I think the way my tweet about eupd diagnosis has gone off tells us all we need to know about how unhelpful patients find this dg. I know so many amazing, caring professionals that will genuinely use it thinking it will be helpful as the patient will avoid misdiagnosing and be 1/
able to access the right help. But do we need to be more creative with how we approach this when knowing we work in an overstretched, underfunded system? What happens to your patient after the diagnosis? Where do they go? Back to the gp or iapt with no knowledge or tools for 2/
dealing with trauma/eupd? Do they pass the high criteria for cmht? How long is the cmht wait? How many pt.s in your cmht are currently waiting unallocated due to not enough staff? Is there edmr/schema/trauma based therapies easily available within cmht? Who and how are the 3/
staff in this cmht? A lot of locums/fast change rate?Tired and cynical? Or motivated, rested, appreciated and knowledgeable? How is the culture in the team around talking about people with eupd? I know we don't always consider these when assessing patients and signposting. 4/
But since we are applying a highly stigmatiaing label - should we consider these? The label and the stigma once applied are difficult to remove. This is all probably a bit brave from a trainee and I don't suggest professionals don't care. I do suggest we listen a lot more . 5/5

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More from @SonjaCowling

14 Oct 19
Since listening to @ClinpsychLucy talk at the general adult psychiatry conference I've been thinking a lot about the illness aspect of psychiatry. I listened to her podcast with @NSthepodcast and have so many thoughts around this. The psychological rather than medical model 1/5
makes so much sense but leaves gaps for me that are filled with questions. Human emotional distress replacing the word illness seems somehow so reductionistic/belittling. Like saying depression is the same as a bit of headache and is a normal part of human experience. It just 2/5
doesn't validate the suffering as well as illness. But then this is a new theory and maybe some of these words could be replaced with something more validating. Another thing I don't understand is the genetic heredity of the vulnerability for schizophrenic/bipolar proven in 3/5
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