How do you avoid getting jaded and burnt out when working with high acuity, low resourced patients who can often be untruthful about symptoms for social reasons?

Advice wanted

I’m a psychiatry resident so don’t get any say in where I work. Most of my rotations take place in safety net hospitals where the majority of patients are the types of presentations that people with a choice in the matter tend not to take (not universally ofc, there are exceptions). A majority of the patients consulted to me are not truly seeking any kind of mental health treatment because they are trying to utilize the hospital to meet needs lower down on maslow’s hierarchy, they’re displaying behaviors consistent with a severe and ego-syntonic personality disorder, or ofc sometimes it’s a combination of both. A not-insignificant number tend to be mean to downright rude with staff if for no reason other than being in a difficult psychosocial situation tends to do that to people. Lying about symptoms for secondary gain (I despise that term but am not sure what would be a better one to use) is also so common it feels impossible to ever truly tell what’s going on with a lot of patients. I thought I’d be better at reminding myself there are reasons, usually trauma and late stage capitalism, that people wind up behaving these ways, but I’m human too and finding myself growing tired and jaded as time goes on. Even if I wanted to with all of my might, I can’t fix the external societal factors contributing to so many of these problems, and getting yelled at by patients every day for not doing enough to get them better housing or what have you is so draining. I worry I’ll be a shell of the passionate, empathetic person I went into the mental health field as by the time I complete my training.

Posted Nov 2, 2023, 1:20 AM UTC

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