Am I a good friend to myself?

On World Mental Health Day on 10/10/2022, the World Health Organisation (WHO) launched a campaign to “make mental health & well-being a global priority for all”, envisioning a world where mental health is “universally valued, promoted and protected”.

We have lived through very serious challenges to mental health during the past three years. The COVID-19 pandemic, major climate events, a war in Europe, and economic uncertainties have all added a series of long-term stresses to our lives. Chronic stress can undermine the mental health of many.

On World Mental Health Day, therefore, it is timely to pause and reflect on what we can do to “value, promote and protect” our own mental health, as well as the mental health of those around us.

In Australia and other economically developed nations, mental health is becoming increasingly accepted as a serious issue that needs discussion. Taboos around mental health struggles have been lifted by those who speak out about it, including famous sportspeople, actors and musicians. The positive contribution of these people to our ability to talk about mental health is immense.

So perhaps the most important thing we can do to protect our mental health is to start talking about it. Much like our physical health, mental health exists on a continuum. Sometimes we only need a little rest and support to get better, and other times we need assistance from a professional. When we feel a little more stressed or anxious than usual, turning to friends and family, someone who can listen and be present for us, can help a lot. But when we struggle with severe challenges, we need a specialist to help us get through.

Once we decide to seek help, the variety of mental health professionals available can be confusing. Where to start?

The best point of contact is your GP. Your GP can provide an initial assessment and a mental health care plan and refer you to a mental health professional supported by Medicare, usually a psychiatrist, a clinical psychologist, or a general psychologist.

What is the difference between these professions?

Psychiatrists are medical doctors who specialise and obtain further training in mental health. As such, they often use medication to treat mental health disorders. They usually see people with complex conditions that respond well to medication, such as schizophrenia or bipolar disorder (also known as manic depression).

Clinical psychologists have at least 6 years of education in psychology followed by a two-year psychology registrar program. They receive specialised training at the Master’s or PhD level in diagnosing and treating mental health conditions using a variety of psychotherapeutic techniques. Importantly, clinical psychology training programs are required to include treatments that are empirically supported: that is, several research studies have shown that the treatment works better than a placebo control condition. Clinical psychologists treat the whole range of mental health problems, but they do not prescribe medication.

General psychologists also have 6 years of education, but they have not completed a formal Master’s or PhD degree in clinical psychology. After studying psychology for 4 or 5 years at university, they usually obtain a Bachelor’s degree and further training through professional placements.

These professions are registered and regulated by the Australian Health Practitioner Regulation Agency (AHPRA), a government organisation that oversees health professionals’ training and professional standards to ensure the quality of care received by the public.

Other options to look after your mental health with the help of a professional include seeing a counsellor or a psychotherapist. In general, counsellors and psychotherapists provide services for people with problems and stresses in everyday living, rather than more serious concerns about mental health. Their services are not regulated by AHPRA, Medicare rebate is not available, and a doctor’s referral is not necessary.

‘Counsellor’ and ‘psychotherapist’ are titles that are not legally protected in Australia. This means that anybody can call themselves a counsellor or psychotherapist, irrespective of their background, level of education, or experience. If you decide to see a counsellor or psychotherapist (rather than an AHPRA-registered psychiatrist or psychologist), finding someone who is a member of one of their own accrediting associations, for example, the Psychotherapy and Counselling Federation of Australia (PACFA) would be advisable. These associations require their members to meet certain educational and professional standards. This would help to ensure that you see a person with an accepted level of education and professional experience in counselling and psychotherapy.

It’s worth mentioning that many employers provide Employee Assistance Programs (EAPs), which can include a limited number of sessions with a mental health professional. This may be with a counsellor, psychotherapist or psychologist, so it’s helpful to understand the differences.

Of course, prevention is often better than treatment, regarding both physical and mental health. There are many ways to look after our mental health, from making sure that we eat well, rest well and exercise well to nurturing or seeking out reliable, supportive, healthy social connections. A lack of social support is one of the best predictors of poor mental health in adults.

In general, however, a good way to look after our mental health is to ask ourselves whether we are our own best friend? Perhaps notice when you criticise yourself or berate yourself for a mistake, or when you tell yourself that you need to keep working even though you are running on empty.

Ask yourself: if my best friend, someone I care about and feel responsible for, were in this situation, what would I say? Would I criticise them? Would I berate them, would I push them, would I give them the same advice I am giving myself? Would I do this to my child?

If the answer is ‘no’, it is time to take notice of our self-talk and to develop an inner voice that is kinder and more understanding towards our own struggles. Becoming our own best friend is a great first step towards taking care of our mental health.


Dr Marianna Szabo is a Clinical Psychologist, a leading expert in Mindfulness and a Senior Lecturer in Psychology at the University of Sydney.