Friday, 9 November 2012

It's all in the mind

A few months ago I was given a great opportunity to spend a month in a pharmacy department at a psychiatric hospital. It was definitely an experience! Here's a little snippet of it...

Talking about mental health and accepting it is increasingly becoming encouraged in society, however there is still a stigma associated with it. I chose to apply for a placement in a mental health hospital partly because I find learning about mental health and its treatments interesting but also because I wanted for myself to see first hand what mental health actually is and meet individuals with some serious mental health problems face to face. It was at times uncomfortable , much more than I expected it to be, however I learnt so much about pharmacy in mental health as well as about patients and discovered a new found compassion for patients with mental health.

My placement began just over a week after my last exam , which didn't give me plenty of time to rest and prepare. I found the first week especially exhausting as I got adjusted to the two hour bus ride there and back.

Anyway, as it got closer to my first day I was begining to become more aware of what I would be faced with , especially after some conversations with my med student and pharmacy student friends, the task became more daunting than I expected. However I knew it would be a great experience and it was.

At first I may have felt a little out of place and that I was getting in the way. I soon began to  learn how the dispensary worked ; understanding hospital prescriptions and getting to grips with clozapine! Some of the staff were unaware of how much I knew, considering I had only had a few lectures on mental health and they had years of experience- not very much! However they were very patient and extremely hospitable, soon enough I got the hang of things and felt part of the team.

I soon found out that ward rounds were very different to the ward rounds in general hospitals and the way the wards are organised is very different. Due to the fact that the patients tend to be physically fit they dont need to be in bed all the time so they walk around the wards, can watch TV and socialize, in fact at times the atmosphere was so relaxed that it was difficult to identify between staff and patients.(however most of the time I was quickly able to identify the patients and the staff) The patients also tend to be in hospital for longer periods of time or are returning patients so its obvious that the staff get to know patients pretty well and pretty quick.

The ward rounds can take between three hours to almost a full day , depending on how many patients the consultant wants to see. Sitting in on these ward rounds with a multidisciplinary team it became obvious that there was a lot more to mental health than I may have first anticipated.
Clearly I was particularly interested with the  drug aspect however this was a minor part of the holistic treatment of the patient, the patients home life has to be considered; who are they living with? (if anyone) and if alone - are they able to look after themselves , if not- who will help them? - what services are available? It was encouraging to see that even the patient's spiritual life was addressed, as some patients were taken to a local church and visited by chaplains on the wards.
 I looked forward to seeing the patients themselves and hearing what they had to say , although at times it may have been difficult to grasp what they were actually talking about or trying to get across , there was always a common sadness to their stories;  a need for recovery and independence.

I found it particularly hard to see how the patients were; "locked in" unable to leave the wards to go outside without the approval of the consultant and even then it may be escorted leave and at a time limit. Clearly I understand why it has to be done , but it was just strange to see it happen in front of me , it made me realise how much I take for granted the independence and freedom I have.

There was also a forensics ward for mentally ill patients that had committed crimes, I was a little apprehensive at first about going into that ward , especially after learning about all the safety measures that are put in place , and I admit that it may have been a little frightening to lock eyes with some of these patients. However when on the ward round the consultant was great, she briefed me on each case that was discussed before meeting the patient. I got to see especially how reliant the staff were on the ward pharmacist , it was clear how he was able to intervene with recommendations on alternative drug treatments and suggested treatment plans.

It was great for me to see first hand the involvement of pharmacists in mental health, and for me to meet patients rather than just basing my views on what I had read/had been told. "There's no health without mental health"- Department of health seems a fitting statement for what I have seen.