Why are mental health patients called "service users" instead of patients?

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xBeautifulMind
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It makes no sense. They are unwell and receiving treatment(s), so why are they not classified as patients in the same way that people with physical health problems are?
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ecolier
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(Original post by xBeautifulMind)
It makes no sense. They are unwell and receiving treatment(s), so why are they not classified as patients in the same way that people with physical health problems are?
Because there's a negative connatation with the word "patient".

People with physical health problems won't mind as such, but some people with mental health problems may not like it.

And of course, there's a huge stigma for being a "mental health patient".
Last edited by ecolier; 5 months ago
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xBeautifulMind
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(Original post by ecolier)
Because there's a negative connatation with the word "patient".

People with physical health problems won't mind as such, but some people with mental health problems may not like it.

And of course, there's a huge stigma for being a "mental health patient".
It can be quite invalidating though, especially when a person has accepted that they are "unwell". A recent poll on Twitter of over 800 people with mental health issues showed that 72% would prefer to be called a "patient", 18% would prefer to be called a "client", and only 10% would prefer to be called a "service user".

Avoiding using the word "patient" for mentally unwell people only adds to the stigma, surely? It implies that people are "choosing" to use mental health services, which is not the case at all. Many people are referred as a last resort, at which point their mental illness(es) are debilitating their life. Yet they are still not deemed "sick enough" to be patients.
Everyone has mental health, but not everyone has a mental illness. There is a big difference.
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ecolier
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(Original post by xBeautifulMind)
It can be quite invalidating though, especially when a person has accepted that they are "unwell". A recent poll on Twitter of over 800 people with mental health issues showed that 72% would prefer to be called a "patient", 18% would prefer to be called a "client", and only 10% would prefer to be called a "service user".

Avoiding using the word "patient" for mentally unwell people only adds to the stigma, surely? It implies that people are "choosing" to use mental health services, which is not the case at all. Many people are referred as a last resort, at which point their mental illness(es) are debilitating their life. Yet they are still not deemed "sick enough" to be patients.
Everyone has mental health, but not everyone has a mental illness. There is a big difference.
I agree, as a healthcare professional I personally prefer the term "patient" but it seems like the world is moving towards "service user" - even for people with physical conditions.
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VeritySleeps
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(Original post by xBeautifulMind)
It can be quite invalidating though, especially when a person has accepted that they are "unwell". A recent poll on Twitter of over 800 people with mental health issues showed that 72% would prefer to be called a "patient", 18% would prefer to be called a "client", and only 10% would prefer to be called a "service user".

Avoiding using the word "patient" for mentally unwell people only adds to the stigma, surely? It implies that people are "choosing" to use mental health services, which is not the case at all. Many people are referred as a last resort, at which point their mental illness(es) are debilitating their life. Yet they are still not deemed "sick enough" to be patients.
Everyone has mental health, but not everyone has a mental illness. There is a big difference.
I work for a social care and housing company that help those with learning difficulties, mental ill health and some elderly people. We would refer to all of them as service users because they aren't patients and we aren't a hospital. We mainly offer support through positive interactions but the vast majority of staff aren't trained to act as nurses etc. We just offer them housing and/or support and they use our services. I think it's important that the terms are used kindly and with respect but it is also important to remember a twitter poll isn't necessarily the best way to discover what people may prefer. I haven't found people to have issues with the terms however if someone did, I would change my language.
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xBeautifulMind
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(Original post by VeritySleeps)
I work for a social care and housing company that help those with learning difficulties, mental ill health and some elderly people. We would refer to all of them as service users because they aren't patients and we aren't a hospital. We mainly offer support through positive interactions but the vast majority of staff aren't trained to act as nurses etc. We just offer them housing and/or support and they use our services. I think it's important that the terms are used kindly and with respect but it is also important to remember a twitter poll isn't necessarily the best way to discover what people may prefer. I haven't found people to have issues with the terms however if someone did, I would change my language.
That makes sense though, because the company you work for doesn't offer a clinical service. I'm mainly talking about hospital settings, where nurses, psychiatrists, psychologists, therapists, dieticians etc are involved. Even within the hospital setting, the "patients" are still referred to as "service users", which doesn't make sense. To me, a "service user" is like when an individual subscribes to Netflix. Not when they are attending clinical appointments where they are being prescribed medications, having their mental capacity assessed/monitored, and offered psychological therapies.
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Pathway
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Tbh I think MH services have bigger issues that need to be dealt with, they're generally a nightmare to interact with. I don't really like the term "client" and it feels weird being referred to as a "service user," I prefer "patient" but tbh I doubt it'd be used with respect given how poorly people are treated in MH services.

