…And the NHS Cocks It Up Again

I had a psychiatric appointment on Wednesday morning. In terms of interaction with NewVCB regarding myself, it was fairly unremarkable. I apprised her of the various events that had occurred since I’d last seen her – Maisie’s deathseeing Paedo; the fact that the doctor’s bloody “surgery” screwed up my Lamictal script for several weeks; the kitten, Srto Gato, had temporarily (yet stressfully) disappeared (the latter two being stuff I’ve not ((yet)) discussed here); and that I saw Paul again.

Essentially, although she had intended to decrease my dosage of Seroquel at this appointment, she decided against it because of the fuckery of the last few weeks. She wants me to get back on some sort of even keel that involves a minimum of external stressors before pissing about with the stuff, an assessment with which I agreed wholeheartedly. I said, “in light of particularly stressful events that previously occurred with various personnel from [Hotel California], I was very, very glad to be taking anti-psychotics over the last few months.”

NewVCB understood. Although 400mg, the dose to which we are intending to reduce the Seroquel (at least in the short-term), had at one point prevented some of my psychotic symptoms, given that the last six weeks or so have been really shit, it would be ill advised to take any chances at the minute.

I did ask about increasing the Lamictal, however. I’m currently taking 100mg, and my internet readings have suggested the therapeutic dose is generally between 150 – 200mg. NewVCB disputed this, though; she said that 100mg is the usual standard in the (admittedly uncommon) circumstances in which she prescribes it.

“I’d prefer to keep it at 100mg for now,” she advised, “in part because you had a break in it enforced upon you, so it’ll take some time for you to entirely re-adjust to it. Thus it’ll take a few weeks to see its full effects again. Then, we can see.”

That seemed fair enough. In terms of the Seroquel, I said to her that I’d lost a lot of my appetite in the last, say, eight to 10 weeks, so at least in terms of weight gain, reducing the dose wasn’t as ‘urgent’ as it had once seemed. I told her that I’d read that Lamictal could sometimes cause weight loss, or at least a reduction in appetite, and she confirmed that this was indeed the case from time to time. She said she was pleased that this had been the case for me, not because she dared to opine that I had a plenitude of blubber surrounding all corners of my body (though clearly I do), but because she knew how annoying my weight gain had been for me especially when I’d been losing so much of my pre-existing fat until I started taking 600mg of this heinous drug.

And that was pretty much that.

Except that it wasn’t.

“Um…now, Pandora, there’s, er, something I need to discuss with you,” she said ominously.

Oh my fucking God. She’s leaving. Oh fuck! Fuck! Just when I thought things with the NHS were actually getting me somewhere! The incipient dread I felt as soon as each word of the sentence left her lips grew overwhelming very quickly.

“The NHS are changing things again,” NewVCB sighed.

Again?! [I can’t find any posts on this, aside from my review of my first appointment with NewVCB, but it was due to NHS changes that my consultant was changed from (Old)VCB to her in the first place, and that was only two years ago. What the fuck? More bureaucratic – and no doubt costly – bullshit from the fucking NHS. What a sack of shite!].

She saw my face, and shot me a sympathetic glance. “I’m moving to [Big Scary Hospital],” she said. “Until recently, it was just assumed that I’d take all my patients from your GP’s surgery with me – but…God, this drives me to distraction! They’re re-drawing geographical boundaries, so right now I don’t know what’s going to happen. I may or may not be taking all such patients. I really have no idea at the minute.”

She was clearly frustrated by this fuckwank herself.

I drew a breath, then ventured, “Obviously – and I know you can’t do anything about it – I’d prefer to ‘stay with you’ if I possibly can.”

“I know. I know. I wish I could give you something more concrete at this stage, but I can’t unfortunately.” She shook her head and twisted her mouth in obvious vexation.

She continued by asking me exactly where my address was in the area, but although I could see her trying to mentally calculate whether or not the house was affected by the boundary change, she came up with nothing but a blank.

“When is this taking place?” I asked. “I mean, if I don’t move with you, will I see you again?”

“Oh, yes, yes – I’ll see you again in six weeks or so. This shouldn’t be happening until two to six months hence.”

I nodded, but something else occurred to me then. “Assuming for a minute that I do move with you. What about Christine?”

“Well. In the long-term, they’re planning on moving the whole team – whatever ‘long-term’ means. But it certainly won’t be any time soon, so if you come with me, you’ll have to get another CPN.”

FUCK!

“And if I don’t go with you..?”

“Then you’ll still have Christine, here, but you’ll be moved to a new consultant.”

FUCK!

This is so fucking unfair. Just when things were going so well with my psychiatric team. Having both a CPN and a consultant that you really like, both seeming to genuinely want to help you – that’s not at all common, especially in this bloody Health Service. And now, regardless of what happens, I’m going to lose 50% of that to a quantity entirely unknown. For all I know, the replacement for either the psychiatrist or the nurse could be fucking amazing – but my longer-term experience of the Psychiatric Service does not lend me to having a great deal of hope about that. Furthermore, even if the person were brilliant, I’m happy with things as they are. I like them! I like NewVCB and Christine! I want to stay with them both!

Don’t cuntwits like Mr Director-Person – who, as the head of mental health at the Trust, is at least partially responsible for this idiocy – realise that this kind of upheaval is likely to only increase illness, and therefore increase costs? That, as a mental, it takes long enough to become settled with members of staff – and that breaking that confidence and trust is likely to lead to breakdowns, misery and crippling anxiety?

