Black History Month 2022: reflections from Dr Oluwatomilola Olagunju

This blog post is part of our series of activities for Black History Month 2022.

My journey into psychiatry started at a young age with my father who worked as a doctor in psychiatry. As I grew up, I was able to have many conversations with him about mental health, psychiatry and what was involved in the field which really made me curious about becoming a psychiatrist. It was during medical school however that my decision to pursue psychiatry as a career was solidified. While rotating through several specialties I noticed an emerging culture in medicine where, due to the ongoing pressures, there was a focus on getting increasing numbers of tasks done in smaller amounts of time. Unfortunately, this meant that the time we as doctors could spend with our patients drastically reduced, leading to patients not being able to have their concerns explored and alleviated. While it is essential to address the patient’s physical health issues, we as physicians have a duty to treat patients holistically.

During my time in medical school and while working as a doctor, psychiatry has been one of the few specialities where you have enough time with a patient to see them as a whole, from a biopsychosocial perspective rather than just for their physical symptoms. It was one of the few places where I saw genuine therapeutic relationships being built between doctors and patients. I saw doctors being able to build rapport with their patients and see their improvement and progress over time which, for me, is invaluable.

Psychiatry is a field where you see an incredibly diverse range of service users and it is for this reason that representation is so important. Due to the individuality of our minds and the different experiences we have while growing up, mental health conditions can present in a variety of ways. This means that psychiatry is inherently subjective. As such, it is important to know what is contextually abnormal, whether with thoughts or behaviours.

Without being able to understand cultural subtexts, this becomes increasingly difficult as it is harder to identify if a service user’s behaviours are out of the norm or if they may be acceptable in a different cultural context. By having a more diverse workforce, we have access to different cultures and as such have a better understanding of the different service users we encounter. This has a secondary benefit of helping to break down barriers. When there is a diverse work force, there is greater ease in building rapport with service users as in many occasions, having a sense of shared experiences can facilitate them opening up more and being more likely to engage with treatment.

To increase the diversity in psychiatry, there are a number of key areas that must be tackled: First is the lack of knowledge about the speciality. In medical school, psychiatry is only explored intermittently through the years and you only come to study it in your final two years of education. Were it not for my own interest in the field, I would not have come into contact with it until my fourth year of study. Second is the awareness of the public about mental health conditions. Until recently, mental health awareness was very low and little was known about the professions involved in helping people with their mental health. As awareness has increased in the last few years, I anticipate seeing more people from varied backgrounds entering psychiatry.

Finally, it is important to note the stigma regarding psychiatry. In many cultures, mental health conditions are seen as shameful and something to be hidden. This has a dual effect of decreasing the number of people seeking help for their mental health issues and also reducing the number of medical students from such backgrounds that go into psychiatry. This is a significant problem as it is often these students that have valuable insight that could benefit the profession. For these reasons it is essential that we have more effort going towards educating the public about mental health issues and towards generating more awareness about psychiatry for students in medical school. This will allow for a more motivated and diverse workforce and for us to have a greater impact on the mental health of our communities.

Dr Oluwatomilola Olagunju, Foundation Doctor