Are psychologists fit to treat their patients?

by Dr Carole Sherwood

In her recent documentary ‘Trans, Racist and Woke: How Psychology went MAD’ mental health nurse Amy Gallagher revealed that she was accused of creating a ‘traumatising environment’ at the Tavistock & Portman NHS Trust, where she was attending a psychotherapy training course. During her training, Amy became aware that Critical Race Theory was being used to ‘encourage unequal treatments, judgements and generalisations about people based on the colour of their skin’.  She spoke up about a lecture she attended titled ‘Whiteness, a problem for our time’.   Amy expressed concern that all white people were being viewed as racist and advocated for the ‘colour blind’ approach where everyone is treated equally and as individuals. In response, she was told her that her beliefs were ‘discredited’ and ‘outdated’. Amy was accused of ‘race-based harm’ and instructed not to be present in the clinic’s reception area because the sight of her face could cause trauma.

Amy Gallagher

In her recent documentary ‘Trans, Racist and Woke: How Psychology went MAD’ mental health nurse Amy Gallagher revealed that she was accused of creating a ‘traumatising environment’ at the Tavistock & Portman NHS Trust, where she was attending a psychotherapy training course. During her training, Amy became aware that Critical Race Theory was being used to ‘encourage unequal treatments, judgements and generalisations about people based on the colour of their skin’.  She spoke up about a lecture she attended titled ‘Whiteness, a problem for our time’.   Amy expressed concern that all white people were being viewed as racist and advocated for the ‘colour blind’ approach where everyone is treated equally and as individuals. In response, she was told her that her beliefs were ‘discredited’ and ‘outdated’. Amy was accused of ‘race-based harm’ and instructed not to be present in the clinic’s reception area because the sight of her face could cause trauma.

What does Amy’s experience say about the state of mental health services, when staff at The Tavistock Clinic, previously considered one of the world’s most prestigious mental health centres, can be ‘traumatised’ by an opinion or by seeing someone’s face in reception?  Is hers an isolated experience, or are the reactions she experienced widespread in the NHS and training programmes?

A freedom of information survey of Clinical Psychology training programmes in the UK, conducted in 2022, revealed some troubling findings. It seems that a future generation of psychologists is being schooled in Critical Social Justice ideology and identity politics, dividing people into ‘good’ and ‘evil’ groups.  These courses are funded by NHS England (previously Health Education England) which requires them to implement a nine-point Action Plan to improve ‘equity’ of access to clinical training for Black, Asian and Minority Ethnic trainees.  While this is a laudable aim, the Action Plan demands that courses ‘decolonise’ their curricula and introduce ‘anti-racist’ and Equality, Diversity, and Inclusion policies. The ‘anti-racist’ policies being introduced are clearly informed by Critical Race Theory, although NHS England denies this was their intention.

Evidence from the FOI survey also shows that Amy’s training course is not the only one providing ‘Whiteness’ training.  It is widespread across UK clinical psychology training courses. Trainees report that if they raise concerns about the divisive nature of ‘Whiteness’ training they are silenced and told to mind their ‘privilege’.

One course responding to the FOI survey, reported that they would not send a black trainee to a white rural area on placement.  How will these trainees cope when they qualify and have little choice who they can or can’t see in clinic? Will they claim to be ‘traumatised’ if asked to see a white person?  Is the course behaving ethically towards local white people who need support from mental health services?

Training courses also reject Western science, viewing it as racist and colonial.  They promote the idea that ‘experts-by-experience’ (i.e. with ‘lived experience’) and ‘other ways of knowing’ have more to offer than ‘expert’ knowledge. Courses boast of ‘loosening the profession’s grip on the ‘expert’ position’ relying, instead on those with lived experience of mental illness to provide knowledge.

People with mental illnesses have valuable experiences to share with mental health professionals, who can learn a great deal from them and incorporate this learning into their clinical work.  It is important, though, to ask how far each of the courses intends to take their downgrading of ‘expertise’.  If a patient was having a psychotic episode, self-harming or feeling suicidal, they need to be assessed by a mental health professional with appropriate expertise and skill, who can conduct a risk assessment and ensure that appropriate safeguarding measures are put in place to protect that patient from harm.  The dangers inherent in such a case can, perhaps, be best illustrated by considering whether you would want to be referred to a surgeon who had ‘loosened their grip’ on the expert position.

Nonetheless, the British Psychological Society (BPS) is actively encouraging people with mental health problems to apply for clinical psychology training.   The results of this can be seen on social media, where trainees and qualified staff openly discuss their mental health problems. For example, there are posts by trainees who talk about being ‘triggered’ by lectures; qualified psychologists who post images of their antidepressants; and researchers seeking to recruit ‘practising clinical psychologists with lived experience of self-harm’.  One trainee psychologist, who spoke of being hospitalised during their training, complained about the review process they were obliged to undergo with the Health & Care Professions Council (HCPC) who regulate psychologist practitioners. The HCPC required the trainee to complete a fitness to practice investigation on completion of their course before they could be registered.

The trainee was so upset by this review process that they complained to the BPS’s Division of Clinical Psychology who put pressure on the HCPC to change their fitness to practice policy.  Previously, the HCPC required practitioners to ‘be able to maintain fitness to practice’. Now, psychologists’ employers are expected to support their employees through periods when they are struggling with mental health problems. This may sound perfectly reasonable.  However, a senior psychologist, who wishes to remain anonymous, has expressed concern that increasing numbers of psychologists with mental health problems are putting great pressure on services and NHS budgets.  If a mental healthcare service employs staff who struggle to manage their own emotions, frequently need time off to recover, or want to limit how much time they spend at work, this means that the remaining staff have to cover for that person in order to meet the needs of their patients.

As for the financial burden, during the Covid pandemic extra government money was provided for psychological support to NHS staff.  Although there were wide variations between NHS Trusts in terms of the amount of funding made available, we understand that many Trusts were spending between £300K and £1.3 million on such support.  The government has now withdrawn national funding but many NHS trusts continue to fund psychological and psychiatric support for staff.  As training courses persist in recruiting people with mental health problems as clinical psychologists, what financial pressure might this put on the NHS to meet their needs?

It is important to note here that psychologists are only human and are very likely, during the course of a career, to experience periods of stress such as bereavement or divorce which may lead to depression or anxiety. Others, who have more enduring mental health difficulties, may be able to manage these extremely well so that they don’t impact on their work.  However, with increasing numbers of psychologists being recruited with mental health problems, who may subsequently find themselves unable to cope with the demands of clinical work, the whole system of mental healthcare might struggle to cope itself.

Finally, it is not only clinical psychologists and psychotherapists finding it hard to meet the needs of those they serve.  In an article published by Genspect educational psychologists Claire McGuiggan, Peter D’Lima and Lucy Robertson ask the question ‘Where are the Educational Psychologists When Children Say They’re Transgender?’  It seems that there is ‘silence, avoidance, or suppression’ in the Educational Psychology (EP) profession regarding this controversial topic.  The authors suggest that one reason this problem may have arisen is because educational psychologists ‘have stopped being psychologists and have started becoming activists.  The authors conclude that within the profession ‘Disagreement must be tolerated and explored. The alternative is avoidance of the issue to protect EPs from discomfort at the expense of the needs of children’.

What hope is there for those requiring help from clinical and educational psychologists, or psychotherapists, if these ‘professionals’ are intent on activism, struggling with their own mental health problems, fearful of causing offence, or traumatised by the colour of someone’s skin?  Amy Gallagher’s documentary is timely in pointing out how and why psychology has gone mad.