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?

CBT doesn't "work". As in you don't sit there passively through it and then miraculously feel better. It's more like physio. They identify what you need to go and practice and you have to do the work. And it is uncomfortable and difficult.

Same with DBT. I have known many people that have done both, moaned it didn't work, but admit that they did not do any homework.

Stop relying on the old medical model of providing medication to "cure" MH needs.
I'd put OTs in every GPs.

That was literally me the first few times i did it. I declared it useless because I didn't do anything outside the sessions. I'm actually quite lazy and dislike doing anything difficult or uncomfortable (OCD). It was only when I was paying £200 a session with a consultant that I really pulled my finger out and dyou know what it really did get better after that.

@HangingOver It’s funny how paying a lot of money for something motivates you. 😂

Wow, you really shouldn’t be practising.

“People are angry that autism and ADHD are poorly served by MH services but that’s because neurodivergence isn’t really a mental illness as such and it’s quite odd that psychiatrists have wound up being responsible for these services (like dementia why is that under psychiatry when it should be neurology?) I’m not saying more awareness wouldn’t be good but if you wonder why we aren’t good at it well many of us were never trained in this area. Recognition of ADHD in adults is a relatively new phenomenon and was not on the curriculum at all when I trained so yes I admit I suck at it. I could retrain (beyond obviously the basic mandatory training) but I already have more than enough to do with all the other conditions I was trained for and am good at treating so I tend to just be honest with people and tell them that it’s not my speciality area.“

So let me get this straight the NHS aren’t training professionals in autism and adhd and how MH difficulties present and need adjustments for in 2 conditions that are more likely to come with severe mental health conditions due to traits and how they present!😱What a waste of NHS money. ND people just get iller and waste non adjusted treatment led by somebody who has no clue about adhd or autism. This explains a lot and why ND people receive crap treatment,are over medicated and over represented in tier 4 hospital and prisons.

Being taught the basic connection between thoughts, feelings and actions at primary school - the keystones of CBT.

Understanding what core beliefs are in secondary school - who you are is fixed but can and will change throughout your life.

Advanced CBT in secondary school. Understanding how and why you think, feel and behave is vital.

@Eyesopenwideawake That sounds like a great idea, but specialists would need to be brought in to teach these subjects IMO. Teachers have enough on their shoulders already, we can’t also expect them to address our children’s mental health as well.

This is a good point actually.

I'm not talking about addressing mental health - I mean teaching children how their minds work (including neurodivergence) as a straight subject. How many adults would be happier today if they had learnt that they are not at the mercy of their thoughts and feelings?

It's also fascinating stuff, which is a bonus!

Not thinking they are likely to have mental health problems.

@Eyesopenwideawake I didn’t phrase that well, I also meant teaching them about how their minds work.

This is a specialized area and expecting already overworked teachers to take this on would be a big ask. At the very least, teachers would need additional training to do this effectively.

Perhaps it could be worked into teacher training in the future, but perhaps something else might have to be dropped in order to fit it into the school day.

I know several teachers so I’m rather defensive about what we parents expect from them! IMO, it’s already a lot.

CBT is just one theory though and doesn’t fit for many people. I wouldn’t want my child taught in that way to the exclusion of other understandings of human development and wellness. I found CBT to be almost gaslighting at points in my process - yes sometimes my thoughts drive my feelings, but there’s other stuff going on too that needed to be addressed.

Research shows that the one thing that makes a difference therapeutically is the quality of relationships - children who have people who believe in them, that are positive and have ambition for them tend to do much better in the face of adversity. I’d rather schools focussed on the quality of relationships between staff and pupils than try teaching one narrow theory.

sometimes my thoughts drive my feelings, but there’s other stuff going on too that needed to be addressed

Such as??? Your thoughts drive everything you do.

I'm sorry your CBT practitioner let you down but that doesn't change the basic principles. And it's also the basis of good relationships - communication, trust and respect; it doesn't have to be any more complex than that.

