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?

It starts early. Stop child abuse, end poverty, support new mothers , bring back the village.

I've worked with people who have had to turn down therapy on the NHS because they couldn't take time off work without disclosing the reason to their employer and they felt they would lose their job, be treated differently or not be supported if they spoke about their Mental Health

I’ve had the same with my DD and CAMHS. She was very fortunate to get open ended therapy with an excellent clinician, weekly sessions meant missing school because there were no appointments outside of school hours. So her attendance was never above 90%, which caused issues at school and meant disclosing she was seeing a therapist - which she would rather have kept private. It also meant me taking a half day off work to take her which also meant disclosing to my boss. Thankfully I have a very supportive employer but if you don’t have that or don’t get paid time off, weekly sessions in work in hours would be prohibitive. Not to mention there’s no public transport option from my town to the CAMHS base, so if I couldn’t drive she wouldn’t be able to attend.

So many barriers even after getting the golden goose that is an actual therapeutic service.

You say you didn't hear the term "mental health" when growing up but that's probably because it is a more modern understanding that it can be unhealthy to bottle things up and squash them down for decades.

My grandparents (born 1920s) were terrified of feelings and would explicitly shut them down, I think because they were genuinely worried if they gave it air space it would take over. They went through some horrific things in their lives and the idea of going to a therapist to process it would have been absolutely alien to them. I think they had the idea that only mad people did things like that. When workhouses and asylums were still in living memory I imagine that the prospect of being diagnosed with a mental illness was absolutely frightening if it meant you could be carted off to an institution.

Their first son died, in the 1950s and people genuinely did avoid my grandma's eyes and would whisper to each other "That's the woman who lost the baby" when she walked past.

Totally agree. And the internet has made things so much worse.

You’re missing the point. Most people won’t get the right help. My Mum has spent my entire life in and out of psychiatric units, often sectioned for two years at a time. Apart from being coshed by drugs and having her brain fried with ECT (which didn’t help her at all) she has never been given any suitable treatment, and she is just as unwell now as she was 40 years ago. She has never been given any talking therapies.

I have cPTSD since childhood. All I’ve ever been offered on the NHS is six sessions of counselling at a time, which never even scratched the surface. Most counsellors I’ve seen have been out of their depth.

Eventually I was forced to pay privately for years of psychotherapy which cost the best part of £20,000. Most people couldn’t afford that. NHS treatments are not fit for purpose. People just get put on antidepressants which can have terrible side-effects and are scientifically no more effective than a placebo because GPs can offer very little other treatment options.

If mental health support in this country is so good, why are so many people on antidepressants? Surely they’d all be cured by now.

Let’s not diss the people who are actually willing to train and work with people with mental health distress-
they get paid peanuts,
they don’t go into a caring profession for an easy ride
using their normal voice that u can’t relate to because of your trauma background is a good place for you to explore what communication can be like in a non abusive / therapeutic relationship

The stiff upper lip of old and the trembly bottom lip of today, are the extremes. Somewhere in-between the two should be aimed for?

evidence based medications can be highly effective for many mental health disorders, and for many disorders psychological therapy AND medication gives the best outcomes
for some disorders - medication is unlikely to alleviate the problem e.g personality disorders but may ease some of the symptoms, whilst therapy - the right one - is more likely to be more effective

I think that pp’s have made lots of good suggestions on this thread already. But given that 8.3 million people in the UK are on ADs, it’s obvious that something is going badly wrong somewhere.

I think what most people need for good mental health is a loving supportive family and a positive supportive school experience as they grow up. So many mental health issues stem back to childhood trauma. Those things don't always happen for whatever reason, so then you need early intervention and proper ongoing support for as long as it's needed.

Schools need proper pathways for kids that struggle with academics for whatever reason. No child should have to sit GCSE's knowing they're likely to fail them all. Those kids should be redirected at an earlier age, they should be doing Maths and English functional skills and practical courses from 14, if not earlier. No child should be feeling like they are a failure. There should also be dyslexia screening for all children still struggling to read at 7/8 - give the kids a fucking chance and find out why they are struggling so much as early as humanly possible. We need far more Ed Psych's, far more OT's, far more SALT's and these should all be working closely with a reasonable number of schools. We need far more autistic units attached to schools and far more pastoral care with much better paid and qualified staff.

People say 'you just need to be more resilient' but to build resilience in a healthy, functional way rather than relying on alcohol, drugs, self harm, isolation/social withdrawal or other negative coping mechanisms you need to feel safe and supported. You need self esteem.

We cannot expect people who haven't had a safe, supportive childhood to have positive mental health.

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

This. Lots of people are stressed and unhappy and the reason for that needs to be unpicked.

A lot of children are unhappy because the curriculum is bloated and boring and there isn't enough funding to meet everyone's needs. This means they are stressed, and then their teachers are stressed and are leaving en masse so the kids aren't getting a stable environment.

A lot of older teens are unhappy because school is constant testing and when they're at home, their phones bombard them with 20 second clips of shite on repeat.

Young adults are unhappy because they can't get a decent job, owe tens of thousands on student loans, still can't get a decent job and can't afford to rent or buy a house and the prospect of living with their parents is bleak.

