To think most people have a completely unrealistic view of mental health services?

[StHeathensGrammar]

...UK NHS services specifically (don't know about other countries!)

This isn't a TAAT but the deleted suicidal thread made me think of it. There just seems to be this "seek help" mantra without people realising that actually talking to a friend or even a bunch of strangers might be all you've got.

And "ordinary" kindness, a listening ear, could well be better than a recorded crisis team message or someone who's got 3 mins to talk to you before rushing off to the next patient. Or sitting in A&E for hours on end, alone, with the end result being sent away clutching a phone number for the aforementioned crisis team.

Plus people seem to have a very different idea of the threshold for hospitalisation than the reality! Funding aside, even a perfect mental health system surely wouldn't put people in hospital long term for relatively minor things? And a supportive social environment means a lot - it's not just whisking the person off to professionals, out of sight of the "normals"...

I wonder exactly what people think services will actually do? What magic help are people thinking of when they urge someone to "seek help"?

Yet they pump money into cancer treatments for 80 year olds.

disgusting comment. Don't go there, really, you are destroying your entire argument.

Shocking provision especially for children, my son needs a play therapist, there are none on the NHS in our area. He is trying to make sense of being in a coma, which he can remember, being in restraints for weeks in PICU, having to learn to walk/eat/talk again, loosing his teeth/right eye, severe facial scaring, not being able to read, remember things. He is 6, there is no provision.
His sisters are struggling with having been in the same accident and seen his injuries, being seperated from us for months, coming to terms with a brother who is completely different to the one they had before, they are not deemed severe enough to warrant help on the NHS at this time, should they stop functioning entirely, then they might get some support, our local CAHMS is entirely crisis management.

We are paying to go privately.

Until you need it, you do not realise how woefully underfunded provision truly is

I had a brilliant experience with psychiatry and CMHT for my ADHD. I was diagnosed at 22, because everyone - including CAMHS - failed to recognise it when I was a child.

I know of people with horrific, debilitating mental health conditions who are regularly suicidal who are treated appallingly by every service that should be helping them. Teams refusing to see them, crisis teams putting the phone down on them when they're suicidal etc. The situation is dire.

OohAahBird thT sounds very tough

I've been under the CMHT for many years with varying levels of support. Currently I see a psychiatrist every six months. Recently I saw my GP as I was feeling suicidal. He contacted the CMHT asking for my appointment to be urgently brought forward. I heard nothing and consequently a few days later I was admitted to hospital where I have just been discharged after eight weeks.

Had I been able to see my psychiatrist urgently it may have made a world of difference and may well have saved the NHS a lot of money, not least because two of those weeks was spent in a private hospital.

We have just been through the debacle that is mental health "care" with our son. He was fine until he had meningitis last year. Since then he regularly self harmed ( he cut his arms down to the bone) tried to commit suicide. I have never come across as much incompetence as I have with the crisis team in our area, I truly don't know how they sleep at night.
He has now been diagnosed with a brain injury from the meningitis, it's such a relief that he is now under the neurological psychologists rather than mental health, they have a plan for him and other teams involved. All we ever got from mental health was , he has to pull himself together...or my personal favourite... if you want to kill yourself you'd better get on with it.

Drop ins, day centres and in-patient stays are very much less in favour - and I can see the argument for not increasing dependence on services, and on resolving problems in your home situation, in the real world (and to politicians the clear cost savings). However, I have never been a big believer that 6 sessions of telephone talking therapies (backed up with questionnaires that it is very easy to show improvement from) is going to cut it for more than a few of the most motivated, resourceful and supported people. And that is essentially what is available for anxiety and depression in most of the country.

A view from inside (an honest and possibly not popular one)

MH services are good at treating severe and enduring MH issues e.g. Schizophrenia and bipolar, severe psychotic depression, OCD. Things that are largely well defined and that we have evidence based treatments for medication and psychological.

MH services are not so good at personality disorders, adjustment disorder, anxiety and mild depression. These conditions are poorly defined and lacking evidence based treatments and they shade into normal experience.

Many of the determinants of 'mental health' are environmental: poverty, abuse, debt, family problems, unemployment. What can a shrink do about those? Will a tablet solve these issues?? Society has labelled a lot of normal life experience a 'mental health problem' and expects services to solve these but how can we? Soaring divorce rates, family break up and all that can stem from that, cyber bullying, loneliness, zero hour dead end jobs, slum landlords etc etc We need to look far wider as a society (hint: vote Labour today for a start)

People self harm for many reasons and not all people who self harm are depressed or suicidal. Some pills or even a therapist may not be able to help someone who is expressing their distress about bad stuff that has happened/ is happening to them.

Admission to hospital similarly is only really good for treating severe depression, psychosis, mania. It does not on the whole help people with PD. It isn't an environment where therapy can really happen. It can be counterproductive as it just promotes a dependence on short term relief of admission. All the issues are still there when you leave.

Therapy is fetishised. Nearly everyone believes that talking about/ getting proper therapy is the holy grail and will solve all their problems. There is a widespread belief that just talking about past issues will cure them but there is almost zero evidence that it does. It can actually make matters worse. For a lot of conditions tablets are way more effective. Therapy does not work at all for severe depression, psychosis or mania in the acute phase at least.

The evidence based therapies are mainly things like CBT that focus on change in the here and now. You have to be motivated to make a change to benefit e.g. Keeping the mood diary, doing the behavioural experiments. Just sitting in a room for an hour a week might be nice whilst it lasts but it is unlikely to be effective long term unless it helps to develop coping strategies. Of course it is expensive too: an hour of a highly trained professionals time is going to be a limited resource and cost way more than a box of pills. That will always be so. Access will always be limited.

