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April 24, 2008 at 6:37 pm 5 comments

One of the original sites, possibly the first, that I put in my blogroll was NHS Blog Doc. This was back in December ’06. In fact, it was kind of an inspiration for me starting this blog.

I started this blog because I was pissed off. My absolute last-resort plan had failed. I’d been kind of hypomanic in the months before this, fueled by my chronic sleep-deprivation. Things has been getting progressively worse over the previous couple of weeks and then suddenly I crashed hard into what I’m guessing was a mixed episode. It wasn’t fun. So cut my arm and walked all the way across the city at 2 A.M., following roadsigns to the hospital. The cuts were minor, but I was thinking of them as proof that I needed help. I asked to talk to someone. And the fucking crisis team refused to see me. Because my self-harm was a long-term problem that should be handled by my GP I ended up waiting to see an A+E doctor. Who turned out to be some exhausted looking SHO who ran through a depression inventory before reiterating the advice to see my GP.

I’d been reading some medical blogs, and NHS Blog Doc had kind of given me the impression that the NHS was shit and psychiatric services were inaccessible. And suddenly this was my direct experience. So I started writing about it. The focus of the blog is a little different now, but for the first six months or more, it was pretty much about how stupidly difficult it was to get any treatment.

Anyhow, today I’ve deleted NHS Blog Doc from my blogroll. I don’t know if I just had a limited view back then, or if it genuinely was a much more focused and interesting read, but these days I’m finding that it’s far too full of useless blathering and poorly thought out invective for me to recommend it to other people in good faith. It’s kind of sad – I really only knew what a CMHT was because I’d read about them (though possibly not the most balanced account) in Dr. Crippen’s posts on NHS Blog Doc.

If you want to read the blog of a British GP, then Dr. Andrew Brown of A Fortunate Man fits the bill. He comes across as a nice person, whereas Dr. Crippen – and I’m being charitable here – doesn’t, – and hasn’t for a long time.

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I Can Has Sleep Plz? Saturday

5 Comments Add your own

  • 1. Alison  |  April 24, 2008 at 8:53 pm

    I shall try the new blog you recommend, I could never get on with NHS blog doctor the layout put me off for starters!

  • 2. Zarathustra  |  April 24, 2008 at 9:37 pm

    The trouble with Dr Crippen is that whenever he makes good points (which, in all fairness, he often does) it just gets lost in the sermonising, self-righteousness and claims that are just flat-out wrong.

    I used to read NHS Blog Doc when I was a student nurse, and what struck me was that when reading his tirades against the way nurses are supposedly trained, that it didn’t bear any resemblance to how I was actually being trained. Eventually I concluded that the guy simply doesn’t have a good, up-to-date knowledge of the current trends in nurse education. Try telling him that though.

    Now I’m out there as a qualified RMN, I’m increasingly of the view that he doesn’t understand psychiatry nearly as well as he thinks he does either.

  • 3. experimental chimp  |  April 24, 2008 at 10:28 pm

    I think with Dr. Crippen, the MTAS stuff last year helped, because it was something he could get all self-righteous about without coming off as a boorish asshole. I wonder maybe if I didn’t notice that this wasn’t exceptional, and this level of bluster was his default mode. Applying the same level of outrage to the idea that nurses can y’know make decisions about stuff just seems bizarre.

    And yes, looking at some recent posts, there’s a definite disconnect between my experience as a user of psychiatric services and how Dr. Crippen thinks they work. For example (from Psychiatry on the Cheap):

    It was said that Dr Birchall “failed to use approved monitoring systems”. Easily said. Sadly, there is no monitoring system short of constant one-to-one supervision that is guaranteed safe. An experienced psychiatrist will pick up early warning signs, if there are any. But he does not have the time to see all his patients regularly and personally. A psychiatrist might have 200 mentally ill patients under his care. He has to delegate. Unless he works in a teaching hospital, he is unlikely to have an experienced registrar to share the load.

    So, it is care in the community, monitored by the kind, caring, hard-working, cheap, non-medically trained CMHT members. They will play at doctor by filling in their tick sheets, and complete their risk assessment protocols, and find much wood and no trees. They confuse caring with competence. They are neither qualified nor competent to make psychiatric diagnoses, but you cannot tell them that. They do not understand. They will not have it.

    Now I see my psychiatrist as required. At the moment it’s fairly frequent because medications need to be reviewed and switched. I really have no idea what I’d have to say to her if I saw her more often. The person who has the best idea of my mental state currently is – unsurpringly – the one who talks to me most often. Which is my therapist. I don’t currently have a CPN because there’s not much point given the ongoing level of support. I did have a CPN briefly and I don’t recall any tick-charts being used. We just talked about stuff. Maybe he was doing it wrong?

    Now I don’t have schizophrenia and I’m not likely to be a danger to anyone except myself, but I can’t see the principle being very different.

    And exactly when during their training does Dr. Crippen think that psychiatrists are bestowed with the ability to read people’s minds? I value my psychiatrist’s knowledge of my illness and how to treat it. She hasn’t demonstrated any psychic ability as yet.

    Anyway, that’s probably more than I wanted to think about, so that’s probably enough.

  • 4. Zarathustra  |  April 24, 2008 at 10:56 pm

    I did have a CPN briefly and I don’t recall any tick-charts being used. We just talked about stuff. Maybe he was doing it wrong?

    I’m a CPN in child and adolescent services. I don’t use many tick-charts, and those I do use are the same ones the psychiatrists use (Connors Questionnaire, Beck Depression Inventory, Asperger Screening Questionnaire etc). Mostly, as you say, I just talk about stuff, which is often the best way to find out what’s going on in someone’s life.

  • 5. Andrew Brown  |  May 2, 2008 at 9:45 pm

    Thanks for the compliment.

    I’m not sure that I’m particularly nice, but it’s good to know I appear that way. 🙂

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Hi, I'm James. I'm a 26 year old guy from England with bipolar disorder (currently well controlled). I also have a circadian rhythm sleep disorder (not so well controlled). This blog has charted my journey from mental illness, through diagnosis and, recently, into recovery. It's not always easy, but then, what is?

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