"Mental health service failures"

A few years ago now, I presented to FSH ED to seek help for an acute mental health crisis, following a misdiagnosis of bipolar disorder and intolerable treatment (mood stabilisers that quite literally ruined my life) from a public psychiatrist at another centre.

I was admitted (at my request) to the MHU. Over the course of my 12 day stay, it was determined by the psychiatry team after many assessments, interviews, several medication trials and much observation, that I did not in fact meet the criteria for a bipolar diagnosis, but rather that I met the criteria for an ADHD diagnosis (which subsequently resulted in anxiety and depression due to remaining undiagnosed for so long).

I was discharged feeling hopeful that, after decades of being unable to identify why I felt so different to others and suffered such debilitating chronic depressive episodes, that I was on the right path to finally feeling better.

I was wrong.

I was sent home with a 3 month supply of a non-stimulant (but still unable to be prescribed by my GP) medication, advice to seek a referral to a private psychiatrist (absolutely insane, in my opinion, that the public MHS disregards and refuses to treat or manage adult ADHD, but don't get me started on that apparent particular failure) and a letter from the consultant psychiatrist confirming an initial misdiagnosis of BPAD. It outlined, in detail, supporting evidence for a diagnosis of ADHD. However, for some mysterious reason, (despite it never being discussed with me by any member of staff during my stay nor being acknowledged in said specialist letter) my discharge summary included a medication list in which my SSRI was attributed to borderline personality disorder.

This has followed me like a bad stink.

I have been referred to a grand total of 14 (yes, fourteen!) psychiatrists in the past few years since my admission. Reason being? As I understand it, BPD is too hard. I don't believe I even meet DSM criteria for that diagnosis! I am furious to this day. I was accepted by and saw exactly one of those psychiatrists. It went exactly nowhere, as both my GP and psychologist outwardly laughed when I presented them with their assessment. I felt it couldn't have been more of a waste of time or money if they tried.

To this day, I am still stuck in limbo, my condition not being managed appropriately and still unable to access appropriate care. I am at my wit's end. My GP has expressed similar sentiments. I would not be surprised if they have nerve compression from all the referrals they have had to write for me.

Having both studied nursing at university and having worked in health for the better part of a decade, I absolutely understand the limitations of outpatient psychiatry services. It is difficult to accurately diagnose mental health conditions for so, so many reasons. It is infinitely harder to diagnose mental health conditions when patients are seen in 10-30 minute blocks by clinicians who are unknown to them.

I feel very strongly that with the current system, public outpatient psychiatry is absolutely the wrong setting in which to attempt to (and in my case, actually) diagnose mental health conditions as 'serious' as bipolar disorder. If someone with my health literacy, insight into my own condition and ability to advocate for myself has been failed, I wonder how many people with less fortunate circumstances or more disabling mental health conditions are being failed?!

I feel something, somewhere, has to change.

Based on my experience, do better.