Story & photo Eve Jeffery
Alan Hainsworth, a Byron-based specialist mental health nurse, believes it is possible to treat some mental health issues outside the ‘medical model’ and that the solution to every mental health issue does not lie in the doctor’s prescription pad.
Alan says two-thirds of patients who go to see their GP exhibit emotional distress. Not all of them are serious enough to be diagnosable, but all symptoms cause some suffering. Ninety per cent of people with mental health problems are managed entirely by their GP.
‘Life is about loss,’ says Alan. ‘It’s about conflict and dealing with bureaucracy or a lot of change in your life. It can be really, really stressful. All these things are now being taken to GPs by patients and GPs are saying, “Oh, I think you’re depressed”, and because they have been talking to the drug reps who say, “Oh yes, this is depression”, they recommend these drugs because of research that has been done, but often this research is completely flawed.
‘The [drug] reps are not giving the negative view of the drug, they only promote the positives – what they want you to hear. It’s really quite corrupted and people without a depressive illness are being given anti-depressants in the millions. It’s huge’.
Now based at the Holdsworth House medical practice, Alan originally comes from Liverpool. Some years ago he spotted an ad in the paper for a job in downtown Sydney working in the St Vincent’s Crisis Team and from there he moved north and has been living and working in Byron Bay for the last year.
Alan says he feels that the prescription of drugs is often an over-medicalisation of what is a normal social problem that you might get over naturally. ‘Giving someone with depression a chemical is not always the best way of treating it. Especially as these drugs have side effects. Some of the side effects of the anti-depressants can give you a bigger problem than your depression.
‘There is one drug that we give that massively increases your appetite. So we are giving you a new problem that is going to create some serious depression for you in the future because you’re going to stop exercising, you’re going to be self-conscious, the quality of your life is going to be adversely affected.
‘It’s very easy for doctors who are pressured to go to their prescription pad, thinking it is going to please the patient because they are going to go away thinking they got some help.
‘It makes the doctor feel good because prescribing drugs is what they are supposed to do and they are pressured by time because there are ten other people waiting in the next hour, so they don’t want to get too deeply involved with this patient. Many feel that in prescribing a drug they have treated the patient with something that they feel is going to help them.’
Alan is by no means saying that drugs should never be prescribed and he says that often a GP is the best person – they will know a patient really well because of history of contact – but sometimes a patient would benefit from being referred to an expert in the field of psychiatry.
Outside the system
‘Many GPs do feel they can manage their patient’s depression on their own because it is not such a severe mental illness unless it’s very profound or there is a psychotic dimension to it. It’s usually only when the patient is really challenging to the doctor that they refer them on to a psychiatrist, but there are many GPs who are happy to refer a patient on’.
Alan has horror stories of the mistreatment of patients in the mainstream. He has removed himself from that world and finds his work in the Bay very interesting.
‘I can’t think of a more fascinating place to do this job. I have such an interesting range of patients – from teenagers in turmoil struggling with addictions to psychotic patients in suicidal crisis. Many patients are simply profoundly lonely and isolated, displaced from family and friends far away. Unlike previous jobs in the mental health system, where I often felt like an agent of social control, this role allows me to use lots of skills, particularly counselling, crisis intervention, case management, empathy, humour, advocacy, empathy and even ukulele therapy.
‘I hope my style is an empowering one that contributes to people being able to fully participate in community life despite their mental health issues.’