Daniel Milošević – Psychologist working with youth


S: Hi Daniel, thank you for coming to us today, for giving us your insights as an expert and as a young person. I would just like to start by asking you to briefly introduce yourself.

D: Thank you Sara for the invitation and thanks to everyone who participated in this wonderful project. I’m Daniel, I have a master’s degree in psychology. I’m currently working in the Center for the protection of mental health of children and young people at the Teaching Institute for Public Health “Dr. Andrija Štampar” in Zagreb. In addition to currently working in the field of clinical psychology, I have been quite active in the field of mental health. More specifically, I was working with young people on mental health. That’s some brief information about me.

S: Great, thank you very much. Here we have a few questions for you, so we are interested in what you have to say. The first thing we are interested in is whether the approach to mental health should be gender sensitive and in what way?

D: Thank you for asking. I think this is an extremely important issue and that an approach to mental health that isn’t gender sensitive is not really a good approach to mental health. Somehow it seems to me that the definition related to a person’s gender identity is woven into mental health. This is important because we live in a diverse and rapidly changing world, and in order to help a person in the way they need help as an individual, we must respect all parts of them. One part of them is their identity, and therefore their gender identity. A person’s gender identity is something that affects their entire life and is actually, in a way, important for therapeutic and professional work with people anywhere, not only in the field of clinical psychology or psychotherapy, but also in other spheres of life. A gender sensitive approach is important through, for example, use of language, to ask a person what their pronouns are, so that when we talk to them, we do not assume the sexual identity that is inherent to the person. Let’s say, in Croatia, we live in a fairly traditional society that is hetero-normative, where it is assumed that if a person of the female sex comes to us, or a person of the male sex, that immediately when we ask them about their relationship or marital status, we assume that this person has a male or female partner. That a woman has male partner and a man has a female partner. The easiest way to resolve this is to be gender inclusive and ask the person if they have a partner. Then the person has the freedom to say “Yes, I have” and to refer to their girlfriend or to refer to their husband if it is a woman who identifies herself that way. Therefore, I think that these small steps in gender inclusion are very important, especially in working with young people.

S: You said that these gender roles are very important, so can you say something more about how gender roles and identities affect an individual’s mental health?

D: As such, the individual is a part of the environment in which they live. We as humans are social beings and we need the environment very much. We can’t function without it, and it can’t function without us either. What is important about this gender approach is that there are some norms and some gender roles that are already assigned in advance, to the male and female genders, and then an individual who was born as male, for example, is expected to behave in accordance with the male gender role. Then the male gender role for him has certain predetermined sets of behavior that relate not only to the behavioral level, but also to the emotional and cognitive level. And then we have little boys who cry and you often hear: “Don’t cry, you’re a boy” because according to the male gender role, it’s not really typical for a man to show his emotions. Fortunately, some of those concepts are changing nowadays, and those norms have changed a bit, but there is still this narrative that women and men should behave a certain way. And with that, I think there is no problem on average, because on average women really behave in a certain way, and men in a certain way, but this is not the case for every individual in general. So, it is difficult when we generalize that assumption because there are individuals who do not fit into such gender norms and roles. It is important to give them the message that what they feel is not something wrong and bad and that they can actually exist in this world free and authentic as they are.

S: You’re an expert, so can you tell us what any youth worker can do to support youth mental health and break down the stigma around mental health issues?

D: My message to the experts is that they should renew all the professional knowledge they have. The times are simply such that knowledge changes every day, new scientific papers are published and new paradigms are created. After a few years some things change, the view on them changes, and then it is important to follow that part with knowledge and get information at professional spaces. What is even more important for anyone who works with young people and with people in general is to be open and allow the other side to be who they are.

S: So now let’s expand the perspective a little more. You’ve already mentioned some of these things, but you can tell us more about what young people need in general when it comes to mental health. Perhaps you could briefly tell us how today’s youth view mental health?

