that is often the misunderstood view in relation to people seeking there own treatment. it is not due to gatekeepers but due to services that are unable to or choose not to address there needs in a meaningful. way
But that IS gatekeeping. That’s what gatekeeping is. It’s evidence based medicine practiced by medics working to medically ethical guidelines. So that any drug prescribed is needed and monitored. That IS gatekeeping
If someone finds the treatment is not what they want, and goes off piste, so to speak, then they’re outside of that ethical and evidence based framework.
And many people do this - there are people who seek alternative practitioners for things like acupuncture or reiki for example. That’s a couple of benign examples - neither of those things can harm you. But you’d be unwise to start taking any prescribed drug outside medical supervision
When a medic prescribes on the nhs they will take a full history. They will have access to full medical notes. They retain responsibility for what they’ve prescribed - that means they must be able to justify it in terms of clinical risk vs benefit. They will monitor the patient closely. They will act if they feel up/down titration of dose or cessation/change of medication is needed. They must adhere to nhs prescribing guidelines.
With internet obtained drugs people don’t know for sure what they’re getting. They need to administer the drug correctly (blockers are depot drugs). They have no checks of medical history, no counselling beforehand, no monitoring. No one is taking responsibility for the usage.
If people don’t like the nhs watch and wait, then that’s not the failing of the approach. I’m still not really sure what you’re pressing for as an outcome? Open access to drugs/affirmative treatment? Earlier access to drugs/treatment?
The nhs treatment is watch and wait. And that’s ethical. What more do you want?