There is a common thread that is running through many of the conversations about mental illness and domestic violence; the failure of health care providers to properly assess and ask the important but difficult questions. I have asked questions about a patient’s mental illness in a routine questionnaire, but I was never trained on how to start the conversation without that form or how to be prepared for those who said yes. I asked the question with the assumption that the person would say that they did not have any mental health issues or suicidal thoughts. If a person would have responded differently, I am not sure what my response would have been.
After seeing this video (posted below) this morning, I was disappointed in myself. Personally and professionally. One of the survivors discussed how she went to the hospital because she had a black eye and no one took the time to ask her how she got that black eye. She said that if anyone would have asked her, she might have opened up and received the help she needed to escape from her abuser. Her words struck me right in my own heart. It reminded me of all of the times that I had suspicions or could have asked more in-depth questions, but failed to go that extra mile and discuss those things with my patient. I have failed professionally at the bedside but that does not mean we cannot change this conversation. Healthcare professionals have to continuously remind ourselves that we are providers of holistic care, not just symptomatic care.
A patient may come to you with symptoms of high blood pressure and obesity, and the only questions that may arise are those that focus on their eating and exercise habits. We never stop to explore any underlying mental issues or emotional problems that may trigger overeating, depression or stress. All of these factors could lead directly to these disease processes and their resolution could in turn fix the overarching issue.
Many times we enter into a patient-provider relationship with preconceived notions that block our natural interactions with our patients. We do not pick up on the subtleties because we are focused on our agenda. Quality health care is effective care. We can only be effective if we are asking the right questions. We can only ask the right questions if we are listening to the actual responses that are being given. We have to open our ears and eyes to see more than the primary issue but all other issues that could possibly be connected.
We have to ask the difficult questions about child abuse, sexual abuse, rape, drug abuse, mental health, suicide ideations, depression and domestic violence, to list a few. It may be hard, uncomfortable or may be offensive to some but that one person who needed to hear those words will thank you. We may be the only outlet or opportunity that they have to get them the help that they need.
Healthcare providers are angels on earth. Our work is never done. We have to continue learning and expanding our skills through traditional and nontraditional means.
Be you. Do you. Tell your own story. On your own terms.