UK Group Wants Consensual Tx Laws; Consumers Not Heard in Tx

Mentally ill 'treated poorly' Sept. 24, 2001 Psychiatric patients are given no say in their treatment - particularly if they are from ethnic minority groups - a report by mental health charity Mind says. A survey of patients' experiences found they feel they are not told about potential side effects and that doctors do not listen when they have concerns. Mind says the situation is "appalling". Both problems were worse for black and ethnic minority patients. Mind analysed 500 "yellow cards" sent in by people with mental health problems between March and June this year, who had suffered adverse side effects from their drugs. The yellow card scheme, first used by Mind in 1995, is based on the system doctors and pharmacists use to report side effects to the Medicines Control Agency. One Black British respondent to the survey said: "Doctors will not listen to, or respect, what the patient says about side effects, which makes it hard to trust them and put your faith in their ability to get it right." Side effects Sixty-one per cent of those who responded to Mind said they had not been given enough information about side effects, rising to 75% of people from ethnic minority groups. Almost two-thirds said they had decided to stop their medication, and 45% reduced their dose, mainly because of unacceptable side effects. There were also examples of doctors continuing to prescribe drugs when they were told they were making people feel worse, and in one case suicidal. Sixteen per cent of cards were sent in from people from ethnic minorities. Language difficulties in particular were linked with a lack of information about diagnosis and treatment. People taking the new generation of SSRI and related antidepressants were most likely to suffer anxiety, nausea and suicidal thoughts. They also found the drugs the most difficult to stop taking, and said doctors were unwilling or unable to help them stop or reduce their dose, even if they were suffering from severe side effects. And although 64% of those who went to their doctor for advice found them helpful, but that compared to 80% of people who went to a non-medical source of advice. Schizophrenia, depression and manic depression were the most common diagnoses. The most common drugs to be prescribed were older anti-psychotic drugs such as chlorpromazine and haloperidol (22% of all side effects reported), SSRI antidepressants such as fluoxetine and paroxetine, (18%), atypical antipsychotics, such as olanzapine and clozapine (14%) and antimanic drugs such as lithium and carbemazepine(13%). The most common side effects reported were weight gain (25%), muscle shaking or tremor (15%), loss of energy or lethargy (14%), feeling sick or nauseous (12%) and stiffness, or a stiff neck or jaw (12%). 'Lack of information' Mind is calling for more information about the side effects of drugs, and better access to information for people from minority groups. The charity also wants a new Mental Health Act which stresses the importance of consensual treatment, and more support for people who want to stop taking their drugs. Richard Brook, Mind's chief executive, said: "It is appalling to see Mind's latest yellow card survey results continue to show the lack of information and choice individuals have using medication. "It concerns me particularly that people from black and ethnic minorities find it so hard to obtain appropriate information." The Royal College of Psychiatrists is currently looking at how to improve services for patients from black and ethnic minorities. Dr Roger Freeman, a general psychiatrist and spokesman for the college, told BBC News Online it was not surprising people from ethnic minorities felt they received a poorer service. He said doctors needed to try to address language and cultural differences. But he said the drugs doctors had to treat psychiatric illness did have side effects. "Unfortunately we don't have the perfect drugs to treat them and the drugs that we have do have side effects." "I don't want to be too defensive, but doctors do feel they need to encourage people to go on taking their pills." BBC Online
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