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Patient or Client?

Health Services Research Department, Institute of Psychiatry, De Crespigny Park, London SE5 8AF

Sir: The article by Ritchie et al (Psychiatric Bulletin, December 2000, 24, 447-450) provides a useful contribution to the debate about the use of titles. I agree that the term ‘patient’ is appropriate for someone who attends a psychiatric outpatient clinic. However, mental health care is diverse and consists of services provided by numerous agencies. What title should we give the ‘patient’ who, after attending the clinic then visits a day centre run by a voluntary organisation? This service may be essential for his or her mental health, but surely he or she is not a patient of the centre's manager. Similarly, the ‘patient’ may need home visits from social services but I doubt whether social workers would regard the person as their ‘patient’. Further confusion occurs when we consider people who have been diagnosed with a mental health problem but who are well and not in contact with any services. Ritchie et al's study was context specific and in their context the term ‘patient’ seems fine. In other contexts ‘client’ or ‘service user’ may also be suitable. I see two solutions to this problem. One is an acceptance that one person can have different titles at the same time, each of which represent the relationship that he or she has with the service provider. The other is to use a general title that applies to all situations. How about ‘individual’ or ‘person’?

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