Peoples expectations of mental health services

[Interestedparty01]

I’ve been working in mental health for 25 years and a lot has changed in that time, much of it has been positive but some ( ward closures and community services cut back etc) negative.
When I started out I mainly cared for people who were suffering significant mental health issues, who certainly required specialists services. There was always a lot of pressure on services but the referrals were appropriate in the main.
Now Many people I see are seeking diagnoses, or have social problems, many have bounced in and out of mental health services but have not made any of the lifestyle changes they need to improve their own mental health however they still come with the expectation of us having a cure or resolution to their issues. Some people get very angry when they are (finally) told there is nothing more we can offer them.
I suppose what I have come to realise is that psychiatry does not have a cure for ‘unhappiness’ as unhappiness in and of itself is not a medical issue or disease.
There is so much in the press now about identifying and seeking help for mental ill health ( and obviously people should seek help for mental illness) but we rarely see anyone talking about the difference between mental illness and unhappiness/ social issues etc.
Feel I am rambling now but honestly interested in people's expectations if what is or should be available via NHS for mental illness.

Well it depends.

I have was diagnosed with depression and anxiety, recently my doctor advised he believes i have ptsd from a very traumatic childhood

I have made changes. But honestly I have felt like this for as far back as I can remember and I am 37. I have been to the doctor before (when it's for really bad), offered counselling and tablets. I never followed it up, because I didnt want to have that label of being mentally ill.

It has got to the point to where I cant function. So yes, I have made changes but not all of them.

I am chronically unhappy. I have changed jobs, moved areas, exercised worked part time/full time, cut out caffeine etc.

I think you are underestimating what unhappy can mean. I didnt want to admit I am ill. But I also wanted someone to pull me out of the hole I am in.

It was confusing and panicked me. I wanted someone to save me, when I wanted to pretend I was ok and no one knew I needed help.

Ita sad to think that people must think I am just unhappy, not ill because I couldnt help myself for a long time. I went to bed most nights hoping I didnt wake up but couldnt help myself either.

Its hard to understand myself, so no wonder other people dont understand.

Hiding thank you for replying, and I am truly sorry you are suffering.
What you describe is a classic depression with all the ‘biological’ symptoms that go with that. I’m not really referring to people with clear cut illness. I suppose its more people who are looking to validate or support unwise ir poor life choices who I feel sad about, mainly as they inevitably reduce resources from people who are really poorly. Xx

we rarely see anyone talking about the difference between mental illness and unhappiness/ social issues etc.

I think these things can be so hard to unravel and tell apart, often. If a young person, for example,

• is the child of an abusive relationship between the parents
• was/is being abused by 1 or more family member
• has only ever lived in poverty
• lives in an area where recreational drug use is endemic /accepted
• goes to an Inadequate school
• comes from a family where unemployment goes back three generations
• sees family breakdown as normal
• has additional learning needs, not adequately supported

then it is likely that any/all of the above will impact upon any mental health issues they might have, and to address the mental health issues in isolation is unlikely to be effective, because the mental health problems are 90-95% the product of the social issues.

If you have a clean break of your leg you will most likely heal and have no ongoing problems. If you have a really bad fracture that doesn’t heal well you accept you may walk with a limp or even need a cane etc.

With mental health problems when your mind needs fixing there seems to be a reluctance to accept that you won’t be cured easily and permanently.

Much like the bad fractures of the leg the focus on healing the mind should allow for the patient to understand that they may never be fully healed but they can do an awful lot to manage the symptoms.

Whether it be medication, counselling, hypnotherapy, self help help in learning to cope and control things like panic attacks through controlled breathing etc.

People become very despondent when they’re handed pills and they go home and expect to be a ray of sunshine in three months time.

That needs to change and people should be shown ways to cope and manage their problems rather than expect a complete cure.

I would find it hard to accept a fracture wouldn’t heal either!

I would like MH services to be able to keep me safe when I really need it and to actually have therapy available in an inpatient setting.

I've been admitted twice in the last month because the crisis team were concerned for my safety. Each time I have been discharged by the consultant because 'there is nothing we can do for you here' and a lot of other really quite shocking statements (I will be making a formal complaint when I am well enough)

So what am I supposed to do when I'm waiting for the CMHT to organise therapy for me, but still struggling to keep myself safe despite trying really hard?

The most beneficial thing for me would be an inpatient setting with intensive therapy available and then the opportunity for outpatient sessions with the same practitioner for a further few months once things have stabilised.

This was available 10+ years ago when I was an adolescent patient, but appears to be an alien concept these days

I suppose its more people who are looking to validate or support unwise ir poor life choices who I feel sad about, mainly as they inevitably reduce resources from people who are really poorly

But sure this is the actual mental health, or perhaps more accurately emotional health, problem. What sort of things are you taking about?

They saw me very quickly with psychotic depression and gave a lot of support. I have family support and asked to be discharged after a while and they said OK. they seemed to quickly pick up that was quite serious.

This is a list of some of the self help I tried before going to the doctors today and admitting none of it was working. Meditation, YouTube relaxation and hypnosis, St. John's wort, vitamins and fish oils, aromatherapy massage, reflexology, Indian head massage, reading books on mental health, counselling, distraction techniques such as colouring books and puzzles, exercise, dog walking, tai chi, yoga, breathing exercises and just crying it out. I am now going to try some antidepressant to see if there is going to give me the breathing space to recover.
If anyone has any other suggestions I can try I will gladly give them a go.