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The state of our Mental Health system

nyssa76 13 November 2005 33

As I write this, I am appalled and severely pissed off by the ACT Mental Health Crisis and Assessment Team.

A friend has just called me to inform me that when she rang them – as she was self harming – the person’s response on the other end of the phone was basically “your psychologist is taking your money, he doesn’t care”.

Nice to know huh?

Last week my friend was told (during another crisis) by another CAT team member that she “had to go now”, minutes later my friend OD’d.

WTF is going on with this damn system? Do people seriously have to take their own lives before the system is checked?

So, as I sit here now, awaiting another phone call…..mind you it’s now 12:20am….I ponder the reason why we even have a CAT team in the first place. Apparently there is a team called “mit” (sp?) and they are a hell of a lot better but on the ACT Health website, they don’t even get a mention. Anyone know who they are or have a contact number?

People are always bagging out teachers for their apparent “lack of duty of care” so why in the hell aren’t CAT being crucified? Surely the money being spent on CAT could be put to better use by hiring people who actually give a shit?

Ok….I’m off my soap box now.


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33 Responses to The state of our Mental Health system
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Thumper Thumper 8:43 am 18 Nov 05

Nyssa,

leave it. Don’t get riled. He’s just seriously baiting you girl.

All the best.

johnboy johnboy 10:15 pm 17 Nov 05

umm, do any of you guys know each other IRL?

Enigma you seem to be speaking clinically, care to share your qualifications?

nyssa76 nyssa76 8:03 pm 17 Nov 05

gingermick, why don’t you go and get f*cked.

Nice to know you value human life so highly.

gingermick gingermick 7:34 pm 17 Nov 05

Bugger! Never mind, nys. There are plenty more out there you can leech onto.

Do keep in touch, petal. You are most amusing.

Did you know that you can’t smoke in the crematorium?

Kisses

nyssa76 nyssa76 4:27 pm 17 Nov 05

Her psychologist’s letter to Comcare (among others) CLEARLY states: MDD.

But it doesn’t matter now.

I got a call this morning that she was found dead in her appartment last night by her mother.

enigma enigma 3:05 pm 17 Nov 05

PS overdoses twice in two days, hasn’t overdosed for 5 days, could it be that CATT’s strategy to minimise this behaviour is working, she will undoubtedly overdose again sometime, but at least she hasn’t been taking up a bed for the last 5 days that a person needs who has an illness where hospitalisation IS indicated .

enigma enigma 1:42 pm 17 Nov 05

Being sent home after 2 overdoses demonstrates that hospital is not the appropriate place for treatment as all it does is reinforce the maladaptive coping mechanism. Keeping her in hospital would be a waste of scarce resources. Clearly she is at little risk of completed suicide as when she overdoses she tells someone/presents to Ed etc, indicating that the overdoses were para-suicidal rather than suicidal acts. Appropriate treatment is to medically treat her (usually just in ED without need for admission and return home for community treatment (ie her psychologist). In the ACT there would on average be at least 5 overdoses per day, of these probably less than 1 would gain a psych admission, not because of limited beds but because admission is counterproductive to treatment. Of those admitted post overdose over half of them would be admitted for 1 day or less, again because admission in counterproductive.
The reason that your friend is not admitted or has short admission is because she has a well documented history/diagnosis of BPD (no matter what she is telling you) and admission hinders rather than helps (her clinicians would [possibly] be as qualified as me, but unlikely to be as experienced).

Again I say instead of publicly abusing CATT make a complaint to the Health Complaints Commissioner, he’s independent, in the unlikely event your complaint has any substance he will identify it and ensure appropriate action is taken. Don’t go around abusing people if you are unwilling to back it up with action.

nyssa76 nyssa76 1:17 pm 17 Nov 05

Her psychologist is well respected – not infamous.

There are no beds for her because there aren’t enough beds in the ACT.

Being sent home from the hospital after TWO OD’s shows a LACK of duty of care of the hospital and CATT.

Hell, she OD’d on a Thursday – got out early Friday morning and was back in there on Saturday for an OD.

So please tell me that she wasn’t in need.

I don’t have a dependency on her. I am her friend and trying to help her as best I can. If you don’t like it, stick it where the sun don’t shine.

Again, she DOESN’T have BPD, so get off that little band wagon. I am sure her doctor, psychologist, psychiatrist etc are more qualified to diagnose MDD than you.

So whilst you berate me, think about all those people that CATT haven’t helped due to the arseholes that work there. Given there are some really nice people that work there but the arseholes have to go.

enigma enigma 10:23 am 17 Nov 05

Implying??? I was specifically stating it I don’t know if I could have been more explicit. Even if this was the case the connection between an implication and assumption is less than tenuous, if I implied the sun came up this morning would that mean I was only assuming it had come up? I think not.

That you have known Kylie since she was a kid is no evidence that she wasn’t sexually abused many people go to their grave without telling anyone about their sexual abuse history.

