Magical thinking and moral injury: exclusion culture in psychiatry

“This is an article about exclusion. We might not like to admit it – even fail to realise it – but National Health Service (NHS) mental health service structures have become increasingly focused on how to deny people care instead of help them to access it.

Clinicians learn the art of self-delusion, convincing ourselves we are not letting patients down but, instead, doing the clinically appropriate thing.

Well-meant initiatives become misappropriated to justify neglect. Are we trying to protect ourselves against the knowledge that we’re failing our patients, or is collusion simply the easiest option?

Problematic language endemic in psychiatry reveals a deeper issue: a culture of fear and falsehood, leading to iatrogenic harm. An excessively risk- averse and under-resourced system may drain its clinicians of compassion, losing sight of the human being behind each ‘protected’ bed and rejected referral.”

Dr Chloe Beale, British Journal of Psychiatry Bulletin, September 2021

Chloe Beale, is a consultant liaison psychiatrist at Homerton University Hospital, London, trust lead for suicide prevention for East London NHS Foundation Trust and an honorary clinical senior lecturer at Queen Mary, University of London, UK.

In this article Chloe calls for the “rehumanising of psychiatry”.

She says:

“Patients and carers have been speaking out about exclusion and iatrogenic harm for too long; psychiatrists complaining about blame culture similarly. It is time this was translated into action by those with most power to effect change. Consider this a call to arms: if the content resonates then ensure you do more than shout into your echo chamber.”

See full article here

Published by CHARM Greater Manchester

CHARM, the Community for Holistic, Accessible, Rights Based Mental Health was launched by The Organic Recovery Learning Community in September 2020.

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