From emails received-what is the point of being offered services that drop us quickly?

Hi there   I'm a service user of clinic 7 and am dismayed at its proposed closure. I have suffered from depression and anxiety since my adolescence and have experienced many types of treatment. I was referred to Dr Malizia 2007 when I was depresssed and suicidal. My GP tried to refer me to the community mental health team but they refused to accept the referral, despite me being a single parent with no family or support in Bristol. According to my GP they will only accept referrals if the client is psychotic or schiophrenic, this applied both then and now. I believe that the Psychoparmacy team, and Dr Malizia literally saved my life and provide a unique and invaluable service both for patients and for GPs with nowhere else to refer depressed patients.   I have contacted PALS at both AWP and Bristol PCT and they have advised me that a letter will be sent out shortly informing patients of the closure and providing individual alternatives. I am very curious about these alternatives as I feel from past experience that they dont exist.   Please let me know if there is anything I can do with you to help fight this closure. It seems to have been triggered by the loss of funding from the university and I wonder if its worthwhile contacting them also? I have discussed thsi with my GP and he is writing to Bristol PCT so it maybe useful if other people could also encourage their GPs to write in. My only other thought is whether we can demand a full consultation before the clinic is closed, but I dont know if AWP is obliged in any way to do this. Let me know what you think   regards

Letter from a service user (edited for confidentiality)

Laura McMurtrie

Chief Executive Officer

Avon and Wiltshire Mental Health Partnership NHS Trust

Jenner House

Langley Park

Chippenham

SN15 1 GG

15 May 2012

Dear Laura McMurtrie

I am angry and dismayed to learn that the Psychopharmacology Unit is to close. I have been a service user of the clinic for several years and it has literally given me my life back. Experiencing severe depression not only destroyed my life but also that of my husband and family.  Depression led me to feel unbearably sad, hopeless, ashamed, worthless and unable to function emotionally, cognitively and functionally. The worst part was an inability to have feelings towards my husband and family. I felt dead inside. I had to give up my job as a clinical nurse specialist and lecturer in palliative care. I had reached the point of despair despite the best efforts of my specialist and the clinical team. I remained severely ill. I rarely responded to medications, ECT and psychological therapies and required numerous admissions to my local mental health unit and intensive care in the community. I did not want to live. Eventually my specialist considered that my local services had run out of options and with the approval of xxxxxxxxt I was referred to the Psychopharmacology clinic at Bristol.

I met Dr Malizia, whose kindness, compassion and clinical skills are unique in my experience, and for the first time in five years I started to realise that treatment resistant severe depression could be treated and overcome. Xxxxxxxx .............. Unbelievably I soon started to recover. Over the next few months my emotions, cognitive skills and functional ability returned. My family was overjoyed and for the first time in ten years I began to feel like the xxxx I thought I had lost. Words cannot express how grateful my family and I are xxxx

The Psychopharmacology clinic is unique and offers support, treatment and hope to those service users whose mental health teams, however skilled, are unable to provide. Its loss would deny individuals like me the specialist skills available at the clinic. To lose such a centre of excellence, built up over a number of years, is deplorable and short sighted. Depression is a significant cost to the NHS and a centre which offers the hope of recovery through innovative treatments should be treasured not disbanded.

I would like to know why the clinic is shutting and how it was decided and by whom. I believe I am entitled to this information under the Freedom of Information Act. I hope you will reconsider this decision. I look forward to your reply.

Yours sincerely

Letter from a relative

We have been attending Clinic 7 for at least 5 years on a regular basis and I don’t know how we would have coped without these appointments and decisions on P’s medications.

Over the years we have seen many consultants who have tried most of the medications available.  P’s previous consultant actually told us he could not do more for P and referred us to Dr Malizia.

P’s current consultant  is kept informed of P’s progress.  She is very keen on ‘talking therapies’ of which P has had many.  In patients with moderate depression I am sure they are very helpful, but such is the seriousness of P’s depression they have little if any long term effect.  She has told us she would not be happy prescribing P such high doses of anti-depressants, and I don’t think she would.

So you can see that he really does need the continuing support of Clinic 7.

There are many other patients who suffer to the degree that P does, who do not have a carer or close family member as vocal as I am, and have no one to speak up for them. It is a very isolating and lonely illness and has devastating effects on family and friends.  It is still, unfortunately, greatly misunderstood, and generally people are not keen to get involved.

Other serious medical conditions have ‘Centres of Excellence’ to deal with and treat serious illnesses, and I hope that Clinic 7 will be able to continue and if possible receive more funding for clinical help and research, to try to help these people with this devastating illness.

If you an use this letter do so by all means, and if either of us can help in anyway, maybe by talking to interested parties, we would be very pleased to do so.

First follow up and news

Firstly, thank you to everyone who has posted a comment and to all of you who have emailed me directly. It is very encouraging to hear so many people who feel as strongly as we do, though not at all surprising. I know some people have struggled to post comments - I think I have fixed this now so please feel free to comment anonymously or otherwise - I look forward to hearing from you. Even if you prefer to remain anonymous do send me an e-mail- we will need to contact you all when it comes to action.

I have been wondering where to go with this blog and what to do with the many suggestions from the emails and have come up with the following:

• I have updated the information sheet as there have been a couple of changes that are important to know about. The first is that the chair and chief executive of AWP NHS Trust (www.awp.nhs.uk) are currently no longer in post so there are new people to write to. The others relate to some comments made in the blog and  to the fact that a person involved with a number of depression charities has become interested in our plea. Finally it is of interest that AWP does not list this specialist service in its website, in spite of the fact that it has served the local and regional community for 20 years.  Please ask for the sheet by emailing psychopharmcare@gmail.com
• Apologies to those of you who are users of the clinic who do not have depression or anxiety- we don't want to exclude you- quite the contrary as your illness may affect motivation less than depression and therefore you may be more able to take action. Join us actively- the email address reflects the concern about the clinic - the blog started with my frustration.
• I will use the blog to publish stuff that I have that is useful to those of us directly or indirectly affected by severe depression. Clearly this goes beyond the closure of a local clinic in Bristol - important though this is to those of us who have benefited from it. The issues of mental illness, its treatment and attitudes to it affect many people across the UK where it has long suffered from being the poor relation in the world of medicine - and they go beyond our own borders. To this end, I have been  in contact with Dr Malizia and he has kindly agreed to contribute some short articles with useful advice about various aspects of mental health and depression. For obvious reasons, he can't comment on the closure of the clinic but I am delighted he can support us in this way. Please email or comment if you have any suggestions of topics you would like him to comment on and please pass on the link to this site to anyone you think will be interested in hearing from one of the experts in the treatment of persistent depression. Start following the blog by pressing the button!
• Separately, I am contemplating mobilising an official protest at the closure of the clinic and I am asking for anyone who wishes to support this in any way to contact me directly on the email below. I already have some people who are prepared to make a stand in principle and would love to hear from anyone else prepared to get involved. Contact me and I can share with you some of the ideas so far. Don't forget, if we cannot demonstrate that the service is important it will die. We will be offered 'local' alternatives initially and we all know that however well intentioned, they didn't work before and are unlike to work now. In addition I can see that the current mantra is that everyone can be discharged until the next crisis. If the same principle applied to severe diabetes, services would only exist when people become comatose

email: psychopharmcare@gmail.com