Doctor refusing to treat me what are my rights

[MysteryMoose]

Hi I'm not really sure what info to put here but I need help with my legal rights.

Basically my mental health collapsed in September. I was very depressed. GP referred to Mental health. Mental health bounced me back to GP. Went to GP. They put me on Citalopram and referred back to MH. Within 2 weeks I was having a manic episode and have been struggling with mixed mania (feeling like life is pointless but all the energy of mania) ever since. Community MH refused to treat. Left me in that state for 6 weeks. They bounced me to perinatal who bounced me back to MH as my daughter was approaching age 1.
Now SS are involved. MH still refusing to give me the "proper" amount of antipsychotics, they have me on a joke dose (5mg olanzapine) that isn't controlling the issue, and they are refusing to give me my ADHD medication because I'm breastfeeding.

I have a letter from the perinatal psychiatrist saying that the "benefit outweighs the risk" and recommending that I start ADHD meds back in October but MH said "that's just a recommendation".

I have never been a self harmer but I've been suicidally manic since October and have now attempted to end it 7 times. Crisis team bounced back to CMH, CMH still refusing to take responsibility or actually do anything.

I have racked up £12,000 worth of debt from the mania, had arguments in the street with my husband (I have never had an argument in my life before, I'm usually very quiet), and harmed myself.

Legally, if they are refusing to treat, surely they have to refer me to someone who will, right? Article 3 of the human rights act says I can't be subject to inhuman or degrading treatment including witholding medication and other neglect, but how does that translate to actually getting someone to do something about this? I am trying to stop breastfeeding but as the perinatal psychiatrist noted, without that ADHD medication I just can't organise feeding times.

Additionally, they have said that if I do come back to them and say I've stopped breastfeeding, they want a signed letter from my husband saying I really have, and they have also said they will want to test my prolactin levels (despite the fact these are unlikely to go back to normal for at least 6 months to 1 year even if I wasn't on olanzapine). I have capacity. I asked if a man had ADHD and bipolar would they ask a man's wife to sign a letter like this and they just blustered. It was humiliating and infantilizing as all fuck.

I'd like to add that according to Lactmed, the medication itself isn't contraindicated for breastfeeding and serum levels are undetectable: www.ncbi.nlm.nih.gov/books/NBK501310/
www.ncbi.nlm.nih.gov/books/NBK501056/

OP I always thought you could refuse treatment but not demand treatment. Though obviously have a right to treatment. Whoever is prescribing will be responsible for that, and they can take advice but don’t have to act on it if it is outside their expertise.

This. Surely the majority of mums have stopped breastfeeding by the time their child approaches one?
Mine both stopped naturally around the 10/11 months stage.
You seem to be digging your heels in about this unreasonably.

As awful as it sounds the Uk mental health system has collapsed. I would give up trying to obtain any help from them. Go private. £12,000 of psychotherapy help would be £ well spent if it saves your life. Hope you are okay.

I find their refusal to issue meds archaic. A friend of mine has schizophrenia that has been controlled by medication for the last 20 years. She continued to be prescribed medication for schizophrenia throughout her pregnancy and 18 months of breastfeeding. Her son is 14 and absolutely fine. She lived in Sweden when she had him but you'd think the U.K. would have caught up by now.

Seems most have spectacularly missed the point that you’re asking for legal advice, not breastfeeding advice, I’m sorry OP.

Do PALS get involved in this kind of medical issue or is that just for hospitals? I’d be tempted to book an appointment with a solicitor if I was in your shoes though OP, you might be eligible for help with the legal costs.

I know how hard it is to organise and function with ADHD working against you, can your husband step up and support you with getting legal advice on this? Or are SS willing to advocate on your behalf?

There seems to be a mental block with stopping breastfeeding. In kindness, your child is 1. Follow on milk is easy to use. Your husband can be in charge of making sure there are bottles to go.

I am sympathetic that due to OP's illness she is struggling to make any changes or take decisions. Struggling to figure out what to do & how to do it.

