>>Jen Aboki: I’ve had a very tattered relationship
with medication. It’s not my favourite part of the journey. Often when you’re in the acute
setting in the hospital, which is where I was, they don’t really talk about other aspects
like ‘how are you going today?’ It’s like ‘here’s your medication, take it’. Medication
for me really represents from people are certainty that if you take this, you’ll be well. And
I don’t believe that that’s all you need to do to stay well.
>>Pat Beinke: I had to do what was told otherwise I would be put back in hospital. I was in
jail within my own body anyway but then I was also in jail with what they were telling
me. So I was outside but still not free. I really wasn’t in the right headspace to remember
too much of it because you’re a little bit like a zombie, I suppose you could call it.
>>Kerin O’Halloran: No-one wants to see their child diminished you know. She was a very
smart person. She was very clever. She had tremendous political wit. I mean you should
have seen her political cartoons [laughs]. They were really a joy. And then you see them
being diminished, bit by bit, because of a medication.
>>Dr Roderick McKay: The first key issue is medication should very rarely be the first
line option. Definitely for mild to moderate mental illness, first line option should be
looking at your lifestyle, things you’re doing, not doing. It also means looking at what sorts
of talking therapy you might be comfortable with. Clearly sometimes some people are not
comfortable with talking therapy. That’s legitimate as well.
>>Dr Michael Tam: The evidence would suggest that psychological therapies, interpersonal
therapies, more psychodynamic based supportive therapies, those sort of approaches I think
are really first line. People with the more severe end, severe spectrum of illness, using
pharmacotherapy – you would consider it earlier.>>Dr Roderick McKay: There’s never one right
medication. It’s always the right medication, for the person, for a purpose. What’s best
for a person is very much dependent on that person and their desires as well as the illness
they’ve got.>>Jen Aboki: To me medication represents the
whole clinical process of psychiatry, of hospitalisation, of the whole process that kind of ties in
with that. Taking medication every day means to me that you need to rely on something to
be well. And so what if that thing wasn’t there? Does that mean you can’t rely on yourself
to be well? The impact of knowing you need to take something forever or indefinitely
is really scary.>>Kerin O’Halloran: She became very toxic
often on medication. So we live with a lot of very severe side effects. She had quite
significant weight gain, she had breast milk, she looked six months pregnant, menstruation
had stopped. So there was all those very severe hormonal impacts.
>>Pat Beinke: I suppose it held me down a bit, it felt like to me, because I had to
do the monthly blood test, I had to make sure I was available to do that. It also makes
you tired. The weight issues and also heart problems. I’ve had a heart attack and I’ve
got tachycardia so they really have to monitor that.
>>Judith Mackson: So if you try to see it from a consumer’s point of view, when adverse
events occur, that they’re actually able to be appropriately managed, and being responsive
enough to see when things change. You need to step in and play a role.
>>Dr Roderick McKay: Medication for mental illness is the same as medication for any
other illness. There’s side effects as well as benefits. And so it’s being able to have
that conversation up front about the fact there are risks as well as benefits and discussing
with the person which risks they’re prepared to take.
>>Dr Michael Tam: Trying to make sure my patients feel comfortable having those discussions
with me is a very important part of making sure the right person gets the right medication
for the right length of time. It’s not just about mental illness, it’s also about the
whole person care.>>Dr Roderick McKay: Unless each person that’s
prescribing is actually aware of the range of problems a person has, be they physical
health problems, social problems, mental health problems, and the medications they’re on,
then things are likely to go wrong. In terms of how do collaborative roles work best, the
key thing is having clear communication and agreeing what the roles are. Because there’s
many ways of working best, but none of them work well unless you communicate.
>>Dr Michael Tam: I think at the moment unfortunately it does tend to be fairly fragmented. One
of the themes that tends to come out is that they have to repeat their story time and time
again to individuals and that becomes a very tiring process. It can be a very re-traumatising
process.>>Kerin O’Halloran: There was all this lack
of continuity. You never knew who to speak to. Just not working in a team.
>>Judith Mackson: I think one of the things that needs to be in place to enable a consumer
to get best possible care is the complete medication regime is known to your providers.
And also the goals of therapy, that the intention of the treatment plan is actually communicated.
>>Jen Aboki: They are very reluctant when I’ve told them in the past I want to get off
medication. I ended up bringing my husband along to an appointment and I said the same
thing to them and then they changed their tune. They said, ‘ok well if your partner’s
here to support you, ok we’ll look at reducing the medication’. I was upset that it took
that. Not everyone knows that they have a voice or a choice.
>>Pat Beinke: I liked going to see the psychiatrist. She actually showed empathy, she would remember
everything. She would obviously make her notes after the appointment. I suppose when you’re
schizophrenic and they’re writing in front of you, it doesn’t really help. I didn’t mind
just opening up and talking to her which made me feel comfortable just to talk and not hide
anything from her.>>Kerin O’Halloran: When it’s a team and everyone’s
equal, there’s kind of this open dialogue. To treat her with respect and give her a very
clear role in the decision making that is incredibly helpful.
>>Dr Michael Tam: Almost all the actual care is provided by the consumer themselves and
they’re carers. What we’re really doing in the longer term is empowering consumers and
the carers so that they can recover.>>Jen Aboki: I can look back and go it’s come
in handy when I have been unwell because it has gotten me well a lot sooner I guess than
if there wasn’t any medication available.>>Pat Beinke: Medication was a big part for
me obviously. It did help me. But, there is no one solution I don’t think for every single
person with mental illness. She actually wanted to help me get off the medication which was
brilliant. So I’m like, let’s give it a shot. It took three years. It’s been nearly a year
now, no meds.>>Jen Aboki: We need to be treated as equals.
The consumer has the lived knowledge and the lived experience and those are equally as