A few of the lesser spoken concerns for prospective patients, many of whom do not know what to expect when seeking psychological treatment.
One of the few positives of the Covid-19 pandemic in Puerto Rico, has been that it’s shone a spotlight on many issues, including mental health. Couple it with the incredibly pervasive effects of hurricane Maria, and you have a population ready to burst under trauma and stress.
“A happy coincidence is that in the past few years we’ve gone through some critical situations: hurricanes, earthquakes, a pandemic. Nobody thought we would go through a pandemic, you saw that in movies. But they served to change people’s perspective on the psychologist. Now they’re looking for help”Dr. Luis Franqui Laracuente Clinical Psychologist
It sounds a bit morbid, sure, but the reality is that the problem doesn’t stem from anything recent, it’s only been accentuated.
As it stands, suicide has been the third highest cause of death on the island, especially among men, since the year 2000, as noted by the Department of Health’s Commission for the Prevention of Suicide in Puerto Rico. According to this entity, approximately every 29 hours, someone falls victim to suicide, often times via asphyxiation. In three years, four disasters have left the population struggling to cope with trauma and stress, a population looking for help.
Not knowing what «help» means
A key part of mental health campaigns is the focus on getting help, but not what that help is. Often times you’ll hear that mental health professionals are there to listen to you and help, which is true, but ambiguous. A psychologist is trained to listen and guide you through the process of working through your emotions and experiences. They are not there, however, to provide you with answers or a quick solution.
“There’s a capitalist discourse that often reaches the clinic. It suggests that if you invest in something, you have to get something in return. A lot of people, when they have a problem, go to the psychiatrist first. They look for a pill, a quick solution. Since there are no pills in the psychologist, it’s more work and more painful. When the pill doesn’t end up working, then they go to the psychologist”Dr. Luis Franqui Laracuente, Clinical Psychologist
Causes to seek help
“I don’t think people need a reason, but I have a reason.”
If you have a mental health crisis, by all means, look for help, although you don’t necesarrily need one to seek a professional. People are complicated and the human brain often works against us. In the same way that an early diagnosis could save your life from a physical illness, it could save you from a mental one.
“Your emotional well-being is just as important as your physical health, and by identifying early signs of such conditions as depression or anxiety, the most serious versions of these can usually be avoided. Early identification and treatment is especially helpful, because later stages often trigger some kind of personal crisis, which then makes treatment much more involved.»Yanko Enamorado, MD, Jan 21st, 2017, Mount Sinai Medical Center
This doesn’t mean that you should see a psychologist annually, but it does mean that you should consider going on occasion, especially after big, lifechanging events.
Therapy isn’t a quick solution
“Human pain, the human situations sometimes don’t have immediate solutions. We as human subjects confront many situations. Having an ally in the form of a psychologist, helps with that. Having a judgment free space where you can express yourself without censorship, helps. After time, that release is what helps people, what you might call a long-term investment in the self.”Dr. Luis Franqui Laracuente Clinical psychologist
There are several reasons as to why just telling you what to do isn’t job. First and foremost, they’re not omnipotent, they can’t read minds, thus they can never fully understand the situations you might be faced with on a day-to-day basis. They could offer you suggestions, but they are bound to anything they say to you. Due to the code of ethics in place by the Psychologist’s Examination Board in Puerto Rico (JEP), if they say something that leads to you harming yourself, they could be liable. Depending on the severity of the situation they could even lose their license permanently.
Psychologists have to educate you on what they are going to do
Before beginning a session, it’s the psychologist’s duty to inform you about the process and everything to do with your participation in an investigation or therapy session, barring a few exceptions such as data on tests they might have for different conditions.
“When an investigation takes place, part of the procedure is informed consent. A person should never participate in an experiment without knowing exactly what is going to happen, what they’re going to do and what are the risks. Informed consent involves everything rights, risks, concerns, everything. There could always be risks so it’s the psychologist’s job to recognize this and provide options to remedy the situation if something happens. The same thing applies to all branches of psychology including psychological therapy.”Dr. Elba García Ochoa, Industrial Psychologist
If you’re not sure about anything you can always ask, it’s their job and their responsibility to make sure you understand.
Psychologists don’t compete
We’re all humans and even though mental health professionals might be more capable of handling their emotions, they have their own ticks and flaws. Not only that, but psychology is a large field full of diverting methods and philosophies which differentiate its practitioners even further. This is why the JEP has a clause on competence.
“It’s an ethical obligation to refer who’s most capable.»Dr. Luis Franqui Laracuente
As the patient, you have a right to receive competent help for your particular situation. A psychologist is taught to recognize situations and understand whether or not they can help you. If they’re not they will be sure to refer you to someone who can or you can request it. For most of them it’s not about the pay, for them to do their job it can’t be, it’s about you.
It may take time for you to find a psychologist that’s right for you
It’s important to know that you have options. At the end of the day, you have to be honest with yourself on whether you’re comfortable with whom you’re opening up to. The process only really works if your being open, so trust and chemistry are key. as stated before, psychologists have different specialties and preferences for traetment too, so it’s far from a «one size fits all» approach. A young patient from Vega Baja, who wished to remain anonymous, expressed:
«There was this one psychologist that I really enjoyed. It was just her energy that I really liked. I could just let loose and tell her all my problems. I was expecting it to be like the same old generic therapist that I had been to before. I expected generic questions and a lack of interest, but she really cared to ask about everything, get to know me and what I was going through.»
There’s also the matter of, despite the field being highly regulated, there are still those who are negligent in their work. A young man from Arecibo, who had received treatment the past year, said:
«I had this one person tell me to «not feel depressed» Like I could control that, right?
As the end consumer, you’re the one that has to decern between competent and inadequate help. The final say is yours. You need to decide what’s right for you.
How can I know more?
Firstly you can look at the short articles the American Psychological Association (APA) has made throughout the years to explain common questions and offer tools for managing stress and dificult situations.
Second you could try attending local activities that focus on educating people about self-care, wellness, or mental health. Groups like, “Calidad de Vida UPR Arecibo” could be a great help, not only for mental health but also health topics in general, like nutrition, and stress relief.
And of course, if you’re ever in need, you can call Mental Services Administration Health and Addiction’s (ASSMCA) “Linea Pas” 1-800-981-0023 or visit their website for immediate help.