Saturday, 18 August 2012

patients are people too

In psychiatric hospitals where the use of restraint, seclusion and forced treatment is permitted it can be easier to forget that patients are people too.

"One temptation is to retreat into objectification of those identified as mentally ill, insisting on the somatic nature of their illness. An advantage of this strategy is that it protects those trying to provide care from the pain experienced by those needing support." from CPD Bulletin Psychiatry (2000), Critical Psychiatry website.

The biomedical model of mental illness gives weight to the distancing treatment and a reluctance to engage with the mentally distressed patient.  Clinical reasoning that the patient lacks capacity and therefore insight opens the door to restrictive practice.  Take your medicine or else.  An excuse for not providing alternatives.  The safeguards in the Mental Health Act are only as effective as are able to be accessed by the patient and recognised by the powers that be.  Especially advocacy that is independent.

Some of us had no choice but to enter psychiatric hospitals because of mental distress caused by life's problems.  It was a cultural shock to be treated like children, lacking capacity and without insight.  Like going through the looking glass into a distorted world.  The good game players learned to go along with the action, bend the rules and to become returners to the game.  Keeping everyone in a job while things stood still and even went backwards in time.  

I want to see psychiatric patients treated as people and person-centred care meaning what it says.  Putting the person/patient first and at the centre.  Regardless of mental illness labels and things written in medical notes.  Using the Tidal Model of nursing practice will help bring this about.  And the new Mental Health Strategy for Scotland is a positive start.

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