The therapeutic alliance in healthcare assistant practice

Patients who have been formally diagnosed with a mental illness are much less likely to access the same healthcare for general health problems as other people. As a direct result of this, patients with mental health problems are statistically much more likely to die earlier of conditions such as cancer and common minor ailments. Clinical symptoms of disease are much more likely to remain uninvestigated, with increasing numbers of mental health patients remaining undiagnosed with type 2 diabetes mellitus, for instance. Ultimately, this leads to a diminished quality of life and a markedly decreased age of death. This article identifies the role of the healthcare assistant (HCA) as one means of engaging with people for whom mental illness may be an issue. The settings in which healthcare assistants work lend themselves to conversations and communication with people which might indicate that a patient with mental illness might need additional support and help. This process can ultimately be termed the ‘therapeutic alliance’. This article highlights key aspects of the need to build capacity within and between all professional healthcare disciplines in order to provide equity of care for all. It uses two theoretical standpoints, along with worked examples, to demonstrate the relevance of basic psychosocial interventions in the context of healthcare practice. The promotion of the concept of recovery is one that has the potential to aid in the removal of stigma for people with mental illness. Healthcare assistants are present during many patient assessment, diagnosis and management pathways and it is here that the concept of the therapeutic alliance could potentially be developed further so that patients with mental health problems might be better supported.