and a hefty dose of denial. The loop of admission, dry out, Psychiatric evaluation and discharge revolves around and around. The problem is "Deathwish" is not a condition covered by the Mental Health Act.

You might argue that repeated efforts at self destruction suggest a soul in torment and in need of help. Indeed it's hard to contend otherwise. But if, on "recovery" the patient can say "I'm fine and I don't need your help" and keep a straight face while doing so, the Psychiatrists hands are tied. Serial "offenders" become well known to their local A&E and Psychiatry teams, and are treated with diminishing regard and respect at each attempt, and many eventually get it spectacularly wrong, and the cry for help ends up literally costing them the earth.

After a forty minute call in which the best I can offer are platitudes and contact details for a support group for families, I am left with the feeling, again, that there ought to be more that we can do.

Then step up Radio 4 (yes I still think they are listening in to my consultations) and the delightfully named Prof Nut a Bristol Psycho-pharmacologist, who says that we may be no more than five years away from antidotes to the "harmful" effects of alcohol.

I pray that he is right, and that this family can wait that long.

7 comments:

Happystance said...

I run workshops in laughter and resilience for carers as part of a voluntary project - and stories like this come up on a regular basis. Oddly enough, it has come up all the time really and is behind a couple of recent posts:

Caring for people with medically unexplained symptoms
http://www.unltd.org.uk/blogs/tonyplant/171

They're not the priority but what would you do for the carers?
http://www.unltd.org.uk/blogs/tonyplant/175

The latter was prompted by an EMP's blog about his recent encounters.

It seems as if we recognise the needs of family/carers, but really have nothing to offer them.

Take Care - Tony/Happystance

Doctor Jest said...

Tony-- thanks for the thoughts. will check out your site when I can. you're quite right the carers in these scenarios always seem to be left hanging, and it leaves me feeling we only ever do half the job here, at best.

Shiny Happy Person said...

A depressingly familiar scenario. Always frustrating not to be able to do more.

greavsie said...

The sad thing is that it's always the person inflicting it upon themselves is the only one who can decide to stop.

One man's strength of will is anothers obsession.

Doctor Jest said...

s h p -- absolutely.

Mr Greavsie sir-- astute observation as ever. the only problem is the number who miscalculate before they get to stop....

Anonymous said...

Dear Dr J

Just a thought........

I am no doc or psychiatrist - but I used to behave like your patient. In my case it was bipolar disorder, which had been missed so I was misdiagnosed. The antidepressants were making things infinitely worse, plus I was boozing to self-medicate my pain.

Since diagnosis and remission, three years ago, I am stable on lithium and have no desire to act out in any way - in fact just want to get on with my life.

I wonder if this man might have bp too?

Doctor Jest said...

Anon-- an interesting thought. I'll pass it on to his own Doc...