Complex issues, don't qualify for NHS and can't afford private counselling. What next?

[Spaghetti127]

In the last year I've suffered bereavement, my FIL has cancer, I've lost a baby and nearly died. On top of this I have ongoing relationship issues with my mum.

I'm not depressed but have low mood days and struggle with anxiety, including panic attacks, social anxiety and hair pulling. I need help to try and process everything as I'm not coping on my own.

I decided to contact my employee assistance program who I'd previously had counselling from for a late miscarriage four years ago. I had an assessment and they deemed my issues too complex to cover in 6 sessions and that it could be more damaging for me to build a relationship with a counsellor for it to come to an end prematurely. They said I'd benefit from long term counselling and said I should refer to NHS.

Fast forward a couple of weeks and I've just had an assessment with them (after they first suggested group online session for anxiety) and they've just told me the same thing. They focus on CBT and EMDR as it's the most cost effective option. Their counselling sessions are only for people with a diagnosis of depression and only deal with one issue and are short term. The assessor apologised but suggested I look into private therapy but I just can't afford it. I've looked at discounted rates but earn about 4k a year above the threshold for low income sessions but as I have a son in nursery I can't afford to pay.

So big question, what do I do now? Everyone acknowledges I need help, but I need too much help to qualify for the help?

How do I move on? What can I do to feel better?
A friend suggested emotional support helplines but explaining everything to a new person every time just feels traumatic?

Any suggestions gratefully received

Hi @Spaghetti127 , I’m in a similar position to you but for different reasons. Complex mental health issues deemed severe but the help offered on the NHS mental health locality team is for short term and considered potentially damaging when the sessions end. I think also due to cuts in mental health services they need to allocate the help to people they think it will be of the most benefit to.

I've tried arguing that I think short term sessions would be of benefit to me because I’m desperate, but to no avail.

The one thing that has been suggested that might be of some use is to self-refer to MIND because they may be able to offer longer term support.

Wish I had something more useful to offer; just wanted you to know you’re not alone in this position.

Unfourtunately the NHS sessions in my experience are only 6-8 sessions and seem to only be focused on CBT and only seem to work on 1 main issue. My husband has had several blocks of sessions over the years (depression and anxiety) and even when he tells them that CBT doesn’t work for him they make all the right noises and then just do CBT again.

Could you find local support groups such as SAND’s? If you’re a carer for your FIL then your local carers centre may offer counselling. My mum attends a local Mind group and that has really helped her. https://www.mind.org.uk/get-involved/supported-self-help/?gad_source=1&gclid=Cj0KCQjwpNuyBhCuARIsANJqL9N5G_llC4SlmdnKG6rNkEf6-o2EqHXOZBvdGZnSCTU-wnjvXABRrjEaAg04EALw_wcB

This is common.

Sorry.

Happened to me.

Try your GP as medication will help with anxiety - I have duloxetine and you can also possibly get propranolol or diazepam for panic attacks. You might also be able to persuade them to diagnose you with depression.

Thank you for the replies.
It's sad that this is common. So much work goes into convincing people it's ok to ask for help and yet it feels like there's a big gap in the middle for people to fall through.

I'll have a look at Mind and see if there's anything there.

I take proprananol for panic attacks but no other medication. I think it might be time to look into other options.

I'd be going back to the gp and ask him what he suggests next then.
So sorry for your loss x

Would you be open to therapy with someone in their last year of training? I did this, it was all online and cost £15 a session. It was brilliant.

Having fallen into the same loop as you OP... It's exhausting isn't it.

Have a look around locally for charities who offer free counselling. These are sometimes not easy to find as often their names have nothing to do with what they do.
The service I found specialising in CSA was called SteppingStones. My GP had never heard of it either 🤷

Good luck OP

Sometimes charities offer free counselling.
My counselling was brilliant and was given to me by a rape and sexual violence charity that the GP signposted for me.
I've heard from a friend that 'Rethink mental illness' gave her therapy, but there will be more.
There are also organisations, sometimes private companies that offer affordable and reduced price therapy based on income.
It's sad because these things are hard to find.
Have you got any kind of local 'hub' that employs people that might offer counselling? I know a few community 'hub's that advertise therapy and because it's community based, they expect that people come form different backgrounds and varying degrees of income/benefits.
I hope you get what you need soon, because I know how soul destroying and lost it can make you feel.

Sorry, I've repeated what some other people have xx

Is there any lower cost counselling near you?

I'm with 'Affiordable Counselling. They are in London but it's online zoom.

I pay £30 a session. Which is the lowest you can pay.

I also get the having to go over everything again and again with new people being exhausting. You get to the point where it’s actually making you feel worse because you’re reliving all of the negativity and distress.

Could you see if a university needs volunteers for their clinical psychology students? This would be fully supervised so you wouldn't be a 'guinea pig' as such

Not sure if this is relevant at all for your particular situation but look up NHS ‘right to choose’ which gives you the right to choose a service (which may be private) and then be referred to it through the NHS. Again, not sure if it would work in your particular case but if you found somewhere that would be able to deal with your needs then you could ask your GP for the ‘right to choose’ this service, and this will then be paid for by the NHS. Not many people know about it but might be worth looking into, it worked for my husband in getting a referral for ADHD diagnosis through a private company when the waitlist for NHS services was too long.

Thanks everyone. I'm glad I posted. I'm sorry so many have been in this situation, its just shit.

A tricky thing is that I work in a large uni that offers counselling and mental health nursing so don't feel comfortable seeking trainees as they might be someone from my uni.

I think going back to my GP is the best bet alongside carrying on research to local charities.

@solitudeisbliss I've not heard of right to choose. Will certainly look into that as well!

What sort of prices have you been quoted for private therapy?

The average around here is 60 for 50 mins for in person. Most telephone/zoom I've seen are 50.

At those rates I'd only be able to afford one session a month. Most counsellor's seem to recommend weekly sessions. Fortnightly at the very least.

I guess the other option is to pay on my credit card and get into debt. But that could just cause more issues if anything else comes up unexpectedly

The NHS team has to refer you on to the complex care team on the NHS

If you become a member of anxiety uk you get discounted therapy, depending on income. www.anxietyuk.org.uk/get-help/access-therapy/

Most private therapists offer some lower fee places. I have one place at £30 for example and know lots of colleagues who see one or two people at a time for £25-45 per session.

I also recommend checking out charities and psychotherapy training institutes in your area for free and low cost services.

Assert to your GP you are becoming distressed and despondent and must be referred to adult mental health services. You may need a full assessment for CPTSD. I'd really encourage using Diazepam as & when. I take half when I feel anxiety coming on and it stops the full descent, propranolol & fluoxetine which may help in the meantime. Keep visiting here for support, mumsnet has massively helped my PTSD issues.

Thanks for this. I've been offered Diazepam before but haven't taken it. I've always been a bit wary but I think it's something to try.

There's nothing really you can do. I'm in the same situation and had to find the money for private counselling. There just isn't the resources for long term NHS counselling.

It sounds like you would benefit from proper therapy but in the meantime would you consider attending a women's circle (sometimes called sharing circle, sister circle etc)?

I have found it immensely helpful to have a place to say what I am feeling/explore my emotions anonymously in a safe space. People are so open and listen without judgement. I have continued to go alongside having therapy.

Costs have varied from £10-£30 per session. Mostly I find events on local facebook groups but also Eventbrite and socials from local yoga studios.