My second semester of Medical School has officially begun in full force and has shown no signs of slowing down. For those that don’t know I’m a 2nd year medical student studying in the UK, my course is ‘Case based’ meaning that we are presented with a case scenario at the start of the week and picking out key clinical and social aspects in our small groups. We explain what we know about each factor identified, recognise holes in our knowledge and come up with learning outcomes that each of us must look into and answer over the course of the week. During the two week block assigned to a particular case, we are given a series of lectures related to that case as well as a clinical placement one day a week. My most recent case was specific to Psychiatric Medicine, focusing on Mood disorders and Psychosis, prior to this, I had no exposure or knowledge regarding mental health.
Having grown up in Nigerian household to traditional parents, mental illness was not something we spoke about often and in many African cultures such a topic is viewed as a taboo. I am privileged to have parents that are well informed about mental illness as my Mum works in that particular field and my Dad in education, so they are both aware of the ramifications of mental illness. I remember visiting Nigeria for the first time at the age of 13, as we drove through a noticeably deprived area I saw a man wandering the streets with minimal clothing and appeared detached from reality, the driver quickly described him as ‘Mad’, which is something you hear quite often in Nigeria. I must admit I’ve always had a very naive perspective of Mental Illness, it always seemed so distant to me. I assumed that patients suffering from Mental Illness were dangerous, prone to violence, unpredictable and to some degree responsible for their illness. I had very little idea of what suffering from a Mental Illness actually entailed and never knew just how common Mental Illness is in the 21st century.
As part of my placement I spent one day with a Community Mental Health Team, which is comprised of Psychiatric Doctors, Clinical Psychologists, Social Workers, Mental Health Nurses, Occupational Therapists as well as other medical professionals, I guess you can say this a perfect example of a Multidisciplinary team. I sat in on a Depot Clinic, which is the administration of long-acting anti-psychotic injections to mentally ill patients. Initially, I thought this was the most boring thing I could have been tasked with, however looking back I learnt quite a few key things. My supervisor took a very interesting approach and did not inform me of what mental illness the patient was suffering from prior to seeing them but I had to make an educated guess after seeing the patient. This was much harder than I thought it would be as Mental Illness is often described as ‘invisible’, you may not think anything is wrong with the individual as they do not appear physically unwell. For example, Schizophrenia can present with negative symptoms characterised by the person becoming more socially withdrawn, showing loss of motivation and increasingly not caring about his or her appearance and personal hygiene in contrary to what is normally shown by the media (hallucinations and delusions). This completely changed my perspective of mental illness.
Psychiatry is viewed as such a dark profession, society often associates mental illness with serial killers and notorious violent criminals due to the media’s portrayal. One thing I really struggled with was hearing the stories of patients suffering from mental illness. I was told of a patient who had a particularly traumatic life, having been sexually abused as a young girl, she struggled with a drug and alcohol addiction and severe depression and on many occasions had tried to take her own life. Hearing of how mental illness has ended lives and destroyed families was heart breaking and challenging to hear. Patients are often reluctant to admit they have been struggling with their mental health and this can be due to prejudice, judgement and the social stigma.
Having completed this case, I must say I have so much respect for this speciality in the field of medicine. It is truly one like no other, based on abstract concepts and an intrinsic relationship between multiple factors, it has come such a long way and continues to progress. Gone are the days of Mental asylums, we now have integrated community care available. With Psychiatry you truly have the opportunity to get to know the patients on a deeper level, not only are the presenting symptoms discussed, but the patient’s entire life story from the moment they were born up until the present day is also elicited. Through consultations you are able to gauge how the person may be feeling, for example: if a patient is anxious, you too may feel anxious during the consultation and if a patient is all over the place and you’re confused it is most likely Mania.
Although I thoroughly enjoyed this case I can agree that Psychiatry is not the profession for me but has truly been a life changing experience.
I have discovered the value of psychology and psychiatry, that their teachings can undo knots in us and permit life to flow again and aid us in becoming more truly human. ~ Jean Vanier