Dealing with Difficult Mental Health Professionals

How she got a job on our unit, I'll never know.

When I was a patient on the borderline personality disorder (BPD) unit at Larue D. Carter Memorial Hospital in Indianapolis, we had a patient-led group. Staff stayed out of this group; it was strictly for us.

L (name withheld) didn't care. She came into the group, and when we protested, accused us of "plotting against staff" and said we needed to "respect my authority."

This was not going to end happily.Step 1: Document, document, document!

"What's your name, please?" I asked.

"Who's speaking?" she snarled.

"What's your name, please?" I asked again, remaining calm.

"Step outside and we'll continue this conversation." Was that a threat? It sure felt like a threat. I politely refused. "Okay, conversation's over," she said. We ended the group early, then went to talk to other staff about what had happened. I went to my room and began to journal about the exchange.

The most important thing you can do if you're dealing with a difficult mental health professional is document. I can't emphasize it enough--document, document, document! The sooner the better; memory can be fickle and it's vital to remember exactly what happened. Write down what occurred, when it occurred, and the names of witnesses, if any. Documentation is vital to prove your case.

We presented our complaint against L to the rest of staff. We never saw her again after that.

Step 2: Debrief

Another important thing you need to do when dealing with a difficult mental health professional is debrief. Talk about how you feel about the way you were treated. Air your grievances. Let people know that how you were treated is unacceptable, and why you feel that way.

One time, a crisis counselor named M (name withheld) made several derogatory comments about people with borderline personality disorder (BPD) in general and me in particular, finishing with a question about my sexual habits ("Are you shacking up (with your boyfriend)?") and a sexually explicit comment about my parents that I don't dare repeat. I reported the comment to her supervisor.

I talked about how her treatment made me feel. I explained it was inappropriate because I was in enough pain as it was. I explained that my sexual habits were my own business and irrelevant to the reason I was seeking counseling. I explained that the comment about my parents was extremely upsetting. The supervisor wrote her up, I talked to someone else, and the situation was resolved.

Step 3: Is it worth complaining about?'

Even if you document and debrief, which I highly recommend, you still have to decide for yourself if it's worth complaining about. Although the law forbids retaliation, difficult mental health professionals can and often will do so. For example, the next time I sought crisis counseling when M was on duty, she threw my chart across the room and refused to meet with me. She said I could wait the seven hours until another crisis counselor came on duty. (Fortunately, another one decided to work overtime and meet with me.)

If you can file a complaint anonymously, consider doing so. However, keep in mind this is often impossible, especially if the complaint is directly related to your treatment. Keep these points in mind when you consider filing a complaint.

Sometimes a complaint about a difficult mental health professional may be filed by someone else, and the powers that be come talk to you. This is why documentation is important--you need to be able to recall whatever happened. A case in point--when I was at Larue Carter, a nurse was accused of double-dosing patients. This is a huge no-no in the state hospital system since the medications are very powerful. Staff came and talked to me about it. Since I'd kept a journal of when the medication mistakes were made, they were able to cross-check my journal against the nurse's notes and prove that she'd done it on multiple occasions. We never saw her after that.

Dealing with difficult mental health professionals can be frustrating. However, it is vital to be able to do so. You may be the one who stops the abuse of power.