In late 2023, we nervously launched a survey of clinical psychologists’ perceptions of lived experience of mental distress[1] (hereafter ‘lived experience’) within the profession. We say ‘nervously’ because it felt like taking a risk. In our planning meetings, we had discussed the lack of visibility of lived experience in the profession, and the role stigma may play in this. Despite our advocacy and advice to clients, we were not always hearing that it was ‘OK to not be OK’ if you were a clinical psychologist.

Just before the pandemic, the British Psychological Society (BPS) released a position paper on the value of clinical psychologists with lived experience of mental health difficulties (Hogg & Kemp, 2020) that encompassed five core value statements1:

  • Lived experience of mental health difficulties is common.

  • Lived experience of mental health difficulties is diverse.

  • Decision making about sharing mental health difficulties is complex.

  • Destigmatising lived experience and addressing discrimination is a whole-system responsibility.

  • Lived experience is an asset.

As a group, we instinctively agreed with this position and these value statements, but that paper was put together by a focus group on the other side of the world. What if our colleagues disagreed? There are so many psychologists doing wonderful work to create supportive environments. However, much of what has been written about lived experience frames it solely as a risk factor or a cause for concern rather than as a potential asset. What if our worst fears were realised and that lived experience was not particularly valued by clinical psychologists in Aotearoa New Zealand?

So, just as we would advise our clients, we devised a behavioural experiment. We decided to face our fears and launched a survey to explore our colleagues’ thoughts. We asked about support for a similar position statement, whether respondents agreed with the five BPS value statements and whether there were other elements that would need to go into an Aotearoa New Zealand-specific statement. We also gave respondents the option to tell us about their own lived experience of mental distress if they wished to.

Overwhelming Support

Psychologists are busy people, we understood that, and it can be hard to find time to do a survey in the middle of juggling all of the commitments we have. However, we hoped some of our colleagues would be able to find some time to do our survey. Given the typically low response rates to online surveys, we hoped that we could persuade 20–30 of our colleagues to lend their views.

The College sent out the survey on our behalf on Monday 11 September. Within 2 hours we had 25 responses. Within 24 hours, 50 people had completed the survey. Within a week, we had 113 responses. And not just numbers, we received floods of qualitative feedback, expressions of support and personal experiences. By the time we closed the survey, 192 clinical psychologists or nearly one-eighth of the registered workforce (see Skirrow et al., 2023) had submitted a response.

‘We are the many, not the few’.

Of the 192 people who completed the survey, 175 went on to answer our questions about whether they felt they met the broad Aotearoa Therapists with Lived Experience Network (ATLEN 2017) definition of lived experience of mental distress. Of those, 144 (83%) felt that they met the ATLEN definition. Many respondents went on to describe their own experiences of mental distress and seeking help before, during and after clinical psychology training.

The message was overwhelming; we are not alone, lived experience of mental distress is common among clinical psychologists. Clinical psychologists, it seems, are people too. We struggle in all the same ways that our client groups do, and it can happen at any stage of our careers. While we did not explicitly ask about experiences of prejudice and discrimination, we received many testimonies that this is both common and needs to be challenged.

Overall, 98% (187) of the clinical psychologists who completed the survey offered strong (82%, n=157) or qualified (16%, n=30) support for the development of an Aotearoa New Zealand-specific statement. Many respondents expressed that a statement was a welcome step forward but is not, in itself, sufficient, with broader changes required to training, regulation and employment practices in the profession. While the BPS value statements were broadly supported, our respondents made numerous recommendations as to how they should be refined, developed and broadened to be applicable to the context in Aotearoa New Zealand.

Summary and Next Steps

A huge number of clinical psychologists participated in our survey, overwhelmingly supporting the development of a future Aotearoa New Zealand-specific statement on the value of lived experience within the profession. Many clinical psychologists in Aotearoa New Zealand would consider themselves to meet the ATLEN definition of having their own lived experience of mental distress, both as a proportion of our sample and as of the wider workforce. We want to thank all of the clinical psychologists who lent their voices to this project, as well as acknowledge the consistent support for this project from the National Executive of the NZCCP.

Our survey generated an enormous amount of data (much more than we expected) relating to the profession’s experiences of mental distress, as well as what needs to change for us to properly recognise, support and value those experiences. It will take us many months to analyse, summarise and report back our findings, as well as to engage our professional bodies in developing shared statements and guidance. But, for now, we hope that it is enough to acknowledge the strength of feeling and the shared experience of many of us within the profession. We now know that we are the many, not the few and in that knowledge we are stronger.

Ēhara tāku toa i te toa takitahi, ēngari he toa takitini

My strength is not that of an individual but that of the collective

  1. Consistent with the literature (e.g. Health Promotion Agency, 2020), we use the term ‘mental distress’ to broadly refer to: those who have had an experience of mental illness and those whose scores on validated questionnaires indicate some level of current distress. The term mental distress is considered to better capture a broader range of peoples’ experiences, better include Māori and Pasifika concepts of health and well-being and are generally preferred by individuals with lived experience.