To say that the healthcare system hasn't a clue when it comes to mental health??

[Danghormones]

I've struggled with mental health my whole life. I've been told an annoying number of times by people 'you've your life so together'. For context, I am fortunate to have an excellent career and I'm married to a wonderful man and have a beautiful baby. Nothing exceptional or out of the ordinary but I'm young in my profession to have got to the level I'm at so from a general point of view, it looks like I've my shit together.

Underneath I feel like I am ready to explode at any second

About 5 years ago my mental health was at its worst and I can honestly say the NHS were no help whatsoever. I actually dropped off their list for therapy and they rang to apologise....7 months later. I was in hospital for mental health reasons and the follow up was absolutely abysmal. I have paid for private therapy 4 times because of this.

Most recently I was referred to a psychiatrist (finally!!) querying BPD and even at that they told me to go look at a course that's in my area. I rang straight away to enquire about it...they said they don't know when or where it's running but it'll be the new year anyway. My psychiatrist also after looking at my notes asked was I referred to the post natal mental health team after I told my health visitor that my mental health wasn't good. I wasn't; I didn't even know it was a thing! She was apologetic and said i'd been let down by the system....what's new I thought??

I have private health insurance and even trying to get an appointment with them was a 4 month waiting list. It mightn't sound like a lot but when you're in crisis mode, 4 minutes is a long time never mind 4 months.

Just so frustrated that I feel like there's so much encouragement to speak up and get help etc and when you do...well you just feel like what is the actual point??

I am sorry for your experience and. sadly, it is not an isolated incident.
Healthcare system has a clue about a lot of things. But this doesn't change the fact that there is no money to train, recruit or retain qualified staff. In my area, the waiting list for neuropsychiatry is closed because they currently have 3 years worth of patients on their books already and only two members of staff. With the best will in the world, I wouldn't be able to refer someone.
I understand the desire to blame people who work in the system but, trust me, we are just as frustrated by lack of joined up care and the length of waiting lists as you. I left MH work because I was tired of constant hoops I had to jump through to ensure someone has a long term follow up plan and being told that the service I am asking for simply doesn't exist or did exist but no longer does due to funding and recruitment issues. Or does exist but the patient does not qualify because they haven't been hospitalised yet. Or, my favourite one, that they can't accept a patient who doesn't self-harm which results in a patient who never self-harmed beginning to do so out of desperation for support. So yes, there is one less staff member in my previous team and my post is still not filled 2 years later... but what can I do.
The buck stops with the government, I'm afraid. If you want to direct your anger there, we would greatly appreciate it. Because when we, as health professionals, try to raise it we are being told that one can't just "pour money into a broken system". This money doesn't buy a SEO a new Lamborghini. It literally pays for bums on seats to staff the services people are desperate for.

I know it’s not the NHS itself who is at fault. I’m in Northern Ireland so it’s even worse from a local and British government level. I feel even at that though a lot of the professionals give different advice, refer to different people etc. it’s all such a mess.

My daughter has needed MH treatment - so I'm not just saying this from a position of smugness.

But the NHS was just never set up to deal with the long-term and very complex issues posed by MH problems. It was set up originally to provide straightforward surgery, free glasses and dentures and basic pharmaceutical treatments.

MH problems are by their nature often very long-term and difficult to treat. And they're usually open-ended too. Personally I've never heard of anyone saying 'Well, I got 6 sessions of counselling, so that's me sorted!" Have you? While I sympathise (having been at the sharp end) I really don't see that the NHS as it stands can possibly be expected to treat MH adequately.

I suspect MH spending will necessarily be focused on the most acute cases - like the son of a friend who is basically on suicide-watch, or ofr patients whose conditions make them a danger to the rest of us.

I don't know what the answer is, but I don't think it will be simple - or just a matter of funding either.

But see my issue is that it doesnt have to get to that stage of critical suicide before it’s treated. I’ve been there myself and felt the care even at that point was shocking.

You’re right though. What actually is the solution?

There isn't one, really. Stop people developing MH issues in the first place? Absolutely impossible - the causes are so complex: childhood abuse, trauma, neglect, addiction to social media, inherited medical conditions or things like asd, adhd, etc etc.

