[tempest81]

Does anyone know how long it takes to see a therapist on the NHS? Thank you

I had to pester for a couple months to get what turned out to be CBT (initially only 4 sessions, but they did offer to extend that..), which wasn't helpful in my case. Months and months and much pestering, a psych evaluation, time with the 'crisis team', and a long waiting list later they finally offered me some 'counselling' (not sure what it would have entailed) - but only 10 sessions, and I'd already found a therapist in private practice by then that I clicked with and didn't want to leave.

I think it depends on what's available in the area you live.. and you really have to bug your GP about it. They'd rather just give you meds and send you on your way.

If you can possibly afford it, my advice would be to go private. It's expensive, but I think it's worth it if it's what you really need.

Good luck

[Crescent Moon]

Originally Posted by just_some_girl

I had to pester for a couple months to get what turned out to be CBT (initially only 4 sessions, but they did offer to extend that..), which wasn't helpful in my case. Months and months and much pestering, a psych evaluation, time with the 'crisis team', and a long waiting list later they finally offered me some 'counselling' (not sure what it would have entailed) - but only 10 sessions, and I'd already found a therapist in private practice by then that I clicked with and didn't want to leave.

I think it depends on what's available in the area you live.. and you really have to bug your GP about it. They'd rather just give you meds and send you on your way.

That sounds just awful. I just can't imagine it. Our huge political debate in the US involving whether we should move to some kind of national health care has merits when you think of people having no access to health care.. but I just cannot imagine a life where I had no choice and where physicians had no motivation to be the best.

Good luck with that. Spent yrs waiting, being miss dx then inept therapists. Had to go private eventually.

Originally Posted by Crescent Moon

That sounds just awful. I just can't imagine it. Our huge political debate in the US involving whether we should move to some kind of national health care has merits when you think of people having no access to health care.. but I just cannot imagine a life where I had no choice and where physicians had no motivation to be the best.

People living in tiny cities in rural parts of the US surely have less of a choice than people living in more densely-populated areas. Same thing in the UK - if you live in London or Manchster you'll have more of a choice within the system than if you live in a village in Shropshire. And it's not as if you don't have the option of going private in the UK, if you can afford it, so the choice is just the same as in the US; based on where you live and sometimes on how much money you are able to spend. I don't even understand your "no motivation" comment.

What I can't imagine, and don't want to imagine, is a life where a medical bill could mean that you can't afford therapy. Which is a reality for several people here, as I've seen in various threads.

[lrt1978]

I must be lucky, yes I was on a waiting list for 3 months, I have now been in therapy for my ED for a year on the NHS.

Previously I had been referred for CBT for depression but only had 4 sessions before they were cancelled then I was assessed again and told by the Mental Health Team that they couldn't help so referred to a counsellor, had 6 sessions and was told on last one that I needed more but would have to pay for them.

Then I confessed about my ED went to the GP he referred me to the Mental Health Team but they said they couldn't help but would refer me to the eating disorder team but was told they probably wouldn't help as my BMI was too high, so had an assessment with the Eating Disorder Team and they planned out a treatment plan, I had to wait for 3 months but I have now been seeing my psychologist for a year.

I do believe it depends where you live and resources are available for your area.

[Perna]

Here's the official word on NHS waiting times?

http://www.nhs.uk/choiceintheNHS/Rig...g%20times.aspx

Originally Posted by Apteryx

People living in tiny cities in rural parts of the US surely have less of a choice than people living in more densely-populated areas. Same thing in the UK

