When city dwellers run into psychological difficulties, the first instinct is often to go and see a "mental health doctor". But where exactly do you find one? Is it a hospital department? How do they go about treating your problems? For most people, these are open questions. This article gives a brief introduction to what a "mental health doctor" is, so that the general public can have a basic understanding of the mental health services available in Hong Kong.
"Mental health doctor"? There's no such profession to begin with
Back when I was at university, chatting with classmates outside the psychology programme, most of them assumed there was actually a profession called "mental health doctor". Generally speaking, "mental health doctor" usually refers to one of two professions — the "clinical psychologist" or the "psychiatrist". Exactly what they are is something we explain below.
Clinical Psychologist
The clinical psychologist's main role is to apply scientifically validated psychological therapies to treat and ease mental illness or other serious emotional difficulties. A clinical psychologist does not — and cannot — prescribe psychiatric medication; generally they draw on approaches such as cognitive behavioural therapy (CBT), treating psychological conditions through talk therapy. When dealing with more serious cases, they also work alongside psychiatrists, so that medication and talking therapy together can achieve the best possible outcome.
Clinical psychologists sometimes can't shake the image of someone who is "all talk" and just "natters on". But every clinical psychologist undergoes rigorous professional training, holds a master's degree or higher, and must complete a placement before qualifying. The therapeutic methods they use have all been through rigorous scientific research; only after the American Psychological Association (APA) has reviewed the relevant evidence and recognised their effectiveness are those methods adopted.
That said, psychotherapy is ultimately a matter of one person connecting with another, and a given clinical psychologist's therapeutic style won't necessarily suit everyone. Psychologists generally spend a great deal of time seeing clients, which can leave them prone to empathy fatigue (Empathy Fatigue), and there is also research suggesting that the therapeutic outcomes of very experienced psychologists may actually be slightly worse than those of newcomers to the field[1]. On the whole, though, thanks to their rigorous training, clinical psychologists are a highly reliable option for psychotherapy.
Psychiatrist
Unlike the clinical psychologist, the psychiatrist relies chiefly on prescribing psychiatric medication as the primary form of treatment. Psychiatry is a branch of medicine, so a psychiatrist must first complete an undergraduate medical degree, then undertake further training before qualifying as a specialist psychiatrist.
Psychiatric medication can effectively treat psychological conditions, because a person is a psycho-physiological being. In other words, beyond being shaped by psychological states such as emotions and thoughts, a person is also affected by the brain's neurotransmitters. For example, the common psychiatric medication Prozac works by raising serotonin in the brain to treat depression – because serotonin is a chemical associated with feelings of well-being.
Although psychiatric medication is effective, and drug treatment is generally cheaper than seeing a clinical psychologist, medication has one drawback compared with talk therapy: side effects are hard to avoid. With psychiatric medication — Prozac again as the example — the common side effects are relatively mild, such as loss of appetite and headaches. There is also research suggesting that antidepressants may, conversely, increase the rate of suicide among young people – though this has not yet become a consensus within the academic community.
When should you seek psychological services?
Training a clinical psychologist or a psychiatrist requires an enormous amount of resources, so their fees can sometimes be off-putting. Moreover, as their job titles suggest, the speciality of a clinical psychologist or psychiatrist is handling pathological mental difficulties. For the general public, it really isn't easy to judge whether your own situation calls for professional intervention. Usually, the severity of a psychological difficulty has to meet three conditions before it is classified as a mental illness: 1) it brings serious psychological distress to the person; 2) it impairs the person's functioning in various areas, such as social life and work; and 3) given the situation the person is facing, the degree of distress goes well beyond a typical reaction.[2]
For milder psychological difficulties, it may in fact be possible to improve things by changing the way you live — your habits — such as improving your social relationships, adjusting your sleep habits, or practising meditation and the like. These methods are equally backed by research and can improve your psychological state. What's more, psychological needs aren't only about pathology: building good habits and finding like-minded friends are also a great help to psychological well-being.
If you'd like a deeper understanding of the process and principles behind counselling, you can refer to our feature article: Counselling: 6 things you need to know. TreeholeHK also offers psychotherapy services and the ForestGuide counselling service, where psychology professionals walk alongside you as you grow, helping you find the strength and direction to move forward.
Of course, seeking help without needing it is always better than needing it and not seeking it, so if you have any doubts, it's best to consult a trusted friend or a professional.
References
1.Goldberg, S. B., Rousmaniere, T., Miller, S. D., Whipple, J., Nielsen, S. L., Hoyt, W. T., & Wampold, B. E. (2016). Do psychotherapists improve with time and experience? A longitudinal analysis of outcomes in a clinical setting. Journal of Counseling Psychology, 63(1), 1.
2.Stein, D. J., Phillips, K. A., Bolton, D., Fulford, K. W. M., Sadler, J. Z., & Kendler, K. S. (2010). What is a mental/psychiatric disorder? From DSM-IV to DSM-V. Psychological medicine, 40(11), 1759-1765.
If you are facing emotional difficulties, TreeholeHK's professional team can help you——we offer psychotherapy and counselling services led by clinical psychologists, counselling psychologists and counsellors.
Not sure whether you need professional support? Try a self-assessment first
Many people hesitate when they consider seeking help: "Is my problem serious enough?" "Will I be wasting the psychologist's time?" That kind of hesitation often makes people miss the best moment to intervene.
You can start by using self-assessment tools to understand your own state. For example, the MindForest App has a built-in PHQ-9 depression screening and a BIG5 personality test to help you clarify the direction of your difficulties and, at the right moment, guide you towards finding suitable professional support.
Of course, self-assessment is only a starting point. In recent years, more and more people are using AI as a "halfway house" before formally seeking help——talking with an AI first to organise their thoughts, then deciding on the next step. Is there research to support this approach? What should you watch out for? We have pulled together the real data and potential risks of AI counselling from research at MIT, Stanford and elsewhere.
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