trying our patients

So, what is  wrong with our “mental  health system”?

Maybe its not just in mental health – maybe our whole approach to healthcare is making us sick – or at best not helping us get well and stay well….

Can a system designed and optimised to apply 19th and 20th century industrial models of  organisation of resources to tackle infectious diseases work for the kind of chronic illnesses we now face?

How does a “factory” model designed to make it easy to deliver industrial healthcare interventions requiring capital intensive machinery, OR theatres, and highly trained physicians help with the kind of chronic illnesses that many folks live with today. Maybe that model doesn’t suit so well and nto that one model of ‘healthcare delivery” we need to develop a different, more social approach like the one in Grmany mentioned in the article.

Our current institutions are based on glamour, attracting large research grants spent on technology and a race to find the cure and donations to build magnificent edifices which serve many good purposes but also lead to “patients” feel they have less and less power over their own bodies and lifes.

It’s difficult to make a connection between all that and healing.

How can our existing model of large institutions marshalling huge technological resources, and  in which we “the patient” play a largely passive role,   work for the kind of illnesses we now know are on the increase?

Especially with chronic illnesses, the choices we make daily play as a important a role as any other – be it our genes, our environment, our experiences  of life and the medications and other tools  available to us. Even with current vogue for talk about “patient centred care” in our healthcare system it is still the healthcare professions who decide what that looks like.

system for the delivery of medicine

Too often it seems we don’t have a healthcare system but a system for the delivery of “medicine” .

In this the experience of the patient plays but a small role: the first person experience is regarded so often as merely ancillary.

So much more money and energy is spent on guarding against or controlling the risks that patients represent –  patients create work, ask awkward questions, make personal demands- or horror: patents might sue! … than is ever spent on listening to patients  or asking patients what they think they want or need.

Yet more radical, how about working with patients so they can contribute to designing an improved experience?

To often it seems people worling inside the system have become worn down by it – snared in a thinking trap and – minded to belive that the system would likely work a lot better if only they  didn’t have to deal with patients..

Yet the vast majority of people in healthcare joined to do th e oposite and often feel as ill-treated, trapped or powerless  as patients might. “People behave according to the systems they are in”.

It’s tough to make connections between a system that so clearly makes so many of it’s own workers tired, stressed, burned out, and ill can “deliver healthcare”.

In an insightful article from EYE Weekly,  Aug 2011 by Brian Keenan- in which he asks questions like this and talks with Sholoum Glouberman, Philosopher in Residence at Baycrest Healthcare, and founder of Patients Association of Canada.

Social medicine

There are different approaches available to us..The article briefly mentions an example of “social medicine” pratised in Germany: a system created within neighburhoods in which neighbours help each other learn how to look after themselves and expensive equipment assets are based in the community. Not only does it help people learn to take a bigger role in looking after themselves but it also strengthens community bonds that reinforce people’s connection with each there so individual and community health improves.

Keenan contrasts this with it’s equivalent in UK – big hospital, highly trained staff and high tech approach which costs more, “delivers poorer outcomes” as the terminology goes, and is  proving difficult to sustain.

Patients’ Association of Canada

for more on the Patients Association of Canada and its work trying to reform Canadian Healthcare through in a different kind of advocacy- not by yelling, raising angry shaking fists or suiing but by working with healthcare organisations .

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We believe people can and do recover from "mental illness" - because we are living it. We believe in the power of supporting each other: learning from and with each other. You are welcome to join us..
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1 Response to trying our patients

  1. Anne says:

    Excellant article! It seems that are though there are some really great people who are engaged and looking to help, the maze and noise that we with the illness must navigate is enormous!
    Lets also be realistic, mental health still carries an enormous stigma and in todays world that carries into monetary terms. Many “pysch” wards are dirty, dull and drab, while mere floors away windows give tonnes of daylight and the paint is nice and bright.
    Much can be done to rehabilitate the buildings…our biggest obstacle is perception and prejudices ingrained in “Mental Illness”.


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