To say that the healthcare system hasn't a clue when it comes to mental health??

Whilst I agree with many of the points raised here (eg the medicalisation of distress, the modern habit of pathologising normal emotions etc) there is an awful lot of survivor bias here too.

There are people out there who are resilient, take responsibility, 'put in the work' at whatever unsatisfactory treatment they are given, if any, and don't make it, or are so marginalised in society that they can't come on mumsnet and tell their story about how they forced themselves to get on with it.

There are people who can't have children ' to break the cycle of abuse' because the abuse they suffered was so severe they can't tolerate touch however much they might crave it. Or maintain work or any relationships as their mind simply cant make emotional connections or are completely shut down.

And yes, I'm sure then will come the 'oh, but I don't mean those people'. But all we can do is speak from our own experience. If something worked for you that's great. But there is a long history of psychiatric/mental health treatments blaming the patient when it doesn't work.

And no, often they don't work (I actually think such treatment is pretty much as scientific as banging on a tv to get the picture back).
But I am concerned about the increasing tendency to talk in absolutist terms (not jist on this issue but everywhere). This goes just as much for those who declare every feeling of nervousness as 'anxiety' as those who go 'people need to take responsibility/build resiliance/I/my daughter/my next door neighbour managed to put one foot in front of the other and this is just what people need to do'.

Everyone is different. Which of course makes prescribing the right course of treatment for each individual impossible.

The sad truth is, sometimes there isn't an answer. Which, in a roundabout way, has been the consensus of this thread.

But I think what might help those for whom nothing has 'worked' regardless of engagement/non-engagement/perceived resilience/taking/not-taking of responsibility would be an understanding that your experience is not necessarily their experience and that most people are doing the best with what they were given in life.

I was sectioned with psychosis and the crisis team were ok. But after that the care was appalling and I went private where I got diagnosed with bipolar and treated. It's joke. I have serious mental health problems and can't get the help on the nhs!!

Actually I think the analogy with physical health is valid - there are many, many physical health problems that are hard to treat. To take the broken bone analogy - many are minor fractures and heal well, some fractures don't and cause permanent disability. Hip fractures have a high death rate. Most mental health symptoms are minor and either need no intervention or GP care. Some people will have lifelong symptoms but live an independent life, others have severe and enduring illnesses such as schizophrenia- with a variable level of treatment response. It's important to be realistic- no one can cure eczema or psoriasis, and some people will have very severe problems, but most have minor symptoms that respond to treatment. Mental health is underfunded but the level of expectation has gone up hugely and it's just not realistic.

CoffeeCantata

I completely agree with your posts. Completely.

I was first diagnosed with MH issues at 17. I've had hypnotherapy, seen numerous counsellors, a psychologist, psychotherapist, briefly had DBT etc.

I was diagnosed with GAD and depression when younger, nowadays through my own reading, self reflection and understanding, it looks more likely that its cPTSD through childhood and adolescent abuse trauma.

I've gained some strategies that get me through daily life but I'm not 'well'. I'm better than I have been in the past right now but it fluctuates. Sometimes, I'm worse.

Sometimes, I feel I can't get out of bed, sometimes I feel I can't leave the house and sometimes I cocoon myself away for months and have very little contact with anyone outside work. I often feel despair, suicidal, have a desire to implode my life, and escape it all.

But I don't have the 'luxury' of being overwhelmed and ducking out of life.

I have a full time demanding career (that I struggle with and feel the fear from every day as much as I also love it). I have a relationship that I'm running into the ground because I can't cope with it.

And every day, I just put those blinkers on, put one foot in front of the other and get on with it.

I have no family support. I don't have contact with the parent who abused me, and the other is dead. Both were only children. I'm early 50s. So there are no aunts, uncles, cousins, grandparents. I have one sibling who is also affected by the same trauma and our relationship is difficult as a result. I don't have any friends because I find it difficult to maintain and sustain friendships as a result of my MH.

I also have two adult children and have spent my.life focused on making sure the cycle of abuse was broken. I've protected them from my MH as much as I've been able to.

I was a single parent. I had to work and I had to provide for them. I had to make sure that they were protected as much as possible. And I have.

And i will be perfectly honest that things have been better in the last 10 years since I realised that there wasn't really a lot that the NHS could do in real terms because of the reasons *CoffeeCantata and others have given. *

There really is an extent to which you have to take responsibility for making positive changes. They're not a cure but they do help.

Removing people from your life who make it work, getting outside into the fresh air, exercise, eating well, drinking water. All the 'soft touch' approaches that are recommended do help. They're not a cure but they mainly give you a sense of agency in your own life. But, as others have said, so many people reject them.

