Mental patients not neglected, assures top health official

Psychiatry Unit at National Hospital coping well

Dispelling fears that patients in need of psychological treatment will be left unattended, a highly-placed health source assured that though Room 40 of the Outpatients Department (OPD) with a Psychologist in attendance has been closed, multi-disciplinary teams headed by Consultant Psychiatrists are available in the Psychiatry Unit of the National Hospital in Colombo.

Last year, these teams saw 2,600 new referrals from other units of the hospital and 900 new day patients who come mainly for psychological therapies, the Sunday Times understands.

Following the publication of ‘Psychologist told to quit, clinic closed’ in the Sunday Times of March 6, which reported the retirement of Psychologist Nimal Liyanage, many health sources stressed that patients with mental disorders should be referred to a ‘mental health team’ which not only includes a Clinical Psychologist but is in fact headed by a medically-qualified Consultant Psychiatrist.A psychiatric problem occurs when a patient starts behaving differently to his/her usual pattern, the Sunday Times learns, with such changes being due to a psychiatric problem or other medical causes.

“That is why such patients need to be under the care of a medically-qualified specialist psychiatrist who will assess the patient along with his multi-disciplinary team, order tests if necessary and prescribe medication if and when necessary. The patient will be referred to another member of the team if he/she needs their expertise,” a senior doctor said.

The evaluation by a specialist psychiatrist is essential as non-medical team members may not be able to diagnose if the patient has a medical problem. Such non-medical members will also not be able to prescribe medications, another source stressed. Delay in the appropriate use of medication will be detrimental to the patient and could lead to serious consequences including death, it is learnt.

Explaining the ‘international model’, another respected doctor gave the composition of a multi-disciplinary mental health team. It would essentially be headed by a Psychiatrist, a medically-qualified doctor who has specialized in psychiatry, a Senior Registrar (a post MD doctor who is in the final two years of training), a Registrar (a medically-qualified doctor who is training to be a psychiatrist), a Medical Officer (a medically-qualified doctor who has concluded his internship), nurses, a Psychologist, an Occupational Therapist and social workers.

The brain is one of the most complex organs, another source said, adding that it is like the ‘boss’.
“This is why when treating mental disorders either one or many things may be needed. It may be medication alone or with physical therapies, psychological treatment, etc. Or it could be physical therapies alone or just psychological treatment,” the source said.

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