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LEARNING IN PRACTICE: Geoff Wykurz and Diana Kelly Developing the role of patients as teachers: literature review BMJ 2002; 325: 818-821 [Abstract] [Full text]

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Teachers with mental illnesses are needed

Sir Nil   (14 October 2002)

Patient partnership pipe dreams

Mitzi AJ Blennerhassett   (27 October 2002)

Teachers with mental illnesses are needed 14 October 2002
Sir Nil, Patient activist http://hem.passagen.se/sir.nil/ Send response to journal: Re: Teachers with mental illnesses are needed	Sirs -- Mental illnesses are ideally suited for patients as teachers, as diagnosis is based on symptoms, which the patients naturally have first hand experience of. This is especially important for schizophrenia, which is considered as the worst and the most devastating mental illness. The care of schizophrenia have during the last 50 years drastically changed from care at mental hospitals to the out patient care of today. The education have naturally changed during these 50 years, but it would be strange if not both the care and education of today also is suboptimal. In schizophrenia, cultural, social and care factors can dramatically affect the disease, as demonstrated by the WHO 10 country study, where the cases with continuous psychotic illness varied between 2% in Nigeria and 33% in Japan (1). Thus other factors than symptoms such as discrimination and social problems are important to get first hand information of. I am not sure if the regular teachers can picture this accurately at present. Ideally, this should be given prior the academic lectures on the disease in order to give best effect on students and also to induce discussions. As the public have prejudices about schizophrenia, this also is true for the students and thus it is better for them to meet a patient with a controlled disease and not the acute psychosis at hospital wards, which are not very representative for normal schizophrenia. According to the WHO fact sheet for Mental and Neurological Disorders (2) almost 50 % fully recovers from schizophrenia. This is much better than most doctors are aware of and thus for the students a meeting with a recovered schizophrenia patient is a must. If the students were allowed to meet recovered patients and patients with a stable disease, I am sure that psychiatry would become more attractive, which in the long term should have a positive effect on the quality of the psychiatric care. 1. Barbato,A (1998) Schizophrenia and public health WHO/MSA/NAM/97.6, 40 pages http://www5.who.int/mental_health/download.cfm?id=0000000055 available free as pdf-file 2. WHO Fact sheet for Mental and Neurological Disorders (2001) http://www.who.int/inf-fs/en/fact265.html
Patient partnership pipe dreams 27 October 2002
Mitzi AJ Blennerhassett, user representative York, London, no limits Send response to journal: Re: Patient partnership pipe dreams	I scanned this article with great enthusiasm. What a ground-breaking idea - patients teaching medical students by doing physical examinations on them! Experiential learning in the field of dignity, powerlessness, unacknowledged pain...This would ensure our future doctors brought compassion into their work. My mind raced. Could I be taught to demonstrate taking a prostate biopsy I wondered (without offering pain relief, as widely practised) - could I insist students undressed without cubicles or gowns (as still happens in a local Cancer Centre). How useful if patients could also be taught communication skills to demonstrate at the same time. A second, slower reading showed I was getting excited about nothing. The patient teachers are still to be simply vehicles for practising upon - the only difference being that now they can give marks out of 10. We all have our dreams.