Mentally Ill Therapist

[WonderWanda]

Should someone with significant mental health disorders of their own be practising as a therapist?

I have looked into this briefly and there are suggestions that mental health conditions are at higher rates amongst psychologists and psychiatrists. It could be argued that a therapist who has experienced issues for themselves would be more understanding and empathetic towards their client's struggles. In cases of of experienced anxiety or depression I can see how this might be beneficial.

Currently there are no restrictions on any mental health conditions that would prevent a person from practising as a clinical psychologist.

In cases of schizophrenia, BPD, psychosis etc, all of which that can leave the affected person detached from reality or with a warped view of events, is it ethical that they be allowed to treat others? I don't see how.

I’d really hate it if my best friends had views like this about me and, even worse, posted it on an online discussion forum.

It all depends on whether it affects her at work or not. I have significant mental health problems including a 5 month admission under section and still work as a health care professional. I take time off sick when unwell, have been open and honest about my illness with my manager and professional body and it seems to be working just fine. There have been times when I’ve not been great but have still managed to work (and continued to get good feedback from patients and colleagues). It’s possible sometimes to go to work and put on your professional persona even when you’re struggling in day to day life. This is true of everyone - I’d bet most of us have behaved badly or in ways we regret in our personal lives but are able to maintain professional behaviour at work.

So, I don’t think a mental health diagnosis, or any other diagnosis, should stop someone working as a therapist if they are well enough to manage that. I also don’t think it’s up to their friends to judge, luckily we have an entire speciality of occupational medicine to help decide what people can and can’t manage safely and what reasonable adjustments can help.

My therapist committed suicide. I was sitting waiting in the waiting room wondering where she was as she was doing it (she was off site). It was shocking.

I wish she had sought help for herself. She was young and healthy and sporty. I wasn't aware of her mental health issues until she died.

Mentioning some of the ways that BPD can manifest itself isn't 'BPD bashing' and the OP didn't imply that her friend, or anyone else with BPD, is a bad person. Nobody is giving you or anyone else with BPD 'a kicking' and the OP hasn't been an arsehole in any way.

Certain personality traits, whether linked to mental illness or not, make people well-suited to some jobs and less well-suited to others. It's not bashing anyone to say that.

A lot of medics have poor mental health and can vary from mild to severe.

If currently mentally unwell/delusional colleagues would most likely question things. If it's simply outside work erratic behaviours some people just are different and as long as it's not illegal against the employers rules etc it's most likely not doing to impact employment.

I know of drs on strong medication that would knock an average person out but they are stable and brilliant drs to their patients.

People can surprise you with how professional they can be within their work environment.

Two of my friends studied psychology, in both of their classes almost everyone had started psychology because at some stage they had had a trauma, and or someone had helped them/ inspired them or couldn’t help and they wanted people to have the help they couldn’t. Makes sense when you think of it that most people who work in mh areas do so because they’ve needed help/ support either for themselves or family

My dh suffers from psychosis and GAD. He's recently been allocated a peer support worker (not a therapist, I know, but someone who is paid to support him in his illness). The man visited once and seemed lovely, then he didn't turn up the next two times he was booked to visit, no phone call, nothing. Then he rang out of the blue, said he'd been ill but was now better and wanted to come and see my husband. He also said he had great news for me, as his carer. He arrived and chatted to dh, all about his own life and illness, it was almost as if it was a counselling session for him not dh, then he told me he'd email me links to organisations that could help me and dh, said he'd discussed us at length with his manager and felt he could really help us. This was three weeks ago and we haven't heard from him since, no links that he was so enthusiastic about have been emailed and he didn't turn up for his appointment again last week. It makes dh (and me) really anxious to sit waiting for someone who doesn't turn up. I don't want to report him to his employers as, if he's ill again, I don't want to get him into trouble and maybe make him worse. I really don't think someone, who obviously still needs support themselves, should be employed to support others with mental health issues. If he was a volunteer I would be more understanding, but he's employed full time to do this job and why isn't his manager asking how he's progressing with dh if he knows all about us? If he's off sick why can't someone phone to explain he won't be coming as arranged? I feel sorry someone who lives alone and is in desperate need of that visit and the person just doesn't turn up.

