This article is brought to you by 'The Therapist', premiering Friday December 15 at 10.30PM on SBS VICELAND and SBS On Demand.The first time it happened to me, I was 16. A mental health case worker had been assigned by my local hospital after a personal incident. I tried to explain my issues with the woe-is-me stop-start diatribes that punctuate most teenage dialogue. My struggles with anxiety and depression, and how my illnesses made me feel like an outsider socially and an underachieving perfectionist academically.
But this case worker, for whatever reason, wasn’t having any of it. The faults were my own, you see? I wasn’t dedicated enough to my studies. I needed to socialise more. Simply put, I needed to pull myself up by my bootstraps.
It was an experience that repeated itself again and again as I traversed through the various levels of the mental health system. A psychologist who said that a workplace was right to fire me for requesting mental health leave. A psychiatrist who found my left-wing politics “concerning”. Counsellors who encouraged me to “make amends” with toxic relatives and friends. Professionals who, for one reason or another, I didn’t see eye-to-eye with.
Disagreeing with your mental healthcare professional’s stances on certain issues isn’t always a big deal. After all, they are there to act as professionals, not friends. But in one unfortunate case, ignorance of my feelings and emotions led to misdiagnosis. As I pleaded to my psychiatrist at the time that my meds weren’t improving my quality of life and may have been actively hindering it, they merely said that my concerns were “noted” as they continued to shuffle through paperwork on their desk. It took a change of specialists to finally get out of that spiral.
When you consider that mental health is built so much on understanding the intricacies of the human mind, it’s preposterous to think that those working in mental health wouldn’t seek a deeper understanding of their clients. Yet the problem is unfortunately not uncommon. And it’s an issue that’s only exasperated when you bring the intersections of race, sex, gender, and culture into the mix.
“I tried to talk to [my psychiatrist] about gender dysphoria and some issues I was having with the hospital relating to being trans,” my friend Kit, who is transgender, tells me. “And he often scoffed, and one time told me ‘I just don’t don’t get the whole transgender thing—I mean, I wouldn’t wear a dress if you put a gun to my head!’ and laughed.”
Similarly, a different mental health professional suggested to another mate, Natalie, that asexuality was something they could “work on fixing”, while being shocked at common instances of fatphobia she experienced. In another instance, Pritika, who’s a woman of colour, went through more than a dozen mental health professionals over a decade, as time and time again she attempted, “…to connect, be heard, be taken seriously and have my mental health needs properly met.”
There are various logistical issues that come into play when these problems arise, as well. If you do step away from one service provider, you’re often left to constantly re-introduce yourself and your mental health symptoms to every new professional you meet. Tova, who experienced issues with discussing sex and politics with mental health professionals in the past, put the process rather bluntly: “Choosing a mental health professional is like Tinder Health.”
The economics of the mental health system can also take its toll. The public health system allows for limited bulk-billed services, if any. Often, you don’t have a chance to “shop around” for someone that truly understands you and who you are. On the other side of the scale, the immense financial cost of some specialists can occasionally place an undue onus on the patient. After all, you are paying so much money, shouldn’t you try and make this work?
All this leads not only to a sense of dissatisfaction, but also resentment and powerlessness within the much large mental health system. “It’s hard to trust any medical professionals when you’ve seen how corrupt they can be” says Kit. “You kind of end up going on word of mouth from other people in the community who’ve had good experiences,” says Natalie. “Which is fine if you have a lot of queer friends, but tougher and more time consuming if not.”
“I think, particularly because of the therapeutic relationship, there's a power imbalance,” Kate Acheson, the CEO of youth advocacy organisation Youth Action, tells me over the phone. “Especially among young people, because of the difference in age and also education and also just the pure fact that you are going to that person to seek help.”
"But, if something doesn't feel right, as someone who is using that service, you have every right to say 'I disagree with you and you can't actually say that' or 'I disagree with you and I want to stop what we're doing’.”
Acheson notes that, if you find yourself in these types of situations, the first action you should take is to either talk directly with the psych or the service provider. Failing that, there’s a wide variety of services available to young people.
“You can complain to a number of different places. You can talk to to somebody like myself who runs a youth organisation, and we can direct you in the right way as to who you can respond to. There's the ombudsman, who'll also respond when people are acting inappropriately, or not in your best interests. There's also the Mental Health Commissioner here in New South Wales, and in the other states and territories, specifically looking at the rights of consumers.”
Meanwhile, the experiences of some have driven them to take matters into their own hands. Pritika’s unique experience made her reconsider her entire career path. After initially studying zoology, she now works in the mental health field herself.
“My repeatedly terrible experience with the mental health system and with stigma in the community made me want to use these experiences to improve it, particularly so that it meets the needs of those using it. My experiences affected my view of the industry so considerably that I made fixing it my life.”
Pritika adds that, in her case at least, her trials have made her stronger, in a roundabout way.“Your greatest strength and resilience is often in dealing with the system that is fragmented, hard to navigate, siloed and still fraught with stigma.”Follow Albert on Twitter