Why are mental health services in the UK so utterly shit?

[Whichwhatnow]

Trying to get mental health support this week after multiple suicides of friends and other issues. Nowt out there available. I'm lucky, I can pay. But how does someone on benefits or NMW pay for therapy?? Surely this should be a basic support element of the NHS?

I’ve always had this dream that if I won the euromillions jackpot I would use it to open a mental health support centre in my area that had 24/7 crises availability with qualified professionals there, from a psychiatrist to clinical psychologists to mental health nurses, to counsellors, to trained support workers. There would be the crises centre (24/7), then the other part would be normal, average opening hours with workshops, 1:1 or group support/counselling, social support groups, access to resources/other types of therapies, targeting of specific groups - children, adolescents, men, women postpartum, survivors of DA etc etc.

Ah, if only,

Hi passenger; there are plenty of non-parents and plenty of men on MN, that's not a problem — but it's true that generally people will work on the assumption that most posters here are probably female, so if your sex is particularly relevant and important to your post, you may find it useful to mention it (although if it's not relevant, but you announce it anyway, you might get some gentle "Lo, a man is here to announce his manly opinion" teasing… it's not personal, just a result of people's annoyance at the occasional poster bringing up being male when it's not relevant and there haven't been any assumptions it's necessary to correct, and in a way that makes it look like he thinks it gives his opinion extra importance).

You might be better starting a new thread to discuss your experience, as this is quite an old one. But what I would say is that it sounds like Healthy Minds is your local primary care talking therapy service, and the GP was trying to suggest you self-refer to them.

Despite the wafty name, if they're the kind of service I think they are, they probably offer both group and individual talking therapy (often CBT-based, but sometimes also other modalities), guided self-help, individual counselling, and maybe things like mindfulness, psychoeducation groups, activity groups, or other types of help.

Why not give it a go? It might be better than you anticipate. Or it might not, but then at least you can go back to the GP and say you've tried that, what's next.

Very low funding.

I'm not sure I emphasised enough that starting a new thread would be a better idea, passenger. Maybe on the Mental Health board, or possibly on Chat? Resurrecting old threads tends to just result in a sprinkling of new posters responding to the ancient OP without realising it's a zombie, followed by the thread rapidly petering out (and it can also be interpreted as hijacking someone else's thread).

By the way, I meant to say that it wasn't that there was anything in your post giving me the impression you were doing "Lo, a man"

I was just trying to make it clear that men definitely are allowed — and warning you that if you do ever see people being a bit tetchy about an individual male poster who's making a thing out of being male, the snark is generally because the poster has announced it with a subtext that pissed people off, not just because they're men (whereas perfectly normal stuff like mentioning that they're male when it's helpful to know that, or just saying that it's "he" when someone's called them "she", or whatever, is unremarkable) — it doesn't mean you're not welcome.

It’s a shit show! Anyone who unfortunately uses the services now this.

OP I’ve had 8 different psychiatrists since the start of lockdown. (Bipolar). It’s a standing joke when I have a team meeting about what my psychiatrist actually knew about me (I work in healthcare). It’s a combination of funding and not having the staff. There are so many vacancies at the moment. Everyone qualifies then goes private.

On the plus my newest psychiatrist has promised she’s staying! My team in work have a bet on for how long 😂

You are looking at mental health services through rose tinted glasses if you think that it generally keeps people in severe risk safe and well. That is absolutely a huge postcode lottery.

My neighbour has tried to kill himself 5 times in the last 3 months and each time has been released with in a day and his parents are expected to look after him. 5 days ago I found out my friend, who was experiencing psychosis, had killed himself. He was very sick but there was no help.

Last year when I walked out in front of a car I was told there was noone in the crisis team who could see me. After my child's birth perinatal told me they were too full and as I was already under secondary care my psychiatrist should see me within 1 week of giving birth liasing with them. I was high risk for post partum psychosis. Noone saw me for 10 months despite my midwife and health visitor trying to find out what was going on. I have seen my psychiatrist in person since before the pandemic. They just call me once every 6 months now. No physical clinic. Completely useless service

6 weeks of CBT after a 6 month wait list is not helpful for the vast majority of people unless it's like minor and that's all the help anyone seems to be able to get where I live.

The organisation I work for used to have a project solely dedicated to working with hoarders. Referrals came from the district/borough councils if they were council tenants, and from adult social care if they were in private rented or owner-occupiers and (iirc) it was jointly funded by both tiers of local government.

Needless to say, it no longer exists because the funding was cut a few years ago, despite the fact that it achieved excellent results.

My friend has a similar story re CAMHS. Her son is only now getting help, after friend had a complete meltdown at the GPs, in part to do with her son's deteriorating MH.

GP got on to CAMHS, who moved him up a tier and he is being assessed next week, more than 6 YEARS after his initial referral. It seems that only the top tier or two of need are getting any help at all. He's been out of school all that time, too.

The under-resourcing of CAMHS is creating more problems for adult MH services imo, because problems are going untreated for years.

Yanbu see it often with work. Even people they are aware of who have severe mental health issues and could be a danger to themselves and others just get told.... you'll get a call later and we will see how you feel then. Its awful.