This “Just asking Questions” format seems innocent but also a bit hostile and judgmental to people with BPD/EUPD as it presupposes that they are more self centered or careless than other people and therefore cannot be trusted to work ethically with others.

I don’t think this is necessarily the case but, in any event, OP seems a bit overconfident and overinvolved. Is that OP’s anxiety talking? Or another part?

If she is a close friend why don’t you tell her your concerns?

OP’s friend is not in a different position to anyone else who wants to do important work and who may, at times, find it challenging.

I can’t speak for the UK but here in the US we receive training, have professional licensing requirements, work for several years under direct supervision, and even in private practice engage supervision (or co-supervision) in order to protect our patients and our ability to treat them.

Someone who works with children in an agency, school, or health care setting is under a lot of supervision and their time with their charges is quite limited and focused. I see no reason why a talented person with some borderline tendencies couldn’t be great at working with some patients. If they are unreliable they will lose their job for that reason. But they are no more unreliable than other people.

@WonderWanda you are incorrect about there being no restrictions, clinical psychologists in the uk are required to be registered with the Health & Care Professions Council and there are standards of proficiency (I’ve attached the link) that they must adhere to ,see in particular standard 3 https://www.hcpc-uk.org/standards/standards-of-proficiency/practitioner-psychologists/. Any of the registered professions can be struck off if they fail to do this.

For clinical psychologists, yes but not for counsellors or psychotherapists - literally anyone can set themselves up because it’s a non-regulated occupation.

One of the best therapists I had, had previously been sectioned in hospital with Post Partum Psychosis, and her experience was what spurred her on to work in mental health.

A lot of people who work in mental health have been mentally unwell themselves, and use their lived experience to help and empathise with others. It is discriminatory to say that they should not work with patients. Where do you draw the line? Not let them work at all?

And of course, there is a difference between having a mental health disorder, and being acutely unwell. With medications and therapy etc a lot of people with disorders live well, hold down a professional job etc.

I'm not exactly the same person in work as I am at home? I have very different (professional) relationships with the people I work with than with my friends or my partner. I'm more careful with what I say, I don't overshare, I don't talk to them about my problems or worries or stresses etc.

What matters is your friends ability to maintain professional boundaries. If she can do that then she can do her job regardless of what she's doing in her private personal relationships.

It’s been that way for years. Everyone who works in the industry knows this. On my sisters first day at uni to do MH nursing one of the first questions she was asked from her fellow nursing cohort was, what’s your diagnosis then?

Personally I would never touch a counsellor or a psychotherapist myself. Good luck trying to find one who never went in to heal themselves. The most disturbed profession ever, and also the most hypocritical. I don’t need “professional help” to have insight in to my own psyche thank you very much. People in glass houses ……

You think someone with a diagnosis of schizophrenia or bipolar who is currently well and stable on meds should somehow be barred from these professions??

Should they also be banned from any other vaguely responsible job like law or the police or teaching? Should they confine themselves to work where you consider they will not harm anyone by being 'detached from reality' Would they be OK to stack shelves in a supermarket do you think or shall we go back to locking people with these diagnoses away in asylums?

You do realise that these are treatable conditions and that many people with these illnesses are well and 'normal' for much of the time? Your language is really dark ages levels of discriminatory.

Medicine and psychology are regulated professions. You are responsible to your regulatory body for your ethics, conduct and your health. As long as you abide by a treatment plan to control your symptoms and recognise early warning signs I can't see why people with MH conditions should be barred any more than people with diabetes or epilepsy who might have a hypo or a seizure in the workplace. If you do pose a risk you will get reported and dealt with.

HTH

I can sort of see your line of argument OP but the reality is, as previous poster stated, you cannot discriminate on disability and that is what you’d be asking for here.

