"Lack of training and knowledge regarding medication"

I can recall a common saying whilst growing up that the British were obsessed with the weather and bowels. If only the mental health services would give more thought to the bowel habits of those taking Clozapine.

If only the service providers would ensure that those prescribed Clozapine were aware of the dangers of constipation not being dealt with. If only those taking this medication were given more information. Leaflets on medication in many cases aren’t read by the patient in my experience, due to tiredness,sedation and mental health issues.

As I scroll down the internet,a disturbing picture builds, that being that deaths from Clozapine due to bowel obstruction are more common than deaths due to low white blood cell count (neutropenia).The research is there, but findings don’t seem to be applied at Northlands, or private care providers, why? On Clozapine monthly blood tests are mandatory,yet no such close monitoring exists into bowl habits,which research shows is the deadlier side effect of the two!

The UK Government states on its own website regarding Clozapine that patients prescribed this need to report constipation immediately. It also states that in August 2017, a coroner investigating a death from adverse effects relating to this, raised concerns with MHRAthat health care professionals might have a lack of awareness about the risk of pseudo obstruction and Paralytic Ileus and their fast onset.

As I reflect on the past,I look back in horror over years and can’t recall either care coordinators or support workers ever bringing this subject up with my loved ones who are on this medication! In fact one support worker didn’t seem to realise the importance of my keeping notes in my diary regarding constipation! My loved one was advised to eat more fibre, whilst I tried to explain the risks from Clozapine and how my loved one was on lots of laxatives anyhow. This to me paints a profound lack of knowledge and training and decent policies and procedures in the mental health services,leaving vulnerable individuals at risk of preventable conditions.

Here I am again the stressed out carer, not only monitoring my loved one's mental health, but also physical health. I fear what would happen if I wasn’t around or wasn’t well, as I feel the services leave people in great danger. To be fair, my own understanding came from a gem of a nurse at Northlands who warned me of potential dangers, we don’t see them now and they are very much missed.

The Michael Carlisle Centre do try, slips are given to patients about constipation,but not much detail.

One of my loved ones is,I think constipated,I have depression and will somehow have to sort this out,if not what will happen.

On a closing note,my loved one has carers visit five times a week,they never ask about constipation,it’s not their fault though,who may I ask has a duty of care to the vulnerable,because I am exhausted being the one continually carrying the burden!