Madness

I’m listening to a radio programme on addiction to prescribed medicines, such as benzodiazapenes.  Very sad state of affairs – and difficult to resolve.

My experience of GPs and mental health has been vastly varied. Some excellence, some absolutely appaling practice.  I am not convinced that even the best GP is well suited to provide the best care for mental health issues.  Even mild ones, which I suppose mine are, most of the time.

What concerns me most, is the impossibility of getting help for people who are too far gone to know, or be able to effectively express, that they need help and why – but who haven’t yet gone so far as to cause damage to themselves or others, or to behave so wildly unacceptably in public that they come to the attention of the police.

As I said in my last post, not all extremists could be said to have mental health problems. Whether Anders Breivik turns out to or not remains to be seen. However – sometimes, people with emerging mental health issues, can be very impressionable, paranoid, and easily converted to extremist viewpoints because they are losing the power to rationally analyse arguments and consider consequences which makes most of us reject the more extreme aspects of whatever ideology it is we may follow – and certainly violent, or terrorist means of furthering our interests.

Had Mr Breivik confided to a friend, about his plans – or even just about his views – I am sure that he has at some point had heated discussions about his feelings about the changes in society, with someone who tried to debate the issues with him.  At what point, does that friend take this man seriously? At what point to they move from thinking it’s all hot air, to seeing that there’s something amiss.  And what can they do then?

Raoul Moat – who went on a shooting spree in the North-East, and was eventually killed by the police. He knew he had a problem. He had sought help.  But he did not get taken as seriously as he should have been.

How many people who are converted at a young age to radical Islam, perhaps to be encouraged into martyrdom operations – how many come from troubled backgrounds, or have emotional difficulties?  How many of the people picking up rocks and increasingly guns again in Northern Ireland, are teenagers, having their opinions and values moulded at a time when their hormones are going haywire?  I digress.

The traditional argument, is that if someone is a danger to themselves or others, they will be sectioned.  Their liberty will be removed, for their own good and the safety of others, so they can be psychiatrically observed, and treated.  Do you know how difficult it is, to get someone sectioned?

My very left-wing friend, that I also mentioned in a previous post – came to me in a time of crisis. Suicidal, in despair.  In trying to get him to see a doctor – I wanted to take him somewhere other than my own GP, who I knew was rubbish when it came to these things, and had the bedside manner of a drunken tramp.  But wherever I called, even when I tried to call people with a stated special interest in mental health, I was told he could not be seen. (He was not in his own city) – I should take him to my own GP.  So, reluctantly, I made an appointment at my own practice, with a Locum.

The locum was better than either of the other doctors I had seen there, but he was still not very good.  My friend was almost unable to speak, he was so depressed. But he managed to express himself a little, and was prescribed anti-depressants, and sleeping pills, as he was suffering severe insomnia.  However, it was also established, that my friend drank.  And the response was simply – well, stop it.

My friend is an alcoholic.  He has tried many times to “stop it” – but never, to this point at least, succeeded for very long. Especially when his mental health problems deteriorate, his first response is to self-medicate with drink.

Meanwhile, he seemed to pick up a bit, slept better, mood improved.

But then one night, he had some kind of psychotic episode – perhaps a bad interaction of drink, whichever drug – probably, having since read up on other adverse reactions, the zopiclone.  He filled my house with gas (by accident), passed out, and when we tried to rouse him, attacked us, in an almost sleeping state. He tried to kill my ex, and made sexual threats towards me. He smacked his head in the struggle.

In the morning, he couldn’t remember a thing.

We went back to the doctor, who pretty much dismissed what we said had happened.  It was just because he was drunk and agressive.  My friend, in reality would never harm a fly. In health, he would have been utterly mortified by his actions. He was taken off the zopiclone, and sent back with me.  Me- living alone with him.  I told him I would do whatever I could to help him, whatever it took – but that the first step had to be stopping drinking. I was prepared to help him as best I could. But he wasn’t ready for that, and he ran away again.

During the whole process, we thought – he needs to be sectioned, at some point this will come to that.  I think it did, much later – but if you aren’t family – it’s almost impossible.  But then, when he wasn’t drinking, his illness presented pretty much as severe depression. It was only with drink in the mix that it would spiral, and paranoid delusions, mania and delusions of grandeur come to the fore.  Fine, you say – don’t drink. But if it were that easy…  Dual Diagnosis, the concurrent problems of substance or alcohol misuse and mental illness, is something which is only going to become more prevalent in our society as many people develop mental illness as a result of substance abuse – or respond to mental illness by abusing substances to make themselves feel better.  There are very few places where this is handled well in the country.

A lot of these people are adrift from the nice, cosy, familial support unit which is supposed to be the one to spot their distress, and have them sectioned. The rules don’t fit their world.  How do concerned friends get help for them? How do employers access help for employees in distress?  Especially if they become non-compliant, and refuse to see anything wrong?

Anders Breivik’s father said he would have nothing more to do with him – but didn’t I read somewhere that he hadn’t seen him since 1995? Even if it was 2005, that doesn’t suggest that this man was under the watchful eye of a caring family. Did he have friends? Or had he always been a loner – wallowing in an online world of hatred.

It troubles me.  If we don’t find a better and easier way of getting help to people when they need it, indeed, when they ask for it- then there will be more tragedies – be they the small personal ones, or the grand disasters.