Over the recent decades, the negativity associated with mental health has decreased. The stigma prevented individuals from accepting if they even had a mental concern. On this rotation, I still noted how many individuals still were afraid to be evaluated by psychiatry and downplayed their symptoms so that they will not get admitted to the psychiatry ward. One of the doctors at this rotation explained mental health in a manner that truly stuck with me. He said that if your arm, leg or other body part was hurt we can open it and look at it, see what’s wrong and fix it, but when the brian is involved we cannot do that. We have to see which medication works to help bring down the symptoms. 

On this rotation I enhanced skills of drawing blood,  conducting mental status exams and writing HPIs. I also learned how communication needs to vary with different patients. During many instances, it was important to be stern with patients whereas during other instances, it was important to take on certain roles to get more information out. For instance, one of the patients I evaluated thought she was a queen of the world and wanted me to address her and speak to her as if she was a queen. Throughout the interview I referred to her as queen, goddess and your honor. These comments caused her to communicate with me more and relay more information. 

An interpersonal challenge I came across was thinking about the patients outside of work. Evaluating patients that felt hopeless, helpless and wanted to commit suicide was distressing and I would take this feeling home and think about the patient. Furthermore, as a provider in the hospital it is difficult/ nearly impossible to find out if the patient was able to get out of these feelings. Towards the end of the rotation I started to learn how to leave work at work and not bring it home. I also realized that a provider cannot always change the patient’s life, the patient must be also motivated to do so. 

I evaluated a variety of patients on this rotation and some patients were very difficult to speak to and evaluate. In psychiatry, patients tend to block their thoughts and be very guarded. These patients were not able to express what their thoughts and feelings consisted of. I had to put in more effort in order to obtain information from these patients. I learned it’s important to be persistent but not force the patient to relay information. Therefore, I visited these patients multiple times before I got the required information. 

One of my perspectives that changed after this rotation was that drug abuse and mental health may co -exist. Multiple patients in this ward were abusers of marijuana, cocaine, heroice, alcohol etc. It is important to recognize these patients and tackle both issues simultaneously.  A memorable experience I will carry with me is the positive teamwork environment. The providers were very proactive in teaching. Although there would be disagreements on patients, a proactive discussion between everyone helped figure out solutions. 

The knowledge I gained here will be helpful for my family medicine, internal medicine and emergency medicine rotation. I will be able to better recognize mental health problems and direct them. I watched countless providers speak to patients to try to motivate them and direct them towards a better path. I always paid attention to how they spoke to be able to do that myself at some point in my career path. I was very proactive at this rotation and always tried to take on any opportunity where I could learn something.  On my following rotations I want to be able to improve my patient presenting skills and not miss pertinent information from the patient. I plan to accomplish this by creating a cheat sheet where I write down the main questions that are needed to better understand the patient so that I do not forget important details. 

Another important factor in medicine I learned about is transference and countertransference. This formulated a very important concept of patient – physician relationship. Though it is important to take care of the patients, it is important to create a boundary between you as the provider and patient. A patient should not feel special treatment is being given to them. This rotation helped enhance several of my skills.