Words are the most powerful drug
Rose McCabe, Professor of Clinical Communication at City shares her vision for better verbal and non-verbal communication and shared decision making in the mental health care setting.
As part of our School of Health Sciences Dean’s Lecture Series we were delighted to have Rose McCabe, Professor of Clinical Communication at the School, deliver the second in the series this year.
Professor McCabe arrived at City last year from the University of Exeter, and her subsequent impact on the School has included leading its Centre for Mental Health Research and setting up the new five-year, NIHR funded ASsuRED project to improve how NHS accident and emergency departments support those who have presented after having self-harmed or had thoughts of suicide.
Her public lecture this week, ‘Words are the most powerful drug’ focused on the importance of words as a powerful tool in medicine, and how they can help and also harm in the clinical setting.
She set the scene with some important statistics including the fact that in England alone last year there were 64 million prescriptions for antidepressants, considered against a population of 55 million people. Another key statistic shared was from a report by charity Marie Curie, suggesting that poor communication within the NHS wastes public funds, damages patient care and is estimated to cost the service over £1 billion a year.
The power of positive and negative beliefs on the effect of treatment was then revealed using the concepts of placebo (positive expectations of treatments) and nocebo (negative expectations of treatment), and she also highlighted the power of the questioner in a medical setting to improve patient experience and outcomes.
Professor McCabe then shared anonymised video recordings of patients presenting to mental health professionals when in distress after having self harmed or attempting to take their own life through overdose, with a forewarning of the sensitive nature of these interactions.
Talking through the transcripts of the interactions she highlighted the examples of practice which acted to elicit more open and useful responses from the people in distress, helping to reduce their distress and improve their confidence in the mental health practitioner supporting them. These included positive body language and displays of empathy from the mental health practitioner.
She also shared examples of where the practitioner could do better in terms of unhelpful questioning, sometimes centred around ‘why?’ the person in distress had acted to harm themselves, and also negative body language, such as leaning back from the distressed person, and being focused on their notes.
The audience was reminded of the incredible pressures mental help practitioners are under, and the need for a service to ‘help the helpers’ due to the ‘emotional hard labour’ they are called upon to do.
She summarised that effective communication, both verbal and non verbal, and shared decision making between the patient and practitioner are key to effective diagnosis and treatment, and that improving communication in the clinical setting has the potential to save lives, save money and enhance individual and societal wellbeing.
Reflecting on the lecture, Professor McCabe said:
“I’m so very grateful for the support I’ve had since arriving at City. I was delighted to see so many faces from different departments at the School and City, as well as many new faces in the audience.
Communication is often regarded as peripheral to the biological and physical factors that determine patient outcomes, but the truth is it’s critical for their effective diagnosis and treatment. From patients’ point of view, having a human connection with clinicians is the most important factor in good mental health care.
Watch the video of Professor McCabe talking about the ASsuRED project, first shared on World Mental Health Day, 2019:
If you're a student at City, and need support, you can get help through the Student Counselling and Mental Health Service.
If you're a member of staff at City, you can access support through the Occupational Health Service.
If you, or someone you know, needs support there are number of helplines you can call:
Samaritans – for everyone
Call 116 123 - 24 hours a day, every day
Campaign Against Living Miserably (CALM) – for men
Call 0800 58 58 58 – 5pm to midnight every day
Visit the webchat page – 5pm to midnight every day
Papyrus – for people under 35
Call 0800 068 41 41 – Monday to Friday 10am to 10pm, weekends 2pm to 10pm, bank holidays 2pm to 5pm
Text 07786 209697
Childline – for children and young people under 19
Call 0800 1111 – the number won't show up on your phone bill
The Silver Line – for older people
Call 0800 4 70 80 90 – 24 hours a day, every day
Anyone can also contact their GP for advice and support.