And this is why I have the mental health topic hidden (got reeled in via AIBU). I thought I had taken the time to engage with the topic thoughtfully and truthfully but no apparently I just ‘shouldn’t be practicing’ because I am not a specialist in neurodiversity. I did say that I have done the required mandatory training about reasonable adjustment etc I just do not consider myself able to give a specialist opinion in those areas.

Thank you. That does help to counter the people who think I just ought not to bother practicing.

FWIW I found what you wrote very thoughtful and interesting - and quite validating of experiences I've had trying to access help. Also refreshing for a mental health worker to be humble and admit that there are areas they might not be able to help in - very different to my experience of them in the wild and sometimes on this thread - namely the patient blaming that goes on much of the time.

You sound oddly like a rich, white 12 year old.

@MiraculousLadybug I agree about the breathing! I feel stressed just hearing about 'box breathing' 🙄🙄🙄

Thanks that’s very kind. It hurts a bit when you have given your working life to something and someone just knee jerk says ‘you shouldn’t be practicing’ over one post on an anonymous forum.

I think it’s best to be honest. Our Trust has separate autism and ADHD services that are not part of the general CMHT (although they are over run with crazy wait lists) so I will either refer people on or suggest they get a private assessment if they have the means when I suspect neurodivergence is relevant for them. I don’t go around making amateur diagnoses outside my competence.

The state of knowledge moves on. It is the truth that adult autism and ADHD services were in their infancy as little as 10 years ago and practically unheard of 20 years ago so within my working lifetime there has been a huge surge in awareness and understanding. Conceptually I think it is problematic to lump these conditions under ‘mental illness’ and I think many people with lived experience agree.

Similarly the understanding of the effects of trauma and the spread of trauma informed care is also quite new. In the past many things were shoe horned into biological psychiatry models and labels that didn’t fit and because we don’t have the services to address those needs mainly because it would be so expensive we are stuck with no treatment or the wrong treatment.

mental health services have no parity at all in terms of funding compared to physical health but as there is no extra money we have to decide as a society what we want to stop doing if we want more investment in psychotherapy which is inherently costly.

I wonder how many 'cases' of poor mental health are really just down to people having the wrong expectations of what life should feel like. Many people claim to be anxious and depressed and so on. But maybe that's just the default human condition. Everyday stress and misery. Materially our lives have never been better. Are the promises of consumerism that we can consume ourselves happy really what's make us think we're sick?

And therein lies the problem, if someone doesn’t find CBT helpful, it must have been a problem with the practitioner, or the client didn’t engage properly. It can’t possibly be that CBT gives us one way of understanding some causes of distress but doesn’t fit for many causes of distress.

This is spot on in my opinion (yes opinion only).
It’s such a difficult discussion to have as it is inherently emotive!
Therapist here, having worked with adults and children in therapy -counselling/ psychotherapy. I’m so lucky as I get no time limit on how long I can work with yp so if we need up to 25-30 sessions or more even (for example trauma or complex mental health alongside neurodiversity) we can have it which is great when accessing service HOWEVER that then means big waiting lists up to 10 months atm. We would need double the team size to deal with influx of referrals.

Neurodiverse yp make up half of the waiting list/caseload I’d say. Truthfully as a neurodiverse practitioner I’m not sure anyone can be properly ‘fully’ trained in ND. It presents so differently and you need imo a humanistic response and versatile practitioners - so training across person centred/CBT/DBT/Attachment or DDP/Play therapy! A lot of funding needed for training /staff retention/ actual staff!

Some things I’ve seen that impact young people the most right now in order of what appears to be most common:
—Social Media and its impact on selfesteem/friendships/
-Isolation
-Neurodiversity and not understanding how this presents, how it differs from actual ‘mental health conditions’ and how it can exacerbate mental health
-Poor sleep and diet
-Sadly some parents want to outsource behaviour management and emotional support
-Lack of social and employment opps

this is my opinion, probably haven’t given a full overview but I’m tired and this is a quick summary / snapshot of what I see every day at work

You are welcome, I can understand why you would not routinely engage with MH topics - I think I should do the same

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