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EDITORIALS: Scott Weich Availability of inpatient beds for psychiatric admissions in the NHS BMJ 2008; 337: a1561 [Full text]

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Social Circumstances

Vasudevan E Krishnan   (12 October 2008)

Stigma in Psychiatry – Worse among the medical profession

Adeola Akinola   (26 October 2008)

Social Circumstances 12 October 2008
Vasudevan E Krishnan, Foundation Year 2 Claremont Bank Surgery,Shrewsbury,SY1 1RL Send response to journal: Re: Social Circumstances	Delay in discharge is certainly an issue which is crippling NHS in a few cases.Many inpatients are having to wait for a few months before getting access to supported accommdation or a home due to homelessness which is all they need and so are kept as in patients till that is sorted.Mental Health services depends quite heavily on the social services around them and if this is a slow process and not very robust it just increases inpatient stay. Competing interests: None declared
Stigma in Psychiatry – Worse among the medical profession 26 October 2008
Adeola Akinola, ST2 Trainee Psychiatry Manchester Royal Infirmary Send response to journal: Re: Stigma in Psychiatry – Worse among the medical profession	Stigma has always been a big issue in Psychiatry from time immemorial. Individuals with mental health problems have always been associated with “trouble”, crime and violence (though many research findings do not support this). It seems that with passage of time, members of the public have come to have a better understanding of the mentally ill and this may be due to better availability of information. What continues to amaze me is the bias that colleagues in other specialties show towards patients with mental illness. A typical presentation in the accident and emergency will be met with a strong bias, “those time wasters are here again”, “let them go kill themselves if they want to, why take an overdose” are typical comments made by nurses and doctors. As a junior doctor in Psychiatry, I frequently get asked by colleagues in the medical and surgical wards while on call to review individuals who “are known patients with Schizophrenia”, have been admitted for purely medical reasons but are straightaway thoughts not to have capacity to make decisions and are treated as potential aggressors. Patients with mental illness are often hurriedly treated and discharged when compared to patients with non mental health related problems. I feel strongly that these attitudes are in dissonance to what we pledged to when we were inducted into medicine-“to keep the good of the patient at the highest priority”. I commend the recent initiative of giving Foundation and G.P trainees the opportunity to rotate through a Psychiatry specialty for four to six months, but I feel that others should be made to attend refresher courses on mental health related subjects and the true meaning of the Hippocratic Oath. Competing interests: None declared