What thing would help people's mental health

evidence based medications can be highly effective for many mental health disorders, and for many disorders psychological therapy AND medication gives the best outcomes
for some disorders - medication is unlikely to alleviate the problem e.g personality disorders but may ease some of the symptoms, whilst therapy - the right one - is more likely to be more effective

I think that pp’s have made lots of good suggestions on this thread already. But given that 8.3 million people in the UK are on ADs, it’s obvious that something is going badly wrong somewhere.

The stiff upper lip of old and the trembly bottom lip of today, are the extremes. Somewhere in-between the two should be aimed for?

Let’s not diss the people who are actually willing to train and work with people with mental health distress-
they get paid peanuts,
they don’t go into a caring profession for an easy ride
using their normal voice that u can’t relate to because of your trauma background is a good place for you to explore what communication can be like in a non abusive / therapeutic relationship

You’re missing the point. Most people won’t get the right help. My Mum has spent my entire life in and out of psychiatric units, often sectioned for two years at a time. Apart from being coshed by drugs and having her brain fried with ECT (which didn’t help her at all) she has never been given any suitable treatment, and she is just as unwell now as she was 40 years ago. She has never been given any talking therapies.

I have cPTSD since childhood. All I’ve ever been offered on the NHS is six sessions of counselling at a time, which never even scratched the surface. Most counsellors I’ve seen have been out of their depth.

Eventually I was forced to pay privately for years of psychotherapy which cost the best part of £20,000. Most people couldn’t afford that. NHS treatments are not fit for purpose. People just get put on antidepressants which can have terrible side-effects and are scientifically no more effective than a placebo because GPs can offer very little other treatment options.

If mental health support in this country is so good, why are so many people on antidepressants? Surely they’d all be cured by now.

Totally agree. And the internet has made things so much worse.

You say you didn't hear the term "mental health" when growing up but that's probably because it is a more modern understanding that it can be unhealthy to bottle things up and squash them down for decades.

My grandparents (born 1920s) were terrified of feelings and would explicitly shut them down, I think because they were genuinely worried if they gave it air space it would take over. They went through some horrific things in their lives and the idea of going to a therapist to process it would have been absolutely alien to them. I think they had the idea that only mad people did things like that. When workhouses and asylums were still in living memory I imagine that the prospect of being diagnosed with a mental illness was absolutely frightening if it meant you could be carted off to an institution.

Their first son died, in the 1950s and people genuinely did avoid my grandma's eyes and would whisper to each other "That's the woman who lost the baby" when she walked past.

I've worked with people who have had to turn down therapy on the NHS because they couldn't take time off work without disclosing the reason to their employer and they felt they would lose their job, be treated differently or not be supported if they spoke about their Mental Health

I’ve had the same with my DD and CAMHS. She was very fortunate to get open ended therapy with an excellent clinician, weekly sessions meant missing school because there were no appointments outside of school hours. So her attendance was never above 90%, which caused issues at school and meant disclosing she was seeing a therapist - which she would rather have kept private. It also meant me taking a half day off work to take her which also meant disclosing to my boss. Thankfully I have a very supportive employer but if you don’t have that or don’t get paid time off, weekly sessions in work in hours would be prohibitive. Not to mention there’s no public transport option from my town to the CAMHS base, so if I couldn’t drive she wouldn’t be able to attend.

So many barriers even after getting the golden goose that is an actual therapeutic service.

It starts early. Stop child abuse, end poverty, support new mothers , bring back the village.

For me personally I didn't get the help I needed because my mum neglected me. She saw my cuts on my arms, knew I was depressed and refused to take me to a Dr or to get any help because she saw it as a reflection on her parenting (which it was but it was also my own mh issues lol). Now I'm on meds and feel better ish (mostly because I'm NC with my mum)

Here's one. Don't tell patients who have had a lifetime of trauma and abuse and misunderstanding due to undiagnosed autism to 'try smiling when you're angry'.
And this was from secondary mental health care.

The NHS mental health system is totally broken. Highly recommend "You Don't Have to Be Mad to Work Here" by Benji Waterhouse - his account of the system from the inside.

Years ago it wasn't referred to as 'mental health' no, it was called having 'nerves', having a nervous breakdown, people in mental hospital were called maniacs and mad and crazy.

If you’re a shit one( and you don’t sound great) yes. Within the NHS the shit psychiatrists are well known to other professionals, MDT teams and patients. We’ve come across them but also amazing life changing psychiatrists.

