What thing would help people's mental health

[PassingStranger]

Just wondered, when people say, they didn't get the help they need, or needed for their mental health.
What does this actually mean?

Does it mean, there's a lack of affordable professional help available.
People have to wait too long for help, there's no help???
I'm interested in this, what would help people?
What missing?
What do people need.
I've heard the expression didn't get the help they needed, so what is that?

To be honest a lot of mental health help isn’t really up to much, even when it’s accessible or private.

I think the greatest help would be to examine why there’s a mental health crisis in the first place.

My baby turned one (which meant I was no longer under the remit of perinatal mental health) before I got to the top of the list for help.

Mental health is such a broad thing, that there is no one size fits all help for it.
What can work for one person, could possibly not work for another.

I think a good way to ask is "what does help look like to you?". However, when I have been in crisis, that can be very difficult to answer. I just want to stop feeling, and having the thoughts that I do.

For some, that help could be in the form of hospital... in a safe environment where they can be started on new meds. For others, it is just having someone to talk to and unpack things with.

Sadly, MH help in the NHS is lacking and the bar for access is set so high. People fall through the gaps and get worse, or sadly take their own life because they were waiting too long to access support... whatever form that was in.

Completely agree @XenoBitch . What would help would be a major cash injection to the mental health services but the government don't give a shit so they keep giving them less and less

This may sound naive but I believe what would help people is if they felt connected socially.
So many people have no support network and it has an enormous effect on their mental health. Some people find when they have mental health problems, their friends fall by the wayside, and they rapidly find themselves incredibly isolated.
I heard the opposite of addiction isn't sobriety, it's connection.
Loneliness is soul destroying and has such a detrimental effect on a person's mental health.

I went to my GP get help for a physical health problem. They said the waiting list for treatment was very long (I’m still on it) but due to my pain and lack of sleep they could give me antidepressants. Lots of ‘mental health’ problems are actually physical health problems not treated.

I have worked in mental health provision in various contexts. Some of the reasons people don't get what they need:

Often the waiting times are too long. 18 months to 2 years in some IAPT services.

Waiting lists for CAMHS are insane - young people frequently age out of eligibility having waited for years without being seen.

Often when people are offered treatment, it's 6 sessions with a trainee therapist - which is nowhere near enough support for someone with complex, longstanding and serious mental health issues.

People have varying needs, and getting help for the particular difficulty (or set of difficulties) you're facing is key.

Someone with a spot of moderate work-related stress might just need some psychoeducation, and practical support such as career guidance, or communication skills training (though often the issue is solved by moving to a job or workplace that's not shit!).

Someone with schizophrenia may need to see a psychiatrist in the context of a multi-professional team.

Someone with complex trauma who is dependent on multiple substances is going to need intensive, ongoing, multi-disciplinary intervention.

Someone with anorexia is going to need specific eating disorder support (and possibly also an autism evaluation).

Someone with dementia needs a different kind of mental health support than someone who doesn't have dementia.

Etc etc.

Part of the trouble is that if there's nobody to correctly assess what the problems are you're dealing with, and consider them within the wider context of your life circumstances and physical health status, you may never be referred to a service that could potentially make a difference.

If you only get 7 minutes with your GP, often over the phone (and it's hard enough even to get a GP appointment at many surgeries), and their first port of call is to put you on SSRIs and stick you on a general counselling waiting list, it might be years (or never) before anyone spots you have dementia, or complex trauma.

Plus, most people aren't going to tell their GP (who they've likely never met before, over the course of a 7 minute phone appointment) they are starving themselves, or addicted to fentanyl, or suffering flashbacks to horrific sexual abuse that they feel ashamed about, or losing their memory, or hearing voices.

It's miraculous, given the system we're working in, that as many people as they do get helpful support. But it's a pretty grim outlook overall.

There's more and more groups these days and activities though to meet people.
I've seen lots of Facebook groups start up for example, that are aimed at people meeting up to get them out meeting others.
This didn't happen years ago. There's more ways to connect than ever.
I never heard the word mental health growing up.

To get to the root of the problem, rather than treating the mental health crisis that it causes.

