nursingforsocialjustice

Is it weird when a diagnosis is not explained to someone because, as the health care professional, we perceive that in the long run it may be better for them not to know? Is it too overwhelming for someone to learn that they are living with schizophrenia or bipolar disorder or borderline personality disorder? Would we hold the same beliefs if the diagnosis was kidney disease or cancer? And, is it realistic to expect someone to adhere to their treatment plan, just because they should trust that we are making the best decision for them? Are we making the best decision for them? Given the historical context of mental health care, do people who have spent a lifetime in the system trust us? Should they? Would you, if you were in their shoes? If  the answer is no, how do we gain trust back? Or are we making the best decisions based on our experiences and values and beliefs? Are we really past the time of paternalistic care?

I think about these questions all the time, especially with respect to notions of abstinence from substances, without full understanding of the good and bad of substance use from the perspective of the person seeking help or the person that care is being provided for. Perhaps that frame has to shift to quality of life, especially if recovery is the goal rather than simply stopping substance use, or decreasing symptoms of psychosis. Do we have all the answers? And, is taking a medication really the most important thing? Is withholding information ever really the best decision for the person and their family or is it the most convenient decision for the health care provider?

Click to access PersonCentredCareMadeSimple.pdf

Peace,

Michelle D.