To think the mental health service should offer evening and weekends?

[SpeedbirdSquawker]

I recently plucked up the courage to access support from my local mental health team for severe depression and anxiety. I almost bailed on the initial assessment appointment but was glad I went.

The next stage is attending two online information sessions which you must attend to proceed to accessing counselling and other therapies but these are only during weekday working hours. I work and can't get time off for these. I feel desperate for help yet can't go further forwards if I try.

But the counsellors work too. I'm pretty sure that they don't want to work in their evenings.

Can you get the time off of work? They are medical appointments, after all.

@Butterkist8 I think it should be more of a flexible service.

@XenoBitch that's what I was wondering, if they would count as a medical appointment.

How do you think it should be funded, OP?

Good to hear you're looking to get help with your mental health if you feel it's needed - the first step is the hardest, I think.

@LaRevolution yet now I can't access it. I made that first step for nothing.

YANBU. I was referred to counselling a few years ago but the latest appointment they could do each time was 5pm, near my home. Which meant leaving work at 4pm latest to get there on time (London).
My employer was just not flexible about it even though technically they are medical appointments - they used to get a private GP to visit the office as a "perk" but in reality they wanted you to use them rather than your own GP so you'd spend as little time as possible on GP appointments. But this was all packaged as "we care about our employees" crap of course.

I stopped going to the counselling sessions as it was just too difficult with work, and I couldn't afford to get made redundant.

The same place used to have organised "mental health" weeks. Fucking assholes.

Biggest advertising agency group in the world.

It would 100% count as a medical appointment. Well done and good luck x

I don't see why 'normal time' workers should have access to out of hours counselling.

It would be lovely but why should highly trained professionals just be at your convenience?

Hardly anyone would do it. They are like you, time wise and have their own lives.

They are medical appointments and if you're severe enough to be under MH services it's classed as a disability so your work should make reasonable adjustments to accommodate it.

If you end up having therapy this can last up to 12 months so you need to speak to work. You won't just be needing the appointment off but the half day after to recover too.

A lot of primary care nhs mental health services do actually offer evening sessions, but the initial assessment has to be in the daytime in case any risk issues come up that need team input/immediate supervision. I would try to get time off for the assessment then ask about evening sessions. Also if they cant offer evenings they should be able to write a compelling letter to your employer stating that you're entitled to the time

Hi OP. Unfortunately health services are unbelievably stretched at the moment. There is not the funding or the staff of in most areas to provide extra service hours.

I work in a different but similar service. The problem with having 24/7 or 10/7 or 12/6 etc cover is that you need more staff. More staff equals more money and there isn't the money.
As others have said, you can 100% get time off work for it. Please don't be put off by this tho' and remember you don't have to tell your employer the exact nature of your appointment.
You've done the hardest pit and made the first step, just try once more and you'll get there.

They are medical appointments, so your employer should not cause any trouble about you having the time off.

It would be wonderful if mental health services could offer extended hours. But they’re so poorly funded and staffed, even 9-5 is a challenge to keep running.

Bear in mind therapy appointments, if needed after the seminars, will be during working hours too. Would it be worth speaking to your employer about it, see if you can agree some flexi hours or something?

@SpeedbirdSquawker why would you think this isn’t a medical appt?! By definition it is!

NHS non-urgent mental health provision works on the same principles as NHS non-urgent physical health provision.
They’re both NHS medical appointments for your health.

Theyre both non-urgent (therefore don’t need to be 24/7)

If patients need regular NHS physio they negotiate the time off work with their manager / HR / OH. Because it’s accepted that physical health outpatients appts are generally Mon-Fri 9-5 / 8-6.

Why should mental health treatment (im assuming you’re referring to IAPT-type primary care provision) be any different? Just because it’s MH doesn’t mean it shouldn’t be prioritised over work. And doesn’t mean us as staff should work evenings & weekends just to provide added convenience.

If your depression is assessed as being officially severe (I’m guessing you’ve had a PHQ-9 to provide the diagnosis of severity?) then you’ll have every right to time off to access health care. You can probably arrange it for the start/end of a day. I always take my patients’ work into account when booking them in, although most aren’t well enough to work in general.

Once you get involved in mental health services, you will find that staff are so much in short supply, that even getting any appointment is a matter of luck.
Professionally, mental health is not inundated with candidates. It is a very difficult job, limited by the shit system called “care in the community”, and is often completely thankless as the people you help often don’t have insight to express appreciation. It is a constant war zone- anyone who makes a career of it deserves a fecking medal .

my ex had “severe and enduring” mental illness. 1 psychologist for the whole of a regional areas’ under 65 year olds. He saw 1 mental health worker per year. Even he got one set of group therapies in 10 years, no individual therapy despite NICE guidelines.

