Psychiatry’s Stigma In The Medical Profession

The stigma of becoming a psychiatrist.

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Today’s GML (Great Medical Link) has my brain wheels turning, so here’s my first 2014 post:

While working one of those long 12-hour shifts I used to pull while on staff at a university teaching hospital in SC as a registered nurse back in 2001, I found myself once again sitting with my patient/client/charge (nomenclature dilemma is fodder for a future post) just… talking. Excessive talking with patients isn’t smiled upon by the bean counters.

“You know?” my RN colleague said to me then. “Have you ever thought about becoming a psychiatric nurse? I think you’d be really good at it.” Hmm. No, not really.

At the time I was working on a surgical intensive care step-down unit where the tension was routinely so thick it could easily be cut with a No. 15 blade *. My patients were attempting recovery from traumas such as self-inflicted throat slashings, gun-shot wounds (“Mr. Smith” and “Ms. Wesson”), car accidents, and cancer’s gone way bad. I didn’t like the continual codes being called, packing gauze into some of the most gruesome wounds imaginable, or emptying yet another Foley bag filled with beige foul-smelling sediment. So the notion of sitting in a comfy chair in a small, cozy room surrounded by relaxing nature photos, green plants, and a miniature zen fountain, across from a fully clothed person that smelled like Chanel No. 5 sounded pretty darn good (on the surface).

2 1/2 years later I walked away from that university with a graduate degree in nursing — specialty: psychiatry. It’s now 2014 and I can easily agree, from personal experience, that there’s a lot of stigma against healthcare professionals working in psychiatry. Statistically, only about 5% of physicians chose to practice in psychiatry. And they get a lot of heat for it.

But the rate of depression among doctors — about 12 percent suffer an episode of clinical depression at some point in life, according to one study — parallels that of the general public, and research suggests that they are at higher risk for suicide. An analysis of 14 international studies conducted from 1963 to 1991, for instance, found that men in medicine had a risk of suicide 1.1 to 3.4 times as great as that of the general population. Among women, the risk was 2.5 to 5.7 times as high.

http://www.nytimes.com/2003/07/08/health/doctors-toughest-diagnosis-own-mental-health.html?pagewanted=all&src=pm

Two of the top three most prescribed drugs in the US in 2013 were Abilfy and Cymbalta (psychiatric medications). If you prescribe it, administer it, or swallow it you’re guilty as charged along with 25% of your neighbors (that’s a NIMH statistic on rates of clinical depression).

The sky is turning blue and the clouds are parting over my fair city in the mountains of Western North Carolina, so I’m ending this post. We’ve had bad weather all week and I’m headed out for a dose of sunshine and exercise, the best anti-depressant of all.

The stigma of psychiatry will continue to lessen as the decades pass, but it’s oh-so-slow.

* The No.15 blade has a small curved cutting edge and is the most popular blade shape ideal for making short and precise incisions. It is utilised in a variety of surgical procedures including the excision of a skin lesion or recurrent sebaceous cyst and for opening coronary arteries.

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