Psychiatry is easy? Then why didn't you try it? Who are you trying to fool, not me!

So, I had been thinking about a topic to write about. Something happened today that affected me quite a bit. I can’t really say how much of it was frustration, how much of it anger, and how much of it just disappointment.

So instead of studying, I began searching for articles, and found many, titled:

Is psychiatry a dying field?
Are psychiatrists becoming a rare species?
What is the attitude of medical students, interns and other medical professionals towards Psychiatry and Psychiatrist?
Should psychiatry change its name to reduce stigma?

And personally, the stigma is real!

The world is going through a change, where mental health is given more and more importance. Depression and suicide are now being recognized as more than just weakness of a person. But the attitudes towards people with mental illness and even those who work in this field have not changed much over the years.

The History of Psychiatry extends to ancient ages, one of the first articles regarding curing mental illness was recorded in an ancient ayurvedic text, and the first hospital was built as early as 3^rd century BC. 20^th century saw a revolution for psychiatry and psychiatric illness, with humane reform to management of the mentally ill. People talk a lot about it, but they don’t want to be the one doing it.

Do we still physically restrain our patients? Do we give them more of the natural therapies, like art, exercise, meditation? Have you ever come to the psychiatry ward and looked at what we do? Have you even bothered to ask us about it?

We are called “chelo gi doctor” or “pagla ko doctor”, (doctor of the mad) and get laughed at. Our patients are mad/pagla/chelo and not people who have an illness and need treatment. Mental health workers are often called weird.  

I have faced a lot of questions about my choice when I said I wanted to take up Psychiatry. Why do you want to do that? Why not do this and why not do that, there is a lot of opportunity? Where so many apply for various medical fields, very few to none apply for Psychiatry.

“Psychiatry di jamtoto imba” coming from a physician. So why are there not more people doing it, why not take an easy field?  You know it in your heart-it’s not. You have to break yourself and re-make yourself to do psychiatry. You can only talk about empathy, to bully your interns and juniors, but have none for your patients. And you would suck as a psychiatrist.

As a psychiatry resident, I (we) have faced stigma, time and again. We take it in our stride, part of the job; don’t want to be a spoiled sport; we knew this stigma existed before we joined the field, and we are here because we genuinely like the field and not here for the prestige or the opportunity. But when this stigma leads to outright discrimination, I think its time to raise our voice.

I am glad when we get called for consultation, it means people are more aware, they are taking into account mental health along with physical health, but it's very disheartening when it’s more or less to dump the case on us. If you can’t figure it out, call psychiatry. And then laugh about it. I smile, not because I want to, but because I have nothing to say to you. When others see us in  the Emergency Unit, “Psychiatry gets calls too?” utter bewilderment!!

 Our emergencies might be different than yours, but it’s still an emergency. And emergencies occur at any time, not just between 9 to 3. But how would you know, you don’t even know what we do, what patients we see.

You see patients with bear maul, gross deformities. We see them afterwards, with PTSD, when their whole outlook of life has changed, when they cannot go on living, when their relationships have failed, and are on the verge of jumping off a cliff. We see people after they have been exploited, physically, emotionally, sexually. Children as young as five and six, come to us, parents expecting justice. We spent time with murderers in an enclosed space, alone, and kept an open mind to their problems and helped them find solutions. We get beaten up by the patients we care for, but not because the patients were violent, but because society judges them and us, treats us like a step child.

20 years since the psychiatry ward came into existence, very little has changed, people have been trained and have left for better opportunities, because it's frustrating.
Our infrastructure is failing, we don’t have enough space for all the “Natural Therapy” people want us to provide our patients. Our medication is limited, non-mental health workers complain a lot about the side-effects but don’t advocate for newer drugs to be brought in. Our counsellors are overworked, but not appreciated enough. Doctors and nurses are burnt out, because we do not have social support. Only a part of psychiatry happens in closed buildings, rest happens outside, in the society.

We have been struggling to change the attitude towards addiction, but people are still being labelled addicts and alcoholics. Rehabilitation centres are viewed as prison by the educated, and advocated against. We do not have enough resources to prevent relapse, families are burnt out, and children neglected. If only people took addiction more seriously. If people were listened to before they are judged, maybe then we can break the cycle.

Psychiatry is easy, limited topics, textbooks, similar drugs work for all the diseases. Come on then, why not try psychiatry.  And then come tell me if psychiatry is easy.

Disclaimer: This post in no way tries to claim that Psychiatry to be superior to any other fields. (Because people love to make things about them and become defensive)