I’m not saying that everyone with depression has a BPD, I’m saying specifically saying your friend has BPD and not depression. People with depression don’t slash to self mutilate, they kill themselves, they find a nice quiet place where they won’t be discovered pick a high lethality method and do it, It’s the nature of the beast, if you wish to die then you don’t want anyone to stop you and you don’t want to fail.

Her psychologist is paying his own fees (???), again if it costs you nothing then that’s probably what its worth. Well known as in infamous?

Is your friend dead yet? If not I suggest probably a good call on Catt’s part, the bed she could have used up has been put to better use by having a patient in it who actually was going to suicide, sounds like appropriate allocation of limited resources to me.

Your not dependent your co-dependent, your fostering dependency in Kylie.

As with any one practising as a doctor, psychologist or nurse CATT staff are registered with their respective boards as required by legislation. Hence they are all qualified and undertake continuing professional development.

Instead of bleating to the world about your complaints why don’t you make it official, Corbell’s the Minister, Sherbon’s the Permanent Head, I think the Health Complaints Commissioner is Patterson, be constructive instead of just whining to the world at large. You don’t have the benefit of being able to read the copious clinical notes on Kylie so us to understand the rationale for clinical decisions made, but staff in ACT MHS do, and this and clinical presentation is the basis upon which decisions are made. You might note that the ACT suicide rate is below the national average.

nyssa76 nyssa76 8:39 pm 16 Nov 05

ginger, I am surprised you can string a sentence together you ignorant caveman.

Why would I want to do anything with you moron?

Besides, it would be past your bed-time and I would rather lick a canetoad than be in the same 5km radius as you dickhead.

Grow the fuck up.

Here’s a thought, find something else to do besides make yourself look lik a complete fuckwit.

gingermick gingermick 7:56 pm 16 Nov 05

Comcare, nys? Bloody Comcare??? Crazy Horse is claiming compo for being a pathetic attention seeker? It gets better and better. Tell us the compo story, nys. Please do.

p.s. Are we still on for to-morrow night? You can bring Crazy Horse along, if you like. She might put on one of her now-famous performances and amuse the bar. See you soon, petal.

nyssa76 nyssa76 6:26 pm 16 Nov 05

Who says she has ever been raped? Your constant implying indicates to me that you’re only “assuming”.

She’s never been raped. I’ve known her since we were children.

BPD for people with depression is like saying all children have ADHD because they are hyperactive.

She doesn’t have BPD. She has Major Depression Disorder – look it up. Her psychologist is well known in the ACT and elsewhere, and is well respected. He is paying the fees himself atm. No Comcare and no income for my friend. She has also seen a psychiatrist (also well known and respected in Canberra) and he agrees that she had MDD.

I am there for her. If you see that as dependence then so be it. However, I’d rather she call someone etc than follow through with her intentions.

Again, she has never been raped and has two clinicians diagnosing her with MDD, not BPD. Very simple to understand.

CATT is a useless waste of resources and all members should be re-screened and if they don’t cut it, they’re out.

enigma enigma 6:07 pm 16 Nov 05

She would have been referred to Rape Crisis to organise an appointment to deal with her childhood sexual abuse (aka rape), Rape Crisis Centre doesn’t have a time limit in which you need to have been raped to access their service.

Your subsequent posts indicating her chronic slashing and overdosing, further support the thesis that she has a Borderline Personality Disorder, this is not a symptom of any other disorder. When depressed people wish to suicide they usually succeed, they very rarely call for assistance (why would they, they have decided death is the solution so calling someone would only defeat their aim), if you want to kill yourself it’s so easy, we all spend most of our time attempting to dodge death (looking before we cross the road, wearing seat belts, making sure were drinking green cordial not pine-o-clean), if your friend really wanted to be dead she would be well rotten by now. Her slashing and overdosing is a combination of care eliciting behaviour (nice way of phrasing attention seeking) and tension release (cutting tends to take your mind of your psychological problems and temporarily releases tension). Her high levels of aggression are also symptomatic of BPD, as is her unstable affect.
Inexperience clinicians routinely misdiagnose BPD as “anxiety and depression” especially on cross-sectional interview.

You may consider BPD “a joke in its clarification (sic)” presumably you mean classification, but your going against the vast majority of the psychological and psychiatric community, it is the most researched of all the Personality Disorders (Antisocial PD running second). Really that is equivalent to arguing there is no such thing as cancer.

You are fostering dependency in your friend instead of encouraging her to develop adaptive coping mechanisms. You present as though you have a need to be needed or have a bunch of rescue fantasies or just like a bit of high drama in your life. Take a step back; people with BPD are often highly emotionally manipulative, their main drive is to avoid rejection or abandonment (real or perceived) and will go to great lengths to achieve this end.

And the pro bono therapist if it costs you nothing that’s what you’ll get. S/he is probably hoping to get in on the Comcare action, now that’s some sweet pay dirt, if you can get Comcare to pay you to treat a BPD one session a week until one of you dies (cause that’s how long it will probably take) at the full scheduled fee ($165/hour) the kids school fees will be no trouble.