Just my opinion though, I'm definitely biased.
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Anonymous #1
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(Original post by Pathway)
Tbh I think MH services have bigger issues that need to be dealt with, they're generally a nightmare to interact with. I don't really like the term "client" and it feels weird being referred to as a "service user," I prefer "patient" but tbh I doubt it'd be used with respect given how poorly people are treated in MH services.

Just my opinion though, I'm definitely biased.
I feel like another term rather than service users would be more welcoming .Service users sounds like the nation doesn't care about people with mental health issues.If someone broke their leg everyone goes racing to help but there still is a negative association with health of the brain.The world needs to change but who will be first to try to help people understand mental health illnesses are common and these people shouldn't be treated differently.
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black tea
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I have only heard that term used by people who are not healthcare professionals (counsellors, psychotherapists, social workers etc.). In my experience, doctors and nurses call them patients.
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ecolier
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(Original post by Anonymous)
...there still is a negative association with health of the brain...
I think you mean "health of the mind".

Patiants with brain diseases are managed by neurologists and neurosurgeons and there are much less stigma towards people suffering from strokes, brain bleeds, tumours etc.

The problem historically is with the specialty itself, and the diseases. Psychiatry has always had a "bad rep" with things like ECT, lobotomies etc., and many mental health diseases were / are / will continue to be badly stigmatised.
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Pathway
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(Original post by Anonymous)
I feel like another term rather than service users would be more welcoming .Service users sounds like the nation doesn't care about people with mental health issues.If someone broke their leg everyone goes racing to help but there still is a negative association with health of the brain.The world needs to change but who will be first to try to help people understand mental health illnesses are common and these people shouldn't be treated differently.
Yeah, and part of that problem is that even MH professionals don't care. e.g. I've been told to "just eat" and "stop wasting time and resources" when I have really bad dips with my anorexia, this is from MH professionals (interestingly, my other specialists outside of MH are much better at supporting me with my MH issues). If MH professionals don't respect difficulties, how can you expect the general public to?
Last edited by Pathway; 5 months ago
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Kerzen
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Something which I think may be true is that 'Service User' might be more appropriate in a modern context because of the sheer breadth of what is offered in a mental health context.

If I take the hospital in my area which is the main centre for mental health as an example, it's clear that the mental health provision is a kind of massive umbrella - in the middle of the umbrella, you do have the sphere in which people are either on the wards or "attending clinical appointments where they are being prescribed medications, having their mental capacity assessed/monitored and offered psychological therapies", as you describe it, but the edges of the umbrella are about something different, they encompass things like, say, Saturday Brunch For Men; these services are in many ways prophylactic and are intended to be supportive of good mental health in the hope that this provision will obviate the need for people to move closer to the centre of the umbrella. It's when you consider these ancillary, mental health supporting organisations that you can see why 'Service User' might be more appropriate than 'patient'.
Last edited by Kerzen; 5 months ago
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DiddyDec
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I personally dislike the phrase and it gets used a lot at work since designing mental health units is what we do for the bulk of our work. More recently I have heard it being used for those on probation and even those in prison which gives the term further negative connotations in my view.

