The Age. 23/2/04

Why my daughter killed herself

Referring to mental illness and suicides my daughter is one of those who did commit suicide.

Her experiences of casualty departments were awful. She was treated very disrespectfully , and was even told at one stage that she was selfish because all the other people in casualty had "real" illnesses - the absurd assumption being that mental illness is not "real".

The effect of this on her - an intelligent medical student was that she found progressively more extreme ways to try and kill herself, precisely so she could avoid the punishment and derision she now assumed she would receive from staff in casualty and intensive care if she were found and revived again. This meant that she eventually found a place to die where she would not be discovered and employed a method she absolutely knew would not let her down.

Yes Patrick McGorry (22/2), we do need to spend much more money on mental health - but the value and attitudes of health professionals towards mental illness also need to change, and this might not be achieved solely by the infusion of more resources.

This is no way to treat my patients

I am a junior psychiatric doctor in a Melbourne Metro community mental health clinic. What I do with my patients is tantamount to abuse. To them, for 20 minutes a month, I resemble a vending machine. They punch in answers to my five quick questions and receive their next packet of medicine (costing the PRS up to $400.per month).

They are distressed. They need to talk . But there's only one of me and many of them. I wonder which they would prefer to get 15 more hours of my time a month($26 an hour ) and take $20 per month drug with more side effects, or have the newest dearest drug based on a rapid military-style assessment. Who knows if they actually felt listened to, they might not leave the clinic and commit suicide, or keep bouncing back into the emergency department or the psychiatric ward.

The nurses haven't been pushing for humane / nurse patient ratios because they want to have more cups of tea in their day. They just want to give patients more time than it takes to turn a screw on the assembly line. The mental health system is geared to deal with more people more quickly than ever before. Is it a cause or a consequence that it has more mentally ill people to deal with than ever before?

We have better, more expensive psychiatric drugs than ever before. Is it a cause or a consequence that there are more people on them than ever before ?

Dr Kaveh Monshat.

Why are there no beds in the inn for mental patients?

I would like to comment on the subject of mentally ill patients not having access to adequate care in Victorian public hospitals (the Age 19/2 - 20/2/04). Our family had the misfortune to be caught up in this horrible mess recently. Our daughter took three overdoses and threatened and (actually succeeded) in harming herself on three separate occasions.

We presented her at the emergency department at Maroondah Hospital each time After a lengthy wait, she was examined physically and told she could go home. She begged to be admitted, as she knew there was something very wrong with her. On one occasion she climbed on to a high embankment outside the hospital and threatened to jump. She actually slipped and grazed and cut herself and had to be admitted back to emergency for treatment, still to be told to go home.

Our daughter was told she would be held in emergency while they tried to get her a bed in the psychiatric ward.On the third attempt the next day, she was finally admitted and told she would be held in emergency department while they tried to get her a bed in the psychiatric ward. After two hours we were told that there wasn't a bed available in any public hospital. She subsequently spent four days in the emergency department and then spent a further four days in the psychiatric ward at Maroondah. I also feel sorry for the doctors and nurses who have to work in these conditions. It is very obvious that resources are not available in this area, and I agree that serious money needs to be put into mental health services.

Mother.