So, primary care services, like you’re seeing, are financed separately, but remain massively under staffed too. Lack of funding, lack of bums on seats and huge vacancies.

staff doing that job cannot work 18 hour days to do extended appointments- you’d need shift rotas. There isn’t the staff or money .

so, yes, you’re right they SHOULD be more flexible, but it will never happen . Even with more money there aren’t the people wanting the jobs in this discipline

if your assessments are under NHS or private medical care, then yes you ”should” be allowed for time out to attend in same way as any other medical appointment depending on your company contract - that contract will define if you have to take unpaid leave/ holidays or they’ll cover wages. Theoretically they could say no. But they are required to make reasonable adjustments for any disability that needs medical appointments - if your mental health issue is long term, then that may be an angle to pursue. But These assessments are the same as going for physical tests like X-rays. They’re designed for professional to understand what your issues are and what the replies would be best for you. They can’t start actual sessions (treatment) till you’ve had thst diagnosis and assessment . Most companies aren’t going to risk you being signed off sick becuase you can’t get treatment for mental health issues - these are some of most difficult conditions for managers to manage and can end up in long absences. They’ll want to avoid that. Be open and upfront with your manager when asking, but you can tell them to discuss with no one else without your prior consent.

if you’ve gone to a non qualified private counsellor it may be different, and be very careful. Anyone can claim to be a counsellor or therapist. Check you’re dealing with someone who is part of professional body and is actually qualified with a psychology degree and post graduate training. I have experienced some very bad counselling that have done actual harm before I twigged this

Yes you can. It's a medical appt. Take the time off work.

Why can't you take time off? Why wouldn't it be classed the same as any other health assessment that a professional has requested for you?

This is part of why mental health services are so poorly funded.

Services can't be provided for extended hours when there is no staffing and no funding.

Just a guess, but maybe OP's manager is stuck in the dark ages regarding MH.
Mine was (and I worked for NHS). I could only get the therapy I very much needed (to avoid time off of work long term sick) during work hours. I had to see Occy Health to clear it in the end. My boss wanted written proof I was attending the appointments. OH dep drew a line when he wanted weekly reports from my therapist about what we had been discussing. My therapist told me (politely) to tell him to fuck off.

It's a medical appointment so you can request time off. Remember these medical practitioners are also parents and childcare nearly always ends by 6, you can't expect them to work anti social hours really

I'm using an alcohol drug treatment center funded by the government and all the appointments are office hours and they want you to attend at least one a week . People do it because they have no choice really.

As a psychotherapist your therapy appointments should be treated the same as any medical appointments. You make the time and your employer has a duty of care to accommodate this.

If therapy is needed and wanted by someone they will find a way to access it. I appreciate it's hard, I work for such a service. Lots of wellbeing teams or specific therapists do offer later appointments on specific days but it depends on the service.

Before maternity leave I worked a 10 hour day to provide late appointments on a Monday and my regular clients booked in took the royal piss unfortunately which is not helpful for therapy or respectful and pissed me off keeping me at work pregnant for no reason at 8pm!

Virtually therapy is offered a lot more now due to the pandemic provided you have a space to talk privately and confidentially. The eliminates the need for a commute. There is NO difference in terms of effectiveness for online vs face to face therapy.

Provisions differ massively from area to area but if this is free counselling provided by the NHS, then resources are limited and incredibly stretched. If you can afford it, better to seek your own counsellor who can suit your times more.

They should count as medical appointments. All my therapy I take time out of work for.

With the greatest of respect, if your depression is officially diagnosed as ‘severe’ you’re probably best off not being at work at least whilst you access the appropriate healthcare.
Or if you’re able to work, it probably feels very bad for you but wouldn’t meet the NHS threshold for actually clinically-defined severe depression & anxiety (which is usually characterised by inability to function, v poor self-care, self-isolative behaviour, inability to leave house, minimal sleep or vastly over-sleeping, tearfulness, agitation, hopelessness, ongoing suicidal ideation/attempts, panic, emotional dysregulagion or blunting, inability to function).
I say this as an NHS MH professional. A big feature of my role is triaging referrals to our service. Those who are working and wanting to fit support around their work (rather than the other way round) generally have mild-to-moderate depression/anxiety. And are offered services concurrent with their level of need.
Those who we see are those with severe depression, who are unable to function and therefore don’t usually have jobs etc.

And I say this as both a MH professional and someone with a severe and enduring MH condition.