In my view if there is to be parity in care between physical and mental health there should be parity in language as well. While it is certainly not the most pressing matter it is small change that could at least be a start.
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MidgetFever
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Seems to be just another part of the trend of not recognising mental health problems as 'legitimate illnesses'

Which is a shame, I wish we could move past the stigma attached to it.
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Sabertooth
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People undergoing psychotherapy are called clients and I think that is fine because of the massive array of issues they are dealing with. But I think people under a psychiatrist or in hospital should be called patients.
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Anonymous #1
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(Original post by ecolier)
I think you mean "health of the mind".

Patiants with brain diseases are managed by neurologists and neurosurgeons and there are much less stigma towards people suffering from strokes, brain bleeds, tumours etc.

The problem historically is with the specialty itself, and the diseases. Psychiatry has always had a "bad rep" with things like ECT, lobotomies etc., and many mental health diseases were / are / will continue to be badly stigmatised.
I don't think I mean "health of the mind" , I mean health of the brain as I stated because many mental health illnesses are also sparked to due damage of the brain,eg physical abuse causing chemical imbalances.Where you have stated "health of the mind" is also true but equally health of the brain as both work together.As a doctor yourself, do you stigmatise mental health with the negative connotations? Just generally asking to hear your opinion on mental health.
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(Original post by MidgetFever)
Seems to be just another part of the trend of not recognising mental health problems as 'legitimate illnesses'

Which is a shame, I wish we could move past the stigma attached to it.
Exactly , there is so much stigma associated with mental health conditions and society needs to work together to overcome this.Not a lot of the population appreciate that mental health and physical health should be treated the same.
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ecolier
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(Original post by Anonymous)
...As a doctor yourself, do you stigmatise mental health with the negative connotations? Just generally asking to hear your opinion on mental health.
Nope not at all. I did find psychiatric diseases very interesting and the patients fascinating.

However I cannot bear to work in a specialty which cannot really deal with any physical condition - e.g. if a patient in a mental health facility develops a cough or fever (pre-COVID), they'd be shipped to the acute hospital straightaway. Another reason is a TW:

Spoiler:
Show
Working as a gastroenterology FY1, I have witnessed plenty of young people with ED, a few actually were very unwell / died because of it and I found it really hard. I didn't think I can deal with that


I do have the utmost respect for my psychiatry colleagues though.

I also think (and hope) that one day we will have technology advanced enough to investigate why some people get depression / schizophrenia / eating disorders but others do not. Perhaps when that day arrives psychiatry (both as a specialty and their patients) will be less stigmatised.
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Joleee
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i didn't know i was called a service user tbh. how would i know this?

personally doesn't bother me one way or the other; they both mean the same thing to me. i guess tho i never associated the term 'mental health patient' with negative connotations. it describes the situation; not the person.
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Anonymous #1
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(Original post by ecolier)
Nope not at all. I did find psychiatric diseases very interesting and the patients fascinating.

However I cannot bear to work in a specialty which cannot really deal with any physical condition - e.g. if a patient in a mental health facility develops a cough or fever (pre-COVID), they'd be shipped to the acute hospital straightaway. Another reason is a TW:

Spoiler:
Show
Working as a gastroenterology FY1, I have witnessed plenty of young people with ED, a few actually were very unwell / died because of it and I found it really hard. I didn't think I can deal with that


I do have the utmost respect for my psychiatry colleagues though.

I also think (and hope) that one day we will have technology advanced enough to investigate why some people get depression / schizophrenia / eating disorders but others do not. Perhaps when that day arrives psychiatry (both as a specialty and their patients) will be less stigmatised.
That's the issue a lot of doctors don't pick psychiatry as their speciality.There is a shortage of psychiatrists and not many doctors want to go into this role-maybe due to the negative connotations or preferring physical speciality roles.Maybe if there were more psychiatrists and people willing to work with non physical illnesses we may see more of a change which is definitely needed.

This is a personal question for you,I wanted to ask you what year are you in off your training ?

You are very helpful on TSR for so many people.A lot of people including me appreciate your help on TSR and I love to hear your and others opinions .Hope you have a lovely year.Thanks
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