Private Psychiatric assessment advice

[Rob2020]

Hello everyone, I wonder if anyone can offer me some advice.  It’s a long story so I’ll try and make it short.  I’m a British citizen but I’ve lived abroad for quite some time now.  I am receiving thorough treatment for a variety of chronic mental health issues but the general health paradigm in the country where I reside seems very different to how treatment is approached in the UK.  Not saying it’s better or worse but it’s different and not really what I was brought up on.  Bottom line is that I’m uncomfortable with the sheer volume , mix and dose of medications that I’m currently prescribed.  My psychiatrist is supposedly eminent in his field and certainly seems accomplished.  On the other hand , his treatment regime seems a little unusual or even cavalier against my untrained but UK-centric expectations.  Frankly, I don’t know whether I properly trust that he’s recommending the right things for me.  I want to believe that he is..... but in the back of my mind I’m uneasy.  Worrying about whether your psychiatrist is actually some mad professor, seems ironic when you’re being treated for anxiety related stuff.

So, I’m considering an investment in a top notch second opinion from a UK based psych.  I’m only going to do it once so, within reason, I’m OK with whatever it may cost.  But, I don’t know how to go about finding someone who truly is a recognized authority and who I could get to see on a private one-off basis.

Could anyone suggest how I could go about locating such a person ?

[Atra]

Hi @Rob2020. It is a difficult question. My very narrow and flawed understanding of UK mental health procedure is that therapy, often CBT, is the first-run after intake. Psychiatric medication is somewhere down the road - if not the very last house on the street - unless the mental illness is considered severe. 

One snag I imagine in your plan would be finding a psychiatrist in the UK who would be willing to offer a diagnosis and treatment options - without having seen you in person. In addition, access to your present and historical medical records may be required.

Weighing your options, is the process of finding a medicine or combination of drugs that helps reduce the symptoms of your mental health conditions a better problem than finding a psychiatrist in the UK to effectively act as your case manager whilst you're abroad?

[Rob2020]

Thank you Atra , that’s good feedback.  I was just trying to solicit some views to shape the debate I’m having with myself.  I think you’re right, as I said I don’t necessarily distrust the system I’m in - it’s just not what I’m used to.  As you say, UK mental health services are (or were) structured in a way that steers down a cognitive approach in the first instance.  That said, I spent  20 odd years trying to work it all out with the NHS and here I am , madder than ever 😊.  Additionally it seems to me that the NHS is creaking at the seems and doesn’t necessarily offer a model that one would chase (love and respect it though I do).  I’m sure the real solution is talk it all through with my psychiatrist and ask him to clarify the plan , it just seems to be piling drug upon drug without taking away what’s clearly not working.  Slowly slowly I guess.  
 

[jkd_sd]

I am not in the UK, but in any system it should be acceptable to voice your concerns about taking multiple drugs (interactions, side effects, etc.).  If expressed reasonably (not a wacky tantrum 🤪), this is a sign of responsible behavior.  Maybe you can review the medications, dosages, etc. with your primary physician.  Even though he does not specialize in psychiatric care, he is a licensed doctor and can give you a professional opinion.

[Epictetus]

I don't really have anything better to offer in the way of advice from what the others here have already proposed to you, but I do hope you find a solution that helps you!

[mmd]

I only can say that a second opinion is always good.

Go to a second psychiatric and ask him if he thinks your former psychiatric is doing a good job, ask him if its necesary to takke so much medication.

And also see if the regime that your psychiatric is giving you have been helping you or not.

Do you see improves on you ? Do you think its not working ? Ask to your current psychiatric when it could be say that the regime takes effect or not.

If you decide to stop with the regime, see if you start to feel worse, so that mean the regime was afctually working.

[Prycejosh1987]

Advice from a psychiatrist is half the battle, the other half is your determination to get through this and usage of the options available to you.