Mental health support in the UK

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Posting here for traffic, sorry.

DH is having a mental health crisis. Huge mood swings but majority of the time very low, hating himself, incredibly negative and angry at the world and how unfair life is. Repeatedly overwhelmed by simple tasks, including parenting.

We live outside the UK. Help is available here but it's not easy: you have a long list of psychiatrists and psychotherapists and you have to basically keep calling them all until you can get a spot. He has found a therapist who will treat him in English but he hates his psychiatrist and looking for a new one is "too difficult".

He is convinced that the only answer is to move back to the UK and that he can get help there.

I know on one hand it would be easier as your GP would refer you and then it's just a question of waiting. But, assuming he can register with a GP & then actually get an appointment with them, how long are we talking?

My AIBU - AIBU to think he won't get better mental health support in the UK?

Don't blame yourself. You had no way of knowing it would end up like this. But given that this is the situation, I might (in your shoes) consider coming home. If for no other reason than you have more resources at your disposal should things not improve and you need to make a speedy exit.

Your children will adapt, whatever happens, so try not to worry too much about that. They're far more resilient than we think. I'm so sorry you're going through this, but you will find a way through ❤️

@NothingVenturedAndAllThat

I think you misunderstood me - those are all the negative things he says. I am very happy I moved here and I am not leaving

DH used to have appalling mental health and when he was at his worst the absurd waiting lists here were part of the problem, they were proof that no one cared about him and no one was ever going to help. He got a diagnosis on the NHS (eventually) and medication (after a long period on wrong medication that made him worse, that the mental health nurse knew was making him worse, and that he was effectively trapped on until he could get to see a psychiatrist to make the change) but getting any sort of talking therapy seemed to be so remote it was impossible. Eventually he got counselling via Maggie's after a cancer diagnosis. It was genuinely excellent counselling that has really sorted out his underlying issues and he has never been mentally healthier - however on balance I really wouldn't recommend this route.

One other thing I will say is that at his very worst DH was never horrible to me. I hope you've been able to set some boundaries to protect your own mental health - it is hard and you are a person too.

I'm sorry you went through this.

I think we are in a similar position as he is blaming the German health system for making him worse as evidence that no one cares.

I also think he was given very bad advice from a psychiatrist. He went to her for ADHD meds, and she said he had to stop his Prozac first. He'd been on Prozac for 10 years and she told him it was fine to just stop cold turkey and go on Ritalin.

I think this medication change has been a horrible mistake. But the psychiatrist isn't willing to discuss it and so he's stuck trying to find a new psychiatrist.

I think you are probably right about the medication change, OP. There is some good, detailed information here on withdrawal from psychiatric drugs that your DH might find useful: https://prescribeddrug.info/

I think the suggestion of seeing a UK practitioner via Zoom is a really good one.

DH had a psychotic episode just under a year ago. The support was outstanding. The GP, mental health crisis team, Police, psychiatrist, psychiatric unit.

If his psychiatrist told him to stop Prozac cold turkey, he definitely needs a new psychiatrist, that's appalling advice!

My experience of MH services in the UK is of CAMHS only, but I would echo most other PPs - he will go on a long waiting list and what help he gets at the end of it will likely be entirely inadequate. My daughter waited over a year for her first appointment and they have been unable to provide much other than medication, we have been waiting 9 months now for her to be allocated a therapist ( on top of the initial wait for assessment).

He may be able to use this service to find a new psychiatrist (presuming he's got statutory insurance) https://www.kbv.de/html/terminvermittlung.php The principle of 'freie Ärztewahl' is quite important in Germany, so nobody should really object to him seeking a second opinion. Depending on where you are, psychotherapy should be available too - but he does have to ring round. He can use the Sprechstunde system that has been introduced quite recently. Waits for therapy to start may be a few months, depending on where you are, but there may be much less waiting time if he goes with a trainee therapist (they are very well-supervised and often pretty experienced, as training involves at least 600 hours of practice and a year and a half in psychiatric settings).
https://www.wege-zur-psychotherapie.org/die-psychotherapeutische-sprechstunde/

Once therapy has started, the provision is much, much better than in the UK - a minimum (!) of 25 sessions for CBT, 80 or 100 for 'depth psychology' therapy or psychoanalysis.

Someone in his position may be a candidate fora short-term stay in a psychiatric hospital to sort out his meds. But again, he has to put this process into action. I presume he has a Hausarzt or a Hausärztin?

The system does mean that he will have to take some initiative, and you sound as if you, entirely understandably, can no longer take it for him. I'm cure the meds change hasn't helped, but it sounds as if he has got into the habit of blaming everyone and everything but himself (sadly including you) for his situation. If you're happy in Germany (whereabouts are you?) and the dc are settled, I'd certainly stay, and begin to think about your long-term future and whether you want or can afford, emotionally, for it to be with him.

(You can find trainee therapists by googling 'psychotherapeutische Ambulanzen' and looking at what's available in your area. Many of them are attached to universities and training institutes)

Your husband seems like hard work, OP. He think if he just waltzed back in the UK everything will be awaiting him on a silver platter? Couldn't be further from the truth! He will still have to do the work of filling forms, meet with various professionals (whom he may also dislike!) and do a long big wait.
He is clearly not willing to put any effort to get help where he is. How has he been living there barely speaking the language? Why can't he hire a translator to help him with the admin?
He has left everything for you to do, self absorbed in his own woes when he can do a lot more for himself. And blaming the system/country he is in, doctors he doesn't like, nothing being right...Classic "victim" syndrome. Stop enabling him and look after yourself and your children. Let him come to the UK, I suspect your life will be much happier and stress free without him.

He is unwell hence needing support. Just getting out of bed can be huge for people struggling with mental illness.

Thank you @ShoesoftheWorld

He rang 116117 in desperation over Christmas and they got him a psychotherapist the next day. But this isn't permanent- they can only get you someone for 12 sessions. However she is wonderful and by amazing coincidence is American so talks to him in English.

He has found a new psychotherapist who will take him on permanently, in English, through our Health Insurance. It's just the psychiatrist he needs now.

Outing myself now - I'm in Karlsruhe

To the other poster who said about language- he does speak very good German. But right now he can barely function in English, so it's a step too far. But yes, he is expecting to walk into England and have everything handed to him on a silver platter which is why I am trying to gather info to show that isn't the case !!

MH services are dire in the NHS. I have schizo affective disorder (a type of bipolar disorder with psychotic episodes) I don't meet the criteria for NHS mental health community services & am under GP only. Crises are dealt with mainly by police.

I’m in the north, working in a non statutory mental health field and I couldn’t disagree more.

The way that trusts are ensuring their waiting lists are low is by not referring or accepting people. There are very limited services who offer long term support anymore so people are just dumped at the end of their episode of care. It’s left to GPs and charities to support those people.

I have so many examples of poor provision that I could describe just over the last few months, including people with active psychosis and at rush to themselves who get absolutely nothing because they’ve finished their three years with EIT and the CMHTS are too busy to take them on so they don’t even get referred. It’s a disgrace and there should be a national enquiry.

Congrats for voting Tory guys 👏🏼👏🏼👏🏼👏🏼