Treatment

[Jaquta]

Hi.  Thanks for providing us a place to ask questions and to have them answered.
I'm not sure how to phrase my question.  I have been offered an independent psych review nearly two years after my last therapist left.  I guess I am feeling a little apprehensive.   I have previously been diagnosed with bpd and other miscellaneous disorders (severe depression, severe anxiety, etc).
I am struggling to rationalize attending the appointment.  I have a poor relationship and history with my current mhs provider.  I personally can't see how the appointment or review will benefit me in any way.  I accept attending is the acceptable thing to do though.
Are psych reviews generally helpful to patients or are they just further opportunities for doctors to exert their own will over vulnerable clients?
By the time of the review it will have been over two years since I have recieved any significant support.  Before, during crises, I was told to half-smile, take out the rubbish, that someone who was unwell was coming in and that there is nothing they can do to help.
Could a review be helpful?  I don't trust the service any more.  Also, I expect, information from the review will go straight back to the mhs.  Some of that feels like a violation.
This all feels somewhat messed up.  I have had issues with mood this year and are currently on holiday.  I have been feeling extremely stressed, depressed and have been having problems, especially in the evenings, with suicidal urges.
I haven't been sleeping well and when I have I've had nightmares.  I've been binge eating badly which I'm finding distressing.  I was going to send my GP, whom I have a good relationship with, an update but I haven't sent one yet.  I have written both a letter and a postcard but have sent neither.
More than anything I expect I just needed to reach out and feel connected to someone.  I guess I'm feeling a bit angry, stressed, frustrated, overwhelmed, unsettled and uncontained.  ??
Sorry for the novel.

[Jaquta]

My understanding of the review is that it will be used as a guide to treatment.  I have limited confidence in health professionals so it is hard to say which way it is likely to go. Ultimately I would like decent, accessible therapy that will help me move forward in a timely way.  Therapy that is sensitive and respectful -all that basic stuff that people seemingly don't know how to apply to 'difficult or different' patients.  Therapy that is containing and has limits, etc.

The review has been funded by my mhs after it was voiced as an option by them over 18 months ago.  My GP, who has been my sole provider of care for the past two years, has been the one following up the review.  It has been a long and timely process.
The main reason for the review is that I have a poor history with the service and the T's lack the skill and experience to deal with me and my issues.

I personally would like to see better management and treatment of individuals with bpd without them being further traumatized by people and systems who are ill-equiped to deal with them.

That is all surplus info.

I don't feel comfortable discussing my issues with the consumer advocate.  I met her while on the psych ward.  My previous post didn't come through but I did mention that I was sectioned for severe depression several years ago.  I found the admission 'difficult' and od'ed on discharge meds once discharged.  After a week in icu and a week at home I had my leave revoked (through lack of understanding and lack of good communication).  Anyway, on my second admission I was threatened with ect.  The doctor was adament that I needed this.  I refused to consent and we went through the courts.  The doctor wanted to give ect before a second opinion.  Long story but anyway I didn't have ect.  This advocate did though, by choice, and there is other stuff there that makes this all difficult.

I was going to make a formal complaint through the health and disability commissioner but my GP asked me to wait until after the review (which has dragged on) and my last T said that even after the process I still wouldn't have anyone to talk too.

Perhaps the problem wasn't about the review but just that I'm not coping now.  I've been struggling with suicidal thoughts and urges (not sure why).  It's all been draining and I want everything to stop.  Are sorely tempted to act.  It's just draining trying to work through it all myself and the anxiety about the review isn't helping.  I'm just venting.  I'm sure this is just a depressive transference.

[Peter Forster]

Certainly an outside review could be valuable. In my practice we provide a fair number of second opinion consultations and I think that in general requesting a second opinion consultation is a good thing and should be done more often in mental health settings. I can't answer the specifics about your review because I don't know enough about how or why it was setup.
Certainly being in a seemingly dependent role in a mental health system you don't trust sounds very disturbing. Is there a consumer advocate that you could consult with?