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Joe Kelly comments on causes of low self esteem in mental health treatment / 15 June 2010

drawing of a phone imposed on face of a figure

Entry phone. Illustration © Colin Hambrook

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When I visit my local Mental Health Resource Centre I'm greeted by running the gauntlet of an entry system that was designed for processing, what would appear to be very difficult people. Firstly you ring a bell next to a door with a glass frame. A buzzer rings and you go into an enclosed space with a glass screen looking into an office. In the corner is a CCTV camera monitoring you from above.

Next you have to sign in saying who you are visiting and the reason for visiting. You then press a button. If you do it properly the door opens. If not you have to try again. Hopefully you get it right first time.

Just to the right is another glass screen behind which sits a receptionist. She is usually busy, but eventually she stops, pull the glass screen asks you what you want and tells you to wait in the waiting room until you are called.

It’s a little different to my experience of an entry system at the Footsteps Arts old office base at the Lido Centre in West Ealing. The door would usually be open. I'd walk into reception and be greeted by a receptionist, pick up my mail and go through a security door to my office desk.

Such a difference; more empowering; more human, more what you want, more respectful. How you are processed by health professionals and their systems tells us a lot about who we are and where we are on the linear continuum that measures respect.

I know a lot of user-survivors call mental hospital 'the bin'. Perhaps it's like the day centre entry system ... makes you feel not respected and consequently bad about yourself. Low self esteem is very common among user-survivors and can be transmitted by little things like the entry system telling us we are not worthy. Feeling not worthy promotes depression. Depression is a serious problem affecting the lives of users-survivors.

I've noticed there are many poorly designed practises and systems in day centre and hospital environments but health professionals seldom check them out. Health professionals are too complacent to notice when I go to my local Mental Health Trust HQ or my local PCT [Primary Care Trust]

Their receptions are not like my day centre. Day centre entry systems don't seem that important - but when you look a little closer it tells you who is in charge and what values they have - and how important the issue of low self esteem is on their care radar?

I hope commissioners and mental health chiefs read this blog?

Keywords: mental health