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!

If people are being refused help because they are suicidal and being refused help because they are not suicidal, how is anyone supposed to get help?

Well, yeah, it's a disaster.

And then they complain that addiction rates and suicides are going up.

People trying to deal with their mental health problems the best way they can.

Article in today's Times about disused shops being converted into tiny 'flats', some with no natural light let alone enough room to swing a hamster.

@Stripesgalore

Presumably, the only people who receive help are those who are causing a problem for the authorities or who are violent towards others.

our NHS mental health services are as good as non-existent. You can have mental health help only if you're rich enough.

(TW suicide)

My brother killed himself in February this year. The day before he went (back) to his GP who was so worried he called mental health services who said they didn't have capacity and to send him to A&E. He was in hospital for 8 hours and told at least 4 different people (GP, mental health services, A&E triage and Mental Health Ward) long and difficult stuff about past trauma and his current intentions to kill himself. He had method, means and motive lined up. He was deemed not in need of acute admission (read: no beds) and discharged to be seen at home by mental health services later that day. 4 hours later rang him to say they would come maybe in the next day or two. He only told me the basics of all of this (I had no idea how close to doing it he was) we found out through the coroners report and suicide note. He was texting me normally that evening, but he killed himself at 4am the next day.

A lot of people excuse NHS mental health as being only for real acute emergencies and crisis. But here was a man who up until the day before was trying to get help because he didn't want to die, and then as a direct lack of available help, a few hours later he did, citing that as one of the main reasons in his suicide note.... that's about as acute a need as you can get.

I love the NHS and it's not their fault that MH services have been underfunded for years. It's just tragic

@rosiethehen I don't even know about that. My (incredibly niche) work community has recently attracted the attention of a very mentally ill lady. She has all sorts of hallucinations and theories about the authorities being out to get her, and she's reached out to a number of us trying to get help. Luckily our community is about as caring as you can get so after some reporting and digging it transpires that she's sectioned (i think), well known to authorities and only deemed a risk to herself not others. It's now got to the point of her stalking to get phone numbers, email and addresses of people in our community who do not have that info in the public domain, and turning up on people's doorsteps. She makes all kinds of safeguarding accusations against her caregivers (which we are as certain as we can be are part of her illness, not truth), so the bar for being a danger to others must be pretty high

@WhateverThePace

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.

@ @WhateverThePace I agree with a lot of the sentiment here but 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.

I couldn’t take responsibility for my MH because I thought I was worthless. I didn’t miss appointments but I didn’t engage much. I did try a group but my autism got in the way. I understand that meant that stretched service could not offer more. The NHS staff were mostly very supportive.

but for many people, not just people with anxiety the symptoms and underlying problems are what stops someone engaging, rather than not stepping up to our responsibilities.

YANBU op. Our DS behaviour and mood changed in lockdown.I rang the police on 3 separate occasions. 3 referalls have gone in. Plus one from the neurodisability consultant . And still no help. He keeps asking why I lied to him when I said he would get help.

Reading the replies makes me so sad, DH has experienced/still experiencing this. Three times now he has contacted the mental health team and has been told they will call him back to set an initial appointment up. This has been going on for nearly three years now and nobody has ever called him back.

Nowadays he’s dosed up on citralopram which seems to be the easy fob off now that people are given.

I agree

The NHS needs to change we need to look at other countries (France for example) but we need to be prepared to pay more

Or we decide what the NHS will cover and the rest is via no profit making insurance

The problem is there isn’t a main political party willing to put this forward for fear that it shall turn away voters

A cross party committee needs to be set up to decide the NHS future

I think YABU. I had fantastic CBT on the NHS and it turned my life around.

Totally, back about 5 years ago I attempted, I woke up 5 days later after being stepped down to the general hospital ward as my first 2 were in ICU, the mh crisis team saw me to assess for admission and despite me being very clear I was going to finish the job, I was discharged to go home on my own with a phone call set for the following fortnight, I had left detailed notes for loved ones before I passed out but apparently I wasn't a risk to myself as if I was I would have completed. I had spent the previous month begging for help but had totally lost all hope.

My partner was told if he was so worried that he should stay with me and keep me safe 24/7 while I was begging for help. He can't due to a serious health condition which leaves him struggling with basic life stuff never mind 24/7 care of someone actively suicidal.

I was "lucky" in that I was involved with a social worker from another team (physical disability) who was also a mh trained sw and refused to allow her team to step back in, and fought hard for admission and she was speechless when the consultant tried to discharge me at ward round 2 days later as I "wasn't actively suicidal", I had slept entire days as a result of earlier in the week not even waking up for food.

I was given a follow up appointment for 8 weeks and left to it, follow up in a month with a nurse. I also didn't need my antidepressants increased as "I would probably take them!) The GP was appalled but that's it around here.

The ward was 20 beds and only half was in use, the other patients one was actively avoiding prison as he described it, 1 on bail and wanting a sympathetic angle for court, 2 in acute withdrawal (alcohol and drugs), 1 anorexic, 1 dementia and the other 2 general anxiety. The point of admission is very random.

