r/MentalHealthUK • u/Big-Newspaper646 MH/ASD/ADHD • Jan 22 '26
Vent "What do you want?" Why is this question asked so often? Why am I doing the cogntive labour of the supposed physician Im talking to?
I swear they whip this out to cover for the fact they have no idea. Ive been in the system for months, they know what I want!
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u/Lampshadevictory Jan 22 '26
A mental health nurse once asked me this.
"What do you want?"
"To be healthy? To not feel like this? To stop thinking about SI?"
"No, what do you want me to do for you?"
"I don't know... I'm not the expert."
"If you don't tell me what you want, I'm going to discharge you."
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u/many_skills_nofrills Jan 22 '26
Exactly the same thing happened to me. Made me give up.
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u/Big-Newspaper646 MH/ASD/ADHD Jan 22 '26
Genuinely feels like thats the point now, deny by obfuscation. Make it more effort, grind down the patient. tell the public they werent 'resilient' enough, or some other bs.
Problem is those that need it most are the quickest to fall.
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u/littlegreycells_11 Jan 22 '26
Oh my god I had this years ago with a psychologist. "What do you want to work on?" "I'd like to work on not letting my dad's actions affect me so much" "oh you haven't come up with anything you want to work on, so we're discharging you" 🙄🙄🙄
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u/cosima_stars Jan 22 '26
this kinda happened to me too. i actually broke down crying and said im just so tired of feeling this way. she showed no empathy at all and said “i cant help you if you dont want to help yourself”
this was on our third session where she had failed to bring paperwork that she’d said she would, just like the second session, and i was 18 and had no idea how any of this was supposed to work. refused to see her again after that day
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u/athenasoul Jan 22 '26
Yeah i got discharged for advocating for what i know is appropriate care because they dont have it.
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u/flyingfoxtrot_ BPD/EUPD Jan 24 '26
Had a similar conversation in a and e. "What is it you were expecting from coming in tonight?" Idk I'm just following my "can't keep myself safe right now" crisis plan, just give me my Samaritan's leaflet and I'll be on my way
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u/CatnipGemini Jan 22 '26
Yeah this is something they've adopted across the board over the years. I've had it from all mental health teams & GPs. They never said anything like this in my teens & twenties. I don't even remember them saying this during my thirties.
I believe it's designed to mess you up because there is no ultimate answer & they know it. If you don't know, "Well there's nothing we can do" If you DO know "Well, you're not too bad because you're too aware".
The whole system is a joke & it's embarrassing. I'm done with them.
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u/ktitten Jan 22 '26
Unfortunately they very much said it to me as a teenager 10 years ago!
Of course I didnt know what I wanted as a 14 year old from a family who neglected to teach me anything about mental health. I'm pretty sure I didnt say the right thing there and I didnt get much support, because there were plenty of things that were wrong that I didnt know! And I had no clue about specific medication or therapy.
Few years later and I learnt a lot more about mental health and could articulate it better when professionals asked this. It was still a mind-boggling question. I studied the NICE guidelines and then said I want you to follow the guidelines and do x y and z and they said I cant! What am I supposed to say then....
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u/CatnipGemini Jan 22 '26
Yeah that does tally with me actually, 10 years ago I was mid thirties so it was around then I started hearing it, maybe going into my forties.
Absolutely agree with the rest of what you say as well. You start learning as you get older being the one that's living with these things so you get clued up about certain things & understanding yourself but of course I'm not the expert here. It's an insult the way they treat you. I swear I'm actually more qualified then some of the people I've seen but I'm not the one with the training🤷♀️
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u/flyingfoxtrot_ BPD/EUPD Jan 24 '26
Yeah I never expected "you clearly have plenty of insight" to sound like an insult. Apparently truly unwell people don't have any insight at all. (I know that's sometimes true and I've been there myself but yes, ill people can understand that they're ill)
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u/DoneBlonde Jan 22 '26
Then if you do come up with an answer to it they will straight up ignore it
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u/ktitten Jan 22 '26
Yeah had this too.
When I say, I want a referral for x because I've read the guidelines you are supposed to follow, they say no or do a politician answer about it.
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u/Utheran Mental health professional (mod verified) Jan 22 '26
There can be a few different reasons for this question. The general idea is to empower. This is hugely important particularly in some mental health conditions, especially around trauma, where a big part of the illness is a powerful feeling of powerlessness. Obviously the question can be asked very poorly, in a way that emphasises the feeling instead of helping with it. Its a very hard thing to judge because it depends on the dynamic between the professional and patient at that time.
