PATIENTS with mental illness are not happy about the way medications are prescribed and they want their voices heard by GPs.
The Mental Health Commission of NSW has received more than 200 submissions from patients, carers, doctors and nurses that provide insights into the “lived experience of medication use” in mental illness.
The summary report released on Wednesday reveals that patients would like GPs to inform them about all possible treatment options, involve them more in the decision-making process, and take their concerns seriously.
Some of the specific recommendations include:
- The prescription pad should not be reached for too quickly. Non-pharmacological options such as counselling, cognitive behaviour therapy and exercise should be offered first.
“Please don’t put us on medication until all the other stuff that actually works has been tried properly,” one patient said.
- Side effects must be part of up-front discussions about treatment options.
“I wish I was given information on what to expect or look out for to see if it was working correctly,” another patient said.
- The potential for sexual side effects should be discussed openly and honestly to help alleviate unnecessary shame.
A mental health nurse told the commission: “[Sexual dysfunction] has a cascading effect on many aspects of a client’s life, affecting their self-image, relationships and quality of life.”
- Better understanding is needed if a patient decides to go off their medication.
“My GP was not happy when I told her about the experiment of going off meds when I went back to [see her about starting] again. Kindness and understanding is what is important for a person to learn from their mistakes and journey in life. Not being made to feel like a kid who doesn’t know what they are doing.”
- Every general practice should have a practice nurse who has experience in mental health.
“That way, any patient with mental health issues could be seen first by the nurse, who may be able to spend sufficient time with the patient to determine an appropriate intervention strategy,” one patient noted.
- Patients should not be made to feel like a failure if their condition d oes not improve.
“As a consumer I felt demeaned, powerless and desperate to feel better when none of the drugs helped at all and I was made to feel at fault,” one patient told the commission.
- GPs should have regular conversations with patients about how their medication is going and whether there is the possibility of safely reducing or ceasing the medication.
“Most of all, listen, listen, listen, listen to what the person with the mental illness is telling you about the medication. It is their feelings. It is their experience that really needs to be heard,” one patient recommended.