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What should we expect from the mental health system and what should we expect from those suffering with mental illness

Emy
Community Member
Hi,

I am the primary carer for my boyfriend of two years who suffers from Borderline Personality Disorder (cluster b), bipolar, depression and the resulting anxiety. Diagnosis have come and gone over the years as have his treating psychiatrists in the public system. 

I would like to explore the following questions and am interested in the thoughts of forum goers:

  1. What obligations does/should the mental health system (governments, society, medical professionals, support services) have towards people with severe mental health issues that prevent them from engaging with assistance of their own accord?
  2. What should we expect from our loved ones with severe mental health issues in terms of commitment to improving their quality of life?
Some context...Engagement with any service (support, professional etc.) relies (to some extent) on the ability and commitment of the mentally ill person to engage. My partner is committed to improving his quality of life but the very nature of his illness somewhat circumvents his ability to actively do so. This often means that he is discharged from health and support services, ultimately for a failure to consistently engage. For a long time I was of the opinion that "I can lead the horse to the water, but I can't make it drink". Having witnessed first hand just how challenging it is for him, I am left questioning how reasonable it is to expect someone to do something that they are programmed to be incapable of doing; are we setting these people up to fail? What is the solution? I have even tried to get him connected with private psychiatrists thinking that surely the service would be more personal and engaging. Four private psychiatrists to date have declined to take him on as a patient. Too hard? Selective? Who knows...? 

He is committed in principle to recovery but for whatever reason his will is overpowered by the symptoms of his illnesses.I am fully aware that I cannot do it for him, but where is the line drawn between self help and intervention to save a human life? 

11 Replies 11

Chris_B
Blue Voices Member
Blue Voices Member
Hi Em, definitely. It can be quite common for people to get caught between multiple practitioners and for the left hand to not know what the right hand is doing. 

White_Rose
Champion Alumni
Champion Alumni

Dear Em

Wow! Congratulations! I am in awe of your initiative. Please keep up the good work for those who are not in a position to help themselves. I feel the biggest problem is in the public system. For example many years I was taken to a public mental health hospital, kept overnight and the discharged. My treating psychiatrist was furious at my discharge and told the hospital psychiatrist this. My psych felt I was still at risk. He would have admitted me to a private hospital but I did not have private insurance at that time.

So what happens to all the poor devils without private means?  On the other hand my GP referred me to a private hospital recently, but because I was not receiving treatment from a psychiatrist I have to wait until someone has the capacity to take on a new patient and also have a bed available in the private hospital.

Neither has happened yet and I think it is unlikely. I am fortunate that I have a caring and competent GP who has helped me over the worst part so I probably will not go to hospital. She is of the opinion that had I not improved my only option would be to go to a public hospital ED. I could have done this but I rather suspect I would have been sent home.

As a Blue Voices member I was asked to comment on an initiative from from a NSW university about patients/clients having more say in their treatment options. In principle I applaud this and believe that when someone is given greater control over their own destiny they become more committed to carrying out the appropriate actions. Obviously this is a generalisation and not useful in some areas. What it does show is the need for more flexible options.

If I heard the news correctly last night, I understand the federal govt is considering new options for the treatment of mental health. We will await the outcome but not holding our breath.

Mary