Just recently I attended a meeting about a respectful, non-stigmatizing approach to people who suffer from mental health problems.
It startled me to hear of all the negative experiences people had had with the general mental health services. A mother described her feelings of humiliation when her 21 year old son had ‘to earn privileges of freedom, as if it were a prison’. And how hurtful it had been when he was left to his own devices for a whole afternoon after a transfer to another ward.

The system

I acknowledge, without a doubt that, things happen within the mental health services that we can’t be proud of. But at some point the atmosphere became really negative.
“I don’t recognize a lot mental health employees in this picture”, I observed. “And I don’t believe that all the people who chose this profession did so with the intention of humiliating others.” Everyone immediately agreed on that. The people who worked in mental health weren’t the problem, it was the system that made them behave so.

Well I can’t do much with generalities like ‘the system’. Ultimately a ‘system’ only exists and changes as a result of the actions of people. So, what do we have to do differently?


I thought about the book Power in the Helping Professions by Adolf Guggenbuhl-Craig, which describes when relationships become unequal: if we as a parent forget that we were also a child, if we as a manager forget that we could also have been the employee and if we as professionals forget that we could just as well have been the seeker of help.

People should keep on being aware that they could have had the other role. If we don’t realize that we could have been in both roles, a relationship can get polarised. Children then become a handful who never do what they are told, parents are patronizing and never allow anything, managers become arrogant brutes, who never listen and employees become whiners who are never satisfied.

Especially when you have more power within the relationship, you have to be extra critical about your own deliberations. It isn’t easy to constantly empathize with others. Constantly thinking, how would I have experienced this if I were not the caregiver but the help seeker, requires some effort.


One day I arrived on a surgical ward to see a girl of 18 who, under the influence of the voices she heard, had jumped out of a window. I started off in a friendly way, but she immediately started ridiculing me. Whatever I tried, she remained hostile, refusing all contact.
Looked at from every angle I had the advantage. I was the doctor. It was obvious she had a problem and I didn’t. I was older. I was familiar with the ward and I wasn’t tortured by psychotic experiences.
In the debriefing with the surgeon, who didn’t think she was easy either, it still took an effort to speak about her with the compassion she deserved, instead of being judgemental.

That it’s difficult, is no reason not to strive for it. Recognising the polarity within yourself – I am the doctor now, but I could have been the patient – is the best way to achieve a truely equal relationship.

Photo credit: Joël Oosterhoff