What is a second opinion?

There are a number of reasons why people with mental illness and their families or sometimes even the clinicians may not be sure about the diagnosis:

• In the early stages, there may be some doubt about exactly what is wrong. 
• Sometimes doctors hope that their patient will recover after only one or two episodes of illness so think it is unhelpful to ‘label’ them. 
• In some cases several doctors may have given different opinions about the diagnosis. This is not unusual as there is no definite test, such as a brain scan, for conditions like schizophrenia or bipolar disorder.
• Some doctors take the view that the diagnosis should be kept very confidential and will even refuse to speak to carers or provide them with any information.
  On occasions there can be disagreement between the service-user, carers and doctors about diagnosis and/or treatment.

Unfortunately there is no legal right to a second opinion. 

Rethink believes that people with a severe mental illness should have a legal right to an expert and independent second opinion on their diagnosis, treatment and care.

How do I get a second opinion?

You could start by asking your psychiatrist or GP, whichever one of them seems more likely to give a sympathetic response. Sometimes it is necessary to seek advice from an expert who spends their time just treating these conditions. You shouldn’t worry about making this request, but it is helpful to be polite and tactful when you do ask.

The exact process of getting a second opinion is likely to vary from area to area, but in general when someone requests a second opinion and their doctor is happy to make the referral, it goes to the local Primary Care Trust (PCT) for consideration.   

What should I do if the second opinion is refused?

If your doctor refuses:

Firstly you should try to clear up any misunderstandings there might be, using as much tact as possible, and then ask again.

You could try putting your request in writing, as it is less easy for a letter to be ignored. If your psychiatrist disagrees, you could ask your GP instead (or vice versa).

If the doctor still refuses, you could discuss your situation with the Patient Advice and Liaison Service (PALS) at your mental health trust. PALS are there to help patients and families when there are any problems with someone’s care.

The Rethink Advice & Information Service would be happy to look for an advocate in your area who could help you challenge a refusal or Rethink may also be able to write to the PCT on your behalf.

If the funding is refused

You could ask for the details of the people on the PCT commissioning panel and write to them directly to ask them to reconsider their decision.