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 messaged the breastfeeding network recently to ask about ADHD medication and they sent me this in case it’s helpful to you

breastfeeding-and-medication.co.uk/wp-content/uploads/2022/03/ADHD.pdf

I’m so sorry you’re having to deal all of that (the unhelpful health professionals I mean).

@MysteryMoose Is there a reason why the perinatal psychiatrist hasn’t /won’t prescribe the ADHD meds for you? A psychiatrist can medicate so not sure why they haven’t.

I see you posted the research from NIH but in the uk there is actually a drugs in breast milk helpline you can message, set up years ago by the BfN - Breastfeeding Network. I used to volunteer with the BfN as a peer supporter and that is absolutely a great place to start with all things breastfeeding/weaning from BM.

I haven’t read it all but have you seen this site?
www.rethink.org/advice-and-information/rights-restrictions/rights-and-restrictions/nhs-treatment-your-rights/

I really hope your SS team manage to get you the urgent help you.
In the mean time, is your husband able to help with the bottles side of things when he’s home and if he works away from the home, are there friends and family who could help with a rota to help with bottle feeding prep and organisation to give you some respite?

It must be such a stressful situation for you and especially with the supposed health professionals constantly giving conflicting advice.

Do you get your ADHD medication through a shared care agreement with your GP? You have the option to move GP but this would usually require a new agreement between the GP and ADHD specialist.

As other PP have explained, the benefits to your child decline after weaning and at a year old they will be getting most of their nutrients from other foods. Nor is their any need to sterilise bottles - totally pointless anyway once they are crawling and literally everything goes in their mouths.

My advice is to look after you for the benefit of your child. Stop breastfeeding and go back on your meds.

Meanwhile serve your child full fat milk - with a blue lid in a suitable toddler cup. Either put it through the dishwasher or wash with hot water.

You have a husband, whom I presume is your baby’s father. He needs to step up and take charge of feeding the baby. It sounds like your baby is over 6 months old, so won’t be reliant on regular breastfeeding.
wWith regards to not being treated, it also sounds like you ARE being treated, but just not the way you’re wanting to be.

@MrsShabadoo its highly relevant to the issues the is having and the medical advice she has been given. Stopping BF is the key to unlocking this - she can then get the meds she needs. Formula feeding schedules (as the op mentioned herself in her op) aren’t of concern any more due to the age of the child - again, highly relevant.

I’ve just realised that your baby is now 1 or thereabouts. In which case, yes you can just stop breastfeeding - it really IS that simple. Your baby should be on proper food now, including cows (or dairy free) milk. Breast milk is not a requirement for their development. You’ve fed your baby for the most crucial stage of their growth. Now it’s time to stop.

Could you speak to someone like Lucy Ruddle? She is an IBCLC and has a particular interest in ND mums and difficulties they face (as she is ND herself)
She has free clinics and is extremely knowledgable and eloquent, someone I would want in my corner!

Stop breastfeeding. At 12 months they don't need sterilised bottles it's fine to just wash them up . I mean this in the kindest possible way. It will benefit you more, at 12 months they can also be on cows milk so no f*ing about with formula either.

You have done amazingly to breastfeed for so long and given your child their best start in life!
It does sound like now, it is time to put your mental health first and do as the doctors ask… your baby will be absolutely fine eating real foods and drinking cows milk. You can always add a vitamin supplement too. Good luck x

Have you actually read all the OPs posts? This is a woman suffering from a severe mental health condition who has a 1 year old child. Children of that age do not need breast milk, which I should imagine her medical gem have already told her and yet she is still determined to breastfeed and insist she gets prescribed drugs that could be transmitted to her child through her milk.

OP I mean this in the most respectful way possible but you don't get to force a clinician to prescribe medication that they view as unsafe/unnecessary/both. If baby comes to harm then not only could you sue them but your baby/an advocate of that baby could sue in future as well.

It sounds as if possibly the treating clinicians aren't fully convinced that these are true manic episodes? Or that the medication is going to be especially helpful? I'm not able to judge that either way but if this is the case then I think realistically your options are

1. Get an advocate as pp have suggested

2. ask to see another MH specialist not previously involved for a second opion

3. stop bf if this will mean you can take the meds you're seeking

4. accept the professional opinion you've already been given and focus on finding alternative ways to manage your MH eg talking therapies.

Best of luck OP I hope you can sort things x

With respect you’re completely incorrect.
Even the guidelines say to breastfeed until the age of 2.
I’m not suggesting the OP should carry on feeding herself but you’re wrong saying there is no development requirement to give breast milk.

Breast milk is continuously changing as your baby/toddler grows and the milk is amazing and adapts for every stage of their development. Different water /fat/vitamin content for different stages.