I will say that switching baby to sippy cup cow's milk is going to be a lot easier than pursuing legal action. In terms of what to do, I suggest that path of least resistance.

I'd guess that you don't have a right to demand specific treatment. If you have been seen and a treatment plan has been suggested I don't think you can legally oblige a medical person to treat you in a specific way.
I wouldn't use up your precious energy trying to make that happen - especially under the NHS. There's some good advice on here about how to proceed. Good luck OP.

According to the OP it was not the GP but the CMH team. But I agree with the previous poster - nobody should be advising someone to lie to any medical professional. You cannot possibly know the details of the circumstances based on one version of the context - none of us can. Siding with what the OP wants/demands is based on nothing. There are clearly valid reasons for the apparent differences in medical advice, and those must be given some weight. That is not for us to do. But if the OP were to lie as you suggest, and something terrible happens as a result, are you dgoing to be taking responsibility for that? Because doctors and other medical professionals are held accountable for the decisions they make - nobody posting on MN is.

The OP has the right to ask for a second opinion. I would also be interested to know why the psychiatrist, if they believe the medication is the correct way forward, hasn't prescribed it themselves, since psychiatrists are fully qualified doctors who can prescribe.

Breastfeeding isn't the only barrier. No GP practice is going to prescribe an ADHD med while she's actively manic.

Most GP practices don't even accept a private ADHD diagnosis in case the symptoms (poor attention, impulsiveness and rapid speech) and SOLELY due to mania. They don't want to be liable for it worsening.

Just to be clear - you don’t have money to go private but you have access to money so that you’ve rung up $12k of debts?

Your doctor won’t prescribe the drugs you need because you’re breastfeeding. I’m not a doctor - but I have been told by my child’s GP that sometimes they just don’t know what some drugs do to babies so unless there is a wealth of available information then it’s best to not expose the child unnecessarily.

It sounds like you aren’t being properly cared for but the reason for the letter from your husband is not because you’re a woman but because you’re not psychologically fit to make your own medical decisions not just for yourself but also for your child. If that’s the case then you shouldn’t be around your child at all and you should be held in a psychiatric facility immediately.

What needs to happen immediately is that your husband write the letter saying that he has taken time off work to support you with a change in medication to facilitate you receiving a therapeutic dose of whatever anti-psychotic medication you need as well as the ADHD drug which will facilitate you attending to bottle feeding times when your husband return to work.

I’m actually really concerned with you saying you can’t stop breastfeeding until you receive your ADHD drugs because you won’t feed your baby.... babies cry when they need something. Your baby will let you know when they are hungry. But also, when I left the hospital with my baby I recorded the amount of formula I was feeding him and the times of the feeds.

Your baby is almost one and won’t need to take a bottle in the very near future. So why would you need to breastfeed? You quite simply don’t need to breastfeed. You need to pick up some formula and some bottles - or sippy cups because you don’t need to continue breastfeeding. Your child has had the benefits of breastfeeding and it absolutely should stop so you can receive your antipsychotics and ADHD meds.

What should ideally happen is you be hospitalised or placed in a psychiatric facility while your medication is sorted and where you can be monitored to ensure there is no adverse effects of the medication change. Your husband should stay home and watch your baby.

You absolutely shouldn’t breastfeed while you take Ritalin or whatever other amphetamine type drug.

You’re getting caught up with human rights abuses but you are clearly still in a manic stage. Do what you have been told to do and stop arguing with medical professionals. You need to comply to receive the drugs you need. You also need to try and go private because the NHS isn’t working out for you. It’s not a human right to receive government funded psychiatric treatment that you dictate the terms. It’s just not.

@mnhq are you able to delete out all of the posts commenting on OPs method of feeding her baby? Or do I need to report them all individually? A woman experiencing severe mental health problems does not need this.

*are solely due to.

