Messages for professionals about mental health

We asked people what they thought was missing from mental health services and what advice they would give to doctors and other health professionals (also see ‘Suggestions for improving service provision for mental health‘). They provided some very clear messages based on their positive and negative experiences of services (see ‘Outpatient & community services for mental health‘). It is important to note that many people felt that other people with mental health problems should trust and work with their doctor (see ‘Messages for others about mental health‘).

1. Listen without judgement

People with mental health problems are often unheard or misunderstood. The people in this study emphasised the importance of professionals listening so that they can truly understand more about the person they are treating: ‘Listen to the patient. That’s the most important thing. You don’t live in their head, they do. End of.’ They felt that listening properly involved giving people time, asking questions and making them feel comfortable enough to talk. In particular people wanted a doctor who listened carefully without making judgements about the person: “Diagnosis was never designed for professionals to make a judgement on a person. It was designed to make a judgement on medication, not on people and what services they should or shouldn’t access’ [See Jay below].

Niabingi compares professionals with a plaster – they help people to heal. She says listening and…

Age at interview 42

Gender Female

Age at diagnosis 25

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Devon believes that the system makes it difficult for professionals to listen.

Age at interview 49

Gender Male

Age at diagnosis 22

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People wanted to be believed and taken seriously by professionals. This was seen as important in keeping a good relationship with the doctor. This was particularly important to one man who had been wrongly accused of not wanting to work. He was keen to point out to professionals that ‘most people that you encounter are not malingering’. People also felt that empathy, both in adult and child mental health services, was important.

Edward feels people need time to talk and says challenging the patient’s delusions may undermine…

Age at interview 59

Gender Male

Age at diagnosis 20

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Listening does not only have to take place in a one-to-one consultation: a few people welcomed the opportunity for public consultations. People also felt that the same weight could be given to service users’ experiences as teachers and books in mental health professionals training. One man suggested to his mental health trust that they recruit psychiatrists with personal experience of mental health problems to equip them to better understand service users.

She’d like health professionals training to involve people with mental health problems and…

Age at interview 36

Gender Female

Age at diagnosis 21

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Anton says it would help if psychiatrists had personal experience of mental health problems…

Age at interview 64

Gender Male

Age at diagnosis 45

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2. Treat everyone as an individual but treat the whole person

Many people emphasised the importance of being treated like an individual and a human being. In this vein, they didn’t want professionals to make assumptions about people based on their diagnosis, but to remain open-minded about them, their abilities and their treatment.

Jay says to professionals: “Stop seeing diagnosis, see people”.

Age at interview 49

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People with mental health problems want professionals to treat them with respect, especially respect for their dignity. They also encourage professionals to show a more caring and friendly side so that vulnerable people feel cared for: ‘Speak to them as a human being, you know, as if you are speaking to someone you love, let them understand that they are not alone’.

She would like health professionals to understand people with mental health problems better and…

Age at interview 60

Gender Female

Age at diagnosis 40

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Ali feels professionals can sometimes be like a “robot” and could show more kindness and…

Age at interview 27

Gender Male

Age at diagnosis 26

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Some thought it was important to find out more about people’s individual belief systems and ‘micro-ethnicity’ in order to avoid making assumptions about them or drawing on racial and cultural stereotypes (see ‘Getting a diagnosis‘).

Professionals need to be “culturally competent” and aware of people’s “micro-ethnicity” so that…

Age at interview 49

Gender Male

Age at diagnosis 15

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With this in mind, people also emphasised the importance of looking at and treating the ‘whole person’ and discovering ‘what makes them tick’. They wanted professionals to realise that people with mental health problems have ‘the same dreams and desires as everyone else’. This involves two steps: firstly, talking and listening to the person and discovering more about their social and family life, aspirations, physical health, cultural identity, religious identity, their history and attitudes to work; and secondly, providing mental, physical and spiritual treatment.

Sara suggests that professionals listen, not make assumptions, and realise that people with…

Age at interview 31

Gender Female

Age at diagnosis 17

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Devon says professionals could treat people with mental health problems as a whole’ mentally,…

Age at interview 49

Gender Male

Age at diagnosis 22

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However, there is a balance to be struck between looking at the individual and the whole person. as one man said about his psychiatrists: ‘They didn’t get me as the person. They got my relatives, how I was brought up, but they didn’t actually discuss about my inner self, about me.’

3. Work together with patients and families

Many people referred to the importance of professionals working together with services users and their families. They themselves wanted to be involved in decisions and choices about treatments and medication. They also suggested that professionals involve families and carers in meetings so they could provide services that were more ‘tailored’ to the service user’s needs. This involved providing families and carers with information in plain, non-technical language about their condition, medication, social security benefits, organisations and support groups, in order to enhance their understanding of the system. One woman thought professionals could ‘be honest and explain’ to service users about their diagnosis and what their outcome might be.

Tariq thought it would be helpful if professionals work more with families, and provide…

Age at interview 21

Gender Male

Age at diagnosis 18

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Not everyone agreed that families and carers should be involved. One woman thought that services ‘listen to everybody else involved and the patient is not taken seriously because they’re ill’. [See Sara above].