Shilpa Prabhakar: Should you choose mental health as your specialty?

shilpa_prabhakarI have always wanted to be a doctor. Perhaps, like many, I was attracted to medicine because I wanted to help people. After qualifying in 2004, I briefly did a general medical rotation before moving into paediatrics and then surgical specialties. That’s when I came across psychiatry.

Mental health is the only specialty where you can have two different patients with the same diagnosis, but they present in completely different ways. The ability to work with patients over a long period of time is very unique to psychiatry. What I find rewarding about working in psychiatry is that I get to know more about the person I am caring for.

I work with adolescents and it’s both challenging and gratifying at the same time. You quickly learn that the right support for a person at this critical time can change the trajectory of an entire life. You learn a lot about yourself too—about being mindful and more realistic about managing your own stress.

It can sometimes be hard to keep things in perspective when treating young people who have often experienced severe trauma. But the rewards of seeing these young people do well are so great that it makes all the hard work worthwhile.

There is still a lot of stigma attached to having mental health problems. I think many people mistakenly believe that patients with mental health difficulties do not or cannot get better. Yet I have seen so many people get better and move on.

I’ve had the privilege of watching young people transform in front of my eyes. I’ve seen young people who were admitted with extreme suicidal tendencies then be discharged, allowing them to resume their everyday lives and reach all those teenage milestones from getting qualifications to learning to drive. I’ve witnessed young people with severe early life trauma and fractured family relationships gradually open up about their experiences, allowing them to start to heal and improve relationships with their families.

Being able a build a trusting, therapeutic relationship with the patient and the team is vital to getting someone on the road to recovery. You know you have been able to do this well when you get a letter from a former patient, thanking you for the support they received. That makes you realise that what you do in your job can become a defining point in someone’s life.

If you are unsure of where your career in medicine is taking you, I would encourage you to spend a day in a psychiatric ward and get a feel for what it is like to work in mental health. It might just turn out to be a life changing decision.

Shilpa Prabhakar, associate specialist doctor, St Andrew’s Healthcare.

Competing interests: I have read and understood BMJ policy on declaration of interests and declare the following interests: None.