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When I was an undergraduate, I went through a period of being clinically depressed.  I met regularly with a Psychologist, and she helped me to understand what I was going through and how I could work on getting better.  Though it was a four-month period of my life that I hoped I would never have to re-live, it was also a time of great healing and self-discovery.  I almost cherish that time in my life because I was able to work through something that I thought would never end.  As a result, I have such empathy for people who experience depression or who are simply having a difficult time coping with the stressors of life.  It’s a difficult battle to fight.

This week, as I have been doing my Inpatient Psychiatric fieldwork, I have had many opportunities to reflect on that difficult period of my life.

Throughout the day we have several interactions with many different patients.  Typically, we first interact in a group with patients who are dealing with issues such as major depression or bipolar disorder or schizophrenia (to name a few).  Then we document what they did and what we saw.  Some of the documentation is narrative.  But most of it involves simply checking off a bunch of boxes.  Type of participation.  Type of affect.  Type of psychotic symptoms.  Amount of assistance given. After a few times of filling out these forms, I began to wonder.

What if I had gotten so depressed that I couldn’t function, and I had to come to a facility like this?  What if someone had filled out forms like these about me when I was depressed? I would really be reduced to a bunch of check boxes?  I would hate that!

Now I know what you may be thinking. They have the check boxes in order to standardize the forms and make them quicker to fill out, since healthcare staff always have so many forms to complete.

I understand that.

But it doesn’t change the fact that, if I was depressed and was staying at an Inpatient Psychiatric unit, and I was able to see the boxes that were checked off as a reflection of my group participation that day, it would make me feel weird.  I would feel like an animal in the zoo.  Or an experiment.

Maybe nobody has thought about psychiatric documentation like this before.  Maybe they have.  But I just found it very interesting how my personal experiences from the past were able to profoundly impact my visceral reaction to how OT’s document the performance of patients in psychiatric settings.

I suppose these are feelings that will shape my perception of many other things besides psychiatric documentation in the future.  But I at least hope that they will serve as a personal reminder that people are people – not boxes to be checked – no matter what they are going through.

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