Some people's.MH will be so severe that this makes no difference. It only makes some difference to mine. It's certainly not a cure.

I think there is very little understanding of what people.can actually do to help themselves. Because most people can even if it only helps a little.

I'm so sorry that you're suffering OP. It must be really hard and desperate at times. Well done for deleting social media, I agree it's not helpful in the slightest. Its only use is to make money (not for your bank account!)

I agree @BaklavaRocks though, the current comparison to physical health problems is not helpful. Both in terms of what the finite NHS resources can cater for and also what people can expect in terms of how to treat MH issues.

If you have a broken leg, it's because the bone is broken. Prescribe a cast/surgery to fix the bone and hey presto! Good as new.

If you are depressed.....well..
It's not as simple simple as prescribe six sessions of CBT and hey presto! All fixed!!

Therein lies the problem and why, even with all the money in the world, the NHS will never be able to solve for MH problems.

i guess the issue with this analogy is that there are only a certain number of ways to heal a fracture. Plaster cast, surgery, boot etc and the patientihht have set instructions to aid that recovery. MH is 100x more complex because recovery involves patient involvement, it requires engagement in a massive way. People scoff when their doctor suggests exercise, ‘well that’s not going to help’. No not on its own, it’s supposed to be part of a joined up approach to promote increased MH wellbeing. Some people don’t want tablets, some think CBT is a waste of time. The ways of helping people are hugely varied, the causes of MH can be associated to issues outside of healthcares remit, so how can we realistically improve MH if the source is say social circumstance. We have more and more people coming forward with MH issues and the healthcare system can’t cope. Sadly there is no quick fix.

Yes and then the patient will be blamed if it doesn't work or they even become worse.

Sorry you are struggling so much right now OP. I hope things get better soon.

Where is the evidence for this?

My ND dc had several debilitating NHS diagnosed conditions and didn’t get the therapy she was supposed to get. After being given a support worker that thought gardening and cbt exercises would solve everything to hold her and didn’t even scratch the surface it took a PALS complaint to get the therapy she should have had. Therapist then kept cancelling and she had half the sessions she should have had. Surprise surprise she’s still struggling with said conditions so back we go to do battle again.

I would like to point at that many ND young people are more likely to have MH conditions and end up needlessly on medication which STOMP is there to give protection from. Access to decent quality therapy done by properly qualified staff is crucial in this and it’s very difficult to access.

Young people are woefully let down by CAMHs and conditions get worse. They are then pretty much forgotten and left to scrabble around for themselves under adult services with transition and the 18-25 provision being particularly bad. It all backs up and treatable conditions become harder to treat.

That is not the fault of patients.

Sorry that was supposed to be @GreenTeaLikesMe

yes I agree with this 100%.

I think this conversation would go better if we could stop chucking "psychiatric illness" and "mental health problems" into the same box.

Some people need psychotropic drugs.
Other people probably can think themselves out of things to an extent (better lifestyle habits, societal stuff, CBT).

If the OP has BPD, then "mental health" is not really the right label to apply here. BPD is a psychiatric illness.

You are right.
I have known many people who had MH treatment via the NHS.... and complained bitterly that it was "shit", "didn't help" etc. Yet would admit the worksheets and homework they had from therapy sessions were dumped at the door when they got home and never looked at.
MH therapy is like physio for the brain. You have to do the exercises and homework, otherwise you are going to be stuck.

Most mentally unwell people want to get better but need good quality therapy done by well qualified professionals. It’s far easier to do the work when this is provided.

The higher tier treatments( not crappy CBT lead by somebody poorly qualified ) lead by high qualified staff and medications have been life changing
Exactly what I said. Psychiatry is mainly pharmaceutically led. You need a specialist to understand the specificity of each medication and the effects these come from. One person will improve massively on one drug whilst another will have horrific side effects, including suicidal tendencies.

The point is that if medication can't sort out the mental issues, there are not many interventions a psychiatrist can suggest. It then comes down to therapy. Therapy comes in different ways, but they all have one thing in common, they only work if the patient is fully engaged and accepting that they are the driver of the changes. They WILL have to push their comfort zones and face their boundaries and that is the very tough part and the ones that many patients sadly fail at. It's so hard to recover, and takes a long time, but is also so rewarding because it makes us so much stronger, understanding and resilient.

OP. You know you best. You know what it's like to live in your head.

What sort of mental health treatment do you think would be helpful?

What would your goals be?

