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The Challenge of the Patient Experience in Behavioral Health

Posted By James Rosser, LCSW , Monday, April 25, 2016

The patient experience is crucial across the continuum of all health related interactions; however, perception of the role of the patient experience differs at various points along the spectrum. Behavioral health (mental healthcare, psychiatry) is an interesting point to consider.

By training and nature, mental health professionals see themselves as patient focused and in possession of empathy and caring honed to a fine degree by intentional development. Does this mean that mental health providers are inherently good at the patient experience?

Certainly, people often choose to enter mental health because they want to be able to care for a disadvantaged group of people. Systems can either nurture such values or – intentionally or not – discourage them. Mental healthcare delivery suffers from the same organizational cultures and pressure as any other part of healthcare delivery – perhaps even more so. Too often mental health is the "stigmatized "part of the system itself, sometimes by misperception of our function, and often we are financially disadvantaged. This stigmatization can increase the burden of the care givers, and that team includes administrative, support and financial areas.

So how does mental health approach the patient experience? The good news is that enormous supplies of caring and empathy actually do exist in our facilities and systems. Extraordinary care gets delivered every second of every day. Does that supply of caring become pervasive and not just limited to the treatment room? That is the question to pursue for those of us in mental health.

Some key factors that may affect delivery of the optimal patient experience in mental health are:

  • Highly regulated patient privacy and confidentiality requirements
  • Philosophical training that intentionally discourages interaction with patients outside the therapy room
  • Inconsistent approaches to treatment that inform the actions of staff differently and, therefore, guide potentially confusing responses to patients
  • A culture of "protecting” clinicians from patients between visits
  • Involuntary treatment situations, either by law or family/societal pressure
  • Universal shortages of care
  • Possible misconceptions about the true meaning of the patient experience

These issues are daunting. Some require huge societal commitments that seem difficult to obtain. Others involve introspection – something we frequently ask of our patients but forget to use in our own structure and delivery of their care. Introspection can inform us in how we may not "walk the talk” of the patient experience.

Guidance from The Beryl Institute’s definition of the patient experience is crucial to success. The question is how often that definition gets translated into operational strategies and tactics that can foster successful experiences. The same question used to round on an inpatient medical unit may well be off the mark for inpatient psychiatry (we don’t usually have call buttons!).

The importance of the patient experience as it interacts with mood disorders, eating disorders and thought disorders is no less meaningful than when a person faces surgery; however, the solution set is likely different.

Nurturing and supporting future growth of the behavioral health component of the patient experience movement is the key to creating the kind of patient care we all desire to see for our patients, our loved ones, and perhaps ourselves.

Working in mental health for over 25 years, James Rosser, LCSW currently serves as the Director of Outpatient Programs at UCLA Health’s Resnick Neuropsychiatric Hospital. He has been at UCLA Health since 1999 and has been a leader in innovation in behavioral health services delivery. He currently oversees 11 programs that provide intensive outpatient services for those with acute behavioral health issues. He is a board member of Association of Ambulatory Behavioral Health-Southern California, and a member of the National Association of Academic Psychiatry Administrators.

Tags:  behavioral health  Continuum of Care  delivery of care  mental health 

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