Depression and dealing with healthcare professionals

Establishing and maintaining a good relationship with their healthcare providers – GP, counsellor, consultant psychiatrist, nursing staff and so on – was crucial to young people’s experience of care and the process of getting better. The key factors young people talked about influencing these relationships were good communication, trust and confidentiality, being treated as an equal partner and being involved in the decisions and, perhaps most importantly, being taken seriously.

Characteristics of a good health professional

Being treated as an individual, and for one’s life situation to be viewed as a whole were among the most important things young people wanted from their health care professionals. One woman said of her consultant, “He’s the only one that’s properly seen me as a person with an illness as opposed to a walking illness.”

Young people described how the best health professionals they had come across were “encouraging”, “respectful” and “non-judgmental”, as well as “proactive” in finding out what would work best for which individual.

Loz says his consultant is great and like ‘an Asian version’ of his Nan.

Age at interview 17

Gender Male

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Sarah describes being a nervous wreck before her first counselling session but says how happy…

Age at interview 17

Gender Female

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When he first saw the GP, Jack says everyone at the clinic was really helpful and he felt it was…

Age at interview 17

Gender Male

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Tina says it was fate that she had such an amazing GP. Tina believes that without her, I…

Gender Female

Age at diagnosis 24

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Many people remembered back to that one special individual who had stood up for them by “going out that extra mile”, being “very special” or just “chatting through the night” by their bedside whilst on the ward. Finding that someone who people felt a special connection with, and who they felt was “on their side” could make all the difference in getting better.

Mandy and Sian say sometimes you get that special person who will treat you not as a number or…

Gender Female

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Suzanna had an ‘amazing’ eating disorder therapist.

Age at interview 26

Gender Female

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Cat’s GP took her to the mental health unit in his own car because she was desperate for help.

Age at interview 23

Gender Female

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When B was on the psychiatric ward and couldn’t sleep, a nurse made her a cup of tea and chatted…

Age at interview 19

Gender Female

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Making decisions together

One of the most important elements of care for young people was genuine involvement in their care and sharing decisions about treatments. People resented just being informed of the care plan and “being told what to do” without discussion or being told the reasoning behind those decisions.

Being involved in all their decisions about care helped people feel more in control and gain a sense of independence. A couple of people commented how it had really helped them rebuild trust in themselves, something which they’d struggled with as a consequence of depression. Some people even described being included in their care plan as the main turning point towards recovery.

Being offered all available help and support was important to many people as it made them feel better able to make most of the care. Some described the health professional’s role as “guiding us to find our own way” through the different options. People said it was important to be treated as an equal over decisions concerning their own life and some criticised these decisions as too “random” or lacking options when they only came from the doctor.

Being involved in your care helps you learn to trust yourself, gives you control and an…

Gender Female

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B says the best way doctors can help is to give her information about all the options available…

Age at interview 19

Gender Female

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Trust and confidentiality

Being able to trust their doctor and the information, advice and care offered by them was key to how happy and satisfied people were with their care. Also, being able to trust their GP or therapist to honour confidentiality, with no information reaching their parents without young people’s consent, was just as important. Lack of trust in health care professionals had made some people “cynical” about talking to a doctor at all, or made them tell “an edited version” of what happened.

Erika-Maye feels cynical about talking to doctors.

Age at interview 17

Gender Female

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Joanna was left in the waiting room while her parents and her consultant decided what would be…

Age at interview 20

Gender Female

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Trust involved having a good and open relationship with the health professional; to feel like they were genuinely interested in the young person’s situation, and trust in the professional’s skills, expertise and knowledge. A couple of people made the point that building trust was a long two-way process.

Tom describes the experience of going to his family GP in acute crisis as horrific but said he could trust him.

Age at interview 21

Gender Male

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Oliver says he wont expect a GP to be that familiar with mental health problems, among broken…

Age at interview 23

Gender Male

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Communication and being listened to

Open communication with their doctor was essential for young people. They found it frustrating and irritating when health professionals wouldn’t speak directly to them but about them, with their parents, for example. They didn’t always feel listened to properly or said there wasn’t enough time in the clinic for them to be able to really tell the professional how they were feeling. Some had suffered from lack of communication or miscommunication between different health professionals within the health care system, for example between their GP and the consultant. Such experiences left these people needing to find things out for themselves and to keep proactive at a time when they were already struggling.

Oliver has learnt to trust his own instincts and to demand from the doctors all the information…

Age at interview 23

Gender Male

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Feeling patronised was the most common complaint. Many people felt they weren’t taken seriously or that the doctors questioned whether their experiences were “real”. Some felt they had to “keep proving” to the doctor how bad they felt, or how much they wanted help. Several young people had initially been turned away by their GPs and told they were “too young” to have depression or their experiences were just put down to “hormones”. One woman described this experience: “I think the health professionals, along the parents, underestimate it because of the age, and they think it’s a phase, and that it’s not very serious. One of my doctors told me to go home and sort myself out, which isn’t exactly something that’s helpful.”

Ruby kept going back to her doctors ‘trying to prove how bad I am to warrant’ treatment. They…

Age at interview 27

Gender Female

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Before being diagnosed with Chronic Fatigue Syndrome, Erika-Maye struggled to be taken seriously;…

Age at interview 17

Gender Female

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Cat says she was spoken to like a child and treated inflexibly. When she wasnt allowed to…

Age at interview 23

Gender Female

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Tasha felt completely brushed off by her GP when she first saw him about depression. She went…

Age at interview 18

Gender Female

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Being told by a health professional that “I understand how you feel” was one of the most patronising lines young people said they could hear. Several felt that a health professional could never really understand their situation and to claim to do so was seen as dismissive and unsympathetic. Some felt they got very little help from their doctors who had only given them limited options (usually only medication) or “given up” on them too quickly.

Sophie finds it hard to believe health professionals’ advice as they can just go back to their…

Age at interview 17

Gender Female

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For some young people, an unsympathetic approach or insensitive comments by health professionals could stay in their minds for a long time after.

Erika-Maye describes difficult experiences with a particular nurse on the ward who made…

Age at interview 17

Gender Female

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Kirsties doctors approach frustrated her because she didnt feel it dealt with her problems.

Age at interview 16

Gender Female

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Listening to your own body and accepting help

However, some people had had therapists or nurses who did have personal experiences of mental health problems and were genuinely able to draw on that knowledge – which many found helpful. Many people emphasised that they knew themselves best and for the health professionals to acknowledge and support this would be a better way forward. Many young people said they knew that health professionals were there to help them, and doing their best, but that sometimes they themselves weren’t in the right place to receive the help.

Stacey says all the professionals are there to help her and sometimes they understand her even…

Age at interview 17

Gender Female

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Health care system

Many made the point that once they had been diagnosed with a mental health problem, all their health complaints were always interpreted within that context, not giving them an opportunity for fair treatment: “Also to be recognised that every health problem that I have, it goes ‘no, it’s psychological’. It doesn’t matter what it is, I can, I could go down A&E with a suspected broken arm, and they’d say ‘psychological’, it wouldn’t, nothing would surprise me anymore.”

“I feel that as a mental health patient that we get treated unfairly, is that mud sticks and once you’re diagnosed with a mental health condition that’s it, mud sticks.”

There were also some structural aspects of the health care system that people found unhelpful; long waiting lists, having too little time in the clinic, not being able to see the same doctor at every clinic, or lacking in appropriate services in their particular area.

Cat says having to change doctors every three months was detrimental to her recovery.

Age at interview 23

Gender Female

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Depression, parents and family

Here young people talk about their relationships with parents and family and how they felt depression or low mood had affected these relationships. Complex relationships...