The folks who work in my local community mental health (CMHT) team maintain good communications between the different people on the team. If I’m having a problem with my medication, I can phone up reception at CMHT, who will page the SHO doctor in question. I’ve had to do this a number of times, for various reasons, for different SHOs and each time they never fail to ring me back within the hour.
If I need to ring the crisis/out of hours team, they always pass my details along to my doctor, who may call me a day or two later.
When I need to see my GP about a med problem and communication is needed with the mother ship at CMHT, again, communications are clear and timely.
Why am I posting this?
Because it’s so much not the norm that I have been used to it just flat out amazes me every time. Also, because this good communication has been essential in keeping me out of hospital this time round. In Big Dublin Hospital, you could be all day trying to get a doctor paged. They likely as not would never ring you back. You’d have to keep chasing for the simplest thing and the admin staff would throw up their hands and say they couldn’t do anything. I’m told this tends to be the norm around the country and I’m very lucky where I happen to live now.
If I’d had the past few months without the good back-up I’ve had from CMHT I would definitely have had at least one brief hospitalisation. Just the extra stress of trying to manage getting in touch without everyone would have done it.
This stuff REALLY, REALLY, matters. Which is why I am posting it.
Dee Dee…. this is indeed amazing, and I guess peaked my curiosity because of recent personal experiences. I was just released after a two week stay at our local mental health unit. Psy Doc in there proceeded to tell me that my private psycologist would no longer be seeing me as I had used the 18 rebated sessions the Aussie govt provided. I freaked..as this was not what my psycologist and I had discussed, and we had already previously come to a private arrangement to use what was available through my private health rebates and then on a pro-rata basis till the end of the year. In my fragile state, I felt this was her way of safely abandoning me while I was ‘locked up” so to speak. When I rang her, she was horrified that I had been told that and reiterated that she had told psy doc no such thing, he had just assumed, and our previous arrangement still stood upon my release. She then spoke again to my treating team in the hospital to confirm her commitment to stay my private psycologist after I left the hospital. DESPITE this I was still assigned a psycologist as a case manager upon release, instead of the standard nurse/social worker ect, who was ALSO told I would be finishing up with current private psychologist. So now, three days out of hospital am in the confusing situation of having TWO psychologists, one private, one public! This added to the other ‘ists’ I have now acquired pyschiatrist, nutritionist, neurologist…….sheeesh!
Second communication balls up, came in the from of psy doc at hospital telling me I would be released later in the week, but the eact day would be decided by myself and case manager…. case manager was seen on monday, but said nothing about release… and then *crickets chirp*…nothing! By Wednesday I asked to see psyc doc again who said in an ever so blase way, oh, yeah…you can go home today I guess….
I do not like hospital… but by far communication is one of the worst attributes of the system. Each shift we were assigned ‘our nurse’. If you wanted anything meds, a chat, to charge your phone (no chargers allowed on ward) to open the laundry door, you had to find YOUR nurse…no other nurse could answer even the most innocent of requests and of course some days it would take a couple of hours just to locate YOUR nurse…. and this was by no means a big ward….
End of story is…am feeling a little better and VERY glad to be home!!
I must say, the communication between my local CMHT is pretty good too. I see a psychiatrist, a CPN and, when I’m being a miserable git, a support worker. They all seem to know what each other’s doing.
Sometimes, communication between services is better than I’d like it to be. I ended up in A&E once after self-harming, and the doctor contacted psychiatric liason (even though I had told him I didn’t want to talk to them – I was fine and just needed to be patched up). When the liason team tried to phone me and I didn’t answer, they contacted my GP who then contacted my CPN. This was all done within 24 hours. I was rather annoyed at the time as I’d really wanted to get the whole mess sorted without getting anyone involved. Never happy, me…
Absolutely right -
My psychiatrist and my GP, who are both competent enough individually, seem to be unable to communicate with each other. For some reason my psych decides on medications but my GP is the one who actually writes the presciptions. When I call my GP up to get my prescriptions refilled I almost always get one which is either months out of date, or just plain wrong.
My GP also has a habit of “helpfully” editing the prescriptions on her own initiative e.g. changing three 15 mg mirtazapine tablets per night into one 45 mg tablet. I guess that makes sense in theory but taking 45 mg mirtazapine in one go can be a somewhat “intense” experience which is why I asked for 15 mg pills so I can split the dose up a bit…