In case you think I am unsympathetic I really am not. I'm just realistic. I am very dedicated to what I do. I go the extra mile for my patients. I am fond of them even if I'm not allowed to show it and I often cry (in private) over the awful things people have told me. So honestly I really do care but it is unrealistic to think that all the ills of society can be helped by ' mental health services'

Re: self harm and suicidal thoughts.

I've spent countless hours in A&E listening to people who have taken an OD, cut or harmed themselves in another way.

A tiny minority of them really intended to end their lives as they felt so hopeless or were psychotic and the voices told them to do it. They might benefit from admission or crisis team and certainly tablets.

A larger number self harm often as a way of coping with distress often stemming from abuse or other problems. All I can do that night is listen for an hour or so but tablets won't help and I have no way to quickly resolve their distress or ways of coping. Some might benefit from long term therapy but there will be a waiting list and it's hard work to change ingrained ways of thinking and acting and many don't really have that level of motivation to change so a sticking plaster is all there is.

The vast majority have just done a stupid thing that they regret. They were very upset and often drunk at the time, had an argument with someone and took pills. They've woken up, sobered up and now are quite keen to get home. Honestly that is the majority.

WokeUpSmeltTheCoffee
"Society has labelled a lot of normal life experience a 'mental health problem' and expects services to solve these but how can we? Soaring divorce rates, family break up and all that can stem from that, cyber bullying, loneliness, zero hour dead end jobs, slum landlords etc etc We need to look far wider as a society"

Wasn't that OP's point? People expect services to solve these things, rather than being supportive and understanding of life issues - ""ordinary" kindness, a listening ear".

"Nearly everyone believes that talking about/ getting proper therapy is the holy grail and will solve all their problems."

From my own experience, just having someone validate my feelings and say out loud "You did not deserve those experiences" was in itself extremely helpful. Additionally, making sense of why things occurred and how to protect myself in future required an outside perspective.

Yup. CAMHS offer urgent appointments in five weeks time. Then we wait 18mths for 6 CBT sessions.

We have twice yearly visits for complex medicated SN including self harming. It is getting worse but as our psychiatrist is going PT we have been told we won't be seen so often. And our appts will be with a diff loc each time.

You are right OP. Friendly listening people are few and far between though. It is excruciatingly lonely.

OK smellthecoffee. What about the young person from a stable, loving home. Socially and academically supported, bright and privileged for whom no school ever raised an issue because they were no trouble and high performing although sometimes caused surprise because they didn't always meet potential. GCSE's 3A 6A and 2B although 7/4 A/A were predicted.

Young person developed depression and anxiety due to frustration and feelings of failure. Self harmed by cutting, poisoning and not eating.

When was society going to pick up the underlying neuro-developmental issue? When they dropped out? When they developed an addiction? What chance for that young person if her parents hadn't been loving and caring and well heeled? What happens to similar young people from less supported homes? You think a chat is good enough do you because services can't be arsed to look below the surface and pull their fingers out?

Ohtheroses.....that in a nutshell. It's so frustrating isn't it. They seem to put everyone in the same box. God help anyone who doesn't fit into their box.

Definetly agree with this.

I'm nearly 30 now. I've had mental health issues since i was 12, when I tried to kill myself. Even then support was shit, it was decided I needed counselling, which was scheduled 6 months later. By that point the window for me wanting to open up was closed and I refused to engage and only had 1 appoitment. I struggled for years and then when I hit 18 and got to uni I decided I'd had enough and was getting help. I saw different GPs about 20 times in 1 year. No help offered despite severe self harm and I wasn't even put on list for cbt until 8 months in when a wonderful old fashioned gp walked past the nurses offices to see me getting bandaged up yet again and stormed out saying this was ridiculous. Other gps suggested I should drop out of uni (and do what? Go back to my home unemployed and sit and stew in the environment whic started the issues?), I stopped seeing doctors because they made me worse not better. After 18 months I got cbt.but the only cbt nurse I could see only worked half a day per week and they had some personal issues which meant they had to miss enough of my weekly appointments it felt useless. I was told at the start I'd get 12 sessions and if I needed more I'd pay private. A doctors surgery with 15 gps and serving 20,000 students had no more to offer.

Over the years I wentback occasionally , normally on the urging of a friend or when my sleep was so awful I'd beg for temporary sleeping pills. Butit's useless. I can function enough that I don't need severe intervention but at 30 I still self harm , I have severe anxiety and I suspect when i am 40 I will drop dead of a heart attack because my relatively simple life (now) feels overwhelmingly stressful. All they will offer me is drugs, I have tried 5 and I react so strongly and oddly to them it's not what I want to try because I don't want to risk my job. I feel like if i had Seen someone who took me seriously when I was 18 I would have had a different life. I had a friend who was suicidal and everyone urged her to see a doctor , go to a and e etc, she went to a and e twice and both times she was told she didn't seem suicidal and to go home.

I know some people get help, but for me mental health on NHS just doesn't exist.

I was misdiagnosed with an eating disorder (based on weight alone, no ED thoughts/behaviours) and spent a long time inpatient. Have PTSD from the way I was treated there. Now suffering from compulsive overeating.
MH services need to learn to spot undiagnosed autism, or this kind of shit will keep happening.

Name changed.

I am under the care of secondary MH for an eating disorder and have to say my care has been excellent.
First approached GP end Feb.
nb he is aware of long history of emotional abusive relationship which has been the trigger for my MH issues and so there was no fannying around with him referring me.

GP referred to MH team. Was assessed within a couple of weeks by primary MH, then referred to secondary. There was a 6 week wait to see eating disorder and assessment team, but since then I have seen psychiatrist (once) and ED nurse (3 times).

I feel very well cared for (though it's very, very hard). There are some communication issues between the different teams and my GP surgery.

I am not sure where I would be if I didn't have this support. Possibly dead.

I am in Essex.