I'll be brutally frank, and I'm sorry to sound so negative, but I think the only (partial) answer is to re-set the current attitude to MH and basically go back to the 'just get on with it' attitude of the recent past. Obviously, not for serious conditions, but for those where social engagement and physical activity, say, could help. For every person who has a serious MH problem, there will be one who claims they 'have anxiety', without any actual diagnosis ...believe me, I've met them.

Also, we've all been sold the line (mainly as a result of social media - which has a lot to answer for in this matter) that life should be happy and trouble-free - but it never has been for most people. If we can rid ourselves of the idea that we should be happy all the time, and that nothing should cause us stress, that would help for many people. Investigate Buddhism - that has a lot to teach about acceptance and not struggling against things which we can't change.

Ready to get torched....but I'm not talking about people like the sons of my two friends. I mean the girl I used to work with who couldn't do any of the slightly less pleasant aspects of her job because she claimed to have anxiety. She hadn't mentioned this at the recruitment stage, of course.

I have nothing to say other than get off the fucking thread. Would you tell someone with cancer to think it away? Wise up
Sadly, this is the issue. @CoffeeCantata is absolutely correct but when you are in it, all you want is someone or something coming up with a miracle cure to take the pain away. Being told that that cure doesn't really exist and that you have to build resilience whilst gaining understanding of what are triggers to build you own coping mechanisms is not what you want to hear.

Psychiatrists mainly deal with severe cases of mental health that affect people in such a way that become completely unable to function in life. Most of the therapies are pharmaceutically based, the treatments are heavy, needing close monitoring and can even be life threatening. Indeed, many people have died as the result of poor monitoring.

Psychiatrists are medically trained, 5 years in medical school, and then speciality trained for many more years.

Many people nowadays suffer from debilitating anxiety and depression for which medication can help, others do well with therapies or a combination of both, but for the majority, it is about learning to make changes in their lives, in the way they think, feel, and accept their strengths and weaknesses.

Obviously no one knows you here and what you've been through so can't make specific comments about your situation, but the NHS isn't to blame. Society is. The NHS can't cure everyone, they can only provide what is available to them and that's not the answer and miracle that those suffering are so hopeful for.

YANBU. Most people need better therapy than a few sessions of CBT. I’ve had to spend thousands on private therapy and not everyone can do that.

Honestly please anyone who is saying you can think your way out of it etc etc you clearly have no understanding of mental health whatsoever. I’ve been in physical pain and had physical conditions and I would take them 100 times over rather than live with a head like this.

Sadly, this is the issue. @CoffeeCantata is absolutely correct but when you are in it, all you want is someone or something coming up with a miracle cure to take the pain away. Being told that that cure doesn't really exist and that you have to build resilience whilst gaining understanding of what are triggers to build you own coping mechanisms is not what you want to hear.

I do agree with this. Granted, @CoffeeCantata didn't quite put it sensitively but there is truth in this. I work with people with chronic conditions. There is no cure. A lot of the time people who do recover - in a sense that we understand recovery model i.e. being able to live a full life despite having a condition - are those who accept situation as it is and learn to self-manage.
But, in the middle of a crisis, it is natural for people to reach out to a health professional for a fix. The fix often doesn't exist and it then becomes a tricky conversation where one is trying to coach a person through the same self-management we've been exploring in the last 147 appointments. A lot of the time, it helps the person to gain agency and sense of control. Occasionally, we get "you are all just useless" response because we can't immediately resolve the symptoms with a magic pill.
It all stems from over-reliance on the medical model. "Here is a broken part, take this and it will be fixed". Even with psychological therapies, a person needs to work through the techniques and build coping routines. It's not as simple as sitting in a room being "therapied".
And yes, the case is the same for people with incurable cancers and many other physical conditions.

I've worked in mental health for many years.

You are absolutely right that the help available is far from ideal.

I used to feel awful for clients who have been sold this message to speak out and seek help. When in reality, there is no (adequate) help available.

I personally think after years and years observing the system, that it's all a massive waste of money.

