To think the NHS mental health system is a shitshow?

[ChaoticGouda]

This is probably going to turn into a bit of a whingey rant, sorry

Disclaimer that I'm not talking about most nurses, doctors and staff, who are lovely and doing their best in unfair, overworked and underfunded circumstances.

However in my years of going into and out of the doctor's office for help and support, the feeling of being pushed out of CBT because I hadn't made enough improvement during sessions, the dismissal both I and loved ones have had when going to GPs about any issue other than depression/anxiety...

Plus the fact that specialist clinics for things like ADHD, EDs, etc (especially for adults) are still hard to access and shockingly underfunded despite these issues becoming increasingly talked about amongst the general public...

Of course I'm grateful we have an NHS, grateful that I'm not forced to pay for everything like in some countries, and grateful that I'm safe and relatively comfortable enough to be complaining about this. I'm definitely luckier than a lot of people on the planet, and I know it's a less-pressing issue to complain about, on the grand scale of things.

Still not going to stop me from complaining, though!

It is indeed a shit show, OP. It is hard to recruit staff - we have hundreds of unfilled vacancies across the UK, and there are nowhere near enough posts even if all were filled tomorrow. The UK has high levels of depression, and our young people are the most anxious and depressed in Europe. Covid and lockdown have made a bad situation worse, so demand for the service far exceeds supply.

The consultant psychiatrists I worked with (I’m now retired) were permanently overworked and exhausted.

The NHS is not a particularly good health system. Most west European countries use an insurance based state system, and offer far superior care in terms of doctor/patient ratios, waiting times, access to scans and diagnostic tests etc. But the NHS is a sacred cow that no government dares reform.

Exactly what @Babdoc said. And please don't think that anxiety or depression are treated well either. My DH had to be committed before getting treatment, and even that has not been enough.

I think we are lucky to get medications and therapy free on the NHS.

It’s very stretched. Inpatient wards are short of beds. There aren’t enough specialist placements or community support to keep people out of hospital. Community teams are underfunded, it’s hard to retain staff and there are more people needing help than there are trained staff available.

Going private is the answer for many people. Or accessing therapy via a charity or helpline.

Sadly some people take no responsibility for their mental health. They miss appointments or community support sessions or phone consultations. Many decline group therapy as they don’t like groups. Then it goes on their record they’ve not engaged. So they get even less support. Anxiety can be a barrier to accepting support but staff have no time to chase people who don’t attend or who don’t engage.

In an ideal world we’d all have better access to mental health support. But it’s far from ideal.

I think we are lucky to get medications and therapy free on the NHS

Medications aren't free, though they are subsidised. And for most people therapy is simply not available - what use is an 18 month waiting list for someone near suicidal? It's no good having a free service that is not truly a service.

Agree! I have bipolar and I fought for years to be seen by a psychiatrist as I knew it wasn't just depression. It took a suicide attempt for action.

However now I'm in that system the support and care I have and previously had is amazing and I cannot fault it. My CPN (nurse) sees me and rings me regularly and I see my consultant every few months.

My experience was outstanding but I was very ill and went from one specialised team to another.
With adhd and autism it seems to be if you're an adult and got there without diagnosis they think you can cope so what's the benefit of treatment.
With depression and anxiety it is seen that everyone has them anyway so standard basic treatment eg 6 sessions of cbt and some ADs will do.
I have been very lucky but it was either help or lose the children.

YANBU, I have a long history of mental health issues and when I began struggling again last year was told that it was a 6 month waiting list even for phone counselling.

I have had some amazing support from individuals in the nhs but the system o really is stretched to breaking point

If doctors believe someone is truly suicidal that person would be admitted (under section if necessary) and treated. For free. Obviously there’s a prescription charge in the community unless you’re exempt eg on a low income.

People do slip through the net sadly. We just don’t have enough resources to provide the specialist help people need in a timely manner.

But many people with suicidal thoughts can be helped by medication from their GP. The GP or psychiatrist has to decide if they’re likely to attempt suicide, or if the suicidal thoughts are caused by depression that can be treated in the community. Then there’s self harm, often a coping mechanism or cry for help and very common. Ideally there would be therapy and help available immediately. But there isn’t, hence the waiting lists and the prescription of medications in the interim.

Take EUPD for example, notoriously hard to treat. Hospital admission can worsen symptoms. DBT (considered the best treatment) is hard to access so people are often referred for group therapy.

Agree. Perinatal mental health support is ridiculously bad. After my initial assessment my "therapist" said "oh, I'm going on holiday now for two weeks so there'll be a break in your appointments". Then I was due to give birth and she said "you'll probably not be able to keep up the sessions with a newborn - shall I discharge you?" To be fair I was doing reasonably well at that point but I'd only had about three or four sessions.

Its appalling. My son is bipolar and every single time hes been admitted I've ended up taking him home to look after him myself because the care has been so bad. He would have killed himself by now without my intervention and nobody seems to care at all.

I agree and I work in the system. Since austerity, mental health care is stripped to the bone. There's nothing out there.

Many with schizophrenia are difficult to engage. To me, that's part of their illness, in that they lack insight, and services should continue to at least attempt to follow up, because to me they're the ones who are at risk, mainly to themselves (self neglect, suicide, being exploited) but often if they don't attend they're discharged as we have so many others to see. It's shocking and very, very scary. I often say in meetings "This is a daily mail story waiting to happen."

I work in the referrals and assessment team, during lockdown our referrals went down as people weren't seeing their GP. I was redeployed to the depot clinic. This involved seeing people with schizophrenia at home to administer injections. When I asked how they were dealing with lockdown, the majority were saying "doesn't bother me, I never go out." Their lives are one long lockdown, with no day services or anything to do but sit around in often dirty cramped flats. So that's community care?? I'm old school, and trained in one of the old asylums. Community care was supposed to be a Brave New World. It's not, it's shit.