D: The fact that mental health is an integral part of health is something that the population is not yet fully aware of and that there is still some shame associated with all the diagnoses and difficulties linked with mental health. It seems to me from my practice that young people are more aware of their mental health. If anything, they are conscious to the extent that they call some things by their name. They will not say that they are having a bad day or that the universe conspired against them like maybe some adults, but they will say that they are angry or that they are sad or that someone has hurt them. They will talk about their emotions, which is something that is very important for every person, including young people. On that side, I would say that they get a lot of information about mental health, that it is something that is important to them. Media content is such that it simply sensitizes them to certain things and determinants of mental health. It is our duty as experts working in that field to protect them, because they have access to a huge sphere of information that is not controlled and completely accurate. It’s not the smartest thing to follow diagnoses from TikTok and think that you have OCD just because you like things to be neat and nice on your table. This is something that should be taken into account and what is always very important with young people is to give them a chance to tell us what is bothering them. Even if our first instinct is to wave our hand and say “Come on, don’t bother me, you’re fine” just because the person seems fine. So it seems to me that we won’t make a mistake if we listen to them or if we react to something that may seem hard or something that’s actually good for them, at least we will send a message to the person that we are there for them, that we are ready to react. It seems to me that when it comes to mental health, that is always better than just letting it go and whatever happens, happens. So I think we need to protect them, we need to send a message that they are still young and that certain levels of responsibility are not yet for them, that they can still enjoy their youth, be reckless, impulsive and explore the environment and the world they are in, but at the same time give them consistent and clear rules about that environment. That we, as adults, are the ones who are their guiding thread. It can often be the case with mental health that people get scared: “Oh, if they’re sick, if they have anxiety or something, now I’ll have to be with them all the time, I’ll have to hold their hand and they won’t be able to let go.” There are some cases where people really need such care and attention, but in most cases they need guidance and to be told: “Okay, what do you think? You are currently on that path, what do you think about the other one? Is it even visible to you now? Can you even see that other path that you have here from the state you are in? Does it make sense to you?” It is important that we generally take what they tell us seriously, but still keep in mind that on the other hand, we are the person who thinks critically and who has more experience in the world than, say, that young person has.

S: Thank you very much Daniel, there was a lot of useful information here and I believe that we could go on like this forever, but thank you very much for your contribution and I believe that this will truly help young people.

D: Thank you very much Sara for the invitation, it was very nice talking to you.

S: Bok Daniele, hvala ti što si nam došao danas, što ćeš nam dati svoje uvide kao stručnjak i kao mlada osoba pa samo bi te pitala za početak da nam se ukratko predstaviš.

D: Hvala ti Sara na pozivu i hvala svima koji su sudjelovali u ovom divnom projektu. Ja sam Daniel, magistar sam psihologije. Trenutno radim u centru za zaštitu mentalnog zdravlja djece i mladih pri nastavnom zavodu za javno zdravstvo „Dr. Andrija Štampar“ u Zagrebu. Uz to što se bavim područjem kliničke psihologije trenutno, dosta sam bio aktivan na polju mentalnog zdravlja. Konkretnije, u radu s mladima baš na mentalnom zdravlju. To su neke kratke informacije o meni

S: Super, hvala ti puno. Evo imamo par pitanja za tebe pa nas zanima što nam imaš za reći. Prvo što nas zanima, treba li pristup mentalnom zdravlju biti rodno osjetljiv i na koji način?

