During our one week stay at MetroPsych Facility (MPF) for our Psychiatry Rotation, we were asked to observe a session of GROW, or group therapy session. During the GROW session, the patients were asked to share important thoughts or feelings regarding their illness, and how it has affected their relationships, or any issues they have regarding their treatment and path to wellness.
I was happy to hear from the patients who had success stories regarding their recovery, and I was surprised to find out that most of the employees at MPF were former patients, pointing to how well they were able to adapt to their condition and find purpose in their lives. However, it saddened me to see that JL, the patient assigned to me was crying a lot during her sharing. She said that she really missed her family and wanted to go home already, but she also expressed her concern that despite being with her family at home, she did not get the support she wanted and needed; especially emotional support from her mother, who according to the one of the psychiatrists at the facility was an undiagnosed, therefore untreated individual with Bipolar mood disorder.
It really is strange how we perceive Psychiatry. If a doctor were to see a person beside him on the train who was coughing uncontrollably, he could recommend that the individual see a doctor, or he could give some medical advice and that person would most probably be thankful for the free medical consult. However, if a psychiatrist were to see a person on a train with an obvious personality or mood disorder and she were to try to intervene, he or she would most probably be seen as rude and acting out of place.
I don't see why there should be such a big divide on how medical and psychiatric illnesses are treated and regarded not just in our society, but even in the medical world. I dislike the fact that referrals to Psychiatry must have a special term, like Consultation Liaison (CL). I know that this is because CL can involve not just the condition of the patient but also relationships within the medical team, but I think that this helps further enlarge the gap that exists between “normal” Medicine and Psychiatry, which perpetuates the stigma associated with psychiatry.
We don't see people with other chronic medical conditions like Coronary Artery Disease (CAD), asthma, chronic kidney disease (CKD), or Diabetes as abnormal, so why must things be different for Psychiatric patients? Why can't Psychiatry be unified with the rest of Medicine? Like all other conditions, Psychiatric conditions are mostly about genetic predisposition, and physiologic abnormalities, so what’s the big difference?
Maybe it's because Psychiatric conditions are so abstract. The impairment/injury is not clearly visible, like when a person breaks an arm or gets a laceration somewhere on their body. In psychiatric conditions, the disability is what is more prevalent, and I think that's what people are really adverse to; they can't relate to Psychiatric patients because they can’t “see” their condition on a physical level. What's worse is that sometimes the condition is completely unified with the person. For example, people stop seeing a patient as a person with schizophrenia, all they see is a schizophrenic. They somehow start seeing the person as the disorder, and I think that shouldn't be the case.
Going back to my assigned patient and her mother with undiagnosed/untreated Bipolar Mood Disorder, I wonder what would have happened had the psychiatrist recommended that the mother also seek Psychiatric help. She would probably have been rebuked/verbally assaulted. Heck, she may even have been sued. Maybe one of the things that we could do to help integrate the idea of Psychiatric conditions and/or interventions into the general scheme of Medicine is to standardize Psychiatric evaluations, or to make them mandatory. In the same way that medical check-ups are mandatory in most institutions, Psychiatric check-ups should be too. But they should be part of the standard Medical check-up so as to not separate it from all the other examinations. After all, Psychiatry is just another branch of Medicine. It is nothing special, but that is not necessarily a bad thing. Psychiatry should be normal, despite the fact that it tackles what people see as inherently “abnormal.”
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