One woman was stripping naked and screaming to be sectioned as she was scared of the voices. She got told to go home, relax and they would call to check in later. We had to watch her walk in the opposite direction of her home hoping she wouldn't hurt herself or anyone walking past her.

I think a bigger, more important, question is why is mental health so shit in the UK?

Totally agree. It seems like every other person has mh issues. I understand the pandemic, cost of living crisis, homelesness etc are largely to blame but we do need to look at the levels of MH problems. maybe mh is just being better recognised. I have just left a job where I was completing disability applications for housing association tenants. The vast majority were claiming for mental illness, drug addiction, alcoholism, depression, anxiety. When you look at the conditions they live in, unemployment, poverty etc you can absolutely see why MH issues are exacerbated though.

Yes, I think poverty is a massive factor.
And social media doesn't seem to be doing our teens any good.

Just thought I'd update this thread. As I've said I'm ridiculously lucky in that I've fallen into a well paying job. So I have just spent a month at a residential facility overseas which involved loads of group therapy, DBT, CBT, TRE etc as well as a really excellent personal therapist, psychiatric assessments with a qualified psychiatrist etc etc. It has really, really helped. I was assessed when I arrived as not stable enough for EMDR as PP mentioned (it's also something that needs to be built up over several weeks and I could only afford a month at this place!). However I am now and will be starting EMDR this month.

I still feel terrible for people who can't afford this kind of care and are left with the shitty provision and waiting lists of the NHS, which is why I started the thread. But I guess at least by going private I'm not taking NHS resources.

https://www.economist.com/britain/2023/12/07/britains-mental-health-crisis-is-a-tale-of-unintended-consequences. Unfortunately it’s very paywalled, but I read the full article in the paper edition last month. The article suggests that rising awareness of MH stuff and a greater tendency to medicalise feelings which would not have been classified as needing help 20 years ago, has pushed out care for the most serious cases, and of course this has happened at the same time as budgets have got tighter.

That’s gold standard care and v difficult to get in the NHS. I am very glad it worked for you!

I am in two minds about needing to be residential and not being able to get that care in the community, if that makes sense. But I guess as a voluntary patient, perhaps being residential isn’t traumatic as people want to be there?

But its not just MH services, its all public health services & all interlinked.

Maternity, GP services, A&E, Elective Surgery, Dental.

Of course none of this matters to those in Govt as they don't use public services & where they have, they don't face waits like the rest of us do.

Because the country borrow billions a week just to pay for welfare and debt interest. Because the number of net contributors is so low that paying for everything and giving it out free is no longer feasible.

Over 10 yrs ago I had really good MH support via NHS - 1 on 1 counselling with an excellent professional, for over 6 months (the time it took to resolve the issue).

Then the funding was cut.

Now you’re lucky to get 6 half hour sessions with a trainee. It’s a joke. No, actually it’s terrifying.

It’s more than that. They are managed dreadfully, many staff just don’t do their job properly partly due to lack of investment and staff, a lot more training is needed and transition from children’s services( which are broken) and provision for the 18-25 group is shockingly poor.

Just another example of this government incapable of managing anything.

Lol!

Benefit payments for those not working (excluding pensions) is quite low.

Yes to less net tax contributors but why is that? wages held down so half the working population need in work benefits just to live, as i said "working hard to stay poor"

The Govt just handed out £20 billion in tax cuts, the biggest beneficiaries will be the better off, as its a % NI cut.

What would £20 billion, year on year, do for MH services?

Its a political choice the Govt has made.

@Megeyhi527 In our case, there simply wasn't any beds nor continuity of staff, emergency patients were being sent 100s of miles away as the Trust had no capacity.
Demand is up, funding is down, no amount of management can solve that, it means just one thing.

Because many more people need MH services than MH services have capacity for.

Due to underfunding and poor decision making, not just by the government but within NHS structures, who insist on expensive layers of ineffective and poorly trained managers.

And because there is not the physical space to see people. And because some people present to MH services when the root cause of their MH difficulty is social and familial stressors or undiagnosed neurodevelopmental conditions, which are then ‘treatment resistant’ but take up vast amounts of time.

And because, when they make formal complaints, clinical staff have to remove themselves from clinical duties to respond to the complaint on behalf of managers, because managers don’t understand what caused the issue. This means even less clinical time to go around, and the outcome of the complaint almost never finds that MH services were at fault, only that they have done everything that they can and they still can’t ‘fix’ the issue.

I don't think that's entirely fair. As a mental health nurse I'm highly qualified, as is everyone else around me. We know how to do our jobs. The issue is that we're firefighting. When I qualified everyone got a job and most people had the choice of two or three. There's just not enough nurses or beds or psychiatrists... People say that they want to work in mental health (and, honestly, counselling/psychology is hopelessly oversaturated) but they don't want to work with the really unwell. We just can't recruit so we have to work with what we have-which leads to the level of service we're currently experiencing.

IME it's shite globally for mental health.

^this.

Certainly our experience.

Lazy to blame staff managers etc etc.

Bottom line is, much like the mtce on our own houses, if you skimp on repairs & investment, you pay for it later on.