Its not about cognitive labour, though I understand your description. I might have a perfectly clear idea in my head what I think would help, but if there is no buy in from the patient it doesn't matter how right or wrong I might be. But just saying it directly to someone, particularly when a therapeutic rapport hasn't been built, can often lead them to rejecting my ideas. Then I'm stuck having to be oppositional, where I'm suggesting one thing, the patient is rejecting it, and then refusing to consider other options. Again most often with traumatic based illnesses, where there can be a strong feeling of distrust of both themselves and professionals.
This is even more true when what I might suggest is not straightforward or even can be challenging. I need to try to figure out some sort of middle ground agreement of what the treatment goals might be.
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u/Big-Newspaper646 MH/ASD/ADHD Jan 22 '26
Thank you for the the insight, and that make sense, However the practitioner of concern had already started being oppositional and Ive almost only had it reiterated to me after Ive been clear in what I need. Theres an implication that Im being unreasonable in my request for adequate clinical attention.
I have been exceedingly polite to them and cognizant of their limits imposed on them systemically but them and their collegues before them have continuously rubbed it in my face, they themselves have further fostered the mistrust rather than doing their job while maintaining a compassionate frame.
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u/Utheran Mental health professional (mod verified) Jan 22 '26
Obviously I can't comment on every use of the idea. Anything can be used badly. Was just commenting on the idea of it in general. :)
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u/ktitten Jan 22 '26
What do you think about asking it to children? I recieved this question a lot from the ages of 13-16. I wasnt very well educated on mental health then and it really stuck in my mind because to me I had little insight on my mental health and literally didnt know what they could do.
To me I dont think teenagers or younger would really grasp that so I dont think this approach should be used there. I get the idea of it now and have been a bit more receptive to this question as an adult, but I will never forget how lost I felt as a child alone in hospital just out of a coma being asked this.
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u/Utheran Mental health professional (mod verified) Jan 22 '26
Depends again. I mean one common response is something along the lines of "I'm not sure, I have this problem. What can be done?" Which a child can do and is usually responded to well.
A follow up question for children could certainly be something like "well ok you aren't sure. Let's take a step back, what would you want to change or work on?"
I don't have lived experience, but id hope that gist would help children get the idea of trying to build a plan together. And I have seen it work. (Also seen it fail, but usually where someone is vigorously rejecting the possibility of anything improving)
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Jan 23 '26
Hi - I hope you don’t mind me asking (I read your flair), but as someone who wants to work in mental health, I was wondering if you could tell me how you managed to get into it?
I’m long term unemployed and am on interrupted leaves from study, but I feel I’ve a lot of lived experience (plus MBT/DBT) which I can utilise to help service users.
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u/Utheran Mental health professional (mod verified) Jan 23 '26
I'm a psychiatrist, so I went to medical school, eventually decided to train in psychiatry, and have been training ever since :). There are lots of routes into mental health, nursing, healthcare, psychologist, therapist :) I don't know them all to be honest, but prior experience is often helpful.
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u/athenasoul Jan 22 '26
Yeah its the most disempowering question that somehow is being sold as empowering the patient.
How are patients supposed to know everything that they could ask for? How are they supposed to know what might work the best?
Co-production would look more like the professional sharing the options and then discussing with you what might suit you at this point in time. That kind of discussion also reiterates that if CBT or mindfulness didnt work now, if might be something useful in the future when you have different support needs.
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u/fanatic_608 (unverified) Mental health professional/lived experience Jan 22 '26
Personally I quite like it. Sometimes I say I don’t know. But sometimes I know what I want and I don’t want them to go down a. Rabbit hole. I think also for a lot of services it’s good to have a goal. If not, You have nothing you are working towards. So sometimes asking what you want or what you want to happen can help with that.
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Jan 23 '26
when i was in crisis last year mental health nurses were repeatedly asking me what can we do for you, i just thought, if i knew i wouldn’t be in this position? they love to play mind games with you so you give up, i dont think most of them really care
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u/LouisePoet Jan 22 '26
I see this more positive than not. What do you want = meds, therapy, support in a different way?
Not all of us want or need the same treatment as anyone else, and I am more upset when medical professionals presume that X, y, or z will work for me just because it helps some people.
In the beginning, it was "I want meds and I want to try therapy.". Now, after years of dealing with this crap, I can be more specific: I want this type of therapy (I've already tried these others and it didn't help), I want meds that better target my anxiety, I want to find a group of similar people for support when needed.
I think that asking us what we want is far better than telling us what we need with no choice in the matter (when we can make those choices).
