Another letter written about 8/9 years ago by someone on my behalf about my psychiatric experience!

This document has been written on behalf of Ervin P. to provide an approximate account of his psychiatric treatment experience with particular note to the year 2011 during which time Ervin was fulfilling the requirements of his Community Treatment Order. We hope we can convince an organisation or person of influence that Ervin has suffered an inappropriate level of inflexibility in the imposing of medication on him even though it was acknowledged by his Carers that he had naturally recovered from the illness being treated.

It must be stated that neither Ervin nor I have access to any relevant personnel or medical records so all events are based on Ervin?s memory but can be verified at the institutes in which he received treatment. To respect the privacy of individuals involved, names have been omitted from this document.

He first began receiving medication in 2005 when after a psychotic episode he voluntarily sought help at the Werribee Mercy Hospital Psychiatric Unit. He spent around one week there and was released with some medication.

Over the next few years Ervin was incarcerated for crimes which he committed while he was mentally well. This put him under the care of the Melbourne Assessment Prison ? Acute Assessment Unit.

He attempted to cease medication on a number of occasions unsuccessfully and relapsed approximately once a year (4 episodes in which he committed no crimes and was not a danger to others). During these years Ervin had not taken any illicit substances although on 3 occasions had consumed alcohol and while intoxicated his recollection was faulty so he claims he cannot be 100% certain.

In early 2010, for the first time he decided to confess his crimes while he was unwell. Upon his release the psychologists he worked with during his six months of incarceration classified him a ?Low Risk? of reoffending which is the minimum level of risk available.

Community Treatment Order 2011
Early 2011
- He experienced a family crisis and took illicit substances for the first time in 7 years.
- Around 2 weeks later he became unwell again and made another police confession.
- He spent around a week and a half at the Werribee Mercy Hospital Psychiatric Unit and was placed on a Community Treatment Order.
- He began attending weekly meetings with the CAT team at Saltwater Mental Health Clinic.
o During this time he complained to Dr. Juliana that antipsychotics were making him feel suicidal. He was told he had to take them regardless of the anxiety he felt.
- He made two further confessions to the police while well.
- He made an unofficial complaint that he had only been informed of a Mental Review Board Hearing 2 hours before it was scheduled to occur.
September 2011
- He made an unofficial complaint that he had only been informed of a Mental Review Board Hearing 6 days after it was scheduled to occur.
October 2011
- Ervin can no longer stand the effects of the antipsychotics so he makes a desperate choice to break off completely and attempt to face his Psychosis. He is able to naturally come out of his Psychosis. Ervin believes recover was due to the police confessions he had been making and also his religious faith.

November 2011
- At this stage Ervin has changed his place of residency and is seeing the CAT team at the Inner West Mental Health Service Waratah Clinic.
- Owing to his obvious recovery, Ervin makes a verbal agreement with the CAT team that he is no longer required to take antipsychotic medication on the condition that he does not take illicit drugs.

