To Disgruntled Consumer's Surprise, Speedy Med-Checkers Yearn To Do More
Maybe all those community mental health doctors I’ve been trashing for years aren’t so bad after all. I had the opportunity to sit in last month on a “Symposium on Recovery for Psychiatrists in Pennsylvania,” and it served, if nothing else, to change my attitudes toward the doctors I had demonized as uncaring slugs. (Sorry!) The event was sponsored jointly by the Department of Psychiatry at Thomas Jefferson Medical College and the Institute for Recovery & Community Integration at the Mental Health Association of Southeastern Pennsylvania (MHASP). The organizers needed people to take notes during work sessions, and looked to the Clearinghouse, whose mother organization is MHASP, for volunteers.
I’m glad I obliged because not only was the food really good, (thanks to our director, Chris Simiriglia, who apparently has a knack for throwing symposiums), but I got to see first-hand that the community psychiatrists who provide care for the poorest and most severely afflicted among consumers of mental health services are as human, complex and somewhat perplexed as the people they—to my shame—sincerely want to serve.
First off, I had to give credit to the forty-some doctors who attended for, well, attending. For those of you who don’t already know the drill, patients rarely get more than fifteen minutes and a prescription out of these people, notoriously at six-week intervals. That more than forty of these doctors took the day to come discuss how to change this practice was impressive enough; then I heard them speak. They didn’t want to just do med checks, they said; they wanted to be involved in a “recovery model.” In place of the brusque, inept, and yet too-somehow-still-too-important-for-your-hopeless-case drone, I saw an earnest group of frighteningly out-of-the-loop men and women who knew they were providing shabby service to very sick people and wanted to do better.
They wanted to establish a standard of care, they said. (Note: This apparently means that, as of last month, there was none!) They wanted to spend more time with their patients, to advocate for community support, to show people that psychiatrists don’t just keep watch over people who are a burden on society, that psychiatrists are doctors in the business of helping people get better. They want society to know that people with mental illnesses can recover and help build their communities rather than weighing them down.
Some even said they wanted to play a part in revitalizing the distressed communities in which their patients often live. This way, they reasoned, key ingredients for recovery: jobs, housing, social supports, quality medical care, etc., would be accessible for consumers.
Pretty impressive for a bunch of—what did I used to call them? Oh, never mind…
I guess the one thing that still bugs me about all this is that no community psychiatrist I ever saw took advantage of our fifteen minutes together to explain that my prognosis was grim because he or she could not provide the care that I needed. As must be true for many consumers, these doctors represented mental health care to me; I knew nothing else. I assumed this was how mental illnesses were treated and I didn’t know that my life, or at least years of it, might be saved by more appropriate care. I eventually learned that for myself, and that knowledge made all the difference. I took out my credit cards, held my breath, and paid a private doctor out-of-pocket in a last-ditch effort to end my pain. Years later, I’m much better, and I have a suggestion for my new-found friends, the community psychiatrists with whom I dined at the Hilton:
IF YOU DON’T HAVE THE RESOURCES TO HELP A PATIENT, TELL THAT PATIENT THAT HE/SHE NEEDS BETTER CARE.
Sorry for the yelling, but it’s an important point. An oncologist wouldn’t see a very ill cancer patient once every six weeks for fifteen minutes without mentioning that better treatment was available, no matter how poor the patient was. A person has a right to seek better treatment, to be informed, to at least try to scrape together enough money to stop the world from disintegrating. Self-advocacy is an important component of any “recovery model,” and we can’t advocate while hobbling around in the dark. We should be able to trust Dr. Stifled-by-the-System to tell us when his hands are tied, because our lives are in his hands.
I think that makes a pretty good interim ‘Standard of Care.’
Posted by Daniele Sadres
I’m glad I obliged because not only was the food really good, (thanks to our director, Chris Simiriglia, who apparently has a knack for throwing symposiums), but I got to see first-hand that the community psychiatrists who provide care for the poorest and most severely afflicted among consumers of mental health services are as human, complex and somewhat perplexed as the people they—to my shame—sincerely want to serve.
First off, I had to give credit to the forty-some doctors who attended for, well, attending. For those of you who don’t already know the drill, patients rarely get more than fifteen minutes and a prescription out of these people, notoriously at six-week intervals. That more than forty of these doctors took the day to come discuss how to change this practice was impressive enough; then I heard them speak. They didn’t want to just do med checks, they said; they wanted to be involved in a “recovery model.” In place of the brusque, inept, and yet too-somehow-still-too-important-for-your-hopeless-case drone, I saw an earnest group of frighteningly out-of-the-loop men and women who knew they were providing shabby service to very sick people and wanted to do better.
They wanted to establish a standard of care, they said. (Note: This apparently means that, as of last month, there was none!) They wanted to spend more time with their patients, to advocate for community support, to show people that psychiatrists don’t just keep watch over people who are a burden on society, that psychiatrists are doctors in the business of helping people get better. They want society to know that people with mental illnesses can recover and help build their communities rather than weighing them down.
Some even said they wanted to play a part in revitalizing the distressed communities in which their patients often live. This way, they reasoned, key ingredients for recovery: jobs, housing, social supports, quality medical care, etc., would be accessible for consumers.
Pretty impressive for a bunch of—what did I used to call them? Oh, never mind…
I guess the one thing that still bugs me about all this is that no community psychiatrist I ever saw took advantage of our fifteen minutes together to explain that my prognosis was grim because he or she could not provide the care that I needed. As must be true for many consumers, these doctors represented mental health care to me; I knew nothing else. I assumed this was how mental illnesses were treated and I didn’t know that my life, or at least years of it, might be saved by more appropriate care. I eventually learned that for myself, and that knowledge made all the difference. I took out my credit cards, held my breath, and paid a private doctor out-of-pocket in a last-ditch effort to end my pain. Years later, I’m much better, and I have a suggestion for my new-found friends, the community psychiatrists with whom I dined at the Hilton:
IF YOU DON’T HAVE THE RESOURCES TO HELP A PATIENT, TELL THAT PATIENT THAT HE/SHE NEEDS BETTER CARE.
Sorry for the yelling, but it’s an important point. An oncologist wouldn’t see a very ill cancer patient once every six weeks for fifteen minutes without mentioning that better treatment was available, no matter how poor the patient was. A person has a right to seek better treatment, to be informed, to at least try to scrape together enough money to stop the world from disintegrating. Self-advocacy is an important component of any “recovery model,” and we can’t advocate while hobbling around in the dark. We should be able to trust Dr. Stifled-by-the-System to tell us when his hands are tied, because our lives are in his hands.
I think that makes a pretty good interim ‘Standard of Care.’
Posted by Daniele Sadres
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