Barriers to Mental Health Care for Mental Health Professionals
How do we help the helpers?
The sad truth is that there are often considerable barriers for anyone to access mental health care. There are also some unique barriers that those who work as mental health care providers must face. As a mental health nurse, this has made things extra complicated for me when seeking out treatment.
Knowing the Professionals Treating You
One issue is the potential for people I know professionally treating me while I'm a patient. During my first hospitalization, one of the weekend on-call doctors was a psychiatrist on the ward where I worked. I spotted him, panicked, and hid out in my room. He later told me that he knew I was there because he'd seen my name on the board in the nursing station, and he'd felt awkward and unsure how to handle that. My subsequent hospitalizations, I've been able to avoid the city where I lived and worked. At the beginning of my last hospitalization I was taken into the ER in the hospital I had formerly worked at. I begged to be transferred to another hospital; they seemed to think it was because I was worried about being seen by patients I'd cared for, but that wasn't it at all. I was adamant that I didn't want to be treated by staff who knew me professionally.
Deciding Whether to Access Services Where Staff Will Know You
Through my work, I've had quite a bit of contact, either in person or on the phone, with nurses at the local emergency mental health service. As a result, I will never call the service's nurse-staffed crisis line. It would just be too weird. At the same time, I'd be worried about calling a different crisis line that's staffed by volunteers, as I suspect they'd be a bit more trigger-happy in terms of calling the police. The end result is that I don't call anyone. Going into the ER, where I'm even more likely to know the psych nurses on shift, is even less of an option.
Working with People Who Previously Treated You
Another issue is having professional contact later on with people who've previously been involved in my treatment. I ended up working with a nurse who I'd seen in emergency after I'd attempted suicide. I was terrified that she would recognize me, but she never gave any indication that she did. There was another nurse who thought she recognized me and asked me if I had previously worked at a particular mental health team. I'd actually been a patient at that team, but I don't think this person ever made that connection. There was another nurse who did recognize me from the hospital. We didn't actually work together but for a period of time, I was seeing her pretty regularly at work and it made me extremely uncomfortable.
In a way, it's strange that I worry so much about these kinds of encounters when I choose to be open about the fact that I have a mental illness. There's a big difference, though, between people knowing I have an illness and them seeing me in all its ugly glory. My illness does get pretty ugly sometimes, and it's hard not to feel ashamed when I know people have seen that part of the illness experience. I want to have control over what colleagues do and do not know about me. If people see me when I'm at my sickest, I have no control, and that's frightening.
There are also issues around professional practice licensing. My province in Canada has very regressive health professional regulations that require hospitals to notify the appropriate professional college any time a health professional is hospitalized for mental illness/addiction. If I am ever hospitalized, that automatic reporting means I have to either give up my nursing license or have it taken away from me (some choice!). Even in places without this sort of stigmatized legislation, there will always be the worry that someone will decide you're unfit and you face losing your professional license. Of course health providers delivering care must be fit to do so, but from my perspective, putting barriers in place that deter a whole group of people from seeking care only increases the potential risk to the public.
I don't know what the answer is in terms of smoothing the way for mental health professionals to receive safe and effective mental health care. I do think it's important that more of us working in the field who do live with mental illness speak up about our experiences and raise awareness that we aren't immune from mental illness. Somehow, there's got to be a better way.