Saturday, April 29, 2006

"To all of the mentally ill people reading this: I am sorry."

A junior psychiatrist rants. "I feel for you. I understand why you feel so bitter." At Trick-cycling For Beginners:
A nurse in our meeting, a senior nurse, the head of the community mental health team, who has never met this patient, gave us this very helpful and thoughtful recommended treatment plan (I quote her, verbatim):

"You need to turf her - a waste of space like that."

All through the meeting, at any mention of any patient with, say alcoholism, or self-harming behaviour, she gave a derisive snort and a roll of the eyes.

How can I keep standing up for my profession when this is the sort of attitude exhibited by my colleagues? Why on Earth should people feel anything but bitterness and antipathy towards a profession displaying this kind of bigotry towards the people they are trained to help? Why the **** should I expect psychiatric patients to understand that the system is in place to help them when this is the kind of crap they have to face?
She's right. Some of the worst stereotyping and stigma can be found in our own field (and not just among nurses). It is spoken, and unspoken. It's horrifying. It's tremendously discouraging.

It's also immune to rants, unfortunately.

More on stigma and the mentally ill: here, and here, and here, and here.


Blogger Fallen Angels said...

This is so sad. I have never been hospitalized, but the few times it has loomed as a possibility, the fear that gripped me was over whelming...all because of things like this. I have an internet friend that was sutured without an anesthetic because "you did it to yourself, you want the pain". Another friend that was told she would be sent to a state hospital against her will unless she (miraculously) stopped hearing the voices. This friend is DID, not psychotic.

My favorite Aunt has been a psych nurse for about 30 years. She's the night charge nurse on an involuntary locked ward in the midwest. She is the kind of nurse you hope for...Kind, considerate, soft spoken. But they aren't all like that...sadly

12:19 PM  
Blogger Spiritual Emergency said...

Thank you for saying as much, Shrinkette. I recently had an encounter with someone who claims to be a psychiatrist in the online environment. I found her treatment of me (I had a schizophrenic break and have since recovered) to be quite appalling and her representation of the professional body of psychiatry to be just as appalling.

I trust that the majority of individuals who choose psychiatry as a career are motivated by a sincere desire to help others to the best of their abilities. Unfortunately, there are a few bad apples in every bunch and when their behavior declines to name-calling, lying, and harassment, it is only fitting that they be called to the attention of their peers.

I sincerely hope, on behalf of people like me and people like you, that this individual is a fraud.

A conversation with a "psychiatrist"

See also:
Choosing a Competant Caregiver

1:06 PM  
Anonymous Nutty said...

Sadly, there are too many people working in mental health who stick labels on people and then treat people the worse if they've stuck certain labels on them.

My moods go too high and too low and I lose touch with reality. I'm comfortable with a diagnosis of bipolar. From time to time, I get a new pdoc who wonders if I'm borderline. I don't think I am, and they always conclude I'm not when they get to know me, but not before I've had a chance to see how differently people get treated according to which label they get, notwithstanding that the symptoms are the same.

PDs are dreadful labels because of the way that some people working in mental health respond to them. You get better care without a PD label and the best care from professionals who don't give a toss whether you've got a PD label at all.

1:33 PM  
Anonymous Anonymous said...

I've been in therapy for 5 years, I've just found out that a behavior I do is considered self harm (not cutting). But I won't tell my therapy team.

I am posting on here as anonymous because I've posted here before and others who read your blog read mine.

I'm simply afraid ... the stigma ... how they'll handle it (you have to go inpatient if you're harming yourself) etc etc etc

1:37 PM  
Anonymous Maria said...

Thank you for posting this, Shrinkette.

6:40 PM  
Anonymous difficult patient said...

Wow, people like that need to choose another profession. 'Nuff said . . .

7:59 PM  
Blogger Kat said...

My half sister tried to tell me she understands my depression because her mother is a mental health nurse - but when I started therapy, she (sister) said I had mental issues and wouldn't let me see my niece.

8:11 PM  
Anonymous Anonymous said...

Reading that makes me really sad.

12:28 AM  
Blogger Donna said...

How frustrating that the stigma is still there with a lot of people, and that they treat people with mental disorders as stupid or dangerous. They refuse to understand that people with mental disorders are just like them.

10:28 AM  
Anonymous Kaetea said...

I don't make a habit of posting...but I like your blog shrinkette.

I am an RN in your town. A very experienced cardiac nurse said of my pt, whom had a psychiatric DX and was on our floor due to a lack of psych beds; "it's a shame people like her taking up bed that people who are really sick could use."

I liked this pt quite frankly, she was very sick and quite in need of help. She had bitten a chunk out of her wrist while psychotic. I found it rewarding to care for her.

I was later to meet her again, at a support group I went to for bipolar disorder...yes..I am a nurse with an MI. Shit happens.

