Michelle Lomax pleads, for her daughter’s sake, for the Southern District Health Board to continue the ketamine programme.
In February, the Otago Daily Times reported that Southern District Health Board's ketamine clinics were ``under review''. I am a mother of someone from the ketamine programme, and it is not an overstatement to say it has been devastating for my daughter and others like her, and their families. It is now nearly five months later, and still we don't know what's happening.
My daughter, whom I'll call Beatrice, has major depressive disorder, and if I had a dollar for every medication she has been tried on, I would be able to buy my shoes from I Love Paris without waiting for sale time. Unfortunately, there are many others like Beatrice whose illness is treatment-resistant. Standard medications do little for her, leaving her with a rubbish quality of life.
Before ketamine, the only thing that helped her significantly was electroconvulsive therapy (ECT).
In 2017, over four years into her illness, Beatrice made the move to Dunedin to study. She's a very bright young woman, who despite having the beginnings of her illness during her last year at school, still got level 3 NCEA endorsed with excellence, as well as two scholarship subjects.
Unfortunately, soon after arriving in Dunedin, she had another breakdown. When the ketamine programme was suggested to us by Prof Paul Glue, we grabbed the opportunity with both hands.
Ketamine seemed less invasive than ECT, and can also be faster-acting. I couldn't believe how lucky we were to live in one of the few places offering this life-saving treatment I had read so much about. For us, Dunedin truly was the best place in the world for Beatrice to live.
Even as I write this, nearly six years after I started learning to live with this cruel illness, I wonder at how casually I talk about such controversial treatments as ECT or ketamine therapy. But as a family, we have had to quickly adapt to help Beatrice live her best life possible.
The ketamine treatment was very successful for Beatrice. She managed an A in a health science paper, an A+ in an English paper, and at the end of the year she moved from her college to a flat. She seemed to be coping much better. Of course there were hiccups, like when she stopped taking another medication because of its side-effects, and required a short hospital stay later in the year.
But we really felt that, with the help of the ketamine programme, Beatrice had a future. Twice a week she would go to the community day programme to a cosy little room where the ketamine was given. She would stay for two hours' monitoring of her vital signs. The staff were highly trained, and very supportive of the treatment and their patients.
So of course, news of the review was a shock. It was worse for Beatrice because of a spell in hospital early this year. On her discharge, she lost her place on the programme altogether.
We are struggling on without ketamine. Now her only option is maintenance ECT, which seems dire for a woman of 23.
Beatrice's psychiatrist is supportive of her continued access to ketamine because he has seen the results for her (big shout out to him). But it would seem that it's out of his hands.
I have been told by Dr Brad Strong, the recently departed medical director for mental health, there needs to be decisions about how to continue to resource the ketamine programme. I assume the current financial pressure on the Southern District Health Board is impacting this. But one of the things that frustrates me, as a family member, is the pitiful amount spent on mental health compared with other areas of health.
Another concern seems to be the ``off-label'' use of ketamine. It's fortunate there were no psychiatrists around to hear my primal scream when I heard that, or they may have sectioned me as well. Medications are commonly prescribed ``off-label'', particularly in mental health, where effective treatments can be elusive.
To be clear, the people on the ketamine programme are people for whom nothing else has really worked. They are desperate, and living truly difficult lives.
It has been reported that the 20% efficacy rate from the ketamine trial is disappointing. But this sounds pretty good to me. Remember these people are not the ``low-hanging fruit''. But more importantly, when you talk to people on the programme, they know it is making a difference for them, when nothing else has in the same way.
I really hope the Southern DHB decides they can help Beatrice, and others like her whose situation really is desperate.
