The tricky subject of ‘like’ in mental health care

I’ve been concerned by comments from some mental health professionals about myself and others both within and under the care of mental health teams – at the insinuation of feelings of ‘liking’ or ‘disliking’ each other from the perspective of both the patients and professionals in question, and the importance that this is given.

If I were to need a heart operation, those health care professionals assessing, operating and treating me would be those most appropriate with regards to their skills, experience, knowledge, and position. The care would be tailored towards my needs, taking the broad spectrum of those into account and weighing up the people and resources available. There may be different treatment options available – perhaps performed by different professionals who specialise in that – and, under the advice of the team caring for me, I would make a decision about which is the best path for me as an individual. In an emergency situation, the options would be greatly reduced but again the most fitting professionals would be chosen to treat me. At no point would how much I ‘like’ any available professional be considered (or vice versa) – and nor should it.

However, I find that in discussions regarding my mental health care, the extent to which I ‘like’ certain professionals is frequently brought up by others as a consideration – normally as an admonishment that I can’t expect to have people I ‘like’ treating me. This then gets compounded by the dreaded diagnosis of ‘personality disorder’ (of which I have more than one)…at that point you hear suggestions of ‘reliance’, ‘demonising and hero-worship’, ‘manipulation’ and more. I find this both perplexing and concerning. To me, this seems to suggest that my expression of whether a professional’s expertise/experience/techniques/knowledge are suitable, helpful or harmful as part of my treatment is misinterpreted as a request of spending time with who I do or do not like. Not only is this far from the truth – I am looking for someone to help treat a serious illness, not a friend of which I am thankfully blessed with plenty – it also demeans the work of the professionals in question as well as the opinions of appropriate treatment from patients. Of course, therapeutic relationships based on trust and understanding are very important, but this has little to do with whether I’d like to have a coffee with the person – like every other illness, it is about which professionals have the correct experience, expertise and working styles for the patient and condition in question – the only difference with mental illness is that, rather than a conclusive medical test, it is often most important to find out from the patient what help they need. I imagine that this is the hitch that is often hit when presuming patients are showing favouritism – combined with the old fashioned view of mentally unwell people having no idea of what’s best for them.

What also concerns me is how this works from the other side: does this mean that mental health professionals get to choose to help or not help someone based on whether they like them? Obviously, safeguarding of all involved has to be a top priority, but when that isn’t an issue surely healthcare should never be based upon subjective judgements and who one might like to spend their downtime with? 

For me, at least, it is much less about who treats me and more about how they treat me. 

Mental health professionals: please try to take a step back if a patient is requesting that a specific professional is or isn’t involved in their care; consider that this is likely not to do with individuals, personalities or interests but delve into what it is about that professional’s knowledge/approach that makes them helpful/unhelpful. Most importantly, please try not to personalise or include guilt in the equation. 

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One thought on “The tricky subject of ‘like’ in mental health care

  1. When my psychiatrist who I’d been with for several years left I made a comment that it was a shame as I got on well with her. I said that if I’d met her elsewhere felt we could have been friends. Stupid! That has been thrown at me so many times since. That was before I was aware of this paranoia that mental health professionals have about being liked! Of course I had attachment problems, abandonment problems etc Must have PD.

    Yeah nice blog Doodle

    Liked by 2 people

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