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The idea of getting "discharged" freaks me out


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Ok so I don't know what to call this topic really. I mean it's too complicated to sum up in a title. I think I'm just looking for moral support.

I saw my pdoc for the first time in three months and both him and my key worker said I am more stable than they've seen me in a year. My last hospital admission was in 2012. Altogether I was admitted 5 times in 7 years.

Now they say they want to transfer me to GP care and "discharge" me from their services. They gave me a timeframe of a year maybe two. In NZ this means I will no longer receive free specialist care - no pdocs, tdocs, key workers or the "trimmings"(dietician and OTs). The big concern for me though is I that I will have to depend on my GP for prescriptions and medical/psychiatric advice (as I can't really afford a private pdoc).

Luckily my GP has an background in psychiatric training but he's no pdoc and the thought of doing without my pdoc (who I have built up an awesome rapport with) makes me queasy.

What if I'm doing so well because of their care and without them I'll just fall apart? Does it really take another hospital admission to convince them of need? And why the fuck does the ambulance have to be at the bottom of the cliff? I understand them working on an needs basis but what if their support it integral to my stability?

I'd particularly appreciate replies if you're familiar with the NZ healthcare system but any input is welcome.

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I'm not sure what to say. I really feel for you though. My pdoc and my GP just consult with each other, and I'm primarily handled by my GP. I see my pdoc maybe 2 or three times a year, that's it. It's REALLY frustrating, because my GP is not that helpful most of the time. But it's hard to get a pdoc in Canada. Thank God I'm (mostly) stable and only rely on my GP for prescriptions. Next time I have a crisis, I'm just going straight to the hospital and demanding a pdoc. Cause this is bullshit. 

 

Sorry to make it all about me, I just really sympathize. It's scary to be without a pdoc most of the time. 

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I'm not familiar with the NZ health care system, but I wanted to reply.  I understand your concern.  For me, any step-down in care usually brings up a lot of fear of how I will fair in the future with less support. 

 

I'm wondering how you feel about your own progress and stability.  Do you consider yourself to be pretty stable, or do you think your care providers have a false perception of your wellness?  If you do not feel like your needs would be met without their services, then that is worth discussing with them.  Understanding exactly why they think you will be ready to make this transition might bring some clarity.

 

Also, if you are discharged from their services in the next two years, would you be able to return to them (or a similar provider/program) if the need arose?

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Awe thanks for the support guys, it's really nice to get some understanding feedback. You also posed some very good questions... I feel very stable at the moment but my history shows I can spiral into mania (usually triggered by some undercurrant of anxiety) caused by even seemingly small stressors in a VERY short time. "Unexpected" and "sudden" are the two key words to describe my relapses.

As I will be starting a new job soon and have a lot on my plate finishing a previous contract it seems the time is ripe for relapse - despite the obvious signs that I am better/"recovered". After a rough ride with public health services it seems I am placing a lot of faith in them to help manage my mental health. I can only hope that once two years are over I know I can manage it with my GP alone or they offer to prolong their services.

My mum seems to think I should cross that bridge when it comes but I have a hard time focussing on the present when my pdoc emphasises the transition for the last two or three visits in a row. In fact is he sees up to 350 patients a month (my key worker told my mum) and the signs of stress show a lot. He wrote me a lithium blood test without checking the lithium box and wrote me the wrong dose of Abilify two times in a row.

However I don't think it is right to just pawn me off to a GP when my history shows I am prone to instability, having a repeating pattern of two and a half years at the most without a re-admission.

Thanks again for your feedback, it means a lot.

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