Firstly, what is the overall mental healthcare system like in Australia? How does culture play a part in the adequacy of care that individuals may receive?
It’s important to recognise that the Western model of psychology fundamentally underpins mental health services and the system in Australia and across the world, even in Asia. And oftentimes, this Western model, which is very much a Eurocentric practice, is often presented as the truth of how humans function, rather than as one of many models - which in turn affects modern-day mental health services and psychology research.
So in the trajectory of mental health and psychology practices, the experiences of people who are not white, middle class, cisgendered, able-bodied or heterosexual have traditionally not been included in the conversation or the research at all. It’s only been the last 10-20 years where diverse voices have been included in the research.
For example, culturally responsive practice (essentially learning how to work with diverse people) is currently only a two hour unit for all mental health professionals. So the Western model of psychology underpins how our mental health services operate, how they function, how they deliver services to the whole community and what they view as success. Yet our whole community isn't Eurocentric. We’re a diverse mix of people, especially in Australia. As a result, the needs of people who don't fit into that Eurocentric mold often get overlooked or dismissed because their experiences don’t exist within the frameworks that Western psychology was founded on, or have made.
What’s been challenging is seeing how new ‘progressive’ principles in mental health such as the examination of systemic trauma, body-based practices, and connection with community and all new topics are treated as groundbreaking ideas in mental health when in reality these principles and wisdom actually originate from our ancestral cultures, like Eastern cultures, African cultures, indigenous cultures. It’s been frustrating at times to see these principles get regurgitated, packaged up and resold back to us through a very white lens.
In terms of how culture plays a part in the adequacy of care, it’s a complex issue. I don’t want to put the blame on practitioners for not knowing how to practise in a culturally responsive manner. Everyone has their own blindspots, including me. There’s so many things that we as practitioners don’t understand simply because the research has been so narrowly focussed for so long. But now we're in an era where we’re starting to listen to the experiences of all types of people, from people of colour to people of different gender identities. Slowly, are we only starting to learn that people have very different experiences and therefore require very different structures of care.
What was working in the crisis service industry like and how did it personally affect you?
I worked in the crisis service industry for about five years, and I ended those years in a complete state of distress, burnout and diagnosed PTSD. I got shingles three times during my time in the crisis service industry (when the norm is getting it once in your lifetime, usually at a very old age) and it just showed me how my whole nervous system was getting affected too. Even then, I still turned up for work because crises don’t stop.
Following that, whenever people leave the crisis service industry as a practitioner, there’s this feeling of shame where you don’t feel like you were strong enough to work with trauma, deal with crises or deal with the most raw and pointy parts of mental health care. For me, it also feels like I've personally let myself down because I couldn't support the most marginalised people in our community.
This really highlights how so much of the burden sits with our frontline workers especially in our health care sector, where people start to leave these industries because they feel like they were completely unsupported by the structures in place. They’re so unsupported to the point that individuals feel like they have to completely deplete themselves to help others. You feel like, if you’re not there, then no one is going to help these people.
In these conversations, people always say we need to pay professions like nursing more. This is true, but we also need to do more than only providing better financial compensation. We need supportive working hours. We need more people in each team so that individuals have the freedom and the capacity to take time off. We need better, or just adequate supervision and for there to be skilled people that can debrief with practitioners so that practitioners aren’t taking these issues back home too. We need better education that doesn’t glorify this intense work but instead helps the general population understand how hard it is.
Alongside the “Shapes and Sounds Club” for individuals to meet other Asian-Australians going through their own mental health journey, you also have "Connect and Grow", a community dedicated towards mental health practitioners. In your experience as a music therapist, how important is it to find a community of people who understand the depth of impact that the work is having on you as an individual?
The reason why we have “Connect and Grow” is twofold.
So on one hand, “Connect and Grow” is a space for mental health practitioners to learn and train. We provide learning and evidence-based frameworks around culturally responsive practice and anti-oppressive practice, since these practices aren’t taught enough, or even at all in university. And even if these therapists and mental health practitioners are people of colour, their lived experiences don't necessarily mean that they’re skilled in culturally responsive practice.
The second aspect of “Connect and Grow” is in building a strong community. There aren't that many Asian mental health practitioners, and I don’t think it’s proportionate to the Asian population in Australia. “Connect and Grow” allows practitioners of colour to come together and actually gain adequate culturally responsive supervision from one another.
For context, mental health professionals require adequate clinical supervision from managers or supervisors to help them process everything that's going on at work - for example to talk through power dynamics with patients, or to ensure that you as the mental health professional are not getting triggered by the person you’re supposed to be supporting etc. When I started out, I was often the only person of colour in a service or an organisation. There’s a few race-related incidents that have happened in therapy sessions, which I wouldn’t ever feel quite safe when discussing afterwards with my supervisor simply because they couldn’t understand or empathise with my perspective. That’s why a community like “Connect and Grow” is so important, so that mental health practitioners can process their experiences and deal with it with other people who would understand.
Australia has a deepening youth mental health crisis, which has only been exacerbated by COVID-19. What key changes do you think need to happen in the overall mental healthcare system to better support both patients and mental health practitioners?
Key changes would involve increasing the capacity of mental health practitioners by firstly making it easier and more attractive for people to become mental health professionals, then creating support structures in place to help professionals. We also need to ensure that the services we provide actually represent the audience that we're trying to reach.
There’s such a huge capacity issue - I know that some universities only train 25 clinical psychologists a year which is barely enough. Even though we’re doing well in encouraging people to go to therapy, we don’t have enough qualified therapists to support this demand. We need to increase the number of mental health professionals by making it much more attractive for people to study these degrees.
The research that we’re producing also doesn’t match the world’s needs and the new generation’s needs. We’re not creating enough relevant evidence-based research to support the younger generation - more needs to be done on gender identity, queerness and culturally responsive practice. I think we’re currently missing the mark, which in turn means people aren’t as likely to seek out traditional mental health services as they stand right now. Young people often end up seeking help in different routes, many often support themselves or self-medicate through things like social media.
Where do you want to take Shapes and Sounds in the future?
I’m currently exploring how to take Shapes and Sounds down the social enterprise route, such that I can build it into a financially sustainable organisation that can support both my staff, myself and the other people connected to us.
At the end of the day, I don’t want to rely on grants or VC funding. With a social enterprise, I can get much more autonomy and agency to create impact, predominantly through the revenue that the organisation makes. I’m exploring this model more, especially since the business is fundamentally about giving back to the community.