After reviewing a young person with a mental health disorder, I was reflecting on what makes a good consultation for them and myself. Is it showing compassion and empathy for the experience the person is describing? Is it developing an extensive management plan, with the inherent complexity and nuances that are required to assist the individual’s unique circumstance? Or perhaps it is advising them of a diagnosis and offering a pill and moving them on to another practitioner, who may have the time and experience to assist.
Often in the media, the GP is seen as the bastion of knowledge, the person with the ability to diagnose, assist and treat each of medical, psychological, relationship and social conditions that present during the 10-15 minutes that is set aside for an appointment slot. This is obviously not the case, with each practitioner having a skill set and experience reflective of the variety of patients that present to them. I have colleagues that are outstanding in the treatment of diabetes or musculoskeletal conditions but would find the treatment of a young person who is self-harming confronting.
The relationship between a GP and a person who is experiencing mental health is important. There needs to be a therapeutic relationship, in which trust is built, in a judgement free environment, for expression of patient concerns, the challenging by the treating practitioner behaviours and thoughts of the patient, provision of information and development of strategies to assist the person with managing and recovering. The development of such relationships can sometimes be a stop-start affair, with both participants in the relationship needing to develop an understanding of each other. On occasion, such a relationship is not created, and it is required of the practitioner to acknowledge this and offer the opportunity to reframe, restart or redirect the patient to another practitioner. This often is not a failure on any individual within the therapeutic relationship, but more conflict of personality.
So, a good relationship between the practitioner and client is essential to assisting in recovery. There may be some patients who only require a “pill” to fix their woes, and there are others who will need many consultations with a variety of health practitioners, redevelopment of their community and reframing of their thoughts to assist in continuing the journey to better health.