Throughout our encounters with community members, we recognized that they prefer to be self-sufficient or help each other rather than seek the help of professionals or outsiders of any kind. Professionals are agents of the untrustworthy government and psychologists are perceived as one and the same as doctors, who spend ten minutes with patients dispensing medication. We spent the first week gaining the trust of the PIPS group and of some of the community. We had to explain who we were, what our intentions were, and how our training can be of help to them. Of course, the best “work” occurred at pubs and events, socializing with the community. We had to fight to be more than just tourists; to really make a contribution and do some clinical work. The heated negotiations between our group and theirs and within our group were invaluable learning experiences.
Professional psychologists/psychiatrists are largely not a part of the suicide response team or prevention work. General Practitioners (family doctors) are the first point of contact, and we have been shocked to learn about the common neglect and ignorance about mental illness, arising from a widespread stigma. PIPS refers their clients to a telephone support line with trained counselors who are available 24/7. We have found that training in this country is of questionable rigor, compared to our standards. Despite this readily available counseling, therapy with professionals is not widely available nor is it thought to be necessary or effective. On top of that, there is a stigma about therapy signifying personal weakness and a belief that only Americans do therapy. To further complicate matters, people do not know what we mean when we say “therapy” or “clinical work” and we all have different ideas about what we mean. We had the wonderful opportunity to demonstrate empathetic listening with the members of the PIPS team by going into their homes and speaking to them one-on-one about their experience of suicide in the family. I treasured this insider experience, learning about how suicide affected a particular family and how political trauma can shape a person’s worldview and damage mental health. I was deeply moved by the people we met, especially by their resilience and drive to better their community and foster togetherness. We were all concerned about how much responsibility people at PIPS were taking on however. One thing we have been emphasizing to them is self-care: caring for the wounded-healer so that they can continue to help others and not be retraumatized.
Breaking stigma is going to be a huge multifaceted task. Is mental illness really like a broken leg (as PIPS says in their presentations) or is it a “normal” human experience to an abnormal situation?
Thanks for reading,