What have you tried? Properly, genuinely, tried? Engaged with for months, putting into practice what you've been taught, including at the end of the sessions?

The NHS obviously isn't set up to offer open ended long term 'venting' type therapy, where you go each week and talk about how you feel for a bit of relief. It offers short term intervention, based on evidence-based treatment protocols, backed up by research. It is in line with NICE guidance, because it'd be unethical to offer treatment that doesn't have some evidence behind it that it's effective. However, it isn't effective for everyone. No one treatment is. Physical or mental.

A previous poster hit the nail on the head around why comparing mental and physical health issues isn't always helpful. The whole 'if you had a broken leg you'd see a doctor! If you have mental health problems see a therapist! It's no different!'

But it is different. Typically with a physical health issue you take the medicine or do the exercises or have the surgery as advised, and it will probably get better for most people. But mental health treatment requires a lot of effort and engagement from clients. No therapist is magical enough that they can simply heal people by being in the same room, when those people have usually had many years of repeating the same patterns, avoidance, withdrawing, or engaging in unhelpful behaviours. There's a reason when you start CBT that the therapist says 'this is not a talking therapy, it's a doing therapy, and if you don't 'do' the treatment, it won't help'. This goes for many mental health treatments. Because there's nothing magical anyone can say to make your mind work better.

It would be a good start to think about what you want, what you believe will help, instead of just generic 'mental health treatment'.

And about making the bed. It’s not about making the bed. It’s about making a choice, taking control, taking personal responsibility, a sense of achievement; however small it first is.

I agree with this. I have been sectioned with psychosis before (suspected schizophrenia as onset at 27). The nhs threw the kitchen sink at me for which I am forever grateful; section, psychiatrists, psychologists, CBT, medication, and preemptive care and monitoring during high risk subsequent periods - pregnancy and post partum with the perinatal MH teams.

And whilst NHS got me through the crisis period and stabilised me enough to be able to be able to think straight enough to begin working on myself; it was the work I did afterwards that has meant I am stable, medication free and back to my normal self. Relapse free 7 years on now.

That’s pretty much unheard of for 27yos with severe FEP. I am an anomaly. And I’m incredibly proud of how I have managed to rebuild my life. And I’m not minimising their input. The NHS provided scaffolding in a way to prop me up. Without that I wouldn’t have been able to have that chance. But afterthat it was 100% me and my thoughts, actions and circumstances that mean I am where I am today.

I have been receiving mental health treatment through the NHS since 2005. I. My experience the specialist services are very helpful. I have had great experience with the 16-19 services when I was a teen, the early intervention team I was with for 3 years when I was first diagnosed with bipolar, the perinatal team after having my daughter and the infant parenting service for bonding therapy. In between times I have been under cmht and they have broadly been hopeless aside from a bit of medication monitoring.

I have friends with MH issues, they've said the biggest help for them has been consistency.

Short term therapy doesn't help. They get to know the person then they're gone.

The ones who're managing the best have had the same physcatrist for years, or the same MH Nurse for years. Seeing that person consistently, a person who knows them and their situation so they don't have to keep explaining. People who don't come in and change their medication on a whim or who are happy to contact the people treating their other conditions so they have a consistent approach and so everything works together. Has been the biggest help.

NHS needs to focus on consistency and helping those people. There will always be people who claim MH issues and want to see those people to, but if the overall mh of the community/country improves then surely it's worth it?

Absolutely awful but I can't say I'm surprised sadly
I worked in the same trust where the Edenfield centre ( which is a medium secure facility for patients with severe mental illness and are being treated there rather than prison ( usually) waa exposed on Panorama ,a couple of years ago ,the behaviour of some of the staff was appalling.

I agree with this.

My sibling's MH (Schizophrenia) is so bad he lies on bed all day everyday in the dark (not because he's lazy but because it's the only.plave the voices don't find him). It would be incredibly difficult for him to change his bedding. Going for a walk would make a bug difference to him, and does help his mood a little if he's able, but he is too scared of the voices which bombard him when he leaves not just his home, but his bedroom, so he is often unable to.do this.

What do you think would make small positive difference to your MH OP? What do you think you need in order to recover? and why?

Don't be so dismissive. Small routine acts such as changing the bed or walking to buy the newspaper daily can actually be very helpful to people with severe mental health conditions like bipolar and schizophrenia.

I think they probably don’t - but then neither do patients.

Most of my patients think ‘a wee bitty sad today’ is depression and needs ‘therapy’

They have no idea about the severe and enduring mental health conditons people and the battle to ensure the limited resources go to those in most need, not those shouting loudest!