Dr Angela Clarke

Tell us about your career to date in the mental health sector.

I graduated as a speech pathologist in 1995 and have almost 30-years experience working in mental health. A year after my graduation, I commenced in a multi-disciplinary (MDT) community-based child and youth mental health team (a CYMHS). My main focus was on assessment of the communication skills of school-aged children, explaining the implications of a child/young person’s communication difficulties to parents, schools, colleagues and others, especially how their communication might be supporting or hindering: mental well-being and health; relationships; participation in education; and engagement with mental health interventions and treatments.

After 4 years in my first CYMHS, I transferred into a long-stay adolescent mental health unit where I was able to develop my inter-professional skills through co-facilitation in group programs. I spent 14 years in this setting. In this role, I developed skills in providing psychoeducation and specific psychotherapies such as Dialectical Behaviour Therapy.

During this period, I also worked as a clinical educator for The University of Queensland, running mental health speech pathology student clinics. I also spent a year working in an Education Queensland Behaviour Support Service, where I supported educators to work with children and adolescents with co-morbid communication and emotional and behaviour difficulties.

In 2014, I commenced 2 new roles: I began working in an adult forensic mental health facility where I managed adults living with schizophrenia. I also began working in a home-visiting, intensive treatment team for high-risk, disengaged adolescents. This setting allowed me to specialise in adolescence – a population I have always enjoyed as they are developing independence and identity and become more autonomous in their mental health care. In this role, I developed my case management and risk assessment skills, and received extensive training in Mentalization-based treatment.

In 2016, I commenced my PhD, which focussed on mentalization (theory of mind), attachment, interpersonal trust, and language skills in adolescents with and without mental illness. More recently, I was the statewide coordinator for a CYMHS-run consultation/liaison service for educators.

Since late 2022, I have been a Consultant Speech Pathologist in CYMHS. In this role, I lead the strategic direction of Speech Pathology across CYMHS in Queensland.

What made you choose a career in mental health?

I had a clinical placement in a community-CYMHS team as an undergraduate student and loved learning about the role of language and communication skills in mental wellbeing and mental health. I was introduced to mental health concepts such as attachment and engagement and transference which seemed to be important across all settings wherever children and young people were receiving care.

What do you find most rewarding about your current role?

In my current role, I am able to lead the strategic direction, professional scope, and clinical activity of Speech Pathology in CYMHS throughout Queensland. I provide clinical supervision to CYMHS Speech Pathologists, giving me opportunity to support speech pathologists to grow professionally, which strengthens our discipline, and enhances consumer care.

What do you find most challenging about your current role?

Supporting CYMHS Speech Pathologists to work to their full scope of practice within the context of organisational constraints. Supporting CYMHS Speech Pathologists’ occupational wellbeing whilst they work with complex, vulnerable, and challenging consumers and families.

Tell us about a day in the life of you at work. What does a typical day look like?

My day might include any of the following: individual and group supervision sessions, attending leadership meetings to discuss clinical governance and service development, identifying new treatment trends, assisting with staff recruitment, developing and delivering professional development to a range of disciplines – e.g., for CYMHS speech pathologists, psychiatry registrars, non-mental health speech pathologists, university students, etc.

I have a small clinical load where I complete communication assessments (where a speech pathologist is on leave, or where a young person is particularly
challenging). Following this, I’ll provide feedback about the assessment’s findings to families/carers, school, and other stakeholders where I explain implications, e.g., how communication difficulties might be influencing a young person’s behaviour or engagement with education. I also oversee and co-facilitate social skills training program. At present, we are running weekly social skills sessions for both adolescents and parents/carers at two different CYMHS sites. I am the Principal Investigator in the ethics-approved research protocol associated with this group intervention.

What are 3 misconceptions you think people have about working in the mental health sector?

1. That only clinicians who work in designated mental health services work with clients’ mental health. All health professionals, wherever they work, are working with clients’ mental health.
2. That mental health services, alone, can ‘fix’ mental health conditions. All the evidence shows that children and young people do best when families/carers/other services and networks are engaged in a young person’s care.
3. That mental health services are risky places to work. In reality, we have many systems and processes in place to address risks, and, arguably, we may provide a safer environment as we are overt about managing risk and safety of consumers and staff.

What advice would you give to people who are interested in working in mental health?

There are a lot of high-quality websites that provide resources and training that you can access at no/little cost, e.g., Australian Childhood Foundation, Orygen Youth Mental Health, Emerging Minds. Peruse these widely, and if they pique your interest, ask a mental health clinician’s about how they got into mental health.