Talking health Systems at the psychiatric university clinic

Monday, 9th of July

Today Tami, Nadine, and Devon gave a presentation about Mental Health in the United States and Palliative care in both the United States and Switzerland. Devon talked a bit about history and culture that shaped mental healthcare in the United States. We had an interesting discussion about the ethics of self-determination and how that is impacted by terminal illness.

The trip to the Psychiatric Hospital was very interesting! Much like in the United States, photography inside is prohibited to protect the confidentiality of the patients. There were many differences, however. We took small tours in groups of 4-5 to visit the wards. This was done in part to reduce any feelings of patients feeling like we were watching them like a zoo. Things that were allowed in the Swiss psychiatric hospital that usually are prohibited in an American behavioral center included:

· Smoking

· Coffee that wasn’t decaf

· Windows that could actually open. These windows had plexiglass inserts to prevent anyone from harming themselves, but allowed breeze and natural light in.

· Cell phones are allowed

· Patients can cook their own meals and are do their own laundry

Social workers also have some differing responsibilities in Switzerland as compared to the United States. One big difference is that social workers in Switzerland do not diagnose patients. Sandra said that she liked not having that responsibility After discussing the stresses of clinical judgement, we can see her point!.Alessandro played devil’s advocate during discussion which helped balance opinions. One thing Tami and Devon are still curious about is intervention planning. Do social workers in Switzerland develop individual service plans for clients like in the United States?

As for palliative care, we learned that it is under utilized in the United States and that social workers very rarely work in palliative care in Switzerland. The culture surrounding death is taboo in the United States, but in Switzerland with programs like EXIT, it seems a little more normalized to talk about advanced directives.

That evening we took it easy and did laundry after a go go go weekend. Can’t wait to see what’s in store for the rest of the week!

Bis dann!