Who is the best psychiatrist, therapist or mental health specialist?

What drives the question?

Ever since moving back to Kuwait two years ago and starting my practice as a psychiatrist in both the worlds of academia and clinic, a question I get constantly is “Who is the best psychiatrist in Kuwait?” People want to know who is top-ranked and leading. In fact, I don’t only get this question from Kuwait, I’ve gotten it from every Arabian Gulf (GCC) region I’ve visited including Abu Dhabi, Bahrain, Dubai, Oman, Qatar and Saudi Arabia. I’ve gotten some version of this question from the wider Arab region as well from as far as Egypt, Jordan and Morocco. I’ve had the opportunity to reflect on this question recently. Because before answering I want think about what the source of this question is… In other words what drives the question? I believe that this question stems from three main reasons:

1. There are many unmet needs in mental health in Kuwait and the wider region. There are few specialists and many individuals working in mental health care with insufficient training. People asking the question “who is the best?” may simply be trying to save time by going to a “competent” person right from the beginning, or they may be searching for a better experience after having a poor past experience with a less-than-competent provider.
2. Mental health stigma is present throughout the world. Many people carry a negative view of mental illness and those who work to treat it. This stigma and negative view is especially high in the Middle East, specifically the Arab world. Therefore, by the time someone has worked up the courage to see a psychiatrist or psychologist in the face of this cultural stigma, they are worried about seeing someone who will do them more harm than good. I once saw an unpublished but interesting research finding from a colleague in Kuwait, that the highest contribution to negative views about mental health in the country were caused not by culture, but by a negative past treatment experience with an incompetent clinician.
3. The last reason, people search for the “Best,” the “Top,” and looking for a “Ranking,” is because this is the mentality we are all entrained to in the age of social media, search engines and online magazines. I’m not passing a judgment on this mentality (although it does have negatives), I’m just stating that it exists.

What is the question that should be asked?

Rather than asking for the best I recommend the following 5 important questions to ask when searching for a mental health care provider. Other than these 5 questions, finding the “best” is really a matter of finding the provider you feel most comfortable with.

1. What kind of training do they have? There is not one perfect kind of training. It depends on the type of specialist you are seeing. For moderate to severe mental illnesses you will need the input of a medical doctor, in other words a psychiatrist. Make sure the psychiatrist you see is a graduate of an accredited medical school and has completed specialty clinical training in psychiatry at a reputable residency training program. Some regional psychiatrists have research or academic training, but not clinical training. Ideally, a psychiatrist should have trained in all three, but the very least in order to take care of “real world” patients would be clinical training. To ensure that your psychiatrist has clinical training they should have taken a specialty board exam and designate this. For example, the DipABPN — American Board of Psychiatry and Neurology (USA) or the FRCP — Fellowship of the Royal College of Psychiatrists (UK) or the FRCPC — Fellowship of the Royal College of Physicians of Canada (FRCPC) and others. Sometimes psychiatrists have added sub-specialty training in a specific area in psychiatry, such as Addictions or Child & Adolescent or ADHD or Schizophrenia or Addiction or Mood & Anxiety disorders (like depression, bipolar disorder, panic disorder and generalized anxiety). This is not a must as any psychiatrist can diagnose and treat the broad spectrum of general psychiatric presentations. But it is definitely of added value if the psychiatrist you see happens to specialize in your problem area. Psychologists and therapists have other qualifications you should be careful to look at, especially Masters or PhD level training, and it is important that the focus of this training is counselling or clinical psychology. A therapist may also have added training from a specific psychotherapuetic institute or school, and this would be excellent as training at these types of institutes mandates a certain logging of “hours in training” before qualifying for independent practice.
2. Where did they do their training? Make sure that your specialist trained at a reputable and well-known university or institute. There are some centers with an indisputable positive reputation and others that are excellent, but not well-known, and still others that are known as not good. Do your research.
3. Are they licensed by the Ministry of Health and what professional memberships do they have? Make sure that any specialist you see has an up to date license from the relevant regulatory bodies and authorities. Most Ministries of Health ask for a renewal of the licence every 5–10 years, so you should make sure your provider has done so. In addition, a psychiatrist with a board certification will have to stay up-to-date with their medical knowledge and prove that to the regulatory bodies in order to remain certified. This is done through a process called CME — continuing medical education.
4. Do they have any past incidents or findings? What is meant by this is were they ever found guilty of unsafe practices or ethical or legal breaches of conduct by their regulatory body. I would say 99% of practitioners don’t have this problem. But its always better to check before you decide to start a treatment relationship with your specialist. Admittedly this is not so easily done in the region. If your provider trained in the US, UK or Canada, you can often look up this information online at their regulatory body where they trained.
5. Do they take their time with patients and maintain a holistic approach? This is the hardest piece of information to find out, but is one of the most important. First ask around! A great source of information is your local family doctor. They may know of specialists that meet this criteria from their connections in the medical community. Of course, you could never find out any information from a doctor’s current or ex-patient, without the patient telling you them self (because of doctor-patient confidentiality), but if someone happens to tell you they had a good experience with a psychiatrist or therapist, this is a good sign. Lastly, you can decide after your first appointment whether you want to continue with this specialist or seek care elsewhere. If you are not comfortable there is no rule that says you have to continue.

In the end, what matters the most is that you seek care if you are suffering. There are many great psychiatrists, psychologists and therapists out there. Follow the tips I mentioned above and find the person you are most comfortable with. But get mental health care if you need it! Because to borrow the slogan from the WHO: “There is NO health without MENTAL HEALTH.”

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Dr. Mohammad Alsuwaidan is a psychiatrist and Head of the Mental Health Unit at Mubarak Al-Kabeer Hospital in Kuwait. He is an Assistant Professor of Psychiatry at both Kuwait University and the University of Toronto. He has trained at the University of Toronto, Stanford University and Johns Hopkins University. He is a Fellow of the Royal College of Physicians of Canada and a Diplomate of the American Board of Psychiatry and Neurology. More information at www.AlsuwaidanClinic.com