Why “choice” does not work for me. It assumes that “choice is good” and that all patients are capable of making an informed choice. (That’s not to say this will be the case for everyone, but here goes).
I really don’t want to have to write this post, but feel compelled to. In part because it’s my third post in 24 hours (which is why I’ve delayed it’s publishing time), and in part because it’s about my messed-up mental health – today being a particularly tough day on the anxiety front. My first blogpost on my mental health issues was Going beyond a pill, followed up by a series of further blogposts in my category Mental Health.
On patient choice
For me there are two things here. The first is politicians having not caught up with further developments in the field of psychology crossed with economics. The mantra from my A-level and university days was that choice was good. One of the few economics staff I respected at my old university was Robert Eastwood, and it was he who pointed out some of the then new developments (in 2001/02) in the field of the psychology of economics. Had I not been this unstable ball of mental health mess at the time I’d have probably been able to have engaged far more with him because he was one of the few people who seemed to be able to look at economics from a critical perspective rather than being the mouthpiece of those that, as I set out here were compromised up to their eyeballs.
Too much choice
Basically the issue is whether choice is an inherently good thing. In some cases yes, in some cases no. The problem with the political establishment is that they have bought the “choice is good” argument in the same way that they bought “light touch regulation for banks is good” mantra. Is choice always good?
Too many choices cause:
- Paralysis rather than liberation – people prefer to make no decision rather than make a complicated choice.
- Less satisfaction with decisions as people have greater reason to regret the decisions they have made.
- Unrealistic expectations.
- Self-blame – when experiences are not perfect, people blame themselves.
This was taken from a lecture by Barry Schwartz back in 2007. In part these explain why I still view my first university with utter contempt, even after graduation some ten years later. You say that’s not normal? I know. Feelings such as this are part of my condition. The number of universities and the number of courses are so bewildering that there can be a feeling of paralysis. With hindsight I never really had all of the information that I needed to make an informed choice of which university to go to. Again, I come back to the lack of an informed and knowledgeable mentor as being a key factor at the time. 2 & 4 above stand out like a sore thumb with having had too much choice and too little essential information on which to base that choice.
Not having the capacity to make that choice
I have an anxiety problem. I’ve spent the past week trying to fight off the side effects of medication withdrawal having come off it for the first time in five years. One of the things that I need (that the NHS does not provide unless it’s urgent & you’ve been on a waiting list for ages) is suitable mental health treatment irrespective of budgetary pressures. Thus I am in a situation (like many) where I have to look for a private therapist who will charge anywhere from £40 per hour upwards.
But I’m ill. I don’t want to have to make any choices – I don’t feel capable of it. I want my doctor to make that choice for me through a referral. But he can’t – he’s got his hands tied. At least, that’s what it feels like. I’d rather through discussion we came to an agreement as to what sort of treatment would be suitable and leave him to sort it all for me.
I don’t want choice. I want to recover.