Interview with one of TAASC's founding members: Dr Etienne Muscat

Not immune to the social stigma that has long surrounded the topic of mental health, Dr Muscat discusses how psychiatry ‘chose him’ when he was still a nervous doctor-in-training, and the misconceptions he has seen influence other individuals’ attitudes towards his field in the 15 years he’s been practising. He also describes his role as one-third of the team behind the creation of TAASC, and why he is so proud of what TAASC has achieved in the 4 years since its inauguration.


What do you think is the biggest misconception people have about the field of psychiatry?

I believe that by far the biggest misconception, worldwide, is that you need to somehow be seriously mentally ill to speak to a psychiatrist. The second interpretation of psychiatry which is far from being correct is that if you go to a psychiatrist then you have to take medication.


So, what is it then that you wish was more widely understood about treatment for mental health?

What I wish more people understood is that all of life’s problems fall on a spectrum. In fact, the vast majority of individuals struggling or having difficulties coping emotionally are not seriously mentally ill but would benefit all the same from accessing mental health services. A whole range of mental health resources exist, and preventative care as opposed to only interventional treatment may be appropriate to help with reducing the rates of serious emotional difficulties and/or preventing further deterioration of someone’s mental health.


When did you decide you wanted to go into psychiatry?

I had to go in by force! I actually hated psychiatry as a student [reasons being] the hospital it was at, because of the way the experience was structured, because I had no real experience as to what psychiatry was… so I felt as though we were thrown in the deep end with patients we were scared of - though now I realise such feelings were influenced by the stigma that did and unfortunately still does exist around mental illness. But as part of my ‘house officer’ training I was obliged to do a penultimate rotation in psychiatry. I remember arriving that first day almost physically sick with nerves, and only a few days later finding I was completely in my element. Before the end of the rotation I had decided to become a psychiatrist, after having planned to be a gynaecologist for a number of years.


As a founding member of TAASC, what was the impetus behind its creation?

TAASC initially started as an assessment pathway, not a general mental and behavioural health hub. As a small team we felt the clinical assessments that had been going on at the time in Malta were far too individualistic – in the sense that it varied by professional, with each one using a limited assessment to give kids a label which would be life-long. This was simply unacceptable and intolerable in other countries, so we thought to emulate the more holistic approach we had each viewed abroad. This involved a number of professionals with multiple assessments working together to reach a far more reliable and realistic consensus as to a single patient’s needs.

Nigel and Kristina, the other founding members, had actually worked in England where such a system was in place, whereas I was the one who felt strongly that psychiatry in Malta was lagging in such structures from my own experiences and wanted a change. So, the 3 points of views together were a good fit.


And what is your favourite thing that TAAASC has achieved over the past 4 years?

On a purely personal level – I am proud of our team for managing to create this set-up and a unique clinical practice from scratch. I am also immensely proud of each team member; the professionalism and personal qualities they add allow us to constantly achieve our goal of providing multi-disciplinary assessments and guidance to people who are asking for help. The strength of TAASC truly lies in its diverse and extremely capable members.


And finally -  what is your top tip for anyone going through tough times and feeling overwhelmed emotionally?

Make sure to keep lines of communication open with the people who are close to you.