When I first learned I was going to be doing half my pre-registration year in mental health I felt a little out of my comfort zone and totally unprepared. I would say from talking to some of my peers' many people have a preconceived idea of what a mental health hospital is like. I would like to share an insight into my mental health experience for those who are interested and clear up some of the preconceptions surrounding this area of healthcare. 

Mental health is a very multidisciplinary team (MDT) orientated. We would have a morning MDT to go through all the patients and what had happened in the last 24 hours since we last met. This would include representatives from a wide range of professions in the hospital and each person would have a chance to comment on any aspects of the patients care. Through the day there would be more in-depth meetings which involved the patients and potentially their family to plan their care and move towards discharge and how they would be supported in the community. For some aspects of mental health, this was a much longer process depending on how long they had been in the hospital. 

From my experience, medicines reconciliation can become a longer process within mental health hospitals as you may have to look further into the details patients have told you. It may also be difficult to obtain any accurate information if you have a very psychotic patient with a variety of delusions or paranoia. When a patient would tell you about their delusions it could be difficult to determine which parts of their story was accurate or not as some of it can sound very believable. My conversations with patients involved assessing whether a patient has been compliant with their medication prior to their admission; if this wasn’t the case some medication would need to be reiterated. The pharmacy department was also heavily involved in patients who were taking Lithium or Clozapine due to the monitoring requirements and titration of each drug. They would often be the people prompting monitoring to take place on admission to determine the levels of each drug in the body. 

The wards in the hospital would have a separate room for each patient, social areas, a kitchen and a garden. So instead of speaking to patients at their bedside, I could talk to them in what was essentially their living room which gave a more relaxed feel to our conversations. Before approaching the patient, I would ask nursing staff if they are appropriate to talk to as they would know if the patient was aggressive or not in a state to talk to me. There may occasionally be aggressive patients but the staff are so well trained to deal with these situations and it is usually associated with the patient at the start of their admission due to them being unwell. There may be a negative stigma attached to working in mental health with regards to personal safety, that many people can find daunting. However, due to the training that I received, I felt comfortable and confident in my work environment. I found through my conversations with patients the topic could move in so many different directions which lead to some interesting conversations. They would tell me about their delusions, why they were in the hospital and even some of the difficulties they were having in their personal life. 

If you are interested in mental health or just want to find out more many trusts offer placements or visits if you get in contact with the team within that trust. 

Bryony Drummond, qualified pharmacist. 

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