Patients ask what depression is, but ultimately our understanding of mental health problems is poor
During medical school I was made aware, in an abstract sense, of the scale of the problem that mental health disorders pose to our healthcare system. Systematically I learned how each one was treated, readying myself to regurgitate management plans in a viva. With my hurried response to the examiners’ question, the hypothetical situation would be resolved, my patient healed.
Years later I am working as a junior doctor in general practice. The receptionists have left a note on the electronic record: “needs to talk about mental health.” My opening gambit is always to listen. I listen to the stories of childhood abuse suffered. I listen to the scores of people who feel that they just cannot go on anymore: work, home, there is no escape for them. I hear about the multiple visits to the emergency department after suicide attempts. I was not prepared for this. I was not prepared for the 25% of adults in the UK who have experienced a mental illness.
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