"Treatment of my daughter's depression highlights the need for change"
About: Leeds and York Partnership NHS Foundation Trust / Adult mental health Leeds and York Partnership NHS Foundation Trust Adult mental health LS15 8ZB Leeds and York Partnership NHS Foundation Trust / Child and adolescent mental health Leeds and York Partnership NHS Foundation Trust Child and adolescent mental health LS15 8ZB St Mary's Hospital / Young adult team St Mary's Hospital Young adult team LS12 3QE
Posted by tracy1 (as ),
My daughter was 17 when we embarked on this journey in late 2009 with a visit to the GP with concerns over depression, however it took until January before the concern had peaked and she was taken to our GP who felt that she was suffering from more than clinical depression. (She had made a suicide attempt by this point).
She then went on to have the following appointments:-
1. January 2010 Community Mental Health Team - it was felt she was showing signs of bi polar and referred on further.
2. February 2010 - Appointment with a psychiatrist at St Mary's hospital in Leeds, after assessment a diagnosis of bi-polar with hypomania. This meeting was very helpful and my daughter liked and trusted the doctor. Tests were needed as Lithium was to be prescribed with referral for CBT.
3. March 2010 - Appointment with psychiatrist to start medication, however, we were told on arrival that the consultant psychiatrist would not allow her to be treated or given the label of bi polar as such a young age, but no other option was provided other than to the support of her mental health nurse. We requested an appointment with the consultant to establish what was to happen next. Also provided a letter from school with details of her changes in behaviour which included an episode of mania to support the evidence, I feel this was ignored by the consultant.
4. April 2010 - Met with the consultant but my daughter had not slept for 72 hours and was very hyper on the day of the meeting, she was also angry as she felt that the consultant had removed her ability to obtain the help she so desperately needed. This meeting was horrendous to say the least, my daughter left in floods of tears and very angry saying that she felt that she had not been listened to and that he was only concerned with trying to find a trigger.
His comments to me were that he felt she was not bi polar and that her problems were psychological and personality related but he would not be making a referral to the psychology team at this point. I stated my frustration and asked the question "is it because of her age?" which he denied. Given that she was having serious issues sleeping, unable to function on a daily basis and was forced to give up the first year of sixth form due to her condition, we were highly dissatisfied.
I arranged for a private psychological assessment and report to be carried out which was very expensive ( whilst I do not in least begrudge paying for this, we were in the fortunate position of being able to find the funds, however, this is not a luxury afforded to everyone and I feel it is inexcusable that we were forced into a position of arranging it through desperation to help my daughter). This took a number of weeks to complete as she needed to be assessed thoroughly. It was ready by July 2010.
The outcome was a diagnosis of bi polar II and that she had no psychological or personality disorder. This was sent on to the hospital and the GP, it took a lot of chasing to finally get an appointment in August 2010.
In the meantime I contacted PALs for support and information - I will not make much reference to this as they cannot be faulted in any way and were absolutely fantastic in their understanding, support and assistance as and when it became necessary. They have been invaluable and greatly appreciated.
5. August 2010 - again told it was inconclusive and he was reluctant to provide medication, but would give her something temporarily for three months as a trial. Apriprazole was recommended and we agreed only because of the few side effects (he did say that it may have a placebo effect!) we have subsequently been told that this medication actually made her depression worse, which was obvious as she has spent the last three months almost permanently depressed. A referral was to be made to the psychology team for CBT.
Further contact with PALs as we were at our wit's end as my daughter has not improved at all and has now missed nearly a year of school without any practical or medical assistance other than her mental health nurse (again, she was lovely and my daughter felt she benefited from having her there to help, she also agreed that my daughter needed help).
A second opinion was sought and at the beginning of October she was seen by a bi polar specialist for assessment.
After this meeting we asked PALs to have a transfer of psychiatrist as we felt that after so many assessments and nearly of year of monitoring, even if another doctor agreed she was bi polar, nothing would be done to help her. This was arranged very quickly and efficiently, again thank you to PAL.
October 2010 - meeting with the bi polar specialist psychiatrist who agreed with the psychological report and confirmed bi polar II, she is now on medication suited to the condition and this will gradually be increased to the correct level until she is in recovery. This current doctor is lovely, very understanding and most importantly listened to everything my daughter told him and in my opinion has treated the whole person.
Due to her age, this has taken a year to resolve, the system needs to be changed as mature adolescents are different to adults and should be treated accordingly. I really do not want another teenager to go through the experience my daughter has endured over the last 12 months due to the system not being able to cope. They should stay in the adolescent until treatment begins or be referred there when they are close to 18. Both myself and my daughter feel that the Leeds mental health trust let her down badly and unnecessarily made her suffer for a whole year.
She had said herself, that without the support and love from home and the help from PALs that the outcome would have been awful, she feels she would have made further attempts on her life. Please look into providing better services for this very vulnerable age group. (This story has been posted with the full agreement of my daughter who is now 18.)