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Our psychiatric patients deserve a better deal

I would like to draw attention to problems with the management of psychiatric patients.

In our PCT, GPs who wish to refer a patient for psychiatric care have to send the patient to the community mental health team.

This is even the case for patients who are acutely depressed and may be planning self-harm or suicide. We do not have direct access to an on-call psychiatrist or junior doctor.

Despite complaints and requests for investigation, I am still unsure exactly who triages the patients I refer. I have never been sent a letter recording the assessment, which is presumably by a psychiatric nurse or social worker.

The GP is sent a letter informing them of an appointment offered with a community mental health worker.

We are not told whether the patient attends, whether it is a face-to-face or phone consultation, who the patient sees or what the clinical outcome is.

I am not even aware if a psychiatrist is consulted or informed of the decisions made. Does a GP's opinion that a case is urgent ensure emergency treatment or is this decision overridden by a community mental health worker? I believe a GP has a contractual duty to refer a patient who requires specialist treatment to a consultant. Why should this be any different for psychiatric patients?

Our patients with mental health problems are generally disadvantaged by poor social conditions and suffer the stigma of low self-esteem.

Even if referred by their GPs, they get a raw deal.

Dr Lal B Mandal, Telscombe Cliffs, East Sussex

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