I actually genuinely believe if you scrapped all mental health care provision in this country, the outcomes for people (on average) would be no different from what they currently are (on average, not thinking about individual cases).

Most of the drugs don't work, most therapies currently offered (which are v short term on the whole) make very little difference.

We r ploughing billions into a system that is broken and does very little good.

Mental health system needs a massive re-think, right through from primary or GP accessed services to inpatient units. It's all a catastrophic waste of money that in many cases does more harm than good.

That's a bit harsh OP.

I actually agree with quite a bit of what coffecantata is saying.

People are sold the line 'you must have X or y diagnosis and should reach out for help'. But sadly that helps doesnt exist and it's unlikely that it ever will.

I do think that we need to re-think the NHS somehow and we also need to reduce the amount we medicalise everything and get back to supporting each other in communities, and learning to develop a different relationship with our emotions which is less about treating and getting rid of them (which is hard, if not impossible and meds don't really work to do this) and more about seeing them as normal parts of our lives, normal reactions to bad experiences etc.. which we can learn to manage

Honestly please anyone who is saying you can think your way out of it etc etc you clearly have no understanding of mental health whatsoever
This was me in my mid 20s. All the negative emotions and experiences hitting me in one go. On the surface, I seem fine, doing all what was expected of me but deep inside, I felt so alone, lonely, lost and just unable to see even a hint of positivism in my future.

I attempted suicide and then saw a private psychiatrist. He did all he could do, give me antidepressants and daily dose of valium, because in the 80s, that's what they did. I lived in fog unable to process anything. No acute mental pain, but nothing remotely positive either.

It took years to break the cycle alone. It took many many small steps. Events that changed the course of my life, accepting who I was, my strengths and weaknesses. Most importantly, my bad luck but also the fortunate things I could hold on to. Ultimately, no psychiatrists, therapists, family member, partner or friend got me out of it. Only me, in time, finally accepting this inevitability, although all the above helped me a tiny bit. Tiny bits I couldn't see then, only later in retrospective.

You don't want to hear and read any such posts. Only, I assume, posts saying how everything and everyone is shit and that's why you are not getting better. That's totally normal. One day, you will be better, pain free, and will reflect on this time with a very different perspective.

I do wish you all the best. The key think to hold on to is one tiny step at a time, and if you take one or two back, it's not sign that it's backwards only from then on, one more little step and the backward ones will diminish while those forward increase.

It’s not harsh. It’s so demoralising hearing people say just get on with it attitude. If I had a broken leg no one would say just walk on. If I had a broken arm and drove my car and crashed it people would say why would you drive with a broken arm? Oh sorry I was just getting on with it.

I have a broken head. I can’t just get on with it as much as I would love to. This is exactly why there’s a stigma around mental health because we do push on and then people are surprised when suicide seems the only option. Oh only if they had have talked, or reached out etc. the post that said about just get on with it is exactly why we don’t.

I know there are people who ‘claim’ to have mental health issues because of one bad day. I’ve often said it’s like having a tight chest one winter doesn’t mean you’re asthmatic. But see for those chronic asthmatics out there? Every day is a struggle. It’s the exact same with mental health. So I don’t tolerate anyone who said it’s a one size fits all get on with it attitude. It’s lazy and insulting.

YANBU but also the science and methodologies behind mental health services are atrocious. So much of what passes for “therapy” these days is at best irresponsible and at worst actively harmful. It’s deeply troubling.

I understand your anger, but the thing is, there is no pill, no one therapy, nothing that can 'fix' it for you.

I think the medicalisation of mental health and all the comparisons to broken legs, cancer etc.. are really not helpful. It makes people think - 'oh, if I can find out what's wrong, get my diagnosis, then I can get treatment and be better again'. But this almost never happens. While CBT and similar can help a bit with depressed mood or feelings of anxiety, a lot of the reason for that is the work the client puts in, and clients are very rarely offered a long enough course of CBT anyway. Other therapies can be effective, but all require work from the client etc.. and it's not really ever the case that you 'have depression' then complete therapy, and then are 'fine'. People usually continue to feel a bit rubbish afterwards and sometimes get worse again. Meds hardly ever work except to dampen and numb our feelings for a while.