I'm actually phenomenally good. 20 years I've been qualified and never had a single patient suicide. Not many psychiatrists can say that

But I'm tired and starting to suffer from compassion fatigue, definitely. It's a very difficult job, and more and more general shit-life syndrome has become the role of psychiatrists over the course of my career

I have all the time in the world for serious mental illness, and paradoxically it's actually at the easier end of the treatment scale because it's so well described and so prescriptive

It's the other stuff, the mixed anxiety and depression (which isn't really even a diagnosis, it's a catch-all label for people who aren't really psychologically well, but don't really have something you can clearly diagnose). I can't do much for people who just make bad decisions, except try to help them make better ones, which is impossible if they won't sign up. This never used to be something I would find on my patient list, but now it's every second or third person.

I don't have the answers but something somewhere is going very wrong

There are so many elements to this.

Through my work I come across a lot of people who struggle to access NHS Mental Health services for many reasons.

They are told they can't have therapy until they've stopped drinking to excess or taking drugs, but the reason they're drinking to excess or taking drugs is because they've been self-medicating for low mood, childhood trauma or anxiety. So they're signposted to AA but the religious element and the potential awkwardness/social anxiety of group support is alienating to some people and it also doesn't address the Mental Health reasons why they became dependent in the first place.

I've worked with people who have had to turn down therapy on the NHS because they couldn't take time off work without disclosing the reason to their employer and they felt they would lose their job, be treated differently or not be supported if they spoke about their Mental Health. I've also worked with single parents who couldn't attend appointments due to having no childcare or because they have caring responsibilities for an adult partner or family member and no one to cover.

There might be cultural barriers, stigma or lack of understanding on the part of Mental Health professionals about the persons specific ethnic and cultural background and how this impacts on their experience of emotional distress. There are some communities where it is still widely believed that Mental health problems do not exist, or where talking to anyone outside of your own family about problems is very much discouraged.

Staffing and resource is a massive issue. I worked with a child who was open to the Mental Health crisis team for intensive 'home treatment' as there were no hospital beds available. They were visited by a different MH clinician every time so they never got to trust or build a rapport with any of them. The people I work with who are open to Adult MH services experience frequent change of workers, temp agency workers, workers go on long term sick with stress etc. Having to tell your story over and over, getting to like and trust someone then they disappear and are replaced by another stranger, can be really difficult.

Having to navigate the endless beaurocracy of the system is also pretty soul destroying. Being bounced around between different services and teams, endless form filling and phone calls, then when you finally get to see someone for an assessment after waiting months or even years they tell you they're not the right service for you so you need to go back to your GP and ask for a new referral, to be placed on another waitng list and no one properly explains who does what and what is the difference between all these teams and services...it's enough to drive you mad on its own.

To be honest, I've also worked with people who have had wildly unrealistic expectations of what "help" for their Mental Health looks like, so then they inevitably feel let down by what is actually available. Some people also don't understand that the act of 'going to therapy', as in turning up every week and sitting in the room for 50 minutes, is unlikely to lead to meaningful change on it's own. You generally have to put the strategies into practice outside of your sessions, not just talk about them. Some people don't want to do that, or don't feel able to do that. Some people also seem to pin all their hopes on therapy but then aren't willing, ready or able to make other changes in their life, work or relationships to address the root cause of their issues, so they blame the therapy or the therapist when they don't feel any better.

Too many therapists have done a relatively short, shallow qualification and just don’t have the breadth of knowledge they need.

I completely agree @Jellycatspyjamas. We’re in the US where it’s easier to access help ( presumably because you pay them directly, they often don’t take insurance) but we had exactly the situation that you describe when DD and DS needed help with anxiety. DS’s counselor was great, he gave him techniques and tool to help manage the anxiety. After some months, DS said that he felt much better and hasn’t needed counselling since.

DD saw a counselor in the same practice
( she preferred to see a woman) who was very nice, but just listened and empathized. DD became frustrated at the lack of tools and as this was after DS’s experience, we knew that it wasn’t good enough. I don’t think it was the counselor’s fault exactly, she wasn’t as well-qualified.

DD now sees someone else who’s much better apparently.

