This paper addresses my difficulties as a carer in engaging with many professionals in mental health, both locally associated with my son's acute inpatient care, and nationally where policies are being developed and their implementation is pursued. All of us are affected by The Department of Health (DoH) Mental Health policies and their implementation by professionals has formed the way in which professionals relate with my son and myself. The way in which my son is impacted inextricably affects the way I relate to professionals. I think my difficulty in engaging lies in the relationships we all have with each another. In focusing on the process within our relationships, I attempt to raise professionals' awareness of what constitutes a relationship when we dialogue. As it takes two to engage in a dialogue, I perceive my difficulty is also the difficulty of the professionals. Carers are becoming increasingly involved in the training of mental health professionals and our combined difficulty needs to be resolved, so that we all benefit. In order to achieve positive progression, there needs to be a radical change within our relationship to provide ease of engagement from all parties. In this paper I tentatively suggest how this process can be achieved.
Medication continues to be the most widely prescribed treatment in the NHS for mental health problems. It has been known for many years that individuals differ in the way they respond to a given pharmaceutical therapy, and one reason for this lies in the genetic variation between individuals. This paper recognizes the impact that pharmacogenomics and pharmacogenetics are having in the field of mental health. Variants in genes that code for the drug metabolizing enzymes in the liver have been found to influence the way in which these enzymes handle psychotropic medication. Individuals can be classified as poor, moderate or extensive metabolizers when standard regimes are used, and this can lead to huge differences in therapeutic effect and toxicity. There are now genotyping tests available which provide information on the individual's ability to metabolize psychotropic medication. One author provides an account of the effects of medication on her son's physical and psychological well-being. Genotyping provided evidence for his poor metabolism of psychotropic medication, and his life is now changing as he is being very gradually weaned off this medication. This emerging field of work has implications for the way in which practitioners consider medication adherence.
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