"At psychiatry, you can listen carefully." Four misconceptions that many people have about psychiatry

The White Paper on Crime published by the Ministry of Justice shows that the perception that "a person who goes to a psychiatrist is a dangerous person" is a big misunderstanding. According to the "White Paper on Crime 2020", the ratio of mentally ill persons (persons with mental disorders and persons suspected of having mental disorders) to the number of people arrested in 2019 was only 1.0%. And this is only about 2.5% of all people who are said to be mentally ill. The link between mental illness and crime is rather biased.

■ Four common misconceptions about psychiatry

However, psychiatric disorders cannot be diagnosed by blood tests or X-rays, and because little is known about what kind of examinations and treatments are carried out, misunderstandings and prejudices are likely to occur. There are four major misconceptions about psychiatry that I often encounter.

Misunderstanding, I want you to listen to the story of Rin Kusara Fumin Ren △ Inu Tatsumi."

Many people think that a psychiatrist is a place where they can listen to what they have to say. It's true that psychiatry takes longer than internal medicine or surgery to listen to, but as a guideline, it takes about 30 minutes for the first visit. The second and third follow-up visits are about 10 minutes at the longest, which is not much different from other clinical departments.

This is the same across hospitals across the country. 10 minutes may seem short, but we psychiatrists are also professionals, so in about 10 minutes it is possible to hear enough information necessary for treatment. In addition, psychiatry, like internal medicine and surgery, is centered on medical care covered by insurance, so it is not possible to run a business simply by listening to patients without leading to diagnosis or treatment, and keeping other patients waiting. I'm going to have to do it.

If you know the market price of about 10 minutes, you'll be able to convince yourself that "it's probably like this," but if you don't know, you'll think, "That psychiatrist doesn't listen to me at all and just gives me medicine." I'm a doctor."

If you want to hear more, you should consult a counselor in the counseling room attached to the hospital. We are collaborating with doctors, so you should be able to listen carefully to some extent, such as 30 to 50 minutes.

■ Will psychiatric drugs become unstoppable?

Misunderstanding that ``Ransai harubukuro'' and medicine will be given out without fail."

This is another common misconception. There is no such thing as a psychiatrist always prescribing medicine. Many people get better without medication, simply by resting. For example, first ask them to take two weeks off from work and then see a doctor again. I often do.

Also, some people have a scary image of taking psychiatric drugs because once you take them, you won't be able to stop taking them. It is true that some sleeping pills and anti-anxiety drugs are addictive, but the dependence is much weaker than in the past. It is possible to stop taking drugs. Once you start drinking, you won't be able to stop (*).

* Do not reduce or discontinue medication on your own, but under the guidance of a doctor.

■ "Isolation room" is quite rare

Misconception No. ``If you are admitted to a psychiatric hospital, you will be placed in an isolation room''

There is a deep-rooted misunderstanding about psychiatric hospitalization, and there are really many people who think that psychiatric hospitalization means an isolation room.

There are two types of psychiatric wards: open wards and closed wards.

The open ward is the same as the internal medicine and surgery wards, and has private rooms and large rooms, and you can move freely in the building, and it is also possible to visit.

On the other hand, in closed wards, the doorway to the ward is locked, so people from outside cannot freely enter, and inpatients cannot freely go out.

This is a mechanism to protect the patient. For example, patients who have a desire to die are prevented from leaving the ward and hurting themselves. It is also for the treatment of patients that they are not allowed to visit freely from outside. For example, there are many cases in which the patient becomes even more unwell by visiting family.

Like the open ward, the closed ward has large rooms, but with one difference: an isolation room. This is probably the room that many people have in mind when they are hospitalized in a psychiatric hospital, but entering an isolation room is a very rare case. The number of rooms is also very small.

Patients who enter the isolation room are particularly unwell even in closed wards, and are so symptomatic that they cannot take their eyes off of them. If a patient walks freely in the hallway and tries to get out, even if it means breaking through the glass, or if he or she becomes agitated and violent towards other patients, they may be placed in an isolation room. The isolation room is locked from the outside, so it can be opened from the outside, but not from the inside. The room only has a bed and a toilet.

Physical restraint, which is often problematic, is also done only in the isolation room. For people who are overly excited and violent, or who try to die by banging their head against a wall. Of course, such patients will return to the large room to live in the large room once their symptoms have subsided, and will be discharged from the hospital when they feel better.

■ Treatment takes time

That misunderstanding is unsatisfactory.

Many people who are unfamiliar with psychiatry tend to think that if they go to a hospital, they will get well soon.

For example, the boss saw a subordinate who was out of work due to mental health problems and was visiting a psychiatrist reading at a cafe. I often hear cases where people misunderstand, "Why can't I come to work when I can go to cafes? I'm under the care of a psychiatrist, so my illness is already getting better."

Treatment for mental illness generally takes a long time. Just because you've been to the hospital doesn't mean you'll get better soon. I can go on with my daily life, read at a cafe, hang out with friends, etc., but it is not easy to return to work. The degree of stress is completely different between play and work, but there are many people who do not understand why they cannot go to work when they can go to play.

There is still a lot that is not well known about psychiatric examinations and treatments, and I think this is the source of misunderstandings. However, it is unfortunate that such misunderstandings increase the hurdles for psychiatry. Going to a psychiatrist is neither scary nor embarrassing. If you feel mentally or physically unwell, feel free to knock on the door.

----------Tomosuke Inoue Industrial Physician, Psychiatrist Learn primary care over a period of time and complete a two-year clinical training. Since then, he has focused on three roles: occupational physician, psychiatrist, and health checkup doctor. Visits about 30 companies every month as an industrial physician. Utilizing my experience as a psychiatrist and health checkup doctor, I am working to prevent health problems and occupational accidents. Also worked as a psychiatrist at a clinic in Osaka Prefecture----------

(Industrial physician, psychiatrist Tomosuke Inoue)