to think that this is inappropriate

[fluffydressinggown]

Went to see the psychiatrist at my community mental health team today. Prior to going in my CPN (who also came to the meeting) said that he had two sixth formers with him who were applying for medicine next year and did I mind if they stayed. I refused and she was very nice about it all and agreed it was not really appropriate for them to be in my meeting.

I think it is hugely hugely inappropriate to have 17 year olds sitting in on appointments in the CMHT. To get a referral into this team you have to have severe, complex or enduring mental health issues, so people attending may be really very unwell or have a difficult history.

I know that experience is important in getting into medical school, but 17 year olds have no training on confidentiality, probably no CRB check, no training on dealing with the things they might hear. They have not even got into medical school so there is no guarentee (as you may have if it was a medical student) that they are even suitable to be listening into such things.

And I think it puts potentially vulnerable people into a difficult situation, I felt confident saying no but maybe other people might not. And waiting to see a psychiatrist is stressful enough without being called into a room before to be asked about that, I was really worried she was telling me the meeting was cancelled or delayed which made it more stressful for me.

In this meeting we planned an admission, discussed in detail a suicide plan, and discussed some distressing thoughts - not things I want to share and things that children maybe should not hear. And I know I refused to have them there but really I don't think I should have ever been in a position where I was asked about it.

AIBU to think they should not have been there at all, I feel like it was a completely inappropriate place for work experience.

Oh and maybe I feel like that because my MH is poor but so is the MH of most of the people that psychiatrist was seeing that day!

My DH is trained psychiatric nurse and former director of nursing for an NHS Trust and my background is in mental health social services. For what it's worth, we entirely agree with you, for all the reasons you mention.

We now run a care agency and we sometimes have potential applicants and people from the Job Centre asking if they can go out with a home carer, just for a look. We also refuse. The potential safeguarding issues are huge, not to mention the dignity of the person receiving care. It's not a spectator sport.

Well you are unreasonable and you're not . On the one hand I agree that it can be hard to say no, and perhaps this should be dealt with in a better manner, in order to enable someone to say no without feeling any pressure. On the other hand, just because they are 17 wouldn't be a reason for me to say no. 17 yr olds can be very adult and discreet too. It depends on who they are. But, if those are the reasons you said no, then I guess its ok for you to feel like that too. So maybe you're not unreasonable, you should feel ok to say no for whatever reason, even if someone else doesn't necessarily agree with you for those reasons.
Phew. I bet that makes no sense!

I work for NHS and 17 yr old students on work experience are not allowed to work with us, for all of the reasons you outlined.

You should not have been placed in the awkward situation of being asked and having to say no. I would ask your CPN if on reflection, he thinks this was appropriate.

YANBU, as a teacher I work with 17/18 yr olds and have worked with some lovely students who have successfully gone on to do medical degrees. They did all need some work experience to get onto their courses but lovely as these students were, I would not have felt they would be suitable observents of the type of meeting you describe. I also don't think they would have gained anything useful themselves from it.

One boy I taught spent time in the labs doing blood tests etc. A girl I taught shadowed an A&E registrar. Each of them gained worthwhile experience that helped them to apply and speak with confidence at interviews. How could someone who had sat in on your meeting write or talk about that in their application process without breaking confidentiality?

YANBU. I work in a sensitive area of healthcare. We have a very clear policy for dealing with requests for work experience - essentially they are refused! We still get snooty requests from ex GPs etc asking for 'favours' for their friends kids etc.

This reminded me there was someone on work experience in triage in A&E once and that was not brilliant either (I refused him as well!!)

My CPN was very nice about it and rather apologetic tbh, she agreed it was inappropriate, especially as it was a difficult meeting and I am not brilliant at the moment.

Noqontrol - you are right, it makes no sense whatsoever! i don't know if you have ever had to deal with MH issues, but it takes an awful lot of courage to talk about it to doctors and trained health professionals, but to talk about it in front of unqualified personell, let alone children is just out of order!! It doesn't matter who they are 17 is no way near mature enough to deal with that. Id have gone ballistic to have even be asked - this is somethin that IF it was to even be contemplated should have been broached by letter when the appointment was made. Totally unprofessional.

Yanbu it was completely inappropriate

YANBU. Perhaps if they were training to be doctors but 'applying for medicine next year'??Not the same at all...

