Evaluation of Patients Who Cannot Be Brought to the Examination Environment at Home / Workplace

*Psychiatric diseases are included in a wide range and manifest themselves with different symptoms. Some patients have good insight, that is, their awareness about their disease, and when they have a problem, they seek a solution and consult a doctor. This group of patients has good communication and compliance with treatment.

*Some people do not consider themselves patients even though they are very seriously ill and cause a lot of trouble to those around them, and they strongly oppose offers to go to the doctor. Sometimes they even say things like "I'm not sick, you are sick, you go to the doctor" to the people closest to them who want to help them. In this group of patients; Suspicion, distrust, confinement at home, getting angry at everything, damaging property and committing violence against relatives are common.

*Another group of patients; Feeling of weakness, exhaustion and weakness. He feels extremely worthless and desires death. The reasons why these patients stay away from the doctor are; They do not believe that they will get better, that things that go wrong will work out, and they see themselves as worthless beings who do not even have the right to see good days. The risk of suicide is high in this group of patients.

*Another group of patients; He cannot come to the examination due to his fears related to panic attacks. These patients do not want to leave the environment where they feel safe and where they think they can get help at any time. The environment where they are most comfortable is when they are at home with their family members. According to his opinion; When he experiences any crisis or fear attack, while he is struggling with his life (!), his mother, father, sibling, wife, etc. will be able to call an ambulance or a doctor (!). These patients are afraid of being alone at home, walking alone on the streets, getting into crowds because they think they will not be recognized and cannot receive medical help, and going out in traffic due to the risk of traffic congestion. For this reason, they cannot come to treatment environments. These patients experience serious losses in areas such as education, work-profession, and social relations and become increasingly lonely.

*Some people cannot come to the examination due to physical diseases or limitations due to old age. Some of these patients are bedridden, and some have difficulty moving. Some feel that they need to get help due to mental deterioration. He can't think. It is possible for all this group of patients to be examined at home, accompanied by their relatives, and to start their first treatment there. One group of patients was worried about being labeled crazy, another group of patients; He stays away from the treatment environment because he is addicted to something (alcohol, drugs, TV, internet, etc.) and thinks that he will be criticized and condemned for this.

* There may be other reasons that keep people away from the treatment environment. Regardless of the thought that causes people to stay away from the treatment environment, treatment services must somehow be delivered to such patients, who constitute a large group. In this context, before coming face to face with the patient, detailed information about these patients should be obtained from their relatives, communication and interview options should be reviewed, one should think about the safety of the environment for the patient and other people, go home prepared for whatever type of treatment can be applied, and establish a short and long-term relationship with the patient. An attempt should be made to establish communication based on respect and understanding.

*As a result; These patients should be examined psychiatrically in the environment where they live and their first treatment should be started. Therapy and treatment support should be continued at regular intervals until they feel ready, at home or in work environments, they should be encouraged to go to a health institution or clinic, and their small efforts in this regard should be applauded.

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