“Sick system” leaves bipolar patients facing 10-year diagnosis delays

One in 20 suicides is thought to be linked to bipolar disorder (Image: Getty)At least one in 20 suicides is linked to the condition, which costs the economy an estimated £20 billion each year.Despite this enormous burden, an 18-month review by the Bipolar Commission found patients waited on average 9.5 years for a diagnosis – with the group’s co-chairman Professor Guy Goodwin warning the ‘system has become sick’.Experts said some sufferers were ‘slipping under the radar’ with symptoms mistaken for depression, teenage angst or a result of drug addiction.And after diagnosis, too many receive inconsistent care that sees them batted between GPs and specialists, the report said. It estimated that six in ten do not receive dedicated treatment or support for their condition.Prof Goodwin, who is also emeritus professor of psychiatry at Oxford University, said patients need more specialist support before they reach a crisis point.He said: ‘Psychiatric services see patients when they’re acutely ill. They often require acute treatment, commonly admission to hospital or intensive treatment at home.’But once recovered they are discharged back to the care of their general practitioner. That model we think simply doesn’t work.’More than half of patients had been hospitalised after relapsing. People with bipolar live an estimated 10 to 15 years less than the general population.Sufferers are 20 times more likely to take their own lives, with one survey suggesting more than a third attempt suicide before they receive a diagnosis.Prof Goodwin also highlighted the under-prescribing of treatments including lithium, which is seen as the gold standard for care.The report was based on a survey of more than 7,000 people living with bipolar and in-depth interviews with over 100 expert witnesses.Its recommendations included a national awareness campaign about symptoms, specialist training across the NHS to help medics spot the signs, and screening for the disorder in anyone who attempts suicide.The authors also called for patients to build long-term relationships with a named clinician who is an expert in bipolar, and for more patients to be encouraged to try lithium.Better post-discharge support after hospitalisation and extra support for women dealing with pregnancy or menopause were also suggested.Simon Kitchen, CEO of the charity Bipolar UK, said: ‘Leading experts around the UK are asking policy makers to act urgently, focussing on quicker diagnosis through specialist frontline medical training and easier access to consistent care for people with bipolar.’Continuity of care is the bedrock of this model, with strong long-term relationships between individual clinicians and patients a critical factor.’There are currently not enough specialists in bipolar in the UK which means that the symptoms are often being missed.’Not only will these changes improve the quality of life for the million-plus people with bipolar in the UK, they will literally save lives.’An NHS spokesperson said: ‘The NHS Long Term plan recognises the need for a step change in how we support people with bipolar amongst a range of severe mental health needs, which is why we have invested an additional £696m this year to expand and transform mental health care in the community.’Last year despite the pandemic, the NHS treated five per cent more people with a severe mental illness in the community, including those with bipolar, compared to the previous year and we are offering more support in GP practices, with more than 500 mental health practitioners now working in primary care.’A Department of Health and Social Care spokesperson said: ‘We will provide an additional £2.3 billion per year to mental health services by 2024, which will deliver an additional 27,000 mental health professionals in the NHS – giving two million more people, including those with bipolar, the help they need.’Since 2015, we have spent over £39 million on research on bipolar disorder, including on studies into various treatments and inventions to help people live with bipolar disorder, and a new study is shortly to be funded on new medicines for bipolar depression.’Rosie Phillips was diagnosed with bipolar disorder 20 years ago after experiencing a manic episode.She suffered from delusions and began hearing voices while running around her neighbourhood.Rosie, 58, said: ‘I was initially treated at home with support from my family and little follow up. I experienced a lack of consistent care after my initial diagnosis and was not given a full explanation about the condition, which meant I didn’t understand how to manage it or where other help was available.’Rosie, who lives in London, said she was sectioned a year after her diagnosis as she had not been warned of the impact of stopping her medication.Since then she has learned to manage her condition and uses an app to monitor her mood. She added: ‘You can live well with bipolar. Learn what you can about the condition and self-management.’If you don’t have a diagnosis, monitor mood and take some bullet points to your GP appointment. Request a mental health assessment and contact Bipolar UK for peer support.’