D: Hvala na pitanju. Mislim da je ovo izuzetno važno pitanje i da pristup mentalnom zdravlju koji nije rodno osjetljiv zapravo nije dobar pristup mentalnom zdravlju. Nekako mi se čini da je u mentalno zdravlje utkana i ta definicija koja je vezana uz rodni identitet osobe. To je važno zato što živimo u raznolikom svijetu koji se brzo mijenja i da bismo mogli pomoć osobi na način na koji je njoj pomoć potrebna kao individui, moramo poštovati sve njezine dijelove. Jedan dio nje je i njen identitet, pa onda samim tim i rodni identitet. Rodni identitet osobe je nešto što utječe na cijeli njen život i što zapravo, u neku ruku, je važno za terapijski i za profesionalni rad sa osobama bilo gdje, ne samo u području kliničke psihologije ili psihoterapije nego i u drugim sferama života. Rodno osjetljiv pristup je važan kroz recimo jezičnu stavku, da osobu pitamo koje su njene zamjenice koje koristi, da kada razgovaramo s njom ne pretpostavljamo seksualni identitet koji je svojstven osobi. Recimo, u Hrvatskoj, živimo u dosta tradicionalnom društvu koje je hetero-normativno gdje se pretpostavlja da ako je u pitanju osoba ženskog spola, a dođe kod nas, ili muškarac odnosno osoba muškog spola da odmah kad ga pitamo za stanje veze ili za bračno stanje pretpostavimo da ta osoba ima partnera ili partnericu. Žena muškarca, a muškarac ženu. Tome možemo doskočiti najjednostavnije, biti rodno uključivi, i osobu pitati imate li partnera, odnosno partnericu. Tu osoba onda ima slobodu da kaže „Da, imam“ i da se referira na svoju djevojku ili da se referira na svog supruga ako je u pitanju žena koja se identificira na taj način. Stoga, mislim da ti neki mali koraci kod rodne uključivosti su jako važni, a posebice u radu s mladima.

S: Pa rekao da su te rodne uloge jako važne pa možeš nešto reći više kako rodne uloge i identiteti utječu na mentalno zdravlje pojedinca?

D: Pojedinac je kao takav dio okoline u kojoj živi, znači mi kao ljudi smo socijalna bića i okolina nam je prijeko potrebna. Mi ne možemo bez nje, a ne može ni ona bez nas. Ono što je važno kod tog rodnog pristupa jest da postoje neke norme i neke rodne uloge koje su već unaprijed pripisane, muškom i ženskom spolu, odnosno muškom i ženskom rodu, i onda se od pojedinca koji se rodio u muškom spolu, recimo, očekuje da se ponaša u skladu sa muškom rodnom ulogom. Tad muška rodna uloga za njega ima određene već unaprijed propisane setove ponašanja koja se odnose ne samo na ponašajnu razinu, nego i na emocionalnu i kognitivnu razinu. Pa onda imamo male dečke koji se rasplaču i često se zna čuti: „Nemoj plakati, ti si dečko“ jer prema muškoj rodnoj ulozi, za muškarca nije baš svojstveno da pokazuje svoje emocije. Na sreću, neki od tih koncepata se mijenjaju u današnje vrijeme, a onda su i te norme malo se promijenile, ali i dalje postoji taj neki narativ da bi se žene trebale ponašati na određeni način i muškarci na određeni način. I s tim ja mislim da nema neki problem gledano u prosjeku jer prosječno se žene zaista ponašaju na određeni način, a muškarci na određeni način, ali to nije tako za svakog pojedinca generalno. Dakle, teško je kad generaliziramo tu pretpostavku jer postoje individualci koji se ne uklapaju u takve rodne norme i uloge i onda je važno i njima dat poruku da to što oni osjećaju nije nešto krivo, nije nešto loše i da zapravo mogu postojati u ovom svijetu slobodni i autentični takvi kakvi jesu.

S: Ti si stručnjak, tako da možeš nam reći možda što svaka osoba koja radi s mladima može učiniti kako bi podržala mentalno zdravlje mladih i razbijala stigmu o problemima mentalnog zdravlja?

D: Pa nekakva moja poruka prema stručnjacima je ta da sva stručna znanja koja imaju obnavljaju. Vremena jednostavno su takva da znanje svakim danom se mijenja, izlaze novi znanstveni radovi, stvaraju se nove paradigme i već nakon par godina neke stvari se promijene, promijeni se pogled na njih i onda je važan taj dio sa znanjem svakako slijediti i informirati se na stručnim mjestima. Ono što je još važnije za bilo koga tko radi s mladima i s ljudima je da uslijed te svoje otvorenosti dopusti drugoj strani da bude takva kakva je.

S: Pa evo onda da sada još malo još više proširimo perspektivu. Već si spomenuo neke te stvari, ali zapravo možeš nam još reći što mladima općenito treba kad govorimo o mentalnom zdravlju. Možda da nam ukratko kažeš kako današnji mladi gledaju na mentalno zdravlje?