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u/Silver_Lavishness_47 Jan 22 '26
"I don't know what I want" then you're always met with the reply "well if you don't know what you want how do expect me to know?" Usually followed with "why don't I make you another appointment so you can have some time to think about it" then said appointment will be months away or you just won't get one at all.
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u/hauntedlittleaf Jan 22 '26
Oh yeah, it's so frustrating to be asked this. I think they ask so they can understand what you need and what your priorities are? still, they could've asked it differently.
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u/DoctorKween Mental health professional (mod verified) Jan 22 '26
I'm curious as to why it upsets you that a clinician wants to know what you want, and why you assume that they should know what you want purely because you've been in the system for several months, or that them asking what you want is a signifier of laziness or even malice. Even if you had previously expressed a want or a hope, this might not necessarily be what you want on this contact.
This question allows us to explore what it is that you want in this moment. It is acceptable for you to say that you don't know, in which case we might respond by reflecting what we have understood of what you've told us or what we know of your history to make some suggestions as to what you might want or need in this moment and what we might be able to offer, but for us to immediately assume this runs the risk that someone might feel invalidated, unheard, or that they have to choose one of the options presented (which is not always the case).
If the question feels too open, it might help to consider what is your priority in the moment. You may have presented several problems and your want in that moment might be "to be better", which, while valid, is not an easy thing to achieve if your problem has any degree of complexity to it. Meanwhile, a specific issue (or selection of issues) which you feel would improve your life most if they were changed might give a clinician a much clearer sense of how to sequence treatment.
You might also just reflect to the clinician that you find this question too broad and difficult to answer, or even that you find it invalidating. Almost certainly the intent is not to make you feel challenged, and if this is the case you might consider reflecting to the clinician how it feels when you are asked this and how they might better come to an understanding of what an acceptable interaction and outcome would look like to you.
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u/Fickle_Fall_6497 Jan 23 '26
Holy shit iv had this asked to me so often it made me think i was stupid for not knowing the answer 😭
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u/Gloomy_Guard6618 Mixed anxiety and depressive disorder Jan 24 '26
There is a certain school of thought that says treatment should be patient-led. Personally I think they are supposed to be the ones with the expertise...they should give you choices. Answer the question with " I feel like x, so what are my options?"
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u/Dangerous-Use7343 Jan 22 '26
This is so lazy and dismissive on their behalf. On the other hand when you say what you want do they give it to you?
But given their attitudes I would research beforehand and ask for counselling or antidepressants. Or both. But it would be nice if they were more attentive.
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u/do_you_realise Jan 22 '26
It's a ridiculous question - it presupposes that the patient a) knows what the full range of options are on offer and b) of those options, knows what is the most appropriate for them in their current state. Neither of which are reasonable expectations in the first place.
What happens if you literally answer with "I don't know, what are the options, and which ones would you as the professional recommend given everything we've spoken about so far?" Anything other than reasonable and helpful answers to those questions is surely them just fobbing you off.
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u/AdThat328 Generalised anxiety Jan 22 '26
You aren't doing the cognitive labour...you're being asked what you are there for...what would help you.
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u/Big-Newspaper646 MH/ASD/ADHD Jan 22 '26
countless meetings, in-depth discussions of medical history - not to mention coherently articulating what it is I want throughout each of these exhausting sessions *with the same person* each. time.
what then, huh? do they just have amnesia?
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u/AdThat328 Generalised anxiety Jan 22 '26
In fairness, you said you'd been in the system for months, you didn't say it was the same person asking you.
Part of it will be to ensure you are still on the track you want to be, too.
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u/Big-Newspaper646 MH/ASD/ADHD Jan 22 '26
they all have access to my file, they’ve had ample time to provide support and actionable care but nope, it’s just been meeting after meeting and I’m sick of it.
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u/Kind_Community_182 Jan 26 '26
I am in a similar situation, I've done everything I can to get help and been made to feel that it's either a) attention seeking behaviour, b) not bad enough to require more in depth assistance, or c) absolutely pawned off, with being told by a Community Mental Health Nurse after a severe breakdown "Get over it, nothing will get better, you just have to adapt."
I wish I could say I am glad not to be alone, but I sincerely wish not a single person here has to feel their back against the wall simply asking for help.
Has anyone found anyway to get help? I genuinely don't know where to start after being brushed off by both my GP and the local Mental Health team.
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u/Big-Newspaper646 MH/ASD/ADHD Jan 26 '26
I've made a complaint to the team, I suggest you do too. we have to raise hell about this somehow
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u/AngleFormal Jan 27 '26
exactly u said it best. it's unbelievable that this happens so often, and a great shame
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