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Richard Downes - disability arts online
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Self Service Psychiatry / 10 May 2012

I attended a CPA yesterday. Care Programme Approach Meeting. It was the first one that my partner had been granted since 2008. She is supposed to have two a year. This was glossed over quickly by the psychiatrist who explained the lack of intervention through the excuse of reorganisation. We reorganise the office, the department, the co-working, we do all this and service users expect to be included, cared for, they go as far as asking for tolerance.

Straight off he’s dealing with his assessment forms.

Are you delusional?
No.
Do you know what delusional is?
Yes.
It’s where you think you are being spied on.
Is it?
Do you understand that it is?
If you say so.
Good then you know what delusional is and you are not because I have explained it to you and you agree with me so we can agree that you are not delusional.

I try to break the yoke.

Would you like to introduce yourself?
I am the psychiatrist.
Does the psychiatrist have a name?
Yes of course I do.
Would the psychiatrist like to tell us what his name is?
I am Dr Astrepoloupazine.
I am sorry I did not get that I am partially deaf.
I am Dr Strepoloopaclav.
Pardon. I cannot hear you.
I AM DOC-TORRRR ASMANICLAVACINE!!!

There is no need to shout, Doctor whatever your name is. Just calm down. Go slow. Show some sensitivity. Believe that there is an outside chance that everyone in this room is a human being.

I am the psychiatrist. I have a job to do. I have to fill out this form. I have until 5 o’clock. At 5 o’clock the office closes. We will not be able to get out. I might have to give you a prescription too.

I have to leave at 5 to 5.
No the office closes at 5. We will stay until then.
I have to leave at 5 to 5.
But, but, but,
No buts Doctor. My car is parked on a meter. I do not want to pay a £60 fine just because you have a form to fill.
Are you paranoid?
Only about getting a parking ticket.

The following day I am talking to an activist about the quality of customer care. She believes that this is a good analogy for mental health services. If you go out into the world, go to banks, go to shops, you will find that customers get treated like shit so it is in psychiatry. The customer care model fits exactly here. We discuss the possibility of Self Service Psychiatry.

Stand in a queue. Go to a machine. Press A for facile, B for couldn’t care less, C for stupid, D for confrontational. I press D. An hologram of my psychiatrist appears.

I am your psychiatrist. Why are you wasting my time.

Keywords: customer care model,mental health services,psychiatry