It recently came to my attention that the best person to assess a client with mental health needs is in fact, the postman. Firstly, yes I have been taking my lithium. Now, think about it, the postman, if a regular to the same address, ticks the box that good psychiatry practices, but very often fails.
Consistency.
I once advocated on behalf of a client who saw a different psychiatrist every quarterly session for four years, each time having the same introductory conversation over again and each doctor had different views about medication so that changed more often than Gloria Estefan's outfit in a pop video.
My postie has seen me every morning for the last six years and must have witnessed the cycle that is manic depression over and over. He's experienced the gibbering insomniac who won't let him leave, ("Just one game of Kerplunk") to the one refusing to open the door for paranoid days on end. He can tell I'm overspending by daily multiple packages and red letters. He sees my fluctuating weight, he sees me glammed up to the max one morning and can tell when I've not got dressed all week.
Sometimes the poor man has reverted back to knock-door-bunk, leaving Amazon parcels outside my front door for the world to help themselves to. (It's good to know that other adults are playing knock-door-bunk. As I was a late developer in the world of student nights and partying, I played knock-door-bunk, alone, until I was 19. Where I grew up many women had a family of four by then.)
It's therefore no wonder that clients, who meet a psychiatrist for the first time and receive a full diagnosis 50 minutes later, sometimes get re-diagnosed by a different psychiatrist later in life, having not only been taking the incorrect medication during that time, but have had to come to terms with a condition they didn't actually have.
Last week I went to visit a friend who's currently staying in a psychiatric hospital. On arrival the doctor was very reluctant to let me see him and I had to say I was a staff member from a mental health service to get in. He told me I can have five minutes and to prepare myself as he was extremely high (manic) and so I took a deep breath and went to find him. I can honestly say he was as manic as he usually is and no more, but having not known him prior to admission the doctor wouldn't know that.
Well, I never thought I'd be putting Royal Mail on a pedestal. They are, after all, up there in the top five things we Brits love moaning about, alongside the weather, husbands, public transport and banks. But then I'm the crazy customer that sends thank you cards to credit card companies and takes chocolates into Specsavers. Maybe one day I'll send Interflora some flowers...