[First in a series of short blog posts about the Scottish Parliament debate on Mental Health,Tuesday 6 January 2015, at which I was a spectator in the public gallery. Pulling out points that struck me as a common theme, a concern or a lack.]
The HEAT target for psychological therapies set by Scottish Government, reducing to 18 weeks by December 2014, has not being met by 10 out of 14 Scottish health boards. This was a resounding message and warning highlighted during the 90 minutes of speeches, interventions and motions.
Mary Scanlon MSP said “the commitment to 18 weeks from referral to treatment for 90 per cent of psychological therapies patients was met by four out of 14 health boards. More than 14,000 people throughout the country are still waiting to be seen. That is not good enough.” I agree.
Meanwhile psychiatric drugs, antipsychotics and antidepressants, are freely to hand, forcibly given if resistant when a psychiatric inpatient and looking for alternative talking treatments or a listening ear. I blame the biomedical model of mental illness for dominating the discourse and tying people in to long term mental health service use and physical disabilities.
I was concerned that there was little mention of the continual rise in antidepressant prescribing and no mention of the issues that some people face on these drugs, the black box warnings of suicidal ideation, the difficulties in withdrawing and coming off antidepressants. The numerous other side effects that are written in the pill box leaflets. For example:
Venlafaxine adverse effects (I was on this drug, maximum dose for at least one year, 2002/3, it didn’t lift my mood, I took an overdose, was very flat & unmotivated, got bone loss & leg break, burst blood vessel in eye, raised blood pressure)
Very common (>10% incidence) adverse effects include (from Wikipedia):
- Headache — an often transient side effect that is common to most serotonin reuptake inhibitors and that most often occurs at the beginning of therapy or after a dose escalation.
- Nausea — an adverse effect that is more common with venlafaxine than with the SSRIs. Usually transient and less severe in those receiving the extended release formulations.
- Asthenia (weakness)
- Ejaculation disorder — sexual side effects can be seen with virtually any antidepressant, especially those that inhibit the reuptake of serotonin (including venlafaxine).
- Dry mouth
Common (1–10% incidence) adverse effects include:
- Abnormal vision
- Weight loss
- Night sweats
- Menstrual disorders associated with increased bleeding or increased irregular bleeding (e.g. menorrhagia, metrorrhagia)
- Urinary frequency increased
- Abnormal dreams
- Decreased libido
- Increased muscle tonus
- Abnormality of accommodation
- Abnormal ejaculation/orgasm (males)
- Urinary hesitancy
- Serum cholesterol increased (especially when treatment is prolonged and it may be dose-dependent)
I contend that Scottish Government should be putting resources/money into the provision of psychological therapies so that people can have access to these instead of being forced to swallow pills. It makes economic sense to provide alternative ways for people to manage their mental pain and emotional distress that doesn’t mean more issues in the short and long term.
See Herald article 8 January 2015: ‘Scottish Government in record £444m underspend‘.