Middle aged people who have finally managed to live independently, are paying out most of their salary on mortgage or rent, the rest on huge childcare fees, food and petrol and are both working horrible hours so they never get to see each other and can't afford to ever do anything fun.

Older people are pissed off as they can't get to see a doctor or a dentist!

Adding 'mental health' support as a £60 a week bolt on or a visit from some NHS mental health practitioner to your school isn't going to fix any of those things.

for many disorders psychological therapy AND medication gives the best outcomes

And where can patients access psychological therapies on the NHS? Because six sessions of CBT, which is the only available routine treatment in my area just won’t cut it.

Even when I was an in-patient myself, the only psychological therapy I saw patients receive was a DBT group for patients with EUPD. Nobody without a personality disorder was prescribed any talking therapy.

There is a strong argument for promoting mental wellbeing. Emotion regulation skills, interpersonal effectiveness and social functioning in our children in schools and clubs,

get off the Screens, into active play, interacting with others, getting exhausted through activity, getting to bed at a reasonable time without the screen and a belly full of crap food -

but this would need to be supported by parents who can role model, support, coach their kids at home in these skills,

Lots of reasons but a lack of access to therapy isn’t one of them.

Social inequality is a big factor.

Increased awareness of ‘mental health’ is another. People don’t like this but the more mental health gets talked about and thought about the more likely people are to identify problems with their own mental health.

I was told by someone who had studied psychology to a doctorate level and two other medics I know that CBT is basically the only “talking” based therapy that has any clinical evidence that it makes a difference. Do you disagree?

It seems that access to some support before a whisper becomes a scream would help. Earlier (and often less intensive) support pays massive dividends (a bit like needing a bit of help for a wound, but only finally being able to access the level of help needed for a wound when leg is gangrenous).

I also personally think shrugging our shoulders at the mental health impacts of covid infections is shameful. At the very least, places like classrooms should have had air cleaners in by now to reduce the amount of infections (not just covid), especially when we don’t have the resources available to deal with the impacts of those infections.

I think a lot of people just need someone who cares to listen to them.

Carers need to be properly supported. It's awful trying to get help for the person you are caring for and it's just not there.

We need to bring back the community, people helping each other out.

The nhs is broken. There are good drs, good nurses, good midwives etc but they don't have time to care for people properly. Mums are being sent home from hospital 24 hours after major surgery and no sleep and expected to get on with looking after a baby and sometimes other children too.

We need more pay equality so that families can afford to have one parent at home if they want to.

I know it's mostly fiction but look at call the midwife. The midwives and dr Turner have time to help people

CBT has a strong evidence base for most anxiety and some mood disorders and other conditions
but it is not true that it is the only therapy with an evidence base-
check out the NICE guidelines
other therapies with evidence :
DBT
CAT
IPT
DIT
EMDR
SSCM

medics won’t be expert in field of treating mental health disorders with psychological therapies
a doctorate level psychologist may have specialist knowledge and research skills in a particular area of psychology - whatever their doctorate focused on - but is clearly not familiar with the range of evidence based psychological therapies

@R0ckandHardPlace I’m sorry that your Mum has had this experience. 💐

Having said that, I do think that some people can only be helped to a limited extent. My Dad (87) has had lifelong mental health problems, been sectioned, had various medications and therapies, etc. and he’ll never be truly stable. He has an illness that there isn’t a cure for. Keeping him relatively stable and not suicidal is the best that can be done.

That’s because CBT (and DBT) can be standardised and offered in exactly the same way to every client - which lends itself well to the types of trial favoured by the NHS. Other forms of therapy that are relationship based are much harder to evidence because each relationship is different which can’t be standardised.

There has been some decent research out of Nottingham University which is building an evidence base for person centred therapy working with trauma but it’s very hard to meet NHS standards for inclusion in NICE guidance.

CBT is good for keeping people functioning on some level but it doesn’t touch the causes of mental ill health for example where that sits in unresolved trauma. We’re literally papering over the cracks.

I’m not against CBT, it did keep me functioning but the only thing that actually helped me get to the root of things was long term work with an experienced therapist working with psychodynamics, personal centred therapy and transactional analysis - I paid for it privately and was lucky to be able to do this. That type of work just isn’t available on the NHS despite being incredibly effective.

This is exactly how I feel too. I need quiet and solitude to recharge my batteries. Some people need the opposite and recharge by being with others. All are normal, just differing personalities.

I haven’t suffered personally but I would say if life were more affordable. If people had more choice to work less, connect more socially, exercise, eat better and not have so much debt. That has to contribute to it in a lot of cases

I think eventually there will be a move away from most diagnoses, or they will be broadened massively. You only have to look at the DSM or ICD to see how much overlap there is in mental health diagnosis, to some degree, and based on training experience and subjective understanding. There seems to be more emphasis on treating symptoms and not the label as such.

more resources are needed, more flexibility and support to keep stable staffing teams

@AndSoFinally Thank you for the work that you do. I’m not surprised that you’re feeling compassion fatigue after 20 years, I think that most people would struggle after years working in this field.

I think often it's support after a traumatic event. We can underestimate the impact, or have external demands that prevent us from 'stopping and reflecting'. So we end up in fight or flight mode on a near permanent basis.

There's a biological need for oxytocin after a traumatic event, it's the reason we often reach out to connect with others after stress as connection creates oxytocin.