Well, I was having quite a good day . . . until the post arrived, bringing with it the reports prepared for my tribunal, which is supposed to take place on 29th February.
There are TWO medical reports. One gives my diagnosis as Paranoid Schizophrenia. The other one, presumably the second, says it is Schizoaffective Disorder, but goes on to add It is also felt that she has an underlying Emotionally Unstable Personality Disorder. *SIGH* Maybe it’s time I just accepted it? I *do* have an intermittent history of self-harm, after all.
In her last admission in 2014 . . . Jane had also thoughts that she a broadcasting device was placed in her brain. Quite apart from the question of how I’m supposed to trust people who can’t even write English, I’m pretty sure I’ve never said anything of the kind!
When seen at her last ward review . . . her care co-ordinator felt that there had been evidence of psychosis during her last 2-3 visits, stating that she had appeared distracted, possibly responding to unseen stimuli. She continued to report low mood with suicidal thoughts. Furthermore she complained of auditory hallucinations and thought interference . . . She reported contact with her psychologist . . . although was reluctant to disclose details regarding this.
The nature of Miss Sage’s illness is that the condition is associated with significant risks to her own health and safety when she deteriorates. This includes historically exhibiting suicidal thoughts, taking an overdose of her prescribed medication and trying to end her life by attempting to run towards traffic. I’d really like to know when I did that!
The current degree of her illness is considered to be severe . . .
. . . she would pose a significant risk of harm to herself. It is also likely that she would struggle to function adequately at home in terms of self-care which would increase the risk to her own health . . . At the current time she has limited insight into her illness . . . It is highly likely therefore that she would no longer take her medication resulting in further deterioration in her mental state
The nurse’s report is mostly more of the same stuff, and in addition:
Jane has fluctuated in her expression of needing or wanting mental health services and about her diagnoses
Jane will attend to many of ADLs however she does struggle with this and require prompting at present
Jane spends a lot of her time using social media and blogs . . . has a strong sense of peer support on the online community of Twitter
Jane is seen in community clinic . . where she receives CBT, which she states is helpful. (!!!)
The most interesting one is the social circumstances report, as this lists all my history:
1988 – Significant weight loss. Jane had diagnosis around this time associated with anorexia nervosa and bulimia nervosa
1990 – Jane saw psychiatrist age 17. No records from this assessment.
1996 – Jane attended counselling, reported excessive alcohol abuse, cannabis misuse, ectasy, LSD, speed and cocaine
2007 – Diagnosis depressive disorder. Admission into hospital following an overdose of zopiclone and tempazepam mixed with large amount of alcohol. That was the joyous time I woke up on a medical ward with absolutely no memory of the night before. I was most put out – it was the first time I’d been in an ambulance and I wasn’t around to experience it!
2008 – July admission as not feeling safe at home and thoughts of suicide, burnt face with a candle. Diagnosis depressive disorder and emotionally unstable personality disorder. September/October admission requiring section 3
2010 – September admission initially informal then placed on section 3. Command hallucinations telling her to hang herself.
2011 – Diagnosis recurrent depression and possible dissociative disorder. February informal admission then placed on section 2 elevated mood, voices derogatory in nature, suicidal ideation, June diagnosis of persistent mood disorder, type 2 bipolar affective disorder. December – informal admission. Jane was increasingly paranoid, persecutory delusions, sleep disturbance. Diagnosis paranoid schizophrenia/persistent mood disorder.
2012 – February admission following an overdose of 50 zopiclone tablets, isolative and low in mood. Diagnosis persistent mood disorder. March – May admission following low mood and suicidal plans.
2014 – June – December admission following increased paranoia and hallucinations. Low mood and thoughts to harm self.
Doesn’t sound that great, does it, when you list it all down like that?
She thinks that she is well without the medication, despite evidence that Jane’s mental health deteriorates further without the medication . . . Once discharged . . . her CPN would monitor for medication adherence and assess the risk if Jane’s mental health deteriorated again . . . she has a tendency to stop all of her oral medications and not inform any of her care team . . .
I’m not sure whether to cancel the tribunal or not. They’re not going to let me out (though then again I do seem to be much better this week, so maybe?) The only point I can see to going ahead with it would be to get the independent second opinion I’m entitled to, to seek further clarity on my diagnosis (I don’t then have to submit the report to the tribunal). Is it worth doing that? Does it matter if I have the wrong diagnosis, if I’m getting the therapy I need anyway? Any thoughts?