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especially in regards to the Joker like what. at least with Harley Quinn they made it so that she slept her way to the degree and didn't care about helping she just wanted the fame of working with famous gotham criminals

What are some examples?

maybe Good Will Hunting would be an example too. I mean come on, troubled youth / rebels against authority is not uncommon at all. All of these doctors would give up after just one session?

Malcolm Long in Watchmen kinda fits too. But again, they go the Harley Quinn route with him, saying that he only wanted to deal with Rorschach to get famous. And then after that he decides to help people for real. So it works to an extent.

basically I think this is kind of just a result of the fact that most writers aren't psychiatrists and don't write from that point of view. So it's an easy kinda Worf Effect way to show how C R A Z Y someone is. It's like the mental equivalent of making all the police incompetent even though in real life they wouldn't be?

But it just seems so unlikely when a psychiatrist can't figure out a character, yet the audience is able to. And yeah, I get that it's kinda necessary in most cases, because it is important to understand the characters. But I feel like Silence of the Lambs and Psycho did it kinda well. But then you have to be the mystery/thriller genre which all those other examples aren't. So I don't know.