I see it as ask for help but expect nothing and you won't be disappointed

@heartsonacake I'm glad you had the support you needed to change your life for the better, and I sincerely hope you're doing well

Not that you're saying so, but I don't think that in itself is enough to excuse all the countless others who are being failed through poor funding and support.

[quote rosiethehen]@Stripesgalore

Presumably, the only people who receive help are those who are causing a problem for the authorities or who are violent towards others. [/quote]
Not even them sometimes. If you're violent / dangerous you're v unlikely to get admitted to a ward and there are few places that are high security.

I'm on 2 different antidepressants, anti psychotic, mood stabilizers but obviously not ill. I have been in mh services for over 30 years and they absolutely saved my life when I was early 20s but has gone to hell in recent years

It's incredibly underfunded but the staff who work there ime do it because they actually care. It's not an easy job.

On the point regarding engagement I would say that many people are rejected/rebuffed many many times before they become ill enough to access what limited resources are available via the NHS; by this point it can be hard to believe that they are not going to be failed again. The underlying message throughout the entire process is 'You dont matter'. My heart goes out to you ColleagueFM; this is absolutely appalling - there are recognised treatments for trauma, relational or otherwise. Why are we as a society allowing this to happen?? Mental health is light years away from achieving parity with physical health and I think the NHS should actually be renamed the National Physical Health Service because it is not, in any way, an adequate mental health service. I work as a therapist in a hospice and am unpaid as are all the other therapists - we often work with incredibly complex grief scenarios and the work is exceptionally skilled, difficult and exhausting. Could anyone for one minute imagine expecting a nurse or a doctor to work unpaid? It is completely unthinkable. Until everyone stops colluding in a system that relegates the importance of mental health care there will be more avoidable deaths. After all the decades of underfunding it transpires that the money is there afterall but it is not and seems never will be deemed a priority. That is what I find most sickening.

I completely agree OP. When one of my DS needed MH services a couple of years ago we went private just to get the help he needed. I realise that's not an option for everyone though. I believe the response to Covid19 was excellent - but at the cost of everything else including patients with life threatening diseases such as cancer.

I believe the NHS needs completely overhauling and a system along the lines of Germany would be far better.

[quote ChaoticGouda]@heartsonacake I'm glad you had the support you needed to change your life for the better, and I sincerely hope you're doing well

Not that you're saying so, but I don't think that in itself is enough to excuse all the countless others who are being failed through poor funding and support.[/quote]
Thank you I’ve been fully recovered for years now; you’d never know I was severely ill for so long.

No, that wasn’t what I was saying. I just wanted to point out it isn’t a shitshow everywhere in the country and the services they provide do help some people.

I’ve struggled all my life. My GP’s have always been fantastic.

Lots of counselling that doesn’t work. CBT is like some sort of joke therapy.

I was so desperate l ended up paying to see a pyschiatrist. When l add up all the money l spent on therapies, counsellors, crap books, the cost per month worked out cheaper.

I can text him whenever l want. I feel ‘safe’ for the first time in my life.

Ive worked in mental health 30 years.

The last team I worked in had 40% cuts in 4 years. That’s the shit we’re up against. Serious, serious underfunding. No way morale is so low. Most staff really care but it’s so bloody frustrating assessing someone and they need x, y and z but they either don’t exist or with a year + waiting list.

‘Lots of counselling that doesn’t work. CBT is like some sort of joke therapy.‘

They have invested so much in CBT that they can’t back down on trying to funnel huge numbers of people into it. I feel really fortunate not to have been pushed down that route.

Lots of counselling that doesn’t work. CBT is like some sort of joke therapy.

TheEmojiFormerlyKnownAsPrince What a ludicrous statement. Okay, so you think it didn’t work for you; doesn’t mean it doesn’t work for everyone.

I had CBT on the NHS over a few months and went from housebound to holding down a full time job in that time, after being ill for many years previously.

CBT works as long as you put in the effort and do what your therapist tells you to. They give you the tools to fix yourself, so if you’re expecting them to fix you and you don’t have to put the work in then no, it won’t work.

CBT is very much something people say they’ve tried when actually they just didn’t want to put the work and effort in and expected to just be fixed. That isn’t how it works. You need to push yourself out of your comfort zone and change your entire way of thinking.

Spot on, ChaoticGouda. All they do is dish out pills and if they don't suit, you are discharged.

I think the truth in mental health is that you do have to work very hard and take a lot of responsibility for getting better. Cbt is a perfect example. Nobody is going to wave a wand and make it better. For trauma much thinking now that going over trauma makes it worse. You need to manage the feelings stopping you living now. Reliving trauma is actually a negative thing.

YANBU, my sister has been sectioned 4 times, she now has PTSD due to the way she was treated the first time, not just her perceived treatment, but it was proven to be inadequate and innapropriate. Upon discharge a string of workers who kept cancelling appointments just before they were due to arrive, messed up medications, dismissive of when she said she was struggling which meant she reached the point she was once again sectioned, when lockdown started she was dropped like a sack of shit- just a text to say everything's suspended, and to phone the crisis line or 999 if struggling. It needs more funding, improvement in conditions and less demand on each worker so that they have a manageable and bearable working environment. I don't blame them at all, they are always swimming against the tide; never enough time or resources to help the people that need help.