Appreciation for ABC article on cultural sensitivity and seeking mental health support

Edited version of an appreciation message I sent to the ABC, for an article on cultural sensitivity and seeking mental health support.

‘I would spend 5 sessions overexplaining my culture and its nuances’: When your therapist doesn’t get it - ABC Everyday
Knowing if a therapist is right for you can take time, especially if you want a psychologist who understands your cultural context. So how can you make it work when you find yourself with someone who doesn’t?

I wanted to say thank you for choosing to report on this topic, of seeking mental health support and coming up against repeated experiences of therapists engaging in culturally insensitive remarks, as well as dismissing or not understanding cultural background and nuances.

I had stopped seeing a psychologist for the past month, even though I really needed mental health support, because of a series of experiences that have left me feeling dejected and really deeply angry, almost to the point of feeling aggrieved.

I have seen about four psychologists/psychiatrist(s), and I felt that two have consistently downplayed my family situation or dismissed my concerns. Some of the remarks that they have said to me include, "you need to learn to live with this", even when my parents have done things that would be considered verbal violence, emotional abuse and threats, when I have contacted family violence support separately through 1800RESPECT.

I have felt really angry at that remark for what I see as its brazenness, that a psychologist can empathise with me some more mundane day-to-day happenings that I told them about, but if I am experiencing family violence, I am told that I am expected to "learn to live with this".

[I have extended this following section by describing in more detail — I guess I feel a pressure to do so, for the benefit of people who struggle with believing accounts of racism, though it is distressing.]

That psychologist also mentioned the not uncommon refrain of "your English is very good," (even though I was born in Australia and English is currently my main language, but of course, the person saying that statement is assuming that, because of how someone else looks or because of their background, somehow it automatically means that English isn't a main language that they speak, but more broadly, it is a form of "othering").

This was when she was talking about my social skills, after she was initially saying to me that "I strongly believe that you do not have autism", before stepping back a bit, as I said in exasperation that I was born in Australia and English is my main language, in addition to other things. (I had just come across this the day before, that I had found very amusing)

(I had also only had four Telehealth sessions with this psychologist, none in person.)

She also praised me, at one point, for suppressing talking about my parents, saying, "I see you've suppressed talking about your parents so far — that's good." And she wanted to reduce the time I spent talking about my parents even further, from the thirty minutes which I first expressed that I would like, to "fifteen minutes and then ten" — even though it was the most pressing thing I was facing and wanted to seek counselling for. That session was when I stopped seeing that psychologist.

Not only those, but she was also pressuring me into getting assessments for other disorders, like OCD and avoidant personality disorder, without fully informing me that she was asking questions for those. She also sent a questionnaire/survey for me to complete, without explaining to me what it was for, and I did not realise that it was for questions about OCD until later on.

I had initially expressed that I would like to allocate half of the session to talking about what had gone on in my week, and half of the session for therapy — practising skills. The second half eventually became full of questions for assessments rather than working on skills — this was started by an aside remark of, "we'll just get through your asessments first", that I didn't think much of, until later.

Another psychologist regularly talked to me in a very patronising tone with a smile, that irritated me a lot, when I brought up incidents that had happened at home, saying things like, "your parents have been through a lot of trauma". My opinion, which happened to be something that a counsellor at 1800RESPECT also said to me months later as well, is that, it may explain my parents' behaviour but it doesn’t excuse their behaviour.

In that same patronising way, and with the same dismissive smile, she also said, "you can't control other people" regularly, when I was bringing up incidents from my parents or from my sister, such as her slamming doors in my presence over a period of months. Rather than increasing assertiveness with mental health professionals and others, this had the effect of encouraging me to be even more internally passive and self-blaming in those situations. And at one point, with the same tone and smirk, the psychologist said, "well you're not going to move out next week, are you?", when I expressed that I wanted to move to live independently from my family.

She also discouraged me from using the term "emotional abuse", saying it was a bit like the case with using "bullying," but stepped back a bit, when I mentioned it using it as term of reference to seek information. Unfortunately, her doing that also meant more delay for me in seeking more appropriate support for more tailored services.