YANBU totally inappropriate. It's bad enough when it's not something personal. I wasn't even asked recently. Whilst half way through explaining the problem to the consultant, a random woman walked in with shopping bags, wearing a flowery dress then started examining me. Had absolutely no idea who she was. Consultant then proceeded to speak to her as though I wasn't there. I thought that was fairly inappropriate. But in the case you describe - you really do need your privacy.

Sorry lucy, i did actually say that it should be made easier for people to say no without any stress or guilt. Or thats what I was attempting to say anyway. But maybe not very well. It doesn't matter what the reason is, the patient has the right to decline and it should be made easier for them to do this. And yes, I do have experience of MH. And yes, approaching by letter with an opt in rather than an opt out clause would be more appropriate too. But I wouldn't immediately say no to a 17 year old. But thats my choice.

YANBU, actual medical students yes, work experience tagalongs no. They wouldn't let an a level student watch you gave a smear, this is just as intimate IMO.

yanbu

and well done for saying no

I share your concerns however that someone else may not have been that able to do the same

I would have been utterly furious if i had been in your position. Completely wrong. Glad you had the strength to say no!

Yanbu, totally inappropriate IMO. Hideous that you should be put in that position in the first place.

I hope the rest of the meeting went better for you and you got some appropriate help and support.

YANBU - I think mental health issues are especially delicate.

Having said that, I had a male work experience student present when I went for a smear test - he politely sat through my conversation with the nurse about heavy periods then stayed on the other side of the curtain while they did the deed.

I agreed he could be present because medical schools expect work experience and it can be hard for young people from our local state schools to get this.

YANBU. I'm glad you were able to assert yourself and I hope you feel better soon.

Noqontrol, you say some 17yo are very adult and discreet, but how would a psychiatrist's client know whether the particular 17yo witnessing their meeting are like that, or whether they are the type who are going to tell their best mate, who'll tell their mum, who'll tell next door etc etc etc. There is no way of telling.

I think it is highly inappropriate.

I was sort of in their position when I was 17. I was on a YTS in a big old Victorian Psychiatric hospital. I worked on all the different wards, including acute admission.

I was allowed to know all things about all of the patients, however, we did have a 4 week induction before being allowed anywhere. During that time, they gave great emphasis to confidentiality and respect.

They have to start somewhere, but really not necessary to start in a very traumatic meeting.

EmmaNemms, I bet we're nowhere near each other, or I would be trying to apply for a job!

They wouldnt Jub, but I'd like to think the person had been vouched for by a responsible person who knew them well. Its an assumption that because someone is older they will automatically be discreet. Having lived with med students in the past, I know this is not always the case. But its a choice isn't it, the way should be paved for people to say no easily. I'd probably say yes 90 percent of the time, and according to this thread the majority would say no.

Yes, it would depend entirely on the circumstances, Noqontrol.

If I were at my GP's (whom I would trust to judge sensibly) and was discussing my medication or something like that I'd be fine on the whole, and would say no problem; however, we're in a small town, and it is quite possible that I would know a 17yo work experience person, and I think - unless it was a very straightforward matter, and one which was generally known (ie, I've got ms) then I'd be more likely to say no. For intensely personal matters such as the op's, I would definitely say no.

When we lived in London, because the population is so disparate, then I would be more likely to say OK, simply because any unintentional indiscretions would be highly unlikely to get back to anyone who knew me.

Intresting to see that most people agree!

I think if I was having a pill review with my GP or an ingrown toenail removed I would care less, but this was so painful and personal (was admitted that evening so I really was very distressed). There are just better places for work experience (used to see a few when I worked in theatres actually which was ok - patients always asked and consented).

I think that MH and understanding it is about relationships and sitting in on one session with me really would have given them little insight because it was all about stuff that had happened in previous weeks.

I think with medical students I feel they have gone through the admissions procedure and maybe have an understanding into the process they are watching. Work experience makes me feel gawped at and it really really isn't a spectator sport.

It's a difficult one. So many people complain about lack of understanding of mental health issues on the front line, eg. GPs surgery. I do wonder if exposure a little earlier may have a more positive impact. I honestly don't know, and as the daughter of a Doctor and the Mother of somebody who wishes to be a Doctor, I think the most important thing is making the right decision, without pressure, for you, at the time.

Yep, agree with that Jub. I would say no if I was in a small town. Definitely actually, I had forgotten what that small town living is like. Im in a city now and it would feel safer to let someone in. But yeah, it wouldn't have worked in that small town I once lived in. Very fair point.

That is true Dawn, but IMO the time to get it is not in sixth form, and there are plenty of community projects for mh rehab that medical students or people wanting to apply can join in with.