
Ever wondered how hard it is to get some antidepressants from a Doctor? Do you have to be referred to a psychiatrist? Do you have to see the Doctor a few times? Anti-depressants, I always thought were the last line of defence against depression, the most invasive of remedies, only prescribed after careful consultation and assessment. I was wrong - very wrong. It took me just 8 minutes and 32 dollars, with a GP I had never met before. I find this staggering, here’s what happened on Forensic Shopping Investigation IV.
I walk into a bulk-billing doctor at 8.45pm, after a quick wait I'm called into his office. I walk in looking rather dishevelled – my normal self, in my normal clothes, but very unkempt. The Doctor is a skinny, quiet, polite, and somewhat disinterested character. What follows is both hilarious and scary, and best captured in script form. To really understand what actually happened I suggest you mimic the Doctors behaviour, and finger type each of my answers into your computer before asking the next question. Also if you can, imagine the Doctor asking most of the questions whilst looking at his computer - not me.
Dr: What can I do for you?
Adam: I’m depressed. I have been for a few years, and I want to go onto medication.
Dr: (type, type type) Do you cry?
Adam: (Slightly startled, as it's a pretty weird follow up question) Ummm, yes.
Dr: (type, type type) How often, every day?
Adam: Often.
Dr: (type, type type) Is there a reason why….is there a history of mental illness in your family?
Adam: No.
Dr: (type, type) Are you paranoid? Do you hear voices?
Adam: No. I am not crazy.
Dr: (type, type type) Have you received treatment in the past?
Adam: I saw a psychologist a few years ago, but I haven't had medication.
Dr: (type, type type) You definitely need medication.
Adam: And there you have it. I have no idea why he came to that conclusion. I didn't ask, and he didn't tell me. I am stunned and find it incredulous. I don’t say anything and the Dr continues as he prepares the script.
Dr: I want you to take one of these every day and come and see me again in one week. We will then create a mental health plan. We will refer you to a psychologist.
He gave me a script, said a few reassuring nothings and then I was out the door. So if you want to get your hands on some ‘Efexor-XR’ and you’ve got 10 minutes to spare you too can have some. No referral to a psychiatrist. No assessment for self-harm or suicide. No assessment of immediate stressors or immediate action needed. No investigations into possible less invasive treatments. No assessment of social supports in my life. No assessment of another possible diagnosis.(i.e. manic episodes, anxiety). No assessment as to if I needed drugs or not. No challenge to my desire to get drugs. No interest as to why I thoughts drugs were the answer. No explanation how the drugs prescribed work. No explanation as to the impact or side effects of the prescribed drugs (which wiki lists as; Hypertension, Vivid/Abnormal dreams, Akathisia, Decreased libido, Apathy, Constipation, Headache, Nausea, Insomnia, Sexual dysfunction, Dry mouth, Dizziness, Sweating, Decreased Appetite, Abnormal ejaculation, Irritable Bowel Syndrome, Fatigue, Vertigo). This appears to be utterly crap health care.
I am not against anti-depressants, they help some people, some of the time (although based on this experience it’s likely they are massively over-prescribed). Nor am I against Doctors (of the MBBS kind), although I find it weird that they are the only profession in the world that is not expected to manage their diary properly - why do they always keep us waiting? Further, I have nothing against the individual Doctor I saw – it’s not his fault – he was doing the best he could, and seemed pleasant enough. However, my issue with what happened is simple ‘quality control’. Mental health is a serious, delicate issue, and ideally would be assessed and managed in a professional, respectful manner. What I experienced was totally inadequate. Putting someone on anti-depressant medication so easily, so flippantly, isn’t right. Anti-depressants should be seen closer to a last resort, rather than happy pills given to anyone who asks. Once on anti-depressants it can be difficult to come off them. Further, they may not treat the underlying cause of the depression. Again, it's not that they are all bad, it's just that they can be good, or very, very harmful - and should only be prescribed with utmost care.
Everyone from fast food chains, to banks, to my local café have actions in place to ensure there is a quality service delivered to its clients. They conduct mystery shopping. They conduct market research. They incentivise their staff when they perform the service in the right manner. What does the Australian Medical Association (AMA) do to ensure, once educated, Doctors deliver a quality service – do they do market research? Do they conduct mystery shopping? Do they incentivise Doctors on quality of service? Whatever they do – it wasn’t working when I saw the doctor.
I’m not depressed, and I haven’t been for many years. Based on my experiences tonight I consider myself very lucky.
- Depressed: Beyond Blue here, Inspire Foundation here
- Find a psychologist here
- Note to complain about a Doctor the AMA suggests you contact Choice! or contact your state board of the AMA. Further there is an interesting site called www.ratemp.com