All of the US that can be densely-populated and have people who need therapy in it, is. We are not like Australia or England or Europe in that way I don't think. It is only 4 hours drive from Boston down to New York and another 4 from New York down to Washington, D.C. but there's not a "rural" part to be found. Our rural literally only has cows in it; our farms are run by machines and are a zillion acres. For the amount of money it costs to buy land in the US, you can afford to jet in a private therapist of your choice:

http://www.landandfarm.com/property/..._acres-397271/

If you can't afford to buy much, you aren't rural enough unless you're in Appalachia, or the "Rust Belt" and either have decent community services or are generally not the sort of person who would think to consider psychotherapy. Our states are the size of small countries and each state has its own school system (why we are so far down when tested against the world but still able to do the lion's share of inventing/innovating and entrepreneurial stuff; the "average" leaves out our very good and our very bad and we have both; I was appalled at one job in my 20's to learn that a younger coworker from a Rush Belt state had had 7 art class electives in her junior and senior years of high school; no wonder she had trouble with spelling and grammar? This was in a practical/"business" curriculum too, not an art one) and regions have nation-sized "personalities" when it comes to social mores and whether "everyone" needs therapy (California :-) or everyone should pull themselves up by their own bootstraps (New England).

The hardest thing to understand about the U.S. is that you can't make general statements about the U.S. because it is so big and diverse. That's how our Congress gets hung up and split so badly, we don't just have classes, nationalities, genders, religions, and the "pursuit of happiness", whatever that is for any given individual; we've never been a "school of fish" like Japan or other Asian and smaller countries; we've always been a bunch of individuals, all doing our own thing and that's always been and will always be "messy". We are amazed, watching Japan with it's subway "people pusher" jobs:

Some in this country would literally kill someone if they tried to do that to us on the subway! We run with scissors and don't play well with others :-)

Perna, maybe I'm misunderstanding you, but there are plenty of rural parts in the United States. Plenty. Spend some time traveling around Texas and areas of the Midwest. Small farming and ranching communities where people live very modest lives, work extremely hard, and traveling hours to the nearest city for even regular medical services, much less psychological services, is a rare option. My family lived in a rural area of Southeast Texas with nothing but miles and miles of farm and ranching land. We were farmers. The town had a few churches, a small school system, a very small post office, one poorly stocked and expensive grocery store and no stop light. No doctors at all. For medical care, we drove a pretty fair ways into the city. That meant leaving work undone (machines do not run farms), animals untended, etc., so it wasn't something done very often. It is still that way in rural areas. Life really hasn't changed much. Services aren't brought into these areas because it is assumed people can travel to where the services are, and of course, it really isn't cost effective to set up services in a town so small that it won't demand enough clientele to pay the bills. And most people doing the farming and ranching just make enough to pay the bills and scrape by, they often have no medical insurance since they are self-insured and that is expensive, so medical and particularly psychological care is not a priority but a luxury (and they pay for few luxuries).

[lrt1978]

Perna, looked at the NHS waiting list that you gave a link for Mental Health isn't included in the right, it's for operations Etc

[Perna]

Sorry the link didn't seem helpful; they are/have been auditing wait times, agree that they are too long:

http://pb.rcpsych.org/content/30/5/182.full

Apparently they are hopeful things will get better:

http://www.nhs.uk/Livewell/counselli...totherapy.aspx

Originally Posted by farmergirl

My family lived in a rural area of Southeast Texas with nothing but miles and miles of farm and ranching land. We were farmers. The town had a few churches, a small school system, a very small post office, one poorly stocked and expensive grocery store and no stop light. No doctors at all. For medical care, we drove a pretty fair ways into the city. That meant leaving work undone (machines do not run farms), animals untended, etc., so it wasn't something done very often.

I'm sorry; I should have qualified what I was saying more; I was thinking now, not back when we were growing up and there were more small farms, etc. but your description is part of the point I am making; you didn't go to the doctor often, just when absolutely necessary (no taking a kid to the doctor to be over prescribed antibiotics for ear aches or colds, for example) and I'll warrant psychotherapy did not cross your parents mind (nor were they familiar with it?), for themselves or you?

