How do I get a 2nd Opinion; must it be from the same clinic?

For issues specific to caring for someone with mental ill health.
I have a mother who has Schizophrenia. Her current unwell-state started back at roughly the end of February. She was suffering from severe Insomnia. All the way through March the insomnia had been the main problem. In April – the issue was the Schizophrenia in so much that her behaviour was out of the ordinary.

Her behaviour through April had been: she was letter writing to banks, dentists and cancelling insurance packages. The theme of her letter is contentious; that she is being cheated by them. She is also writing letters to other people unknown to me. She was also showering at midnight; crying for no reason when she normally does not cry; she wrote a cheque for £100 for the Prince of Wales. She also was and is focused on keeping records of her finances, keeping them in order, writing constantly ledgers and figures. She is losing track of days, forgetting appointments. She is obsessive in what she does.

I realise and appreciate that her behaviour is not life-threatening, but are more of a cause for concern for what’s acceptable social behaviour; still – the accumulative effects of these strange acts were impacting on my own mental health at the time. I was on red-alert constantly and felt left without any support or relief whatsoever. Thankfully – in May – I now have Carer’s support – or at least I have access to support.

My initial reasons for concerns were:

1) The Psychiatrist in charge of my mum – who we saw on the 15th of March - I feel is incompetent. She prescribed Promethazine as a sleeping pill initially about 2 years ago (according to my mam). With the insomnia disturbing my mams sleep, the same Psychiatrist gave in to my mam’s request for the same Promethazine which my mam prefers to use. The dosage went from 10mg to 50mg. But the pill did not give my mam the desired sleep.

At that time, I was instructed to allow time for the pills to work, but after four days of absolute anguish hearing my mother crying at night and begging her imaginary tormentors for mercy – I decided to seek help from a GP. So I saw my mam’s GP who prescribed Zolpidem – which did work relatively quickly. That left a bitter taste in my mouth as to the competence of the Psychiatrist overseeing our family’s mental health.

2) The care-coordinator is hard to contact – even though I have her mobile phone. Also – to cut a long story short – she arranged for a full examination but on the last Good Friday. I left a message on her mobile to ask if this was a valid appointment and could she please text back to confirm. She did not answer. It’s a pattern in the way she works that has become more and more apparent. As a care-coordinator – she does not seem to care. Current – she is apparently on sick leave. I have nothing against her personally – but I feel she is not fit to occupy her position of trust. I suspect most people in her position are overworked and emotionally fatigued.

3) The Crisis team – did not return my calls. Twice - on different occasions, in the height of my distressing circumstance, when I had contacted them they've not responded. I looked online for another Crisis team’s number and rang. I got a helpful lady on immediately who gave me advice. So the initial Crisis Team is next to useless in assisting me. I was advised that they will only deal with life and death situations – anything less and they will not offer a helpful word.

Coming now to recent events: on the 1st of May – we saw the Psychiatrist in charge of my mum again. She interviewed my mum – getting her to express how she feels and what her plans and activities were. Her concluding diagnosis on this occasion is that my mum is suffering from clinical depression. I would assume it is “clinical” since there is nothing I can point to in her life that would cause such sadness. So the lady Dr prescribed Mirtazapine for the depression and Temazepam for the bouts of insomnia. We are supposed to see how this works and come back in 2 months’ time.

The Psychiatrist trusts my mam to allow her to administer her own medication; that’s been the routine till now. And it’s a routine that they can’t seem to break out of. Why is it not even considered by the Psychiatrist that perhaps there is another issue beyond simple depression layered on top of the Schizophrenia?

They appear to be increasing her Clopixol/Zuclopenthixol medication; they gave her the injection on the 11th of May; now the next schedule is the 25th of May. So they are increasing her dosage from once a month to twice. Yet they don’t seem to be acknowledging this.

I realise – I am not privy to the medical decisions being carried out for my mam’s treatment. But I have first-hand experience of what she is doing and how she is looking overall. This is not just depression. She looks tired and washed-out and skinny. She is not even remembering to eat and will only do so when I remind her. She eats with gusto – but only when I prompt her to have something.

My complaint no 4)

My mother forgets to take her “normal” medications such as the ones for her underactive thyroid and diabetes. Yet the Psychiatrist strictly instructed me to not inforce any control on her pill taking. She is leaving all the scheduling for the Mirtazapine purely in my mother’s hands. Why I completely disagree with this arrangement – is that my mam since then has left packets of Mirtazapine on a toilet stool. Perhaps she has left it there to use at night, but it certainly does not show her to be taking care of where she puts these pills.