[To people who have trouble believing accounts of racism, now I would like to add this:]

It is not our problem to fix, explain or educate
We don't, actually. It is simple: racism is a crime.
You don't need educating to know that people of colour are human beings, too, and should be treated as such. How hard should it be?
Instead, by the end of this week, Heritier Lumumba was again having to explain to white people what racism is. Again he was forced to revisit his trauma for the "education" of others.
Lumumba wasn't the only one. I heard former footballer, Allen Christensen, asked on radio to recount when he'd been racially abused and how it made him feel.
When are journalists going to realise how offensive those questions are? When do we get to stop opening our veins so that Australia might better understand racism?
ABC's Q&A program tried to have the conversation we apparently all need but still missed the point. We get stuck thinking racism is about personal abuse or discrimination, it is much more systemic than that.
We could change behaviour and enforce all anti-discrimination laws and we would still live in a society founded on racist ideas where Western (white) civilisation and values predominate.
Ending racism doesn’t mean people of colour just get to live more equitably in a white world.
This week has also reminded us that it is people of colour who will have to shoulder the greatest burden to deliver even incremental shifts in racism.
We didn't invent it. It is not our problem to fix, explain or educate. It is as though black people must convince white people of our very humanity.
I am reminded of what the black writer and psychologist, Frantz Fanon, said: "I am not a potentiality of something; I am fully what I am." [Source: Stan Grant, on ABC]

These parts also resonated with my experiences a lot:

Nearly all of [the mental health professionals] have been white. This means most of the therapy she's experienced has involved mental health workers with little knowledge of her South-East Asian background. [...]

"I would spend five of those [sessions] really trying to overexplain my culture and its nuances, and then five trying to get to the root of the problem [...]"
Inez says she also copped a lot of "insidious, racist and stigmatising remarks" from various psychologists and psychiatrists along the way.
"If you're talking about your culture, or cultural experience, and feeling like you have to justify yourself, or your therapist's response to some of your cultural stuff is [negative] and you're feeling frustrated and annoyed about how they're responding, or you're having to repeat yourself or even feeling that they just don't get you, then that's a red flag."

And my experience is similarly reflected here:

[…] can also be made culturally sensitive, getting around the fact that psychologists are overwhelmingly white.
[…] “There’s growing discussions overseas about how psychologists are largely from affluent backgrounds, university-educated and from inner-city areas,” says Professor Meadows.
“You can see how someone from a different background might not feel a connection with that kind of person. So we need to recognise that different groups need different approaches.” [Source: ABC]

I found that this, from the U.S., and though it is a report on seeking physical health care, also summarised my experience with seeking mental health care in Australia, as someone of Vietnamese background:

The National Healthcare Disparities Report showed that White patients received better quality of care than Black American, Hispanic, American Indian, and Asian patients. Dominant communication styles, fewer demonstrated positive emotions, infrequent requests for input about treatment decisions, and less patient-centered care seem to characterize patient–provider interactions involving people of color. [Source: Implicit Racial/Ethnic Bias Among Health Care Professionals and Its Influence on Health Care Outcomes: A Systematic Review]

I have decided to try and seek support again after reading this article, and try to trial some more psychologists and explicitly seek for skill with cultural sensitivity. I also want to thank ABC website editorial staff for featuring it on the ABC News home page as well.

And on another note, not sure if I can do two-in-one, but I would also like to thank Stan Grant for bringing up this issue on Q&A too, in the aftermath of "March 4 Justice", as it has to do with Australia in general:

"As necessary and as urgent and as righteous as these claims are, and this movement [on gendered violence] is, there have been so many women's voices who have not been listened to for a long time," Grant said.
"And ... when it becomes a white middle-class issue, when it is in private schools, when it is in Parliament House, when it is in the press gallery, we take notice.
"But when Aboriginal women who have been suffering domestic violence at rates 40 times higher than the rest of the population, 10 times more likely to die as a result of that violence, when I have seen Aboriginal women marching and protesting and calling for support for generations, I did not see the same women outside Parliament House.
"When poor women, when migrant women, when refugee women have suffered these things, I did not see the same media attention.
"Poor women do not end up on television programs, they are not on Q+A, there are a lot of voices that are not listened to here and while this is a movement and a moment we need to reflect on our own blindness and biases."
"What a shame it is that a nation reveals what it is by what it cares about. And what a shame it is that it has to happen in white middle-class society for people to suddenly say there is a massive problem here." [Source: ABC]

If this has raised any issues for you, you can contact 1800RESPECT in Australia, or inTouch, if you are in Victoria, and identify as culturally and linguistically diverse. If you are outside Australia, you can contact your local family violence or mental health support services in your country.