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??

What struck me trying to get help for children with mental health issues was the fundamental lack of common sense of the psychiatrists we saw. Basic things like apparently not understanding how distressing it would be for a child to hear their parents discussing their difficulties in front of them. Or failing to provide an environment that would relax rather than the clinical setting that stressed them out. Or if you medicate the child actually monitoring to see if (a) It helped and (b) It did not cause side effects. ds2 actually did a lot better when we stopped engaging with mental health services because as dh used to say an assessment is not help and it is not no-cost for the patient (or their carers) so unless they have the resources or expertise to help it is worse than useless.

I work in MH. It is almost unbearable. Its been my profession for a long time, I love what I do when I have the time, resources and support to do it. But MH is always back of the queue when it comes to funding. They even had to impose a minimum spend on MH to get Integrated Care Boards to put money in - it was 2.8% of the total health care budget in every area and some places even failed to do that. Now the MHIS standard has lapsed, MH will be cut again.

Rather than just moaning, people need to be asking questions of their local ICBs and MPs about why they are allocating so little money to MH and demanding they do something about it.

I work in an IAPT (or Talking Therapies as it has been renamed). There are a lot of poor practices in many IAPT services, and minimally trained staff who feel 6 sessions will be enough for anyone. BUT that is not the case everywhere - the service I work for has a lot of very experienced staff and takes problems that others will not The problem is, in many areas, funding is so low that only one or two services will bid and they are the ones driving poor treatment practices - mostly they are for profit companies and these are the ones driving the 6 session model because after this, their profits disappear. There is nothing in the IAPT treatment models that limit people to 6 sessions - most of them run to 20.

Where I work, 3 NHS trust has been driven out of offering IAPT by cuts in funding for the work. So private providers come in, are driven by profits, and use NHS badging so people lump them all together as NHS services.

The actual idea behind IAPT was good - MH services for people who would not otherwise get them. The issue is that due to cuts to other services people who would have had access to other, more intensive services now find it is IAPT or nothing.

I trained overseas. I was horrified when I really got to understand the MH system here. Run by people who can only see it through a very old fashioned and narrow definition of MH, who are disdainful of anything new, and whose skills are much poorer than I was used to. I have been in supervision groups with many of our local psychologists and have formed a mutual respect with them about our work but on the whole I find the whole NHS to be based on a 'my qualification is better than yours' attitude and some of my secondary care colleagues seem woefully under educated. And the whole 'recovery' approach is bullshit - basically completely discounts people with chronic problems unless they are really really low functioning.

@Hotflushesandchilblains I hear you. It really is a postcode lottery. I actually worked in IAPT for several years, before moving to IAPT-free Scotland! I had positive experiences in IAPT but this was quite a few years ago now (before AQP came in) and this was also in an affluent area with an exceptionally well funded NHS Trust. Some of the most skilled and talented therapists I have ever met worked in IAPT. My criticism is aimed at the broader structures - government and funding pathways. I have done extensive research in this area and unfortunately it seems the services you and I have worked in are the minority. Most IAPT services do not offer 20 sessions, even if it is what the evidence base states is needed. I also have concerns around the quality of training the lower intensity therapists receive, in addition to the high volume nature of that role - burn out in IAPT is rife. It is a business model at the end of the day and not a sustainable one.

I also agree that there is an entrenched hierarchical structure within NHS MH teams which is very frustrating. The medical model is still very dominant in most services too, with psychological perspectives and approaches playing second fiddle to psychiatry. In short, I can absolutely see why patients are demoralised and lacking in hope in MH services. I really hope things improve but I am not holding my breath.

I hear you @Plastictrees and you are spot on. Cant wait to get out, as the basic idea has been devalued so much I am not sure it is fixable.

If another patient tells me how a crisis team practitioner suggested they have a bath in the middle of an acute crisis, I might just be in crisis myself!

Or telling a vulnerable young woman to go for a walk in the park at 11 pm! What could possibly go wrong?

The mental health system is broken. I don't think there is a utopia. One of the issues health issues are lumped under one umbrella. There are people suffering from low income, house, homelessness etc - this people are understanding distressed. These people need help to change their social circumstance instead blaming people for their distress - mental health can do very little in these circumstances. Therapy cannot fix social problem.

On the other end spectrum there are people who have experienced trauma and abuse - there no magic wand. You cannot cure the effect of abuse and neglect. Therapy maybe able to help someone learn to live and process what happened to them but it not a replacement for parental love. We need to do more prevention.

There are those with serious mental illness such as bipolar - medication is the most effective in this group - this is area Dr and nurses receive the most training. The back