It opens up a very difficult situation where suddenly it’s okay where do we draw the line? People who suffer as you’ve described, would you allow them to be police officers? Teachers? Firemen? Care home staff? Would you allow them be nurses? It’s a slippery horrible slope.

It also wouldn’t just stop at mental illness, you’d be opening the box to everything else as well. If you’re obese, as previous poster suggested, then would you really let that person be a doctor, nurse, health professional? If we’re talking about people’s judgement & assuming they are exactly the same in their personal life as they are in their professional capacity then actually we shouldn’t have morbidly obese medical professionals going into schools etc to talk to children about healthy lifestyles.

The reality is that for these job roles there is vetting, assessments, quality checks etc- you have to be “signed off” capable for the job.

@WonderWanda all doctors and healthcare professionals working for the NHS and private providers have to meet fitness to practice standards as per the GMC (or equivalent body for other healthcare professionals) and their employer. If you have concerns that an individual poses a risk to patients due to their health (mental or physical), you can report your concerns to the relevant employer and/or regulatory body. If an individual is in a training programme or a junior post, then they'll also have supervision and oversight from senior clinicians as part of that.

Like many other health conditions, even major mental disorders such as schizophrenia or bipolar affective disorder can be effectively treated - a person may have a lifelong disorder, but that doesn't mean it can't be controlled and they can't go on to do well professionally. They may need or benefit from some adjustments, but the fitness to practice standards they have to meet are the same as for anyone else.

Couldn’t agree more. OP you’re just bashing people with BPD now. Please stop.

I did an entry-level counselling course years ago - largely because the listening skills gained were useful in my day job at the time. Oh my god, there were people on that course that were so unstable they should have never been allowed within 10 miles of a vulnerable client! Talk about 'physician heal thyself'. I stopped the training after level 1 because I had no real intention of ever training as a professional counsellor. But some proper headcases went on to counselling degree courses. I was appalled by how low the bar for acceptance into these programmes was....

I’ve known quite a few medical doctors with bipolar disorder, including two psychiatrists. I also know a pharmacist with bipolar disorder. What do you think people with these diagnoses should do? Be restricted to working in a warehouse or on a farm or something? Why shouldn’t they pursue a career they’re capable of? There’s plenty of batshit people around without a MH diagnosis.

You would hope that a clinical psychologist is working amongst plenty of other professionals and it would be very much noticed if they were suffering from a current psychosis affecting their view of reality

Therapists on the other hand, yes there's more room for interpersonal problems from MH ... but how you know someone as a friend suffering from EUPD is extremely different to how their clients will know them. The relationship isn't a personal one for them to bear their own problems to

Are you a psychiatrist?

Fucking hell... "headcases"?

I am glad you didn't pursue counselling if you would refer to people that would potentially need the service in as such a way.

I never suggested they be barred, I questioned how ethical it is to provide mental health support if you suffer from certain mental health conditions yourself. Other PP have been useful in explaining how monitoring and supervision processes work to recognise if a person is fit to do the job. Talk about adding 2 and 2 and getting 5.

I worked with a MH nurse with EUPD. She self harmed on shift, took regular overdoses but had no restrictions on having access to ward meds, overshared with patients, very labile mood and told constant lies. It's impossible to do anything about it because of discrimination laws but it's completely inappropriate.

Absolutely not. How have I bashed people with BPD by expressing concern over some of the behaviours I have witnesses in my friend over the years, and speculating on how that could potentially affect the job she intends to pursue.

Certainly not over confident. You could argue over involved but we have effectively become one another's 'therapists' over the years so I am aware of some of her darker traits as she is of mine.

My anxiety is health related. I am basically a hypochondriac and I worry about the health of those I care about. This isn't related to why I have asked the question on suitability to practise though.

I couldn't possibly broach the subject of 'Do you think you are fit to counsel children having had a train wreck time yourself?' It would be patronising.

I am pleased to hear about the supervision processes that are in place.