2013-06-04

Counselling came around again today, it has been a month since my last one.

It started with a great big farce of my own doing. I looked in my diary yesterday and saw that my appointment was today at 4pm. Great, I thought, how convenient. Then suddenly at 2am I realised that was unlikely to be correct – I’d never had an appointment in the afternoon. So in the morning I called the IVF clinic. Eight times. And left a message. No reply by 9.30am so I took the decision to get on the bus on the off chance that my appointment was in the morning at some point. Just as I was arriving at the clinic at 10.40am they called me to say my appointment was at 10.30am. Helpful. Well my counsellor was very understanding and we still had 45 minutes for the session so that was fine.

I wasn’t really sure what I’d talk about today, and I felt fairly OK, but it turned out to be useful. It helped me to see that:

  • I feel much better than at my last session – ups and downs happen, but the ups do come.
  • I embrace chaos and uncertainty (imposed by others!) in my working life, so I should be able to get my head round the same with this IVF thing.
  • The Consultant was baffled by us because he was so sure IVF would work for us eventually. The positive part of this is what I should take out of the whole sorry episode.

The counsellor mentioned to me in passing that her room was being changed, again, because it was needed for something else. She muttered about the ‘medical model’. I happen to know about the medical model through work, it means that care is focused on a doctor diagnosing a condition and then trying to fix that condition. The medical model is not the only legitimate model in healthcare, and in fact in Scotland we lead the way in more holistic patient-centred care where people are thought of as more than their diagnosis.

This – along with my recent experience with the Consultant – got me thinking.

IVF is a huge pain in the ass. The hormones and the invasive treatment and the relentless appointments coupled with the feelings of grief and hopelessness and anger make it really hard for a lot of people that do it. IVF is not great for a person’s wellbeing (see my photo for what some bird off the Apprentice had to say in the Metro today). You don’t do it to feel good, you do it because a positive outcome will make you feel good. But there is a slim chance of a positive outcome. It is my guess that the majority of people doing IVF feel fairly shitty.

However, in a hospital the wellbeing of IVF patients is considered secondary to getting the drugs and the scans and so on done. I would observe that the counselling is not valued as an integral part of the system (more of an aside), and the stress and wellbeing associated with IVF treatment is considered to be an irritating distraction that we patients should expect but try to ignore. I think this is short sighted.

Firstly, mental health is important and it isn’t just about people who present to their GP with diagnoseable mental health conditions. Preventative care by maintaining good mental health is a medical concern. And a Scottish policy area – I quote from the Mental Health Strategy for Scotland: 2012-2015:

“The focus on “prevention, anticipation and supported self management” is central to taking forward mental health policy in Scotland.” 

“Health and care must be: Person centred – which is; Mutually beneficial partnerships between patients, their families and those delivering healthcare services which respect individual needs and values and which demonstrate compassion, continuity, clear communication and shared decision-making.”

Secondly, if a little more care was put into the patient experience and looking after wellbeing it would make patients feel better and consequently save a load of hassle for doctors and nurses. Potentially this could also save money in other areas associated with poor mental health (e.g. treating depression and stress induced physical conditions) and it might even raise the IVF success rate (off the top of my head less stress, lower blood pressure, better drug compliance, less unhealthy habits such as comfort eating, more people continuing with treatment rather than not being able to face another try).

I know that directives come down right from the top on how this stuff should be done, and I know that a lot of individuals within the system are doing a brilliant job of mopping up the messes caused by ignoring it. But seriously…. could do better.

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