The jobs where you’re a shoulder to cry on, but mental health training is rare

It’s easy for Paul Brooks to tell if the passenger jumping into the back of his taxi is up for a chat.

The veteran driver starts by offering different routes to get to the destination, which he says breaks the ice.

“That’s when they tend to start getting a bit chatty,” he says.

Mr Brooks has been driving in Melbourne for about 27 years, almost always on the night shift.

Often, the journeys end in a funny story. There was the time a young couple were discussing chucking a sickie and skipping work the next day, when Mr Brooks realised he knew the woman’s boss and told her “you probably should go to work tomorrow”.

If he had to put a figure on it, he’d say about 20 per cent of his passengers open up and share parts of their lives from the back seat.

“Sometimes when they get in, they say ‘just drive, get me out of here’,” he says.

“That normally leads to a longer conversation.”

He jokingly dubs this part of his work “free therapy”. But the 50-year-old says there’s a more confronting side to the job.

He’s one of the drivers registered to pick up people to remove them from domestic violence situations.

“And you’ll take a single person or a mother with a couple of kids, and they’ll try and get as much of their luggage and belongings in the boot, and you’ll drive them from one side of town to the other, or somewhere else,” he says.

As someone who witnessed domestic violence as a child, it can sometimes hit close to home.

He admits there have been times he’s left a job, driven around the corner and shed a tear.

Like most drivers, Mr Brooks has no formal training in mental health first aid, or how to deal with vicarious trauma.

But he often finds himself on the frontline.

On a recent job, he picked up a woman he believed was a mother. He says they stopped at a service station for her to buy a bottle of water and it then became clear she went to the bathroom to use drugs.

“You pick up fares like that, and I tend to think about it for the rest of the night,” he says.

As he talks, it’s clear he often finds himself thinking about the barriers for people on the margins of society to access help.

Vicarious trauma is just part of the job for some workers

The Commonwealth’s Australian Institute of Health and Welfare suggests about one in five Australian adults has experienced a mental disorder in the past 12 months.

The data indicates about half of Australians will experience a mental disorder over their lifetimes, with the institute noting “a person does not need to meet the criteria for a mental illness or mental disorder to be negatively affected by their mental health”. 

Psychiatry professor Andrea Phelps is the deputy director of the Phoenix Australia Centre for Posttraumatic Mental Health at the University of Melbourne.

The centre speaks to a range of people for mental health training and research. Many are involved in traditionally frontline jobs like defence or have experienced natural disasters.

Others work in industries where trauma may not be front of mind.

Professor Phelps says often, those workers have never thought about the impact interacting with distressed, traumatised or abusive people at work was having on them.

“They’ve just accepted that there are difficult calls that they have to take sometimes, and that kind of thing,” Professor Phelps says.

But exposure to other people who are experiencing difficult situations can cause vicarious or second-hand trauma.

“We’re not just talking about feeling empathy for someone, we’re talking about people who actually then suffer themselves, as a result of having supported someone else,” Professor Phelps says.

“And then that’s obviously something that we need to try and avoid.”

Playing the role of security guard, therapist and help desk

At the front desk at a busy bulk-billing medical clinic in Melbourne’s northern suburbs, Mary McCloskey’s job description is to take calls, sign in patients and help with office admin.

But she says she has somehow ended up being “a magnet for the more sensitive situations”, or for people seeking medical advice she is not legally allowed to give.

“And I suppose I’m a good listener, and don’t like to hurry someone off the phone when all I can offer is to hear what they have to say, and just be an empathetic human being with them in the moment,” she says.

Those more personal conversations became more frequent during Melbourne’s extended lockdowns — something Mr Brooks notes about the taxi industry too.

The pandemic also saw an increase in abusive behaviour directed towards retail and hospitality staff, especially as mask and vaccine mandates came into effect.

Ms McCloskey strongly remembers one conversation in particular, when Victoria introduced vaccine mandates last year. A man told her over the phone he would self harm if he was unable to get an exemption from a doctor.

She kept talking to him, “essentially just trying to keep him on the phone so that he could calm down with me, and feel heard”.

“By the end of the conversation he had calmed, he apologised for what he said and I told the doctor to call him as soon as he had a chance,” she says.

She says she and her fellow receptionists have received customer service training and got group advice from a counsellor.

But she still summarises the impact on her mental health as “brutal” and would love to have more training.

The ‘three d***head rule’ and other coping strategies

Professor Phelps says there are broadly three ways vicarious trauma can present — feelings of psychological distress or helplessness, intrusive thoughts and/or physical symptoms like tension and increased heart rates.

Longer-term, people experiencing vicarious trauma can feel perpetually on edge, have disturbed sleep and begin to withdraw socially. Some people use drugs or alcohol to cope.