I think you meant to say stopping breastfeeding won’t harm her baby, as opposed to dismissing the proven benefits of extended breastfeeding.
No mumma should be told ‘you should be ….’ And ‘now is the time to stop…’.
It’s @MysteryMoose choice and there is absolutely nothing wrong with her wanting to rule out the possibility of continuing to feed with her medication, if that’s at all possible. Instead, she has been just down by people (GP etc) who don’t necessarily understand the complexities of breastfeeding and medication.

Hi OP. This may not be 100% relevant to your diagnosis but this charity for postnatal mental health are very good and should be able to advise and support www.app-network.org/

The charity La Leche League are also very good for advising regarding breastfeeding and medications.

I sympathise because this sounds really tough, and I commend you for trying so hard to work things out.

I gently think perhaps you are putting all your energies into the wrong battle though…

Here’s what I would suggest:

1. Your husband takes two weeks off work to support you in the transition
2. You buy two weeks worth of those ready made formula bottles
3. You stop BFing and start the meds in those two weeks
4. Your husband takes responsibility for the morning and evening feeds.
5. You start by setting an alarm on your phone for one of the daytime feeds.

As your mania becomes more controlled by the new meds, you should be able to take more responsibility for the other feeds. However, if you can’t, presumably he can still help with the morning and bedtime bottles even when back at work, but also if your little one is nearly 1, very soon they will need less milk anyway.

Does that sound possible?

I would contact PALS, I've found them really helpful when I've had issues.

I don't think MH should be overriding what your psychiatrist says, I doubt they are more highly qualified than a psych. Are you able to contact the psych to ask them to prescribe? Everyone knows MH is a shit show, I'm so sorry they're trying to force you to stop BFing. I hope you get the help you deserve soon.

@MysteryMoose one thing I would recommend if you do manage/want to wean from the breast is to miss out the bottle stage.

As long as your baby is having the correct amount of milk per 24 hrs, you can give it in a cup. This takes away that worry about making up bottles/when to make bottles/washing etc.

There are so many silly cups with dual handles and soft rubber tests that make the swap easier. As a breastfeeding peer supporter, someone in the group recommended this and I did this with both of mine, as I found organising bottles after exclusive breastfeeding a complete nightmare!

Is your Bi polar type 1 or 2 ? As aware they differ and treatment varies .(my sister has type 2
Hopefully Ss can kean on them but pysch can definitely prescribe and someone needs bounce it to them on nhs I would do it in writing saying are causing harm as paper trail

‘Sippy cups’

No mumma should be told ‘you should be ….’ And ‘now is the time to stop…’.
It’s @MysteryMoose choice and there is absolutely nothing wrong with her wanting to rule out the possibility of continuing to feed with her medication, if that’s at all possible. Instead, she has been just down by people (GP etc) who don’t necessarily understand the complexities of breastfeeding and medication.

This, a thousand times this. So harmful for random people on the internet who won’t be there to support any transition to be making such sweeping statements about the simplicity of stopping. And the poster who said she was being unreasonable… SMH.

No I’m not ‘completely incorrect’.
NHS guidelines do not say ‘to breastfeed until the age of 2”, they say this:

*How long should I breastfeed for?
Exclusive breastfeeding (breast milk only) is recommended for around the first 6 months of your baby's life. Breastfeeding alongside solid foods is best for babies from 6 months.
You and your baby can carry on enjoying the benefits of breastfeeding for as long as you like. Breastfeeding into your baby's 2nd year or beyond, alongside other foods, is ideal”
It is important to not be selective when quoting NHS advice.
Mothers who are experiencing a mental health crisis may well need to be “told” rather than just advised. Especially when they have already admitted to being ‘suicidally manic’ and ‘tried to end it seven times’. This sounds like someone who cannot think rationally or make appropriate decisions. Remember that there is also a 1 year old caught up in this situation.
As a first time mother, I suffered from severe PND and ended up voluntarily admitting myself to a mental health unit. I could not make any decisions for fear that anything I would do might harm my baby. I am certain that if it were not for the medical staff and others making decisions for me at that time serious harm could have come to both me and my baby.

This sounds like a very reasonable solution.

Your DP really needs to step up and help you.

Organise the bottles, make a wall chart, set timers, or whatever would be helpful to you.

www.additudemag.com/how-safe-are-adhd-medications-while-pregant-or-nursing/

Sorry, this sounds like a really stressful time OP, and I am sorry you are feeling this way. I agree with PPs who suggest taking the energy and focus away from fighting legal battles to coming up with a plan to stop breastfeeding and get you into your proper dose of ADHD medicine. Time for your husband to step up and help.
The CMH team are not the enemy here, they are trying to keep your baby safe. Work with them, not against them. They will help you if you cooperate.

But surely you organise feeding times at the breast?
Could your husband not help with the feeding?