Well, of course Mr D-P doesn’t realise that. He doesn’t realise anything about mental health, because he’s nothing more than a general manager, and always has been – he comes from a business-y private sector perspective, that isn’t even remotely tangential to mentalism. So no, despite all the fucking risk assessments they’ve no doubt claimed to have undertaken, he and his cronies have no idea what it’s like on the fucking ground, in the fucking real world, of someone with (a) mental health condition(s). It’s alright for him to sit in his inviolable ivory tower of an office, and play about with geographical lines on a computer (or, more likely, ‘getting his secretary to play about with geographical lines on a computer’ whilst he plays that little mini-golf game you always see executives figuratively masturbating over). It’s not alright when the ramifications of that feed back down to patients who are, as a direct result, going to suffer like fuck.

And nobody can do a damn thing about it. Fuck the Trust. I can’t for the life of me work out what it is that they care about, but it certainly isn’t their patients ‘service users’. Bastards.

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14 thoughts on “…And the NHS Cocks It Up Again

  1. I am afraid you’re not alone in this; all over the land, mental health spending is being reduced regardless of the implication to patients and staff who are becoming as (di)stressed as their patients. I fear that this is all a prelude by Cameron and his Chums to declare that all mental illness has been abolished so there’s no longer any need to waste money on it and all those yummy sites can be given to the Chums as profitable, for the Cayman islands at least, chunks of real estate…

    • It’s an odd one, David; we’re ostensibly unaffected by Lansley’s bullshit over here, and the impression that the MLAs are trying to give is that what happens in GB doesn’t necessarily happen here.

      Unfortunately for them, the vast majority of us realise how subterfugal they’re being. Sometimes I really wish Northern Ireland was more accepted by either Britain or, indeed, Ireland (Ireland can’t be arsed with us, as a supposed economic blackspot), because right now it feels like we’re in a political limbo 😦

      • To be fair, this isn’t simply a Tory thing. I went through a spate of seeing a different psychiatrist at every appointment, have seen about 15 in three years, and then I was moved to a new team in a new place with no prior warning at all. And this was under Labour. It’s been going on for decades.

        Still sucks though.

      • Well. Yeah. And whilst it’s not just Northern Ireland Ireland that’s shafted, we’ve always been especially unfortunate in terms of mental health budgets, Tories or Labour alike (we receive disproportionately lower spending on mental health than anywhere else in the UK, despite having higher rates of mental illness). That said, I can’t see it getting any better with the current residents of Downing Street in charge, and the DFP/Assembly are too incompetent to try to seriously challenge any of it.

        On a personal level, I should have expected another kick in the face anyway – aside from the fact that things were going too well within the NHS, 2012 has already made it abundantly clear that it doesn’t at all like me!

  2. Ok, I know I’m talking shit here but you know me, will say things and not worry about the consequences.

    Aren’t you in danger of relying on medication? Of sheltering behind it rather than taking the hit that reduced meds will inevitably allow through? Yeah I know that circumstances haven’t exactly been the easiest but then this will be the case regardless of meds. Not saying you should be off meds, just asking the question.

    Can’t believe how much of a fuck up the whole swapping this is, the benefits better be huge but I seriously doubt they will be. Business sucks when doing this shit

    • But I really don’t want to make things even worse by reducing medication when there’s not an urgent need to do so. As and when external factors calm down again, hopefully I’d be more capable of coping whilst taking the shit reducing Seroquel might throw at me. Maybe not, but there’s at least some more security in doing it at another point – right now I’m teetering on a brink anyway, and losing a third of a major drug at this juncture seems distinctly ill-advised – to me. Others’ mileage may of course vary.

      Am I in danger of over-reliance? Well, I’ve been taking psychiatric drugs for over 14 years, so… 😉 I know that in the grand scheme of things I’m quite young, but I honestly don’t see me ever not being medicated. I made my peace with that probable fact many years ago.

  3. Arrrrggggh. I feel your pain. This is so frustrating and unnecessary. The NHS should stop wasting time and money in reorganising services into various locations and start putting more energy into continuity of care and actual good work with patients. I’m sorry you’re having to go through this upheaval. It’s worse that you’re kind of in limbo about it too so you can’t even start getting your head around what’s happening. Not that it would be easy to anyway.
    Take care.

  4. Having changed psychiatrist four times (the first one I fell out with, the others apparently don’t like working here for some reason) and having just changed cpn I realise how terrifying this is for you. At least she’s telling you in advance which is somethign (a very small something). Wish there was somethign I could say to help xxxxxxxxxx

  5. fuck, that is so unfair! I’m so sorry you have to choose between them, I don’t see why they need to mess with things constantly, don’t they have anything else to do??
    Hugs x x x

  6. That sucks, big time! They don’t seem to realize or care that change and mental health can jack a person up and they don’t have enough employees who give a damn to screw around with that.

    I’m really sorry Pan. 😦

  7. Awk Pan. Really feel you and so many others have been let down by the system. It is so unfair.
    Is it any wonder that people are put off and don’t ask for help when they so need it? It takes time to build up trust in this area and to suddenly just remove it and expect you to trust someone else. Grrrr. I remember my therapist telling me after 6 sessions that I could only have another 4 because unfortunately my problems were not as bad as others( he didn’t quite put it like that). Fortunately for me I was in a position to be able to pay him as a private patient. I’ve since had a further 40 sessions. Do my national insurance contributions over the past 16+ years count for nothing?
    Hope things work out for you
    ❤ xxx Ash

  8. I just wanted to say how sad I am that it doesn’t seem to matter whereabouts in the UK you live, the NHS mental health services cannot do joined – up thinking. It makes me so mad that what is undoubtedly a cost cutting exercise will in reality cost everyone far more in the long run as people relapse in reaction to the removal of their established support systems. And worse still the loss of faith and hope and trust that the NHS wants to help. So sorry you are having to go through this.

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