Sir, – One can only empathise with the health difficulties experienced by the individuals referred to in Laura Kennedy's article "My grandmother was sectioned. She became a creature of her psychiatrists" (People, June 16th). I encounter people with similar challenges on a daily basis. In this regard, might I suggest that the article's headline is somewhat stigmatising to individuals experiencing severe mental health difficulties, giving the impression that if they seek help they will lose their autonomy? In my experience, such words often create a barrier to help-seeking that, in turn, reduces the chances of meaningful recovery. We should not forget that untreated severe depression carries a mortality of around 10 per cent.
In general, medicine is not an exact science and psychiatry is no different. Diagnosis in psychiatry can be challenging but it is not nearly as ad hoc as is implied in the article. Listening to the patient and their family is the first step. Beyond this, psychiatrists take a systematic approach to diagnosis, using the World Health Organisation's International Classification of Diseases (ICD-10). This allows for an evidence-informed approach guiding an individual's personal journey of recovery.
Most psychiatrists that I know lose sleep over their severely ill patients. Rather than “imprison”, many are under considerable pressure not to admit their patients to hospital because of a scarcity of beds. Where involuntary admission is unavoidable, the Mental Health Act 2001 ensures vulnerable patients’ rights are protected. Indeed, psychiatry is one of the most heavily regulated professions in the country, coming under the scrutiny of the Mental Health Commission, the Medical Council, the courts and various other overseers.
One final point. Effectively telling the public at large that “the drugs don’t work” is not very helpful, particularly when statistics are quoted out of context. Although it may be true that only 40 per cent of people taking first-line SSRIs report an improvement in symptoms, it is important to note the broad range of other medications and treatment options available that bridge the gap. This treatment is based on thousands of peer-reviewed papers in reputable international journals that influence rigorous international guidelines.
Depression in 2017 is very treatable. – Yours, etc,
Dr STEPHEN
McWILLIAMS,
Consultant Psychiatrist,
Saint John of God Hospital,
Stillorgan,
Co Dublin.