Yes, in deed. Yet the time restraints on GP appointments, the unlikelihood that translators will be present, or that a language line translator will be booked make the exploration of the benefits or not of "treatment" extremely unlikely.
Rather than medicate the suffering of this client group, or any other, a compassionate health care system would look to the easing of material pressures as part of a holistic approach to the individual. Instead we now have a legal system which is dictating the process and availability of health care. It is very easy to reach for the prescription pad. I have one client who has clearly been struggling for a very long time. His GPs response is to medicate in increasing doses to what I think are alarming proportions. The client, however, sees the increasing strength of the dosage as an indication that he is very ill. This is an educated man, yet here he is isolated and despairing, destitute, without any regular place to stay and he is finding the struggle to survive this harsh system, which is so blaming and critical in its punitive view. The ultimate source of his unhappiness is that he is disbelieved in his account of the events which forced him to leave his country, does not know how to set about proving it, cannot find a solicitor as the numbers offering a service decline, cannot cope with the fear of return to his country ( where he was sufficiently afraid to attempt suicide and still bears deep scars), and has no where to sleep at night.
Yet another client who was abducted as a child , alleges that he was tortured by the militia and rebels , was branded with a hot branding iron ( in addition to the cigarette burns, graze scars on arms and legs from crawling on all fours in the heat of the desert), cannot sleep at night and yet the Home Office cannot give him a decision because t.
they want to know the significance of the number branded into his chest. Yet the GP gives him five to eight minutes and writes out a prescription for anti depressants.
The main problem is that we have institutional madness in government
Date: Thu, 28 Feb 2008 17:39:56 +0000
From: [log in to unmask]
Subject: Re: Anti depressants 'of little use'
To: [log in to unmask]
Re: the issue of seekers of asylum, refugees and anti-depressant medicatoin
The really dreadful thing in the context of people living with what some clinicians call 'PTSD' (Post Traumatic Stress Disorder)
is that SSRI medication is known to give some people nightmares, violent thoughts and suicidal thoughts. The medication can thus
actually heighten the trauma not dampen it. The patient continues to be viewed as having 'PTSD' and clinicians are largely unaware
that the 'trauma' being experienced by the client may not only be induced by their client's past experiences of horror, but may also be
induced by the medication prescribed by the clinician to treat it. Indeed SSRI's can amplify that horror to levels impossible for anyone to bare.
p
Paul Duckett
Division of Psychology and Social Change
Manchester Metropolitan University
England
Phone +44 161 247 2552
Fax +44 161 247 6364
email: [log in to unmask]
-----Original Message-----
From: The UK Community Psychology Discussion List [mailto:
[log in to unmask]]
On Behalf Of miriam hollis
Sent: 28 February 2008 10:29
To: [log in to unmask]Subject: Re: [COMMUNITYPSYCHUK] Anti depressants 'of little use'
The reality for the "patient' is that in their country of origin they may have been tortured, imprisoned for inordinate lengths of time without expectation of release, monitored, harassed, raped, repeatedly raped, witnessed the deaths or rape or torture of family members/friends/neighbours, and arrive in the UK (or other European destination) with an expectation that they will be protected.
What they face is a system desigend to repel them with only the modicum of respect still remaining for allegations of persecution. The Legal Services Commission has cut back yet again the number of paid hours for a practitioner to prepare an asylum case. Legal case workers are shutting the doors and changing their specialisms in the face of continuing changes to the practicality of a service provision.
Asylum cases are easy for a general practitioner at the outset. The new client is invited to come in, sign the form, tell us what happens, thank you and goodbye. The next time a client ,may speak with their practitioner could be on the day they have a hearing, despite perhaps many hundreds of calls to find out what is happening with their own particular case. Cases that are ill prepared dont come to the surface until Hearing date and then it is too late for the client to attempt to find the evidence that they need to support their allegations.
This is just the beginning of a new nightmare. Inadequate housing, shared accommodation with others similarly under stress, inadequate income, denial of the right to work whilst they wait, limitations on freedom of movement because of reporting restrictions and inadequate financial support.
Once the asylum claim is refused the client loses his or her accommodation within a fortnight. With the loss of their temporary home comes the loss of income. Further, they loose the right to have a home or an income. Destitution brings the end of all rights, and now the Home Office have withdrawn the right to healthcare except in situations of accident or emergency and a few small exceptions ( HIV treatment is not excepted - treatment can continue if treatment was started prior to the refusal of the asylum claim but access to anti viral drugs is not excepted). Interestingly, it is at this point that GPs start to refer to services such as ours. Now that the client/patient is destitute and desparate, penniless and brought to the lowest situation possible for them without actual return to their country and GPs are less able to prescribe, they cast around for services that can continue some care.
Anti depressants to this client group are glaringly inadequate. I note the comment that sometimes anti depressants can grant a temporary relief or "holiday" to symptoms. However, for this client group there is no respite. The awfulness of everyday, haunted by intrusive and destructive memories of the past, and without ongoing psychological or psychotherapeutic support, leaves a client on medication which is ineffective, entrapped within an environment which is at best isolating and destructive to the self esteem, and at worst on medication and destitute. A bottle of whisky on prescription would be a different, damaging but, in the short term, more effective.
Meanwhile, out of the despair of so many, pharmaceutical companies become wealthy drug pushers with their incentives to GPs.
Interestingly, such is the state of thinking about the power and status of medicine in this country, that seekers of asylum who claim to be suffering from any of the symptoms of depression but who are not in receipt of medication, are disbelieved at their Hearings - because if they were truely depressed ( an acknowledged and respected medical term hitherto) they would be taking regular medication.
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