As an early-career psychologist, I thought the stigma and barriers surrounding mental health issues would be less prominent in the healthcare field. It wasn’t until I worked with multiple families that I realised the fight is far from over.
The statistics are clear. One in six Australians currently experience depression, anxiety or a mix of both issues (ABS, 2008). Help is clearly needed, yet individuals who are aware of their mental health struggles continue to neglect reaching out for help. Why is this the case?
I found the answer right under my nose while working in clinical practice.
“I’ll get called crazy.”
“I work with people who hate having to do mental health outreach, despite being a mental health worker themselves. They sigh and say, ‘Got to see the crazies now’.”
The word crazy is thrown around as if it held no sting. As if it were somehow acceptable to call a person in need ‘crazy’.
A study conducted by McCann and colleagues (2018) piqued my interest. The study aimed to explore the experience of paramedics who work with AOD and mental health calls. Whilst some paramedics believed these calls were an ‘integral’ part of their practice, others believed it was well outside their ‘scope of practice’. An interesting quote illustrated the lack of understanding those in the frontline may have:
“I find [mental health calls] really challenging, purely from the perspective that I am not qualified to make a formal decision or diagnosis that ‘you’re faking it’ and ‘you’re full of ‘crap’.”
Another study conducted by Krakauer and colleagues (2020) found that paramedics were the least likely people to seek help for themselves if they were experiencing a mental health issue. After all, we all need a mental health top-up.
The attitudes within health organisations also may prevent people from seeking help. This only creates a further decline in one’s mental health, and perhaps creates further stigma and resentment against those they need to care for in their professional fields. Unfortunately, mental health education is not prioritised in many careers that are not solely focused on caring for this demographic.
For example, a paramedic remarked that they received “very little undergraduate mental health training” before they were released into the field where a large portion of their work was mental health-related (McCann et al., 2018). With so little preparation for mental health work, how can we expect the absence of stigma?
What I learned is that people still do not perceive mental health as a physical illness, similar to a broken bone or a headache. Decades of research has shown there are physical changes in the brain of people experiencing depression, schizophrenia, posttraumatic stress disorder and so on. So too, there is an abundance of evidence illustrating the physical effects of mental illnesses through somatisation – the physical expression of emotions and stress via the ‘mind-body connection’.
We cannot hold our healthcare workers accountable if they were never prepared for this field of work. An interesting study by Kopera and colleagues (2014) revealed that long-term contact with mental illness at work does not relate to a change in negative attitudes. Therefore, we need more education on these issues, rather than holding the assumption that all individuals who work within the health industry understand (or will eventually understand) mental health needs. As a psychologist, I am also guilty of having made this assumption.
The prioritisation of mental health needs to change, and this starts with educating our upcoming workers to ensure an informed decision is made. Once education is provided, stigma is in our own hands.