Psychiatry

Psychiatry, a scary word? It was to me. Psychiatry has a lot of stigma attached to it which is understandable given its unpleasant history. Anybody who has watched the popular movie One Flew Over the Cuckoos Nest will probably have negative view of mental health and psychiatry as a speciality. The stigma and negativity surrounding psychiatry is common not only amongst the public but also amongst health care professionals, which s surprising. Psychiatry is always represented in the worst light in the media which does not help a great deal. Fortunately this negative stigma is being tackled as awareness regarding mental health problems is being raised. 1 in 4 people are affected by mental health problems. When psychiatric problems are so common we cannot afford to stigmatize such a growing problem.

I will admit that I was very apprehensive of psychiatry before starting my placement there. I was scared of being around patients who were being kept in a secure facility because of their poor mental health. What was I scared of? Being attacked by patients or accidentally letting a patient escape. My imagination was definitely a creative force when it came to thinking about the many possibilities of what could go wrong.

On starting my psychiatry placement the first day certainly did not help with my nervousness. After an overly long induction we were taken over to the wards. The security protocols were explained to us and we were given personal alarms. Some of these alarms had a big red button on them (yes, I was tempted to press it).

On placements medical students are usually assigned consultants who they will be attached to. My consultant whom I was attached to was in charge of the psychiatric intensive care unit. So during my time on psychiatry I was exposed to people who were severely ill with their mental health problems.

Psychiatry as a speciality is the most integrated speciality that I have experienced so far. The average ward round (when patients are reviewed) in most specialities usually involves the consultant, a junior doctor and the nurse looking after the patient. In psychiatry the ward round involves a whole room full of people; a consultant, a junior doctor, the nurse, a social worker, the patients family and most importantly the patient is present during the ward round. In psychiatry the patient is present and an active participant in their care, there is transparency as the patient is present when the doctor is discussing their management. I think this is brilliant and something that should be taken into all other specialities.

My first experience of patient contact in the psychiatric intensive care unit was with a young lad who had taken a legal high and hallucinated as a result. It was then found that he had underlying schizophrenia which was triggered by the drugs he had taken. This young lad was someone who was doing well in school and had aspirations for the future, or in other words, he was a normal teenager. He ended up being sectioned which is a label that will stay with him for the rest of his life. He just made a wrong decision that lead to an unfortunate end.

A lot of people who were at the psychiatric hospital did not want to be there but had to be sectioned. Sectioning is not done lightly as it is a label that will follow someone around for the rest of their lives. Being sectioned has many consequences such as limiting the countries that person can travel to and more importantly their job prospects. To be sectioned can have an impact on a person not to dissimilar to being sent to prison. A person is only sectioned if they are a danger to themselves or to others.

My experience of being on psychiatry has completely changed my views on mental health. Most of the people who were in hospital were victims of circumstance. What struck me the most was that a few bad decisions and I, or anybody, could have ended up in their shoes.

Take home message of the blog: Having a mental health problem is just as real and important as a physical health problem. They are normal people with an illness. With so many people suffering from mental health problems we need to tackle the perspectives of psychiatry and mental health. We need to change the culture of this topic and make it ok to speak about mental health and suicide.

This blog is a reflection of my personal views before and after my psychiatry placement. I do not intend to cause any offense but I do apologise for any offense that may be caused.

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