Mostly I was just drawing attention to the different cultures; I was just in England in September/October and we rented a car and had to buy our own gas (petrol :-) it did not come with the rental car. We found a station in time (tank really was "empty" scaring us as we had no clue where to find stations or how they worked, anything about the roads/route, etc.) and we bought a tank of gas for $200 and drove to the country, the Lake District, an afternoon drive for most Americans these days, lots of us commute longer, but a whole different world if you are English. When we returned the rental car, despite all our couple days of extensive driving, there was half a tank ($100) of gas left; who knew? (to not fill up the tank)

The most similar I can think of is New York State and some parts of New England, but "New Hampshire" is so small to most of us (especially after Texas :-) that the idea of driving from "here" to "there" is not the same as it is in England. We took a train from London to Stoke-on-Trent, where we rented the car, everything was easy/peasy, not something we could do here in the United States. I was reminded of Switzerland where we took trains everywhere. The whole travelling thing is a different world than here in the States, at least for me. In the same subway/train/bus station, you can go a few blocks or to Paris, your choice.

There's a unity to most European countries; yes, other nationalities live in the big cities but the English countryside has mostly English in it, the French country side has French people; Italian, Italian, etc. "The" Government says, okay let's do X and everyone pretty much falls in line because everyone comes from a similar background culture place. The English all have bank "credit cards" tied to their accounts that they buy with, they rarely get in line anymore and use a cash register, roving waiters/waitresses/shop keepers come by with or you step up to hand-held computer devices and swipe their card and they're done (no signing or paper). The Government mandated this and it happened. Can you see that happening with us anytime soon? We can't even agree on how to help our health care system, never mind mandating how you spend your money?

[Crescent Moon]

Originally Posted by Apteryx

People living in tiny cities in rural parts of the US surely have less of a choice than people living in more densely-populated areas. Same thing in the UK - if you live in London or Manchster you'll have more of a choice within the system than if you live in a village in Shropshire. And it's not as if you don't have the option of going private in the UK, if you can afford it, so the choice is just the same as in the US; based on where you live and sometimes on how much money you are able to spend. I don't even understand your "no motivation" comment.

What I can't imagine, and don't want to imagine, is a life where a medical bill could mean that you can't afford therapy. Which is a reality for several people here, as I've seen in various threads.

With respect to "motivation," what I was trying to convey may be based on a US culture thing. Here, people who become physicians are likely in part motivated by the altruistic "help my fellow human" ideal, but since most of medicine here is private, the amount of money they can make is a significant factor in their motivation. Reward for performance is an across-the-board motivation. Here, the best and the brightest, those who want to find new treatments, to improve techniques, to design medical devices, etc.. they reap huge financial rewards. Even with therapists, the more well-known and respected you become, the more you can charge. So I was imagining that a NHS is similar to our HMO's here - where physicians are salaried. There is a disincentive for them to treat.. they are rewarded for ordering less tests, etc. There have been huge issues over the last 10 years in the US, as we try to figure out how to make sure people are not left without access to care, over HMO health care systems' attempt to manage costs - and people don't get treatment for expensive illnesses as a result. Diminished quality of care is one of the criticisms of those opposed to moving toward a system that looks more like NHS.

As for the indigent here, they do have access to care. It's just unreasonably clumsy. For cryin out loud, we even take care of people south of our border who cross over specifically to have their medical crisis in the US because they know they will get reasonably good care in our public hospital system. As for mental health treatment, it is available to the indigent, but it is publicly funded (not private), and therefore is similar to what I've heard described about NHS: loong waits, getting approvals, restrictions on care, little or no choice in providers, etc. In the US, if you have private insurance (which is available through employers), you can pick any doctor you want to pick, and your insurance will typically pay from 70% to 90% of the bill. HMO's here require approvals and place restrictions on care, but with most private insurance you can see your therapist every day if you want to.

But please know.. the indigent do have access to care. But in comparison to what is available to those with private insurance, it may seem like "no" care.

I sure didn't mean to offend... but in the US our expectations are built on what has been in place here for a long time, and it's hard to imagine what it would be like to go through what just_some_girl described.