Abstract

Author(s):

Katherine Gill

Functional Neurological Disorder [FND] is classified as a Mental Illness in the DSM-V, but involves a variety of disabling, distressing and debilitating neurological symptoms, including paralysis, gait disorder, tremors, fatigue, chronic pain, seizures and blindness. Historically FND was thought to be associated with trauma. Recent fMRI studies have identified abnormalities in the functioning of the brain1. Functional disorders are one of the most common diagnoses in neurologic practice2, but this is not reflected within mental health services, or the level of public awareness, funding and services available to people with FND.

A recent study funded by the National Mental Health Commission, surveyed 179 consumer and carers about their experiences of FND in Australia. The outcomes highlighted significant gaps in regards to knowledge, attitudes and services for FND. Many people [79%] reported distressing experiences when seeking care. Many struggled to obtain a diagnosis of FND. Failure to diagnose early, after onset of symptoms, can lead to iatrogenic harm, repeated testing and significantly worse outcomes. After diagnosis, treatment was difficult to access; only 36% of consumers accessed any form of treatment in the six months post-diagnosis, significantly increasing the risk for permanent disability.

FND crosses the divide between physical and mental health3. It lacks a medical home, with neither neurology nor psychiatry taking ownership for the care of people with FND. This is reflected in the lack of services, and poor awareness and knowledge of FND across health services and the community. The system gaps are having devastating consequences on the mental and physical wellbeing of consumers. Their quality of life is greatly affected; people are unable to participate in valued daily activities, including employment, leading to dire financial impacts for many families. The outcomes of the study will be presented at the symposium with recommendations to address the serious system gaps.