My Psychiatry block has been one of the most exciting and meaningful parts of medical school so far. It felt especially significant because it’s my mother’s speciality, giving me the chance to experience firsthand the work she does day to day. When people think of Psychiatry, images of straitjackets and padded rooms often come to mind. While this block certainly exposed me to the madness and complexities of mental health, it also revealed moments of deep connection and reward. Here are a few thoughts I gained from my hands-on experience in Psychiatry.
- Psychosis is no joke
Before this placement, psychosis felt like something out of a movie rather than a real-life condition. The idea of someone seeing things I couldn’t or hearing voices that weren’t there was almost unimaginable until I stepped onto the wards on day one. From stories of cyborg police officers and stalking relatives to believing their body was dead and they were just a soul, I quickly realised there are no limits to the severity or variety of experiences a patient’s illness can bring. Although it was initially shocking, I found it fascinating to learn how to approach their hallucinations and delusions, particularly during history-taking, where it’s crucial not to dismiss their beliefs but to explore, challenge, and reason with them when appropriate.
- The environment is completely different
Compared to internal medicine and surgical rotations, Psychiatry operates in a completely different way. For one, there’s minimal emphasis on clinical skills like inserting cannulas or taking blood. Additionally, the wards have a unique layout. Instead of large bays with 6-8 beds, psychiatric wards typically consist of up to 10 private bedrooms. This setup fosters a more relaxed and private environment, encouraging patients to feel at ease and share their thoughts more openly. This design reflects the reality that patients often spend months on these wards, unlike the shorter stays seen in other specialities. Even ward rounds have a different vibe; the patients come to you, not the other way around. I found this change refreshing, as it allowed me to settle into a chair, get comfortable, and actively engage in discussions without constantly moving from room to room. Psychiatry offered an environment unlike any I’d experienced before. The idea of doing much of the work in smart attire, seated comfortably in an office, definitely spoke to me nicely.
- Law and Ethics can make things complicated
One aspect that makes Psychiatry uniquely multidimensional is the role of the Mental Health Act and the process of sectioning a patient. For those unfamiliar, this legislation allows for the admission of a patient against their will if they pose a danger to themselves or others. This introduces complex ethical and legal dilemmas, often requiring consultants to tread carefully.
During my placement, I had the opportunity to observe several appeals against being sectioned and Mental Health Act assessments, where decisions about sectioning were made. The delicate balance between ensuring a patient’s safety and respecting their autonomy was fascinating to witness. It’s a dynamic I haven’t encountered in any other speciality and one that added depth and challenge to the experience.
Overall, Psychiatry did not disappoint. The chaos was exactly what I anticipated, but it was balanced by the unique environment and the incredible reward of seeing a patient make significant progress, sometimes even overnight. I would highly recommend this speciality to anyone who enjoys connecting with people, listening to their stories, and analyzing words, movements, and behaviours. It’s a field where meaningful interactions truly make a difference and where the human side of medicine really shines.
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