December 2011
- Ervin meets with the CAT team who ask him why he has no job if he is well. This makes Ervin feel that they are ?blackmailing?/insinuating that he was not being honest with them. He is told that they were considering placing him on medication again.
- I Almunther spoke to Ervin after he had been off medication for roughly two months and had been out of psychosis for forty days. In my unprofessional opinion he seemed completely normal and his beliefs regarding Religion and a Monotheistic Deity were not in any way harmful to a tolerant society and are in line with my own beliefs. He does have a passion for his Religion, but in my opinion his mood was less ?elevated? than people you see on the Religious Channels on Cable Television. I believe he was in a recovered state as we spoke at length about his situation and he seemed normal.
- At a subsequent CAT team meeting, Ervin is informed that the Clinical Risk Management Team met and they came to the conclusion that Ervin was at a high risk of relapse and would either take medication voluntarily or have his CTO revoked.
o He argues that he was told 0.01% of people recover and never relapse again but the CAT team denies every disclosing such statistics.
o He is told that he will have the opportunity to talk at the Mental Health Review Board meeting scheduled less than a week after.
 Having been told his CTO will be revoked, he is not going to have the opportunity to attend it.
o He is offered the option of weaker medication if he complies.
 Owing to the circumstances of his recovery Ervin believes medication can only harm his recovery and refuses to voluntarily take it.
 He expresses his disappointment that they are going to force him to take medication purely as a preventative measure even though he is strongly opposed to the action and is not even ill.
- On December 10th, Ervin is forcibly removed from his home and taken to the John Cade Unit of the Royal Melbourne Hospital. While at John Cade Unit:
o Day 1- He is informed by one of the doctors that he has psychosis because he talked about religion too much and had an elevated mood.
 Ervin argues that his mood was elevated due to the dramatic escalation of events that led to his hospitalisation. And argues he should not have been hospitalised as he was not ill.
o Day 2 - he meets with a doctor.
 Ervin walks out during the meeting disappointed with the doctor?s refusal to let him seek alternate treatments options and having determined that the sole purpose of the meeting was to determine the amount of medication required.
 Ervin is forcibly administered 50ml of Zuclopenthixol
o Day 3 ? Ervin is forcibly administered 200ml of Zuclopenthixol
o Day 6 ? Ervin has up till now refused to talk to doctors due to his disapproval of the entire affair.
 While being forcibly administered 300ml of Zuclopenthixol he is told he should cooperate or he will simply be diagnosed with Paranoia and given larger doses of medication.
o Day 7 ? Ervin decides to talk to doctors.
- On December 15th Ervin misses the Mental Health Review Board meeting due to his hospitalisation and revocation of his CTO.
- Upon release the next day Ervin?s friend refuses to allow him to ride a bicycle due to his lack of alertness. Over the next few days he hears comments from his friend that his behaviour has changed. I too noticed he seemed more apathetic about life.
- Ervin suffers anxiety attacks and considers suicide, he resorts to antidepressants.

Having described his situation, Ervin and I would like to express our dissatisfaction with the level of care provided and point to a few shortcomings:
- Mental Review Board Hearing
o was told about a hearing 2 hours before. Giving him insufficient time to access Legal Representation;
o was told about a hearing after the actual event date and time had passed. Causing him to miss the hearing and potentially have a negative impact on his compliance record;
o had his CTO revoked a few days prior to the hearing. He had been told during the CAT team meeting that he would be able to attend it. This is an example of the disconnect between what patients are told and what actually occurs.
- He made an agreement with his Carers to not take illicit substances if they did not medicate him which they recanted without warning or reason.
- Ervin claims to have been given statistical information that 99.99% of patients never recover after multiple relapses. This discussion was denied to have ever happened. Such disagreements could be easily refuted if all correspondence between clients and service providers were documented and recorded.
- Ervin felt staffs were insinuating that he was lying about his recovery and reformed character. As there is no means of determining how clients are being treated by their Carers, this also builds a case for greater transparency and integrity during all interactions between clients and service providers.
- There appears to be no appeal process for the revoking of his CTO.
- Talking too much about religion and elevated mood were the reasons given for his re-diagnosis of psychosis which according to the Mental Health Act appear insufficient criteria in determining mental illness.
- Forced Drugging ? At his time in John Cade Medical Unit, Ervin was complying with all instructions. However Ervin refused to talk to doctors and this caused them to inject additional amounts of anti-psychotics. These drugs affect Ervin?s negatively, inducing severe anxiety and suicidal inclinations. Nurses at the Unit commented that Ervin did not appear to have any illness so this seems an extreme measure just to get someone to talk against their will. Ervin and I believe antipsychotics have long term effects that are damaging and should not be administered just to make someone talk. We are also shocked at the level of the dosages.

It is our hope that we have provided enough detail to prompt an investigation or spark interest in this case.