I had an appointment with my GP today. I have been seeing her for almost twenty years. She is an absolute legend, and I couldn’t imagine seeing another GP. In a city where bulk billing by doctors is almost unheard of my GP regularly bulk bills me – especially after I have been in hospital. She is thorough and caring and knowledgeable. If all doctors were like her the world would be an amazing – and healthy – place.
Sadly, not all doctors are like my GP! I don’t want to criticise the whole profession but over my 31 years of having schizophrenia and my lifetime of being AuDHD I have a lengthy list of unhelpful doctors who evidently weren’t listening to the commandment to ‘first do no harm and then do no harm’! The scary thing when a doctor gets it wrong or is disrespectful and doesn’t listen is that they have a lot of power and the impact can actually damaging or sometimes even fatal. Firstly, they have a lot of power over your health including with diagnoses and medication. Imagine if I went to see a doctor and they told me I didn’t need my schizophrenia meds? The impact of that on me would almost certainly involve me getting really unwell and having to take a couple of years out of my life to recover, including many months in hospital. The other element of power that doctors have in many countries is a high level of respect and prestige around their position. This is fine and often well-deserved, but it does mean that if there is an issue with a doctor being harmful or negligent people are less likely to speak up.
In my own experience psychiatrists are probably the worst culprits for poor practice by doctors. I often joke that I killed two psychiatrists – don’t worry, I didn’t actually harm them, they just died, but both of them treated me badly so when they passed, I didn’t feel much need for grief. Both of these doctors were negligent and arrogant and didn’t listen to their patients or their patients’ families (well that was true in my experience, and I imagine probably others they treated may have had similar issues). When I was younger and first needed to access mental health services, I was extremely vulnerable. I had drug addiction issues, was homeless and was recently diagnosed with schizophrenia. I was also autistic, ADHD and Queer and an ex-prisoner. Yup, I ticked a fair number of intersectional boxes! What this meant – among other things – was that my capacity to self-advocate was pretty much zero.
Fast forward 30 years and I am big and tough and extremely bolshy. I can absolutely advocate for myself even if I am unwell with psychosis – and for others if needed. I still need to go to hospital fairly regularly due to my illness, but when I do, I am much more able to advocate for myself. There is still a power imbalance between me and the doctors, but I always aim to be in control of my own care. I have a bunch of advocacy strategies which help get my needs met.
I am thinking I should probably share some of my tips to help others! A few of the strategies I use when accessing services are:
- I do not feel less empowered or important than the doctors. They are on my team, and their role is to use their expertise to support me to recover. We are equal partners in leading the project which is my supporting my positive mental health and helping me to recover
- I always make a list prior to seeing doctors – including questions I want to ask them, and what symptoms I am experiencing and what my concerns are, how long I am likely to be in hospital etc
- If something is causing sensory issues in hospital, such as lighting or noise, I will raise this with staff
- If something seems wrong (for example when a nurse accidentally swapped my notes with my roommate and gave me her diagnosis instead of mine), I will follow up with whoever is in charge
- If I want something (reasonable – such as to be transferred to a different ward) I ask. I might not get it, but I almost certainly won’t get it if I don’t ask!
- I don’t have self-stigma around my illness. I am not ashamed of it, and I am happy to talk about it.
I often describe a psychiatrist who is harmful as being like a plumber that you call to fix a leaking tap. But instead of fixing the tap they break your toilet. You don’t ever want to get the doctor who metaphorically breaks your toilet! Thankfully things in public system mental health care in Australia have changed for the better in recent years. Self-advocacy by those accessing services can definitely help. Legislative change can also help. In Canberra where I live we had a new Mental Health Act enacted in 2015 and from my observations it really has made a difference including in the attitudes and approach of psychiatrists.
As I said, if all the doctors were like my GP, the world would be a better place! We all have the opportunity to support those providing treatment for us to be effective and inclusive, respectful and kind – and not metaphorically break the toilet!

Image is Yenn speaking to a room full of psychiatrists








