Scenario 3 - Mental health - Depression

Hello, is that Mr Smith?

Speaking.

Good evening Mr Smith. My name is Shaun, I am one of the Urgent Care practitioners from the doctors out of hours service. I am just ringing about your call earlier on this evening. Before I go any further, can you just confirm your full name and date of birth for me, please?

Mark Smith.

Yep.

15th of August 1959.

Okay. So I have got your details in front of me, Mr Smith. Is it alright to call you Mr Smith or would you rather I call you Mark?

Call me Mark.

Okay, Mark. My name is Shaun. I am just going to have a conversation and then we will decide what we need to do this evening with you. Is that okay, Mark?

Yeah.

So tell me, what is the reason for the call tonight? What has changed? What is the reason for your call?

I just feel like what is the point?

Okay. Is this a new problem, Mark? Or has this been going on for a while?

It has been building up since last year.

Okay. And did anything trigger this off last year?

I lost me dog.

You lost your dog. Sorry.

Lost me dog.

Yeah. Okay.

He was 18.

Okay. And has anything else changed now? Has anything else triggered this off tonight, has anything changed?

When I was 30, I had... They said it was a nervous breakdown.

Okay.

And they said that I had depression.

Mark, are you known to any mental health services at all?

Yeah. I have to go to my GP.

Yeah.

And I have... In the past I have had a nurse who used to, for about six months or whatever.

Yeah.

And she just checked if I was alright, really.

Okay. And do you mind me asking what medications you are taking, Mark, at the moment for this?

I take amitriptyline.

Amitriptyline, yeah? Do you know what dose it is, Mark? Do not worry if you do not.

Two a day and they are 25mg, I think.

25mg, yeah, times two. Twice a day, yeah?

Yeah.

Anything else that you take at all, Mark?

No.

Okay. What about allergies? Are you allergic to anything?

No, no. No allergies. I mean, I am fit and well, but I do not know, it is just...

Well, we will carry on talking, Mark. And then we will see what we can do for you this evening if that is alright. What about your social circumstances? Who do you live with at home? Who is there with you?

I live alone. I have always been alone.

You live alone. Okay. Do you work, Mark?

I used to.

What did you use to do?

I used to work at the cardboard factory.

Okay. Okay, Mark. So have you tried to contact the... Any mental health services at all this evening, Mark?

Well, I have got a number that I can phone.

Yeah.

I phoned that and there was no answer.

Okay.

And I have got a number that the nurse gave me years ago and I tried that and that was linked to my doctors and somebody else that I do not know, but there was a recorded message. And I left a message, but nobody has phoned me.

Okay. So we are the first person that you have spoken to tonight so far.

You are the first person that I have spoken to about this for a long time.

Okay, Mark. I understand that. And then the question is now, what do we need to do tonight? So you are telling me that you are feeling low, you mentioned that you are questioning what is the point of it all. Can you expand on that at all for me, Mark?

I just... I have had this before when I know when I am feeling low.

Yeah.

And I do not feel like that. This is different. I just... I do not... I am not... I just... There is just... There is no point really.

Okay. Can I just ask you another couple of questions? Have you got any plan to harm yourself at all? I know it is a strange question, I am just trying to determine how we manage you best this evening.

[pause]

You still there, Mark?

I have thought about it. I have thought about it, yeah.

Okay and now...

If I am honest, I have thought about it.

As we speak tonight, have you done anything at all prior to this call to harm yourself?

No.

So you have not taken any tablets? You have not harmed yourself at all? I am just trying to build up as best a picture as I can, Mark, as to what is going on at the moment and what we can do for you.

At about... See, I am not eating. I am not eating and I looked at the tablets, my amitriptyline, and I got them out and I thought... And I have not got the guts.

Okay. I think given that it is in the night time at the moment, Mark. And we are going to struggle to get you seen by any mental health services. I think it would be really good, for us and for you, if you came in and saw us at the centre tonight. If I tell you where that is, would you be happy to come and see one of our clinicians and we can do a full assessment of you and see if there is anything else that we need to be thinking about tonight to support you? Would that be okay?

I would appreciate that because this is the worst it has been.

Okay. Well, what I will do, Mark. I will put this into the queue for getting an appointment, where you will be seeing us at the Urgent Care Centre, which is in the grounds of the Royal Stoke Hospital. Do you know where that is?

Yeah.

Right opposite the emergency department down the grass bank from where the ambulances park, we are the bungalow set back on the grass verge. It is signed outside. When you come, somebody will ask you for your details to allow you through the door. We do that with everybody, so do not worry about it. And what we would ask you to do is just wait to be seen by the clinician. Even if it is busy, I would really prefer if you did stay and get seen, so we can just rule out any other problems that is causing you to feel like this tonight, particularly with you not eating as well, it can have other effects on the body. So, shall I arrange that appointment for you now, Mark? Would that be okay?

Are you talking about the place next to the children's place?

The Child Development Centre, yeah. We are next door to them.

I know where you are. I know where you are. Shall I go now, shall I?

No. Wait for a call first and somebody will tell you what time the appointment is, because I am not sure what the list is like at the moment.

Okay.

And we will get you seen by one of the clinicians. Is that okay for now, Mark?

How long do you think it will be?

I can not tell you, I am afraid, because I am on the clinical screen, not the appointment screen, but I really would prefer it if we saw you this evening. Is that okay?

Yeah.

Right. I will sort this appointment out for you now, Mark. Stand by your phone, do not be using it. Somebody is going to ring it. It might show as a number that you are not familiar with, or it might show as unknown. If you would answer it for me, then they will give you the appointment time, okay?

Okay.

If there is any problems before you get to this appointment, will you ring us back on 1-1-1 and update us if anything has changed at all, okay?

Okay.

Okay, Mark. You look after yourself anyway.

Alright. Alright, thank you.

Thank you now. Bye-bye.