Personally I think the following are big players in causing the MH problem:

• too much choice and information at our fingertips 24/7. This in itself creates stress as there’s too much continuous decision making and you are never certain if you’ve made the right choice. When my gran was furnishing her house or choosing her holiday she went to the local dept store or the local travel agent and chose from a limited amount of options. Then the choice was made and she could move on happy that she had made the right choice.

• breakdown of multigenerational living, meaning parents are left on their own to do everything, and children are raised in a smaller group of people than they would have been.

• the expectation of a standard of living that is high and sophisticated compared to 70 years ago, such as having two cars, owning your own home, having multiple TVs, eating out, going on holiday, paying for entertainment subscriptions etc etc. this means both parents have to work to support it and it creates a ton of extra admin that needs to be sorted out outside of work

• high rental / housing prices, also meaning people have to work longer hours

how any of this is solved though is beyond me, as it has become ingrained in our society as natural progression

I've heard the expression didn't get the help they needed, so what is that?

Appropriate and timely intervention in order to avert a crisis. It could take the form of a psychiatric evaluation and medication, hospitalisation, home visits or support to meet people and reduce isolation.

I think mental health problems wouldn’t be so prevalent or would at least be less serious in children and young people if there was a massive cash injection into schools, particularly SEN and also a whole curriculum shake up in both primary and secondary.

For a lot of people, affordable, decent, secure housing. Mental and physical health would improve for many.

The NHS is under tremendous pressure so waits are long and not all treatments are available in all areas.

However, people's expectations are often unrealistic. They want things that don't exist (anywhere, not just unavailable on the NHS), or unlicensed treatments they've seen in America on YouTube, or they think they need a treatment that isn't designed for the condition they have because their auntie's neighbour had it and he's much better now.

Often when I ask people what they want/need/expect, they really don't know. They just want "help". They are also unrealistic about what "help" will achieve. Anything with results short of instagram perfection mean they've been failed by the NHS and didn't get the help they needed. They are often unwilling to do anything that requires effort in the pursuit of help, they just want a pill to make everything perfect and don't realise they actually have to make changes if they want things to change

Obviously not all patients, but a frighteningly large proportion!

So true

The amount of people who miss / don't engage with mental health services when they are offered an appointment is staggering.

I've been in hospital often with chronic illnesses...

I've seen a few people sent home the next day after suicide attempts.

I've seen a MH professional after struggling with months of severe illness/sepsis, stuck in hospital. It was diabolical. I knew more than them. They actually scared me. Recruit and retain high calibre people? ( Not going to happen right now sadly).

I have a number of suggestions -

• Encourage access to therapy - good therapy long term. Not 6 weeks CBT bullshit.
• Address this huge obvious element where we have an incredibly large ND population who deserve an assessment and access to trying medication without being gaslit
• Let people openly talk about suicide. Yes that's right, I used the word suicide ffs. People want to talk about very real feelings and contemplations. I believe this does not make people do themselves in
• Can we move away from normalising pretty damaging things like SMedia, women working to death and juggling kids like such a good wife 🖕No. This is so much for women and it's not right.
• Society needs to change dramatically to address all the things that really make it so hard for people to feel good. The list is too long for that. The school system is my first place but that's beyond anything we can change right now.

For me - getting away from incredibly damaging toxic family ( yes they really are. No buzz words here )
Time with animals and nature
Saying no more often

😘❤️

I have schizoaffective disorder. I had my first psychotic episode when I was 19.
I did not get the correct diagnosis for a further 15 years. It took many further years of poor care with poor communication, high turnover of staff etc which meant I was not on the correct medication to stabilize it.
Each crisis involved the services bouncing me between them - each referal leading to an assessment which only led to a referral to another team and so in. Repeatedly left until police were called for section 136. Followed by a brief assessment then discharge & repeat.

I lost the important teenage & young adult years which you can never properly make up. Plus the longer you leave a mental illness without adequate treatment the harder it is to get under control.

The correct care would have been referral to the correct service & continuity of care - not being assessed & bounced. Then ongoing longer term care to stabilize & support.

Ideal would be: Referral to crisis intervention/home treatment from a&e or section 136 for say a month then community service for 12 months after then say 6 monthly check ups ongoing for life.

