Am I a Client or Patient?

Last week I introduced the topic of integration of primary and behavioral health care. I’ve been listening to some podcasts about it (got to love those) and heard about an interesting system a local hospital is piloting. Each general care practitioner clinic is required to have a behavior health professional on staff. That professional has two roles.

  • See individuals referred by the general care staff.
  • Keep the staff current on new mental health medications and research.

Evaluations of the program have been positive thus far. The primary care physicians have seen a dramatic decrease in the resistance of individuals in scheduling and attending an appointment with a mental health counselor. The doctor will write a note in the individual’s chart, and when they check out the receptionist will ask when they would like to schedule an appointment with the mental health professional. Often, they are able to make same or next day appointments. Moving the mental health professionals into the same clinic as the primary care doctor increases convenience and lessens the stigma attached to therapy. The clinic has found the convenience of same day appointments is especially beneficial to low income individuals who have transportation concerns.

I love this idea—and will be interested in seeing if it spreads throughout the larger Indiana community. I’m not ashamed of therapy—but I still have some awkward moments in the waiting rooms. Everyone there is trying to avoid eye contact with you, and you start wondering why they are there. And figure they are trying to figure out why you are there……or what if you run into someone you know? What’s the protocol on that?  So sometimes I think it would be nice to park my car in my general care doctor’s office, and sit in the waiting room. Then people could just assume I was there for an allergy shot or something.

But now I need your opinion on something! The administrator presenting the pilot project, said one of the most basic problems they are encountering is a debate between primary care practitioners and mental health practitioners. Are individuals being seen by mental health practitioners “patients” or “clients”? Primary care practitioners identify them as “patients” the same as every other individual they see. Mental health practitioners believe they should be addressed as “clients”.

Seems like a simple concern—but there’s actually a lot riding on this debate.  I see the case for both sides.

  • Client:  The connotation is of the individual having more responsibility and control over their treatment.
  • Patient: This connotation brings to mind someone who is sick—on one hand, I think that can be a good thing. I want to start to associate this anxiety/depression crap with physical illnesses so people realize it’s not my “fault”. But on the other hand, not everyone in therapy has a physical illness and sometimes when I am doing well I do not like to think of myself as sick.

So—I can be swayed either way on this issue!  VOTE and then leave a comment with your thoughts on why you voted the way you did (if you would like to!)

6 thoughts on “Am I a Client or Patient?

  1. NZ Cate says:

    In my country we get called ‘consumers’. I hate that. I’m not buying anything

    • Nicole says:

      True! That term slipped my mind. I tend to hear consumers more in the mental health advocates/awareness field. For example, the support group I go to is for “consumers” and the other one is for family and friends. Should I add it to the poll?

      I know the term consumer comes from the idea that we are “consumers of mental health services”. But I agree that it is unfitting. Also, isn’t part of the problem that many people with a mental illness are not “consuming” mental health services? So this term excludes them!

      Thanks for reminding me of this term!

  2. Jezebel says:

    I had a tough time voting, but in the end I decided on client because I like the idea that I have more control over the treatment. That’s always been my biggest problem with mental health treatment, feeling out of control and like decisions are always being made for me. On the other hand, patient has its place too because mental illness DOES need to be seen as more similar to physical illness in that it’s a problem with our brains and we did NOT choose to be this way.

    • Nicole says:

      I feel like your post was written from my brain! I am torn for the exact same reasons. I like the reminder that we should be in control of our care!! Thanks for commenting!

  3. I agree NZ, consumers sounds so unfitting! I never really gave it much thought until now. I know that I am a “patient” in the medical field, and a “client” in the mental field. I think that always resonated with me because in the medical field, I am very uneducated as to what physical symptoms mean, illnesses, medication, etc. I don’t feel confident in speaking up, instead I bring questions to my doctor. Whereas in therapy, I see it more of a partnership – my therapist is there to help me with what I want help with. She can only help me with what I share with her (willingly and not so willingly!) as there are less often clear-cut physical assessments (the way my doctor can use blood work or x-rays or CT scans and know what I will need.) However, I can definitely see the other side where patient fits, too. Interesting conversation piece!

    • Nicole says:

      Those are great points! I like the distinction of the “clear-cut” physical assessments that doctors use oppose to those in the mental health field. That physical assessment does lend itself more towards the “client” side.

      I never really thought about it either until the presentation I watched!! But as the systems integrate more it is probably going to become a bigger issue. Just think about even simple things like the signs or forms you sign in the doctor’s office that say “patient”.

      Thanks for joining in the discussion–I love hearing other “consumers” “patients” “clients” opinions. I personally think we should all just go by those super awesome individuals with the amazing special brains!

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