Parity of Esteem
Over the past few years psychiatrists have tried hard to promote “parity of esteem” for our patients, something that the government and Department of Health have at least supported nominally. Our efforts and the publicity in the media, not always positive, have enabled us to get mental health up the agenda so that, for the first time in my career (over 37 years), it has been featured as an election issue. So far, so good. What receives scant attention is the prejudice shown by our colleagues in the medical and nursing professions. Our patients have scant attention paid to their medical needs so that mortality and morbidity rates for psychiatric patients are much higher than average. something that is nothing short of a scandal. Not that you’d know it though!
The prejudice is also shown to those of us who have chosen psychiatry as a career. According to the current Secretary of State mental health does not involve working on the “front line”. This has led to greater than average cuts to mental health services. Not on the front line? I’m reminded of an evening on call in west London when I was trying to conduct an emergency assessment. I arrived with the social worker and several van loads of police some dressed in riot gear. The man we were trying to assess was behind his front door allegedly armed with a machete. We were able to persuade him to let us in without the police – he didn’t have a machete and we were able to carry out our assessment and make the appropriate clinical decision. Not on the front line? Give me a break!
Psychiatry demands of doctors the ability to listen to patients’ stories, the ability to negotiate treatment packages and a commitment to care over long periods. If ever there was a speciality that was holistic it is mental health. It requires patience, empathy and that truly undervalued attribute needed in all doctors – kindness.
Dr John Wilkins, Consultant Psychiatrist is commenting after reading https://www.theguardian.com/healthcare-network/2017/may/25/worried-working-psychiatry-patient-taught-lot