As a sixth former, I need to find work experience in order to gain the crucial knowledge and understanding which will enrich my application to medical school. Initially I struggled to find a work placement having contacted at least 50 hospitals and GP practices around Manchester, Chester, Macclesfield, and Warrington. Fortunately, through a former classmate, I was offered a placement by the Cheshire and Wirral Partnership NHS Foundation Trust (CWP) in February 2018.
“Cheshire and Wirral Partnership NHS Foundation Trust (CWP) provides mental health services for children, adults and older people, as well as learning disability and drug and alcohol services. CWP offers the services in Adult Mental Health, Child and Adolescent Mental Health, Drug and Alcohol, Learning Disabilities and Physical Health Services (West Cheshire)”.
Like all students, I was excited to undertake my first period of work experience in a real hospital, and working with the Learning Disabilities Team broadened my horizons from day one. The mental illness wards are really different from how I imagined them to be. Some people’s expectations of mental health hospitals are perhaps quite negative and consist of a perceived sense of chaos. They may think that there are many patients sharing one room, patients who scream or speak unintelligibly and patients who just stare into space. However, my internship at the CWP revealed the true, and far more positive nature of the reality, and I want to share my experiences within this unique environment with everyone.
On the television or in films, people with mental difficulties are often described as “abnormal” or “strange”. Take for example Dr Jekyll and Mr Hyde or Girl, interrupted or Psycho. These shows skew the view of mental illness. Also, Britney Spears who is a worldwide celebrity had what was dubbed as a “meltdown” for her so-called “abnormal” and “strange” behaviour. This isn’t accurate.
As an intern, I was allowed to observe and engage with patients. On my first day, there was a clinic being held in which the doctor saw her patients individually. One senior citizen had Down’s Syndrome which is characterised by some level of learning disability and certain physical attributes. This patient was very friendly and joked with us. She told my mentor doctor that she thought I was “really sweet” and I was so touched.
I observed that the wards were clean and quiet. Each patient had a single bed and a shared bathroom. Each room was designed with safety in mind: without any objects that patients could use to hurt themselves such as curtains or sharp items. Under Dr Awan’s supervision, I had the chance to observe numerous aspects of hospital life, from doctor/patient interactions on the wards to attending treatment planning sessions and training sessions for social workers. In addition, I communicated with medical students and participated in the Ballint group where members and leaders sit together to discuss a case study.
I became aware of other aspects of mental health and their interaction with learning disabilities, for example Autism, a developmental disorder characterised by troubles with social interaction and communication, and by restricted and repetitive behaviour. Most importantly, I learned how the patients are affected and how to build communication and trust with their family members. Positive behaviour support is an intervention designed to improve social skills, communication, and functioning in individuals with developmental disabilities. This valuable learning experience included information about policies, regulation, and advocacy relating to persons with disabilities. The staff were extremely welcoming and helpful, and offered me very useful career advice – recommendations of areas in which I could conduct further research and strengthen my career development. I also very much appreciated the professional approach, compassion, and sound judgement of my fellow staff members. I am very grateful for having had the opportunity to work with doctors and nurses who are committed to improving the lives of people with disabilities.
I feel very fulfilled as a result of this work experience as I have learnt so much about mental health. This internship experience increased my confidence, enriched my medical knowledge, and enabled me to make a lot of helpful contacts. The most challenging part of this experience was trying to help patients who had difficulties using the toilet as you had to carefully manage personal privacy.
What is so often unthinkingly stigmatised as a “mental hospital” has given me the invaluable chance to develop into an adult. I learned the art of communicating a diagnosis and empathetic listening skills. The patients would describe their situation and we would assimilate their stories to help throw light on their difficulties. I also took from this experience that it is not always good to conclude a diagnosis too soon. One interesting session I participated in included “Ready Steady to Go” which was an exercise that allowed the patient to express their journey to health, the obstacles in the way, what they felt was needed to get there, and what would be at the end. I came to understand how the creative process cannot be planned out in advance: the journey of expressing oneself is what matters most in the healing process. In the end, the patients gave very positive feedback on the session and expressed how valuable it was, and how much they enjoyed it. I saw the patients smiling. Their smiles could make flowers grow! How lovely they were! This work placement has given me great confidence in helping patients in the future.
Meanwhile I scoured medical literature about learning difficulties in China, and to my surprise, there is no agreed definition of “learning difficulty”. Educational researchers focus on children and refer to their bad academic scores, barriers to learning, and inappropriate behaviour. I found that it is also an almost empty area of research with regard to middle-aged people or senior citizens. There are no learning difficulty units in Chinese mental hospitals and I had conversations with Chinese academic researchers who stated two reasons for this: firstly, the relevant statistics aren’t sufficiently reliable, and secondly that some parents could refuse to accept their children’s disability. There is no government policy or social care in this area and I am interested in exploring this further. I hope to be able to study mental health at a British medical school in order to develop my knowledge and contribute to China’s understanding of mental health.
Many people categorise patients with learning difficulties or mental illnesses as “crazy” or “not easy to talk to” or “annoying”. I now feel really guilty, because before I began this work experience, I thought the same. Having worked directly with patients and having had actual conversations with them, I am shocked by my earlier thoughts. How could I even think that way? I am writing this account of my experiences as I want to tell everyone that nobody with a disability should be stigmatised or thought of as “different”. Everyone deserves to be loved and cared for.
- “Overview- Cheshire and Wirral Partnership NHS Foundation Trust”, National Health Service, last modified July 5, 2018, https://www.nhs.uk/Services/Trusts/Overview/DefaultView.aspx?id=2807.
About the Author
Junhan Zhao, 18, United Kingdom
Junhan Zhao is a year 13 student at Withington Girls\’ School, one of the leading independent schools in the UK. She is studying maths, biology, chemistry and will apply for medical school in Sep. 2018. Having been doing work placement in three different hospitals, she got the inspiration of writing this paper for her understanding of learning difficulties. Junhan was mentored by Dr Nadie Awan of Cheshire and Wirral Partnership NHS Foundation Trust in February 2018.