This is not what NHS care looks like. Section 136 are almost always discharged with no follow up. Home treatment/crisis services & inpatient are so far over capacity that very few meet the threshold, community teams are now short term (6 sessions) intervention followed by discharge.

Have you any awareness of mental health services OP? as I'm confused as to why you need to ask these questions.

Joining in more socially. Too many people are addicted to their phones/the internet etc. ‘back in the day’ we went out, danced, joined groups, helped at Brownies etc, all brilliant for mental health. Plus, joining a community choir should be top of the list, numerous members of our Choir have overcome poor metal health by singing in our Choir. There’s no feeling quite like it.

Dismantling capitalism.

I also agree with others, that information overload plus cost of living is taking a huge toll on the mental health of people who would not have found it so difficult to function 30 or 40 years ago.

I also see many people who need much more practical support with everyday life tasks than we want to acknowledge. There is a whole population of people without learning disabilities who just can't really function on a day-to-day basis, and end up burning out again and again when they try to live independently.

I think most would probably do well in a supported living environment where they could have independence and privacy, with a lot less decision-making, and help with things like shopping and cleaning and cooking and admin. But who is going to fund it?

What is your role? You said you ask patients what they want and don’t like the response when they suggest things but also don’t like the response when they don’t know. The phrase can’t win seems to come to mind.Personally having 3 children let down massively by the NHS causing huge harm I’d say I want professionals who actually know what they’re doing,are properly qualified, informed and experienced,who are informed re ND and don’t rely on patients to do their job for them. All the above seem to be sadly lacking.

It is simplistic to think meeting people is going to help many people with mental health issues. Often isolation is the result of it rather than the other way round. When I’ve been depressed I don’t want to engage with anyone even though I have family and friends around me.

As to not hearing about ‘mental health’ before now, are you unaware of ‘mother’s little helper’, valium given to women in the 50s and 60s? Do you not think that many people with problems with alcohol/drugs have underlying issues? This isn’t a new thing, it just hasn’t been openly talked about. It is only recently that some of the stigma has lifted but now people like Badenoch and this government seem to be minimizing anxiety and depression and I fear the stigma will return.

They want things that don't exist (anywhere, not just unavailable on the NHS), or unlicensed treatments they've seen in America on YouTube,

I think too the fact that the vast majority of treatments need to go through the incredibly restrictive NHS research/approval process doesn’t help. In therapy terms it means a heavy reliance on manualised therapies that can be reproduced for evaluation and a move away from relationship based therapies that are longer term (and therefore more costly) but that can bring about genuine change in people. While there’s a fair amount of quackery in the States they also have room for innovation that we just don’t have because of the way the NHS gate keeps.

Often when I ask people what they want/need/expect, they really don't know. They just want "help". They are also unrealistic about what "help" will achieve. Anything with results short of instagram perfection mean they've been failed by the NHS and didn't get the help they needed. They are often unwilling to do anything that requires effort in the pursuit of help, they just want a pill to make everything perfect and don't realise they actually have to make changes if they want things to change

Yeah I've heard people on MN who are so-called MH professionals say this before. It's appalling victim-blaming and lack of insight that people with MH problems can't dig themselves out of the hole, that's literally why they were referred to you.

But whatever helps you sleep at night about the fact that most of you don't actually have any effective skills or knowledge to help the people who need it, who get driven to disengaging because they're so disillusioned with the system, really.

I am a Samaritans volunteer so talk to people every week who are having a terrible time.

What I’ve noted is that lots of people are missing really important things at the bottom of the hierarchy of needs (below).

Example- they have not slept, sometimes for months. Or they have an eating disorder so have not eaten well, sometimes for years. A young woman the other day had only one room in a hoarded, rat infested house, so no appropriate shelter and nowhere else to go.

The idea is you cannot progress to the next level of fulfilment without all the items on each level being met. So if physical needs (red) are not met, you’re going to be in a really bad way.

So what im saying is sometimes people’s basic needs are what is missing.

https://en.m.wikipedia.org/wiki/Maslow's_hierarchy_of_needs