D: Činjenica da je mentalno zdravlje sastavni dio zdravlja je nešto što bi rekao da kod populacije još baš nije sasvim osviješteno i da postoji taj neki sram vezan uz sve dijagnoze i poteškoće koje se vežu uz mentalno zdravlje. Nekako mi se čini iz prakse da mladi ipak jesu osvješteniji o svom mentalnom zdravlju. Ako ništa, osvješteni su utoliko što neke stvari nazivaju svojim imenom, pa onda neće reći da imaju loš dan ili da se svemir urotio protiv njih kao možda neki stariji, nego će reći da su ljuti ili da su tužni ili da ih je netko povrijedio i zapravo će razgovarati sa svojim emocijama, što je nešto što je jako važno za svaku osobu, pa tako i za mlade. S te strane bih rekao da imaju dosta informacija o mentalnom zdravlju, da je to nešto što je njima važno. Medijski sadržaji su takvi da ih jednostavno senzibiliziraju na određene stvari, odrednice mentalnog zdravlja, ali tu je zapravo naša dužnost kao stručnjaka koji rade u tom polju da ih zaštitimo, jer oni kao takvi imaju pristup ogromnoj sferi informacija koja nije kontrolirana i posve točna. Slijedit dijagnoze s TikToka nije baš najpametnije i pomisliti da imaš OKP samo zato što voliš da su stvari uredne i da lijepo stoje na stolu. To je nešto što treba uzeti u obzir i ono što s mladima je uvijek jako važno je dati im šansu da nam kažu što ih muči. Čak ako nam je prvi instinkt odmahnuti rukom i reći „Ma joj ajde, pusti me, nije ti ništa, dobro si“ samo zato što osoba izgleda dobro. Tako da meni se čini da nećemo napraviti pogrešku ako poslušamo osobu, da nećemo napraviti pogrešku ako reagiramo na nešto što možda i nije neka prijeteća ili ugroza od opasnosti li nešto što je najbolje na svijetu, barem ćemo poslati poruku osobi da smo tu za nju, da smo spremni reagirati. Meni se čini da je kod mentalnog zdravlja to uvijek bolje nego samo pustiti pa šta bude, bude. Tako da mislim da ih trebamo zaštiti, trebamo ipak poslati poruku da su i dalje mladi i da određene razine odgovornosti još nisu za njih, odnosno da još mogu uživati u toj svojoj mladosti, da smiju biti nepromišljeni, impulzivni i istraživati okolinu i svijet u kojem se nalaze, ali jednako tako im dati dosljedna, konzistentna i jasna pravila o toj okoli. Da mi budemo, kao odrasli, ti koji smo njima nit vodilja. Često zna biti slučaj s mentalnim zdravljem da se ljudi uplaše: „Ajoj, ako je ona bolesna, ako im anksioznost li nešto sad ću ja stalno morati bit s njom, morat će ju držati za ruku, neće ju moći pustiti.“ Postoje neki slučajevi gdje je zaista potrebna takva njega i skrb osobama, ali u većini slučajeva njima treba putokaz i da im se kaže: „U redu, što misliš? Sad si trenutno na tom putu, što misliš o ovom drugom? Jel’ ti je on uopće vidljiv sada? Jel’ uopće možeš iz stanja u kojem jesi vidjeti i taj neki drugi put koji ti je ovdje? Ima li on za tebe smisla?“ Važno je da generalno to što nam kažu, da shvatimo ozbiljno, ali i dalje imati na umu da smo s druge strane mi ta osoba koja kritički promišlja i koja u svijetu ima nekog više iskustva nego što recimo ta mlada osoba ima.

S: Hvala ti puno Daniele, ovdje je bilo jako puno korisnih informacija i vjerujem da bi mogli ovako u nedogled, ali hvala ti puno što si dao neki svoj doprinos i vjerujem da će mladima ovo pomoći.

D: Hvala ti puno Sara na pozivu, bilo mi je baš lijepo razgovarati s tobom.