10 Things Patients Want From Psychiatrists

My relationship with mental health professionals has been fraught at best. After 20 years, I’ve found therapists and psychiatrists to be egotistical and inept.

I’ve met psychiatrists who love themselves. One of them even called himself “The Rolls Royce.” There was also a woman who promised to cure me in 6 weeks. Apart from giving me medication based on their database of choices, they haven’t done anything to help me.

That’s not to diminish people who have had positive experiences. I’m glad for you. I want “the system” to work, and it pains me that it’s so lacking for so many of us.

If I could tell a psychiatrist what I want from them as a patient, I’d say this.

1. Do some basic prepping.

Psychiatrists are busy people. My medical record is the thickness of an old phone book. I don’t expect them to read 20 years of history before my appointment.

I do expect them to know who I am and why I’m there. The final straw came when a psychiatrist asked me how I was coping with flashbacks of the fire. I had no idea what she was talking about.

A psychiatrist in my medical history connected my trauma to a fire. It’s almost ingenious. I’ve seen violent death in nearly every form imaginable EXCEPT a fire.

The experience ruined my consultation and left me raging at their incompetence. How long has this fire myth been perpetuated? Who came up with it, and how? What other nonsense is in that vast case file?

2. Don’t talk down to me.

A couple of decades ago, I was just like them. I am qualified in therapy, and I have counseled people as a volunteer on a suicide hotline. As a police officer, I’ve saved the skin of several psychiatrists in danger of getting a kick-in from a patient. During this time, they never cooed at me, talked around me like I wasn’t there, and never once patronized me.

As soon as I got ill, it was a different story. They treated me like a child, discussing me with my mom while I was present. One person even performed a puppet show using sock puppets stored in a drawer. I don’t know what’s worse — this idiot with his sock puppets or me for sitting through the entire performance.

While in a mental hospital, people shouted at me, ignored me, and treated me with scorn. It reminded me of the prison guard experiment.

3. Either explain why you’re using a database or try and hide it.

Psychiatrists have studied for years to get where they are. They prescribed medication, which helped change my life. Fantastic right? All that training paid off?

Not exactly.

Whenever I go to change my medication, they work through a computer database.

If the next medication didn’t work, I could see what prescription I would be given after that. True patient involvement. Years of training to read a list and move down. If they had sold me the program, I could’ve saved much time and frustration.

So, if you’re going to laud your qualifications over patients, at least hide the database we can all see.

4. Explain the side effects and how long meds take to work.

No psychiatrist has ever told me about the side effects of a medication they prescribed.

He didn’t tell me that taking an anti-psychotic to help me sleep would almost certainly cause weight gain. I gained 80lbs in a year.

I took an anti-depressant that made me angry. The response was skeptical and made me feel like a liar.

Luckily, I’ve learned to read the leaflet with the meds myself. The psychiatrists had an opportunity to show what they learned, but I only had a factory leaflet to rely on.

5. Don’t ask me what I want from them.

Mental health professionals often ask patients, “What do you want from me today?” It’s a harsh and hurtful question.”

Imagine turning up in the ER after a car crash, and the Dr asks you what you want. You’d probably despair and shout that you want him to repair the damage.

When someone with mental illness sees a psychiatrist, they don’t have the same knowledge. So what kind of answer does the professional expect besides “stop me suffering?”

Since you’ve received training, you should understand the needs of someone in despair. Make sure you have different treatment options and suggestions you’re prepared to offer. Stop relying on the mentally ill to do your job for you. It’s lazy. Use one of your databases if you must.

6. Don’t cancel appointments at the last minute.

It takes a lot for a person with a mental illness to pluck up the courage just to leave home. It takes a bucket of courage for them to attend a doctor’s appointment. Cancelling at the last minute can ruin an entire day. It destroys rapport and damages whatever trust has been built until that point.

Even worse is canceling but not bothering to tell the patient. It’s especially egregious on a home visit. I’ve stayed home for hours waiting because we can’t find the missing nurse/therapist. When this happens to me, I’m done with that person.

There’s nothing more precious than time. Even people with mental illnesses deserve consideration.

7. When you say you’ll do something, actually do it.

Don’t say you’ll call at a specific time and then not do so. Don’t say you’ll refer me to someone for further investigation, and then leave the forms on your desk. Don’t say you’ll write a letter and then not do so.

It got to the point where I’d groan when a psychiatrist told me he was going to do something. I didn’t believe them and knew the frustration that would bubble up when they broke yet another promise.

8. Don’t tell me it was God’s plan.

I don’t expect a sermon when I go to a psychiatrist’s office. A psychiatrist advised me to gather myself and accept that what happened was God’s plan.

Firstly, whatever God you have, I reject him. I’m a staunch antitheist, so the minute you invoke “him,” you’ve lost me.

But it shouldn’t matter, even if I was devoutly religious. It’s not professional to tell me to pull myself together and talk about God in therapy.

I should have reported him, but instead, I just never went back.

9. Don’t tell me to have a warm bath, watch something good on TV, or treat myself to a takeaway.

When I was feeling suicidal, someone gave me a 24-hour number for the “home treatment team.” This team consists of doctors and nurses who help patients stay at home instead of going to the hospital.

I didn’t like them and didn’t trust them, but I was desperate on one occasion. So I called the number at 9 pm. The woman on the other end had two unique suggestions before cutting the call short.

. She said I should watch “The Biggest Loser” on TV because it’s fun and will take my mind off my despair.

. She said I should have a hot bath afterward.

There is an entire TikTok account of parodies of the lousy advice doctors and professionals give. The people I’ve talked to have had takeaways suggested as the route to nirvana, using massage oil, or taking a walk.

10. Don’t lie to me.

I had the same caseworker for years. As far as these characters go, she was alright, but she was running out of ideas on how to treat me. She asked me to visit her and the practice manager to make a plan together.

In fact, the purpose of the meeting was to end treatment, and she brought the manager with her in case I got angry. From that day, no one checked on me, asked if I was okay, or came up with any alternatives.

I didn’t get angry. I was too depressed and sad to be angry. I just walked out. I wasn’t even surprised.

I can tell when someone is lying to me. After being a police officer for years, I’m an expert at it, and I can spot when I’m being told stories a mile away. I’m mentally ill, but I’m not stupid.

Final thoughts.

For a long time, I’ve alluded to the negative experiences I’ve had with mental health professionals. I decided it was time to lay it all out. To let them know how collectively useless I think they are and how bitter I am towards them.

At the same time, I want to reassure you that I got better despite these encounters. Despite the professionals, my life is better than I ever imagined. If you’ve had similar experiences, you can also recover.

I expect I will still have to see a professional now and then for a “medication review.” But thanks to Covid me and the fire I was never in have dropped off the radar entirely. I haven’t heard from anyone since 2019, and long may it stay that way.

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This post was previously published on MEDIUM.COM.

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