How to access NHS MH support?

[Brennah]

Can anyone please advise how I can access proper mental health help from the NHS?

I told my GP that I was anxious and upset and having difficulties. She diagnosed me with autism and referred me for an official diagnosis. The waiting list is 3 years and I can’t access any autism support services until I have a diagnosis (even then these services are basically non existent for adults).

She referred me to a MH nurse but I only get 1 appointment. The nurse referred me to an external service, which has offered CBT, which started last week. I get a 30 minute weekly telephone call and I’m not allowed to talk about any of my difficulties or what I’m struggling with, or ask for advice or help. It doesn’t attempt to actually offer therapy or fix any of my problems. It’s focused solely on changing the way I think and thinking positive.

I don’t see how it helps to think positive about people excluding me? I need help to behave more normally so I don’t get excluded. I need someone to teach me how to make friends and tell me what I’m doing wrong to make people not like me. I don’t want to think positive and convince myself that it’s ok to be isolated and excluded, because it’s not. I need to work through my feelings about issues in my past like being physically assaulted, raped, bullied and abused. I need to address the trauma that makes me afraid of people in the street, and the low self esteem caused by decades of repeated bullying. I need coaching to pass an interview, not trying to believe that it’s ok for me to be unemployed because of my autism.

So far the therapist has just tried to get me to think positive about being alone and excluded. Saying things like I’m free to do what I want, I have more time for reading and other enjoyable solo activities etc. I don’t think it’s good to gaslight yourself into believing that bad circumstances have a silver lining. The bad circumstances need to be fixed, not tolerated by convincing yourself that actually it’s not that bad.

So to return to my original question, how do I access therapy for my rape and abuse and trauma? How do I get practical support to fix my problems? Thank you.

Hi OP, you should be able to self refer online.

www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/nhs-talking-therapies/

It will vary depending on where you live, waiting times would be about 6 weeks. Sometimes earlier if they have a cancellation.

Hmmm I'm rereading your OP, hopefully it's not the same service that you were already referred to

Are you able to go private? I used https://psychiatry-uk.com/ to get a diagnosis for something else. It cost £360, which included sending a letter and care plan to my GP so I could get further care under the NHS.

Hi BodegaSushi, yes that’s the service I was referred to. I contacted them and they decided to offer me CBT to address my depression.

I told them I want to talk about my previous rape and abuse because I’ve never told anyone and it’s getting harder to repress it. And I said I want practical support to solve my problems, like I want to be able to walk down the street without feeling scared of people. And I want to learn how to address the deficiencies cause by my autism so I can live a normal life. They seemed to think that CBT was the correct solution.

But then the therapist has said I’m not allowed to talk about my problems, CBT is focused on identifying negative thought patterns and changing them. I said my thought patterns aren’t negative, they’re based on reality - I was raped and abused, and I am scared of people because of how many times I’ve been physically assaulted, and I am excluded and isolated. I don’t see how it’s helpful to “think positive” and gaslight myself into believing that those things are ok and don’t matter?

What I need is therapy to talk about my trauma and unpick why it happened and how I feel about it. So I can feel better about it and move forward. But I don’t know how to access that therapy? I was very upset when the therapist said we aren’t going to talk about my experiences. I’ve spent years not talking about my experiences and it’s led me to this traumatised state that I’m in now.

I am sorry to hear you've had such a difficult time OP and accessing help have you considered speaking to rape crisis they should be able to help you I don't know where you are but I think they should be able to help you through this my DD got offered online assistance through text and email support xx

Thanks but I’m afraid I can’t afford thousands of pounds for treatment. £900 for an autism diagnosis and £120 per hour for therapy is just totally out of reach. I need advice on how to access this from the NHS.

The reality is that it is very very hard to access long term psychological therapy on the NHS. I would say impossible without any sort of diagnosis and even then what is available is not necessarily what you may want or need.

Saving the money to go private, although hard, may be your best option in the short term.

Its rubbish OP, you are quite right.

For the rape/assault issues try rape crisis or similar - they don't only deal with women in the moment of crisis, women contact them long after the actual assault.

Separately from that if you have any means to go private then do so. Mental Health treatment on the NHS is functionally non existent for most people - the kind of "think positive" CBT where you are not allowed to discuss any issues is not helpful for people needing to work through deeper issues and seems largely to be tick box to enable some bureaucrat to say "seen them". IME its also not provided by qualified clinical psychologists but counsellors who have been on a short training course.

The link above might help get a diagnosis one way or the other regarding the autism but the sexual assault related trauma issues are likely to need a specialist therapist.

Do you have any kind of work related insurance to help pay for private treatment?

No, no work related insurance unfortunately. No work in fact. One of the things I need help with is addressing how my autism is preventing me getting a job.

PUK costs £360 for an ADHD assessment. The autism one costs £900

Unfortunately this seems to be the case the more I look into it. There’s a patchwork of support… rape crisis centres to help with rape and abuse trauma, autism charities to help with issues arising from that (but only after you’ve waited 3 years for diagnosis), CBT from the NHS which is totally useless and seems to be mostly about pretending that everything is ok. No actual therapy where they address everything and say yes you were raped because your autism made you vulnerable, trauma from physical assault is feeding into low self esteem, etc. These issues are inter-related but I can’t seem to get any actual help. Unfortunately I am never going to be able to afford £120 per hour for private therapy.

Insane isn’t it? Thousands of pounds, and that’s just for diagnosis.

Totally agree. However they are part of the Right to Choose program, have a look, they even give you a template to send to the GP. Waiting times for an assessment through RTC with PUK are about 6 months. Might be up to 9, but much better than waiting 3 years. And again might be sooner with cancellations.

More info on accessing mental health services through RTC www.nhs.uk/mental-health/social-care-and-your-rights/how-to-access-mental-health-services/

Part of the difficulty here is the lack of a diagnosis of anything. They won’t offer treatment for trauma if you’ve not been diagnosed with ptsd for instance. There is no treatment for ‘being autistic’ and you certainly won’t find services who can help you behave in a more neurotypical way which is what you seem to be saying you want. There are pockets of good services spread around the country for supporting autistic people in the workplace, but you need to dig a bit to see what’s available where you are. For our local one you don’t need a formal diagnosis.

Try EDMR if you can afford it.