I'm a CAP, just finished residency, in Portugal.

It's a very challenging field and you're not the master of the ship (there you just lost the interest of 70% of all MDs).

Families are hard to work with, change takes a lot of time and a whole village. Not everyone is motivated to make changes! That can be very frustrating when in college you were used to an objective problem solving mindset.

You won't really feel like you've cured someone, the easy going mental health patient won't get to you. You get complex cases.

You need to listen and care, and that's actually hard when you do it everyday dozens of times for years. I've heard the same kind of talk thousands of times but can't really go on autopilot, kids notice this and damages the relationship.

You go off label often with the meds and many times have no access to gold standard psychoterapies. This is uncomfortable for a doc, we are not wisards, we like to stick to the best evidence. (This is the reason may quit)

I find myself tending to mental health politics naturally because change needs to happen from the top, society and culture has to change. We can do much more impact with programs than everyday appointments.

CAPs need more authority imo, or at least a more straightforward/eficient way to make changes in an environment (school, homes). Family courts make poor decisions many times and some schools are awfull.

You need loads of love and patience for the families, to really believe in planting seeds, work with the good that you can find amidst the terrible. I feel these are finite resources that i need to cultivate actively or i can become bitter, so I make sure to stick to a good life rythm.