5) I have started to keep records of my mums behavioural “anomalies.” Currently she is focussed on writing vast amounts of stories and letters. She is applying to study on the Open University – Business and Admin as she had a bachelor’s degree on the subject. I support this idea for the time being, knowing that as before - I have experienced her getting business ideas – that inevitably fail to succeed. All my records of her behavioural patterns and my concerns were not even acknowledged by the Psychiatrist. It’s as if my first-hand experience of what’s happening at home (since I live with my mam) is of no importance. The brief interview of her – is apparently conclusive enough so that the Psychiatrist is confident that she is just depressed. I find this appalling and utterly devoid of skill and expertise.

I’m still not persuaded than my mother is in good hands. As instructed by the Psychiatrist – I have not attempted to provide a controlled environment so that her medications are being used with regularity. My mam is free to do whatever she wants – with the exception of her iPad and Mobile phone use; that – I do my best to control since she would use these devices all day and all night. And the problem with these devices, which I tried to mention to the Psychiatrist – didn’t even seem to register concern. It’s now apparent that blue light from these screens can cause insomnia.

Close friends and even Carer support team agents have mentioned the possibility that my mum could be suffering from the onset of Dementia. The random crying and forgetting the day she is in – seemed to make it a possibility. So I saw a GP on the possibility of having her tested for Dementia. He quickly gave her a memory quiz – which she passed. She scored 5 – when you need 8 to qualify for referral. I was sort of relieved that it may not be Dementia. But still – I have my fears that something else is wrong with my mum. She is not simply depressed.

What I would like is a 2nd Opinion on what is really wrong with her. If that 2nd Opinion comes up with the same diagnoses – then I would be better able to cope with the daily uncertainly of what she will do next.
I would first of all complain to the Care Quality Commission if you don't think the service she is receiving is good enough. They need to know. I would also record the crying fits etc. etc.
You don't mention how old you are and how old mum is? This could be crucial.
From the MIND web site :

https://www.mind.org.uk/information-sup ... complaint/

How to make a complaint.


Said page contains a wealth of information which will be of immediate assistance here.

A second opinion ?

RETHINK for this one , link follows :

https://www.rethink.org/living-with-men ... d-opinions

Again , a wealth of information thereon.

As usual with almost all supporting organisations , they are NOT trade unions.

They will merely supply an individual with information for them to take on the System.
My understanding is that everyone IS entitled to a Second Opinion from a different consultant, anywhere in the UK. We do not have to be treated by the 'local specialist'.

However, if the PATIENT does not want a second opinion, that is the tricky bit.

Mental illness is notorious for the 'non-cooperation' of the patients, and family are tied into knots trying to get hem the treatment they NEED as opposed to all too often non-treatment they think they are fine with.

(My mother was probably a paranoid schizophrenic, but would never take any meds as she said they were part of the plot against her.....)

(I know it is illegal, but I can understand why frustrated carers 'sneak in' the meds eg, in food or whatever......sigh.)
bowlingbun wrote:
Sat May 19, 2018 7:27 pm
I would first of all complain to the Care Quality Commission if you don't think the service she is receiving is good enough. They need to know. I would also record the crying fits etc. etc.
You don't mention how old you are and how old mum is? This could be crucial.
She's 75 this year; I've just turned 46.
jenny lucas wrote:
Sun May 20, 2018 9:21 am
My understanding is that everyone IS entitled to a Second Opinion from a different consultant, anywhere in the UK. We do not have to be treated by the 'local specialist'.

However, if the PATIENT does not want a second opinion, that is the tricky bit.

Mental illness is notorious for the 'non-cooperation' of the patients, and family are tied into knots trying to get hem the treatment they NEED as opposed to all too often non-treatment they think they are fine with.

(My mother was probably a paranoid schizophrenic, but would never take any meds as she said they were part of the plot against her.....)

(I know it is illegal, but I can understand why frustrated carers 'sneak in' the meds eg, in food or whatever......sigh.)
The complaint process - needs her consent. As far as she feels - she's getting better.
Chris From The Gulag wrote:
Sat May 19, 2018 7:57 pm
From the MIND web site :

https://www.mind.org.uk/information-sup ... complaint/

How to make a complaint.


Said page contains a wealth of information which will be of immediate assistance here.

A second opinion ?

RETHINK for this one , link follows :

https://www.rethink.org/living-with-men ... d-opinions

Again , a wealth of information thereon.

As usual with almost all supporting organisations , they are NOT trade unions.

They will merely supply an individual with information for them to take on the System.
Thank you.
Your welcome.