First contacts with a psychiatrist.
Back
to Schizophrenia a Personal Experience
There may be some resistance on the part of the patient
to being interviewed. Why should I tell you about my problems? It is
necessary to sell the concept of being mentally ill.
Hospital design is part of the process - in the one I attend there is coffee
available, music playing and art on the walls. The
informality of the staff is also important. Plus attention to how psychiatrists
and nurses dress casually? First impressions or are we too ill to notice? What
more can be done to get the message across? Is it all in vain?
The answer here is no. I think people who constantly care for emotionally
distressed people demonstrate an ethos of care which manifests itself in the
being and behaviour of nurses and doctors. This in my hospital is so visible the
above considerations seem to fade into the background.
If the patient closes themselves off to the staff then a relationship of trust
and confidence will be harder to establish.
You might, if you are not aware of these influences - because you are so caught
up by the illness - feel like you are just a part of the system rather than an
individual in the eyes of the staff. This is not true.
If I was more aware of the buildings I would have wondered a little about the
notorious carcareal history of psychiatry. Though I am doubtful newer buildings
would help in this respect.
One important point is that they should know what they are doing when they label
someone with `schizophrenia.' Having a social worker on hand to explain all
about the media stigma and the connotations the word has, the negative language
involved and how its all just ignorance in that respect. This is better than
just saying it is a chemical imbalance which may be enlightened only if we are
properly educated in this respect. My parents felt there was a general lack of
information about the subject.
I think when you are sectioned you should have a lawyer on hand to supervise the
process from the start. This might just help reassure the patient that their
rights are not being infringed though I'm not altogether sure about this. But if
the police are involved in a crime you get one so why not for mentally health?
I think hospital can be a good thing in respect of educating relatives and
sufferers because you are in a medical institution
thus the idea that you have an illness is inescapable. Alternatively home visits
could introduce the subject in less confusing
surroundings. By this I mean the hospital buildings bring a rather vague and
confused picture of `mental health' as opposed
to `physical health' to mind but do not always help by doing this. At the limit
I think both approaches have their merits but a home visit then a day unit
appointment might be the best introduction to the system.
We educate teenagers about war in schools so why not schizophrenia? It is just
about as frightening. In the end some kind of public program is needed to
underpin initial psychiatric contact.
When I was first labeled with `schizophrenia' I had a sub conscious fear of it
and although I was dimly aware of its existence my immediate reaction was to ask
"what is that?" I had heard of it but it was not in the fore front of
my mind that it was an illness at all. After a couple of weeks the medical
aspect dawned on me. I went and looked it up in the library. This was the worst
thing to do. The reason is that a little knowledge is dangerous. I saw it
literally meant split mind - what could that possibly mean?
A day unit is a much better place to learn about mental illness than a G.P.s
Surgery. There are notice boards every where advertising Mind, web sites and
self help groups, information on therapies etc etc.
Ultimately I don't think the word schizophrenia should now be used at all. It
may be better simply to describe it as paranoia and of hearing voices as
hallucinating. These terms are not ideal but they are far more innocuous than
schizophrenia or psychosis. By way of contrast I think depression is an
excellent term and far clearer than mood disorder.
Ultimately people who cope with particularly severe schizophrenia should awarded
the Victoria Cross. This is the best public defense against the stigma. What the
future holds in the age of science and robotics and more than bravery is
intelligence. Mental health and the associated stigma are vital here. This
illness destroys what could be a fertile mind. This is the best surety for the
progress of societies.