Mr Evil Mr Evil 4:36 pm 16 Nov 05

Sounds like the only people the CATT operator didn’t suggest your friend call was Telstra Directory Assistance. She’d probably get more appropriate advice if she rang Telstra; and that’s really saying something!

nyssa76 nyssa76 3:32 pm 16 Nov 05

enigma, after just speaking to my friend, she has also informed me that the idiot from CATT that she spoke to also stated that my friend could ring the Rape Crisis Centre for help.

Now, this is a person who hasn’t been raped and my question is: Why would they be referring her to Rape Crisis?

The CATT member is an idiot and should be sacked.

nyssa76 nyssa76 2:05 pm 16 Nov 05

enigma, she has been diagnosed with Major Depressive disorder and has registered high for stress, anxiety, depression and agresssion. She has OD’d twice on anti-depressants – once mixed with panadol and a non anti-depressant medication. She has self mutilated over 12 times. There are no beds in 2N and I wouldn’t send a wounded dog to PSU. She’s been “borderline” (CATT’s words not mine) to go to PSU three times in the past 3 months.

She doesn’t have BPD – which is a joke in it’s clarification anyway.

The psychologist ISN’T being paid. He is working pro bono until the Comcare claim goes through – I didn’t want to get into many details over this but your post has prompted me to do so.

So by being there for her, I am helping her.

enigma enigma 1:55 pm 16 Nov 05

She (lets call her Kylie) doesn’t have an illness Kylie has Borderline Personality Disorder which is a (DSM-IV) Axis 2 disorder so it is technically a mental dysfunction not a mental illness. Kylie does not have a Major Depressive Episode or a Generalised Anxiety Disorder although she may have a low mood or anxiety as part of her chronically labile affect. Hospitalisation or emergency responses are contra-indicated in BPD (as you should know from the peer reviewed literature) so inaction by CATT is therapeutic (counter-intuitive I know), making a production out of Kylies self-harming/self-mutilation reinforces this maladaptive coping mechanism. By buying into Kylie’s behaviour you reinforce it, so you are doing your friend a disservice. With a prevalence 2% and that BPD is not an illness rather a dysfunction (so you don’t get better although symptoms can abate) this means there are 6000 BPD people in the ACT, as chronic self harm is a common if not the most common symptoms this probably means that 200-500 people will self harm each day in the ACT, no Govt system is equipped to deal with this (even if emergency response/hospitalisation was indicated for BPD which it is not). Most sensible people (oxymoron) with BPD self harm and then head down to their GP to be stitched up. Panadol overdoses are not treated by flushing with saline. The treatment, (if required) is an IV infusion of Paravalax which binds the paracetamol in the blood stream and prevents liver damage while the normal excretion processes take place. No surprise that Kylie’s psychologist Doesn’t want Kylie calling CATT as she can see one of her cash cows getting slaughtered if Kylie starts getting advice as to what the evidenced based treatment for BPD is (which is Dialectical Behaviour Therapy). It would be unethical for a clinician not to advise a patient if it was found that the patient wasn’t being treated in an evidenced based manner or otherwise incompetently. And Kylie’s therapist doesn’t care about her as one would about family or friends she cares in the professional sense, big difference. Her psychologist cares that she is doing a good job that’s professional, caring about her as one cares about family and friends would demonstrate a marked lack of professional boundaries and would be unethical (you don’t have to like your patients to treat them effectively). The list of inaccuracies in this discourse is too long to any where near fully address but this is a (small) start. Also hoping that someone had suicide so that a CATT worker would get in trouble is ungenerous to say the least (re the comment in the police in Hawker post).
It’s not Kylie’s fault she has BPD (if you want to blame someone, blame the guy that sexually abused her as a child) and the good news is that in many cases symptoms spontaneously remit as the person enters their fourth decade. Treatment with DBT is also successful, but the disorder is not cured rather the person uses psychological strategies to reduce the expression of symptoms. Get a Boundary
CATT Crisis Assessment and Treatment Team
MIT Mobile Intensive Treatment Team (generally (but not exclusively)for patients with schizophrenia or other psychotic disorders who need high level support, not a crisis service except for patients that are already on their books, does not operate 24 hours a day).

nyssa76 nyssa76 1:49 pm 16 Nov 05

LG, well said. 🙂

Thumper, she’s doing ok for now. But as you know, it’s one day at a time.

Thanks.

LurkerGal LurkerGal 10:38 am 16 Nov 05

Good luck Nyssa. Mental illness is hard to deal with, all you can do is be there for her, which it sounds like you are doing.

And Ginger? Tosser? It is an ILLNESS. If Nyssa’s friend had cervical cancer, would she be an idiot? If she had epilepsy? Or how about if she had MS? It’s the same fucking thing. It’s an ILLNESS! Fucktard.

Thumper Thumper 8:15 am 16 Nov 05

Sounds fairly normal for them. As much as we get reassurances from the government that they are “looking into” and “addressing issues”, nothing ever changes.

No accountability, no probity. Why does it always take a tragic death to get someone to actually do something.

Hope your friend is okay.

Cheers

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