I saw a psychiatrist who said he can treat women with bipolar who've given birth (triggering symptoms) with a low dose of diazepam. It might be easier to get. My GP prescribed this.

Well surely that's a chicken and egg situation then. What are you (and your husband) going to do about it?

If your MH means that you aren't even capable of feeding a baby then you're really not safe to be looking after one. How do you organise feeding times while BF? And how has your child survived the last 12 months?

Speak to a medico - legal professional.

The impact this is having on your family is particularly difficult, someone will be able to write a letter for you.

Very sorry to hear what you're going through. I've not had time to read the whole thread, so sorry if someone has already said this, but if you've not already done so, I would contact your MP about the situation.

@WildGeece - the OP wants to continue breastfeeding her child while she takes a high dose of anti-psychotics and an amphetamine type drug. No remotely competent doctor would prescribe those drugs when their patient is still breastfeeding. Your comment isn’t helpful.

This sounds like a living nightmare, with no one taking you seriously. Any chance you could try a different GP? And while you’re doing that, make an official complaint about the current GP and how they are handling your requests.

I know first hand that it’s hard to stop BF, so it’s not as simple as just stopping. Do keep trying every day with bottles, though. One day it might suddenly click. Ultimately you’re doing it for the right reasons for your child, not just for your own MH, so stay strong with your efforts.

Its about where to put your best energies though isnt it?

The child needs to be protected ultimately and cant be if mum isnt treated effectively. To treat mum effectively the prescriber wants mum to stop breastfeeding which isnt unreasonable given the child's age.

So perhaps people are advising on the basis of what would be the best way forward for the child to be safeguarded. ARguments and legal action about whether mum was treated correctly can come later surely?

Have you spoken to the Breastfeeding Network?

They're really good on supporting BFing mothers around medication issues.

One of their founders is Wendy Jones, who is the absolute expert in BFing and medication and a great advocate for mothers and babies coming up against this inflexible, unevidenced nonsense from doctors who know very little about BFing.

Their helpline is on 0300 100 0212 and they're open every day, 9:30am-9:30pm

I don't think a GP can be forced to prescribe a medicine if there is a chance it could have a detrimental effect on a breastfed baby. They could open themselves up to be sued.

@JonSnowedUnder ADHD drugs and high dose antipsychotics absolutely shouldn’t be taken when breastfeeding. Encouraging the OP to lie when she is already suffering psychiatric illness and has the primary care of a vulnerable infant is not only reckless - it is dangerous. Please read the thread. The OP thinks that her human rights are being broken. That simply isn’t the case at all. She is not complying with her treating physician and refuses to stop breastfeeding her baby. ADHD drugs are primarily amphetamine based and infants should not be exposed to this via breastmilk. Especially an infant who is almost one and can tolerate cows milk.

If your DD is nearly a year she can have cow’s milk. Bottles don’t need to be sterilised anymore, they can go through the dishwasher or washed in hot soapy water if you don’t have one.

Yes, just like normal washing up. Could you manage that op?

My DP use to be an advocate for people with disabilities.

Every single person was capable of putting their point across but they weren't listened to, at all or properly, unless my DP was with them by the healthcare and other professionals who were supposed to be treating or providing services for them.

In addition the fact that DP was there as a witness meant the professional knew their version of what happened needed to match his.

Even people who don't have disabilities sometimes need some to go with them to medical appointments. I've done it for people and know others who have.

having myself been in the dilemma of meds versus BF, it is unfortunately highly relevant ...i held off accepting meds for 4 months because of my need to keep BF and looking back my mental health being treated with medication was far,far more important than me breastfeeding ....but like many people in the grip of mental struggles it's very hard to see the wood for the trees. My child was only a young baby and in comparison the OP's child is nearly one so perhaps from a mental health professionals viewpoints it makes sense to give up the breastfeeding and move onto cows milk via a cup rather than expose a child of this age to meds via breastmilk? However OP, if you are still reading replies, I can understand if BF is highly important to you but I would look at the bigger ,long-term picture.