My Journey: Reading Psychiatric Records

splitimage · Jan 08, 2023 at 10:46 AM

As a fellow Canadian, I am absolutely appalled at how you were treated. I wish I could say I was surprised but I wasn't.

One only has to read the newspapers to know that systemic anti-Indigenous racism is still alive and well in the medical system at least in Quebec and Ontario and I suspect other provinces as well

I really hope you achieve your goal of being able to speak to medical students and residents to educate them.

The_little_didgee · Jan 15, 2023 at 06:26 PM

Thanks Splitimage.

There are a lot of stories that don't even make the news.

Most Canadians don't know much about Indigenous people. If they did, they would realize only a minority conform to the stereotype.

Healthcare in my experience seems to be filled with a lot of entitled and judgemental people. We put the helping professions on a pedestal. Why??? They are highly and narrowly trained individuals who are vulnerable to bias just like the rest of us. They really don't deserve the power and prestige society has given them. -- The banging of pots and pans angered me back in 2020.

Emergency staff are in my opinion seem the worst offenders followed by psychiatric staff and social workers.

The_little_didgee · 07:43 PM

I read more records last night. The reading made me realize there was profound misunderstanding on both sides (misdiagnosis and suspicion) and lack of communication. There was no way an alliance could form under those conditions.

Psychiatric Emergency Service at the Ottawa General (This service is to be avoided):

"Patient is guarded with her history."

Later entry:

"Patient left hospital; refused follow-up."

I wonder why? If they took the time to investigate further and actually listen I would have been more compliant.

The consultation was done with a PGY-4 psych resident. Notes from this consultation:

Past psych history - see chart. No contact since around 2 years.

Impression: 23 year old female with difficulties coping and complains of ??? consistent with major depressive episode with panic attacks.

......

Unfortunately patient does not appear ready to accept help. When help was offered (e.g. acute day hospital) she rejects it. Appears to be an ongoing problem. ..... patient states we don't understand her problem. When challenged with our offers of help she decides not to talk further about the issue.

Patient would likely benefit from SSRIs for major depressive episode and panic attacks, but compliance with meds has been a problem in the past and starting it from the emergency without having agreed to followup would risk ??? and misuse of meds. Also SSRIs may initially worsen panic attacks. Therefore meds need to be started by someone who can followup.

.....

Forcing treatment would not work and may reinforce non-cooperative stance with treatment. Unless patient agrees to help offered, prognosis is poor.

Patient left unannounced.

-- This visit was in spring 2001. It was one of my last encounters with this service. The resident's note did not contain any personal attacks at all. It was written in a way that the patient might actually read it someday.

No one was listening to me. All they were doing was judging my character, assigning motives I did not have, and telling me conflicting things. No one was consistent with me. Nothing was ever explained. I really had no say in anything.

Doctors shouldn't tell their patients they can't do anything for them then offer referrals in the specialty and medication. It's so confusing.

The_little_didgee · Jan 20, 2023 at 08:15 PM

The hospital's privacy officer has made some progress with the encounter's list. The health records department is looking into getting all the diagnoses removed off that alienating list. Apparently they have to get the "vendor" to edit the content, since they don't have permission. If the vendor cannot remove the data, the hospital is going to add a second privacy directive to each date, so no one can see the content before 2004, the year when they stopped including diagnoses on that list.

I would prefer the data be removed, but I will accept the second option if that cannot be done. It's a compromise. Plus the privacy officer took the time to explain it all. That is something I really appreciated.

A little explanation from psychiatry was all I wanted all those years ago. They just made decisions and refused to work with me.

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