3 Things Every Psychiatric Practitioner Should Remember


As both a mental health patient and an advocate, I hear a lot of complaints from patients about providers. Each side sees things from their perspective and a power struggle often emerges.

There are many things I wish psychiatric practitioners understood about living with mental illness. Much of this, however, is taught in medical school and many practitioners do understand and incorporate into their practices. When discussing an entire profession, spread across an entire country, who work with a variety of different people, it is impossible to offer advice that benefits everyone.

That said, here are the top three things every practitioner should keep in mind to help their patients achieve better results. If you are already doing them, thank you. If not, please consider adding them to your routine.

1. What is the goal of your patient?

Whenever I give a speech to providers, I always start by giving the group index cards and pens and asking them to write the number one goal for their patients.

Answers like “med-compliant” and “miss less appointments” and “follow my instructions” are always the most popular answers. I use this to illustrate the divide the between patients and providers. Almost no one ever writes “live well” or “go to Hawaii” or “get back to work.”

Being med-compliant, missing less appointments and following medical advice are steps to reach goals, along with many others. If your goal for your patients is that they go home, swallow pills and come back – on time – then your goals are the wrong ones. The fact that many practitioners feel this way becomes very obvious to patients very quickly.

Work with your patients to understand the benefits of following these steps. We all have goals in life and you are in the position to help someone achieve theirs. When your patient understands your objective is to help them achieve their goals, they will be much more inclined to follow your lead.

2. Ensure your office staff understands the needs of your patients.

The phrase, “You never get a second chance to make a first impression” is important to remember. Most times, that first impression isn’t created by the provider, but by the provider’s staff. Office staff sets the tone for a practice. Even things as simple as rushing a patient through check-in or not thoroughly explaining the process can be troubling to a patient who is particularly vulnerable.

Visiting a mental health provider can be scary for many reasons, and the office staff is on the front line. If a patient is anxious, feels threatened or feels isolated, and the office staff behaves in a way that is deemed threatening, the patient could become defensive and combative.

This extends to the waiting room, as well. Crowding, noise and uncomfortable temperatures can all trigger people suffering from mental illness issues and side effects.

Depending on your medical specialty, your patients may spend more time in the waiting room and with the office staff than they do with you. Creating an environment where the patient feels immediately safe and supportive will go a long way toward improving the effectiveness of care you can provide.

3. Medication without understanding limits compliance.

Medication is an important tool for reaching recovery. It’s also very misunderstood by patients and, given the confusing nature of a mental health diagnosis and the lack of knowledge surrounding these disorders, misinformation often becomes fact in a patient’s mind.

Realize that a patient may not be refusing to be medication compliant because they are difficult, malicious or even ignorant. It’s because they are scared of something. More often than not, it is a side effect they are suffering from or a perceived moral value in the taking of psychiatric medications.

All of this can be remedied with education. Psychiatric medication classes should be offered by medical practices. These classes would cover exactly what different medications are for, the appropriate expectations of taking them and the patient’s responsibility — more than what a pharmacist is tasked with, but specific information for psychiatric patients. People need to stop believing pills work instantly and without side effects, and that doctors always prescribe the correct pills and the correct dosage on the first visit.

Medications, as all doctors know, don’t cure everything. Therapy, support groups and experience, in conjunction with medication, lead to wellness. If patients mistakenly think a single pill, taken twice daily, will solve all their problems, they mighty stop taking all medications when that doesn’t happen.

When people understand how difficult it is to find the right combination of medications, and feel like they have input into that search, they will become motivated to work with the process instead of against it. Managing expectations and fostering an understanding of the process improves the patient experience and, therefore, compliance.

In Conclusion…

This list could easily be a top ten list. Patients, myself included, wish that providers had more time to spend with us, that the waiting list wasn’t so long, that providers asked better questions, assumed more, or assumed less.

We wish providers knew it can be intimidating telling our stories to a stranger. Along those lines, it can be hard for a patient to remember four, eight or more weeks’ worth of moods since the last visit. We often just answer how we feel in that moment.

It is important to discuss diet, exercise and sleep with us, because our bodies are connected to our minds. We want you to celebrate small victories with us. Getting out of bed for the first time in two weeks is a big deal to us.

But, more than anything, we want our providers to understand mental illness can be pure hell. We want to know you are dedicated to helping us lead great lives and are taking our issues and concerns seriously. Living with mental illness means a lot of people in our lives don’t take us seriously. We need to trust you, and for you to trust us.

To see more from Gabe Howard, visit his site

All rights reserved. A version of this article originally appeared on PsychCentral.com as “Top 3 Things Every Psychiatric Practitioner Should Remember.” Reprinted here with permission.

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