The last installment of this series explored flaws within the mental health system, leaving us wondering: How can the system improve? What do practitioners do right? What makes for a good therapist?
As a reminder, I spoke to some Londoners between the ages of 18-24 years old about their experiences with mental health services. Combining personal anecdotes, testimonials, opinions, and research, I’ll highlight their experiences. For their own privacy, participants will remain anonymous.
How Can We Improve the System?
I hope it is abundantly clear we cannot improve mental health care without addressing the system’s failings as a whole. The different levels of government in Canada vastly underfund mental health. While mental illness accounts for 10% of the burden of disease in Ontario, the government spends only 7% of healthcare dollars on mental health. Additionally, systems of oppression, such as white supremacy, remain embedded in mental health research and practices. From eurocentric research, to lack of culturally competent services (which will be further examined in the last article of this series), white supremacy and racism in the system must be eradicated completely.
Issues like wait times, feeling rushed in and out of appointments, and feeling like a number or item on a checklist, won’t resolve without fixing the shortage of staff to meet the high demand for help.
Can anything improve on a smaller scale? Yes, in a couple of ways. First off, interviewees discussed the difficulty they had navigating the system, understanding resources, finding a therapist. They described how the government, health services, and educational institutions in the city make minimal effort to educate them on the resources available. Many expressed having no understanding of where to begin looking for help. A few suggested that organizations in London should invest more in educating the public about mental health resources and their purposes. Another suggested streamlining the process of searching for resources or services by compiling them on a website. It is hard to know what kind of therapy is best for you or what kind of practitioner you should be seeing. Having an unbiased website that allows you to search through practitioners in London based on your needs would take away some of the pressure. An interviewee pointed out that when suffering from a mental illness, even looking for help can be an intimidating and arduous task.
In addition to an improved effort to help people navigate the system, individual practitioners could also make some improvements. The individuals I spoke to understood that systematic challenges and burnout may negatively affect practitioners’ ability to do their jobs. However, it is still important to remember that how these practitioners perform will impact actual patients. Numerous participants said practitioners were condescending or apathetic. Others felt they were being rushed along, not listened to, or judged by their practitioners. When you are already struggling with your mental health, feeling unimportant or bothersome to the professional supposed to help you is damaging. One participant spoke specifically about the lack of bedside manner from psychiatric nurses, another about how their psychiatrist was often rude and mean. Despite flaws in the system, individual practitioners can control whether they care about their patients and treat them with kindness and respect, or not.
What Makes For A “Good” Therapist?
It is important to look for a counselor that is appropriate for your needs. What makes for a good therapist, though? While the answer to that question can be subjective, as much of the relationship between practitioner and client depends on chemistry, here are some general thoughts gathered from the people I interviewed.
A therapist should have strong interpersonal skills, including being attuned to non-verbal communication, and demonstrating active listening.Participants want to feel that their therapist understands and cares about what they are saying. A therapist with strong interpersonal skills can sense how their client is feeling. Exuding empathy and warmth is also important, which many participants said was lacking from their therapists. Interviewees brought up having therapists who weren’t just cold, but also condescending and judgemental. Those are the last things you want in the person whose job is to help you feel less bad. One participant shared that when you’re struggling with your mental health, you “need someone who listens to you and who accepts you for what you’ve gone through in the past.”
Another individual valued a therapist who can adjust their methods to fit the needs of the client. It’s important for a therapist to know how to adapt treatment plans because the exact same application of one method can vary in efficacy from client to client based on situation and personal characteristics.
One last point that arose frequently over the course of my interviews was just how crucial it can be to have a therapist who identifies in the same or similar ways that you do. For example, if I were to see an East Asian or queer therapist (or one who is both) as someone who is East Asian and queer. The last article of this series will explore this more in-depth. In short, having a therapist who understands your experiences is different from one who just learns about them.
Is Improvement Possible?
Seeking and receiving treatment within the mental health system should not further hinder your mental health. I believe we can slowly work towards improvement. People need to pressure the government for adequate funding of the mental health system, and an improvement in anti-racist education of mental health practitioners. It will take time, but with increases in funding and education, tearing down barriers for marginalized students and work towards abolishing white supremacy, ableism, misogyny, and queerphobia within fields such as clinical psychology and social work, we will eventually see a better mental health system.
While it’s important to note that helping people for profit (more specifically within private practice) can create an area of moral ambiguity, eliminating this factor may not be possible in the current system in which we live. What we can do is strive to create a mental health system which provides quality services for all who need it. We need a system that values both the quality and quantity of help. Changing nothing within the mental health system will actively harm our communities.
This is Part Two of a series by Teigan Elliott exploring the mental health system in London, Ontario. In Part One, Teigan spoke to several young people about their experience of the system and its failings, and in Part Three, Teigan will investigate the unique experiences of queer and racialized individuals accessing mental health services.