I do agree with a few other posters in that we need to re-think the MH system and how the media and others portray mental health. If I have a diagnosis of "anxiety" then I will assume I need treatment for that and will want it and will not be satisfied if it doesn't work (which it.often.wont). We do need to.oberhaul.the MH system as currently there is simply not resource to treat the millions of people in need.

I do hope one day we'll get rid of this analogy with physical health problems. It's not helpful. I think.its been perpetuated by psychiatry and used in a well meaning way to try and reduce stigma. But the message has backfired and is fundamentally flawed

The solution needed is a societal overhaul on every level, but mainly…..

• Emotional intelligence and resilience development should be in the curriculum from the very first day of school until the last.
• A change from the current societal culture to one of personal responsibility, accountability, community, tolerance and respect.
• ALL healthcare, caring, social care, law enforcement, education, political employees etc and parents need significant training and education on the impact of adverse childhood experiences and how to apply trauma informed practice.
• Social media in its current form should be entirely eradicated. It is the greatest toxic poison of the modern world.
• Funding for meaningful research into general mental health and specific mental health illnesses needs to be increased.
• Mental health care services need to be better staffed, more visible and more accessible.
• Acknowledgement that health inequalities exist and an improvement programme to address this.

I disagree. Poor MH is a lot more than depression. I have dc who have had clinical depression, severe anxiety, CPTSD, suicidal idealisation with attempts and a severe ED.

The higher tier treatments( not crappy CBT lead by somebody poorly qualified ) lead by high qualified staff and medications have been life changing.

This is exactly it. Are you planning to run for election by any chance?

funny you should mention social media, I actually deleted some of mine over the weekend because of how triggering it was. I’m not sure how much coverage there is of it outside of Ireland, but Conor McGregor was involved in a sexual assault civil case and the woman who brought it against him won and some of the stuff that was coming up on X was so vile and triggering that I ended up deleting it completely.

Well said. I agree with a lot of that. Especially the introduction of emotional literacy and resilience in schools.

Who cares about Pythagoras and ox-bowe lakes when we can't leave the house because of anxiety.

MH should be taught in schools, as should resilience and strategies to manage MH, regulate emotions, manage difficult situations, manage difficult thoughts etc..

Many years ago we had county asylums for people with long-term complex mental health issues ,they existed in the 1800,s the problem was many patients were wrongly admitted to them sometimes for very tenuous reasons and many were kept in hospital for far too long and became institutionalized
By the 90,s many of these hospital,s were closed down

I was just using depression as an example.

I'm v pleased your DC has been well supported and found the intervention helpful. They were lucky to get decent therapies. But it's unrealistic that that huge level of support can be offered to everyone. Close to 1 in 3 people experience diagnosable MH probs. We simply don't have the resources available to change everyone's lives in the way your DCs life appears to have been changed.

FWIW OP I am with you. I feel the impact of my mental health issue everyday and the help available has been meagre and ineffective. I just get on with it but the problems are systemic and the whole system needs rebuilding top to bottom. I wish you well.

Well that is ridiculously shortsighted- socially,educationally and medically. My dc would be causing the NHS and tax payer further ££££££ if they hadn’t been treated properly. You don’t leave physical illnesses to get worse until they cost far more so MH should be no different.

I'm sorry you're dealing with this. It's so frustrating.

My experience with the NHS for MH has actually always been excellent but I had anorexia which, let's face it, gets far more than its fair share of money and resources because it has physical symptoms too, has a high death rate and (if I'm going to be cynical about it!) disproportionately affects young, affluent white people! I also haven't needed any treatment or input since pre Covid so I suspect things are not so good now. But ny treatment was life changing and quite possibly life saving. And I got it more than ince. So I will always be grateful to the NHS.

But that doesn't mean that what's happening to you isn't awful. I totally agree that the NHS was never designed to treat mental health. But it wasn't designed for a lot of the other things modern life needs it for either. We either need to scrap it and start again or sort it out!