I think the information is out there with numerous books and on line info tackling all sorts of mental health issues but the main problem is actually putting supposed solutions into practice/action. Maybe if there were groups like AA set up around the country, but for mental health issues, it might help?

for those who say I had no support, there is limited resources, but it helps to access the right something if you know what your problem / ask is
and the power of self efficacy-
addressing our own
sleep, diet, activities, exercise.
practising breathing properly when we are in overwhelm,
using emotion regulation skills
Problem solving life stressors
making changes where we can
there is sometimes a disconnect between people’s expectations of wanting to feel better but not doing the things that would facilitate feeling better

But that's really hard when people are struggling. On a good day, I easily eat healthily and get outside for exercise. On a bad day, I struggle to get out of bed. The thought of cooking or going for a run are so far down the list of things I'm capable of achieving. Eating and drinking are the first things to go when I'm in a negative spiral. My parents would punish me by withholding food and drink as a child and now I do it to myself.

I've done countless child protection courses and I know on some surface level that my childhood was abusive but it hits me every time like it's brand new. Articulating what's actually wrong when faced with a stranger is really hard. It took me multiple psychiatrist appointments before I stopped lying to both of us. With therapy, it took weeks for me to feel comfortable. I was lucky in getting weeks, most people I know would have run out of time before they actually opened up.

Face to face support tailored to the specific mental health condition, not over the phone and generic.
More information out there about why mental health problems can be a disability, and acceptance that sometimes people can't work or can only work part time and may need accommodations.

None of those things are bad.

But lots of people experiencing mental health issues need a hell of a lot more than just fewer screens and more exposure to nature.

Unfortunately, "mental health" nowadays is used so loosely and lazily that it has led to a whole load of misunderstandings. Being nervous before an exam is not a mental health issue, neither is feeling sad after a bereavement or a break-up. Those things are part and parcel of being human. (Normal anxiety/sadness can sometimes develop into a mental health issue. When the person's everyday functioning is seriously impaired.)

Agree and I don't think any of this is helped by the post-COVID fetishisation of "introversion" and the pathologisation of normal human emotions which leads people to avoid anything vaguely socially uncomfortable.

So many threads and posters on here betray a real neurosis about contact with other human beings which is profoundly unhealthy.

Brits have always been reserved and reticent but it used to be accepted that some social contact was normal and healthy. A lot of people, aided and abetted by social media, seem to embrace the idea where real human contact is best avoided and rush into self-validating echo chambers where they find other "like-minded" people.

Human contact isn't always easy and sometimes its downright irritating but its a fairly effective antidote to loneliness, radicalisation and the rabbit holes which so many of us seem to have jumped down.

None of this will help with serious clinical depression or major depressive disorders and I don't want to minimise these: there's a huge mental health crisis which just going to the pub or taking up hobbies won't alleviate.

But I think we've slightly lost the ability to help ourselves through community interaction.

I agree, some people really will never get out of the hole they've dug. Or they might, but they'll go right on to dig another one
It's not their fault, but there does need to be some acceptance of that as a reality on their part, and not just a knee jerk reaction to blame the mental health professionals who are trying to help for their lack of progress

I wonder how that conversation might go?

“I know you have enduring depression which is why you’ve finally been referred to psychiatry. I’m not blaming you but you do keep digging your own holes here - if you could just engage with the robo-therapy CBT programme (again) while I increase your meds (again) and get out in nature more that would be great. You don’t want another round of CBT? Well I can’t help you if you won’t engage”

Cash could pay for more staff. Mental health services are grossly understaffed, both in hospitals and in the community. With the result that the staff they do have are overworked and under a lot of stress themselves.

Cash could also pay for better professional development. The number of mental health professionals, for example, who appear to know virtually zilch about autism. (I'm mentioning autism because that affects two people in my own family, but I suspect it's not the only thing that MH professionals need to learn more about.)

Money doesn't solve everything, obviously.

Yeah I've heard people on MN who are so-called MH professionals say this before. It's appalling victim-blaming and lack of insight that people with MH problems can't dig themselves out of the hole, that's literally why they were referred to you.

I agree, some people really will never get out of the hole they've dug. Or they might, but they'll go right on to dig another one

It's not their fault, but there does need to be some acceptance of that as a reality on their part, and not just a knee jerk reaction to blame the mental health professionals who are trying to help for their lack of progress

You can give all the therapies in the world but there really is no way to force someone to engage if they don't want to. And the sad reality is that there's a whole queue of people behind them who do want help and will engage. When treatments are rationed by default due to the stretch on services, it's really tough to justify the resource for someone who doesn't seem to want the help available

It's a horrible truth that no one really wants to face, but it's happening all the time

If you’re a shit one( and you don’t sound great) yes. Within the NHS the shit psychiatrists are well known to other professionals, MDT teams and patients. We’ve come across them but also amazing life changing psychiatrists.

So I’d say good quality professionals are key.