And there are lots of nurses in this town that maybe...maybe need a little shit to come there way and then they might understand what it feels like to be treated like something disposable.

5:40 PM  
Blogger NeoNurseChic said...

Funny (in an awful and sick way) how this stigma carries over through a variety of different illnesses, too. I've been suffering from a continuous migraine for over 5 years, and I'm also an RN. I used to want to work with headache patients who were inpatient before I became a neonatal nurse, and I received so much crap because of that. I still have surveys from an educational intervention I did with nursing students on migraine and headache, and the commentary on there from people who supposedly "care" is just incredible.

I've been an inpatient for headache at least 8 times myself, and I have gone to the ER a few times in the midst of a bad one when I couldn't get ahold of my doc. One night, however, I was doing clinical as a nursing student in the ER, and I heard this nurse that I actually liked quite a lot, turn to a neurology resident I've known for years and say, "I wish all these migraine patients would just go home and stop wasting our time."


I tapped my friend (the neuro resident) on the shoulder and said, "Yeah - we ought to all just get the heck out of here and quit taking up space..." *sigh*

Makes me wonder how people like that survive under serious adversity. And yet, I'd still treat them with open arms if they were my patient for any reason. Going through experiences like these teaches us how to be so much more compassionate than close-minded people ever will be...

6:37 PM  
Blogger Joel said...

I was talking to a friend just today who ranted about how NAMI has taken the position (I'll take her word for it) that all mental illness is the product of organic brain dysfunction and that childhood experience has nothing to do with it.

Now I know that to be a line of bull-pucky -- my parents didn't cause my bipolar disorder or OCD, but they did cause my PTSD. One form of prejudice that medical professionals engage in these days, therefore, is the notion that the caregivers are blameless.

When you hear the stories of violence, rape, etc. and then hear some psychiatrist/nurse get together with the perpetrator of these crimes as if the patient were lying, you begin to lose faith in some of the medical profession.

I've gone to so many talks where the caregivers stand up and say "But how do we control them?" A few of the psychiatrists nod and give them the "oh yes, they can be difficult" line right in front of the rest of those of us who are afflicted.

I am tempted to stand up in one of those meetings and say "Doctor, I want to know this. How do we control them? They freak out if we laugh. If we want to go to the store, they ask us for a complete shopping list. They check our pills. They read our diaries. How can we control them? They are so clearly out of hand and what is worse, they don't think they have a problem!"

That is the variety of stigma which I see killing the spirit of many of the mentally ill. One thing about the old psychoanalysis was that it did not discount stories of abuse as readily as some contemporary mental health professionals. Maybe it is time to stand up to the caregiver lobby and say "Yes, it is organic. But it can also have sociological roots, too. Recovery is about accountability. You need to start setting a good example."

1:17 AM  
Blogger Spiritual Emergency said...

I think I'll go with, "the system stinks".

It's not that there are not excellent and committed caregivers out there but there are also caregivers out there who could be better than they are if the system wasn't set up the way it is. And then there are caregivers who are so unhealthy themselves, they shouldn't be within 100 feet of any wounded human being. Those ones are a double burden, harming both the "patient" and the reputation of sincere and committed caregivers in the field.

I consider myself exceptionally fortunate to have bypassed the entire system.

8:23 AM  
Blogger Shiny Happy Person said...

Gosh - what an accolade! Thank you so much for doing this, Shrinkette. My comments have now gone through the roof....

BTW - if you think it worthy, would you mind putting my blog in your links list, please? Thanks.

1:17 PM  
Blogger Spiritual Recovery said...

Gosh - what an accolade! Thank you so much for doing this, Shrinkette. My comments have now gone through the roof....

Any individual who is willing to at least see the bias from within is worthy of the accolade in my opinion, but the bitter truth is that little will change simply by venting in a blog.

To a certain extent, nurse are on the front lines and that's difficult too. Nurses can ease your job or make it ten times more difficult. Nonetheless, you're the one who is there. The nurse is the one who is there. If you sincerely believe her behavior to be unacceptable, call her on it. If you won't or you can't, then that is an entirely different problem.

3:08 AM  
Blogger Katie said...

I used to be a therapist prior to embarking on a Ph.D in chemistry. I was always sadly surprised by this type of attitude among my fellow mental health "professionals".

8:41 AM  
Blogger Melissa said...

I am a nurse and I can't tell you how many times I've seen my felow nurses display this same discompassion. It sickens me and makes me ashamed of my profession at times. I wish I knew what the answer was to get through to them.

8:49 AM  
Anonymous Jessica said...

This is so sad, but so true. I'm currently struggling with depression but the only person who knows about it is my neuro, and she dosen't even know how bad it really is. I'm so embarassed, about and the fact that a large part of society dosen't accpect it.

8:49 PM  

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