IAPT are pretty much rubbish, sorry. They can't deal with any level of risk. As an example, someone might go to IAPT and admit to suicidal thoughts. IAPT are throwing their arms up in horror "we can't deal with risk! Refer to secondary services!" We have to then assess risk....but many of them when secondary services assess them are saying, "yes I have thoughts, but I'm not going to do it. I'm a single mum, whose going to look after my kids?" Or "I'm not going to do it, I'm Muslim, the Koran says it's wrong" so we end up sending that back to AIT. It ends up an extra layer of assessment and a delay to their treatment.

AIT=IAPT

I had a letter the other day offering a virtual support group to begin in Jan.

THREE YEARS after my referral for crisis support . I emailed them and said I didn’t even know I was still on their system and thanks but no thanks

It's awful. The reality is unless you have the money to pay for it or are seriously unwell enough to be sectioned you will get very little, if any help beyond a prescription for 'magic' pills.
I don't know what the answer is.

STBEXH has suffered for a long time with depression, which is massively exacerbated by addiction issues (also a mental health problem). Putting aside the fact he has to want to engage with support, whenever he does ask for help it is not available, or he goes on a waiting list. Ironically the times when he's received immediate support are when he's attempted suicide. Why should it have to get to that stage? Even then they only gave short term support, then discharged him to my care (without my agreement) no ongoing support offered.

The UK doesn't have a mental heath care system to speak of, it can't afford it. The reality is mentally unwell people have no option but to take care of themselves because no one else will.

Babdoc, what kind of posts are unfilled and why is this?

Wow, didn't even notice this thread had been replied in until now

Thank you all for your comments. Caught between being glad that I'm not alone in feeling failed by the system, and feeling so sorry/angry that so many other people do, in fact, have similar experiences.

@Advicewouldbeappreciated hit the nail on the head RE: Adult ADHD and Autism. It really does feel like they look at you, see you're not actively falling to pieces, shrug their shoulders, and say "Well, what can we do? What difference would it make? ¯\(ツ)/¯ " Considering the high comorbidity between these conditions and longterm anxiety/depression, it would make a whole world of difference!

@madcatladyforever I'm so sorry to hear about what both you and your son are going through. I'm sure it means a lot to him that he has such love and support from his family, even though he should be receiving that same support from the system that's supposed to help him. You sound like a wonderful mother.

@riotlady I understand what you mean I was put on the waiting list a few years back for dissociation, suicidal thoughts and panic attacks and I had to phone the doctors more than once to beg them for help because I was struggling both at home and at work and couldn't wait those months.

OP, I have been waiting 10 months now with similar symptoms to yours.

I assume this is how many people end up homeless. Their mental health is left to decline so much that they end up destitute.

@zoomzoghedgehog I'm so glad to hear you're in a better place now! Although it's also shocking to hear that you had to be pushed to the very brink in order to get the support you needed. It really does feel like they don't understand how much you're struggling until you're pushed to the point of actively holding your own life hostage.

@OverTheRubicon Yes, you're right about not even depression/anxiety being treated right either I'm sorry, that was insensitive of me to say, and there are countless others like your husband who aren't getting helped by a system that is supposed to look after them. I hope both you and DH are doing well, despite the circumstances.

@Evilwasps You're exactly right as well! People with addictions are still so demonised in society, but a vast majority are those who are self medicating for issues that the same society just can't, or won't, help them with. With the long waiting times, paywalls, dismissal, multiple appointments, stigma... It's no wonder people stop trying after a while. And when they turn to substance abuse instead, that just kicks off the downward spiral that leads to a prison sentence, a hospital bed, or a headstone. It makes me so angry

(On a lighter note, what does STBEXH? I'm still new to mumsnet lingo )

The problem is sheer numbers of people needing help. Virtually everyone I know seems to be on anti-depressants, struggling to cope/ some sort of anxiety or their teenagers have. Maybe it's just me but the problem seems to be huge. Work stress/ lack of support etc all play a aprt.

STBEXH = Soon to be ex husband !

@Stripesgalore I'm so sorry to hear you're still waiting for help. I hope that once your letter comes through you'll have the right support and treatment you need to work on your recovery and make it through to the other side

I completely agree with your other point. When you're struggling with your own mental health then other pressing issues can fall by the wayside, often worsening how you feel, culminating in a vicious cycle of stress and avoidance that leads to everything falling to pieces if you don't have a support system there to intervene. And, of course, accessing mental health support when you're homeless is even more of a nightmare, making it more and more unlikely that you'll recover

If doctors believe someone is truly suicidal that person would be admitted (under section if necessary) and treated.

That's not true though is it? No beds available means no admission, however ill someone is.

Anyone hear Matt Hancock try to claim the suicide rate actually reduced during lockdown? There's no hope for the system to improve when the Health Secretary wilfully misrepresents the statistics.

(And by wilfully misrepresents, I mean lies!)

@ChaChaCha2012

If doctors believe someone is truly suicidal that person would be admitted (under section if necessary) and treated.

That's not true though is it? No beds available means no admission, however ill someone is.

Anyone hear Matt Hancock try to claim the suicide rate actually reduced during lockdown? There's no hope for the system to improve when the Health Secretary wilfully misrepresents the statistics.

Most officials would rather protect their reputation than the health of the people they're paid to work for. Sad but true.

I'm sorry you're having so much trouble.

I just wanted to say I got taken by ambulance to a&e. Got assessed by mental health crisis team. But because I talked about suicide they said I was too high risk so couldn't help me.

I can't tell you how devastating it was to be rejected by the mental health crisis team. The one people I thought could help.

I told my gp about this when we were upping my sertraline. She actually laughed.