[pegasus]

I wanted to do a post about psychotherapy in the UK and particularly in the NHS. Unfortunately mental health has taken a backseat for many years. This is about to change. The government is ploughing in money to bring in more therapists. Of course it will take a while for these therapists to be trained but this is good news. It is called, 'Improving access to Psychological Therapies' which is starting to roll out over the UK this month.

It is aimed at anxiety and depression to start off with. There will be low intensity therapists which would be the first point of call leading to high intensity therapy for more complicated problems. This will leave the more specialized services of CMHT to help those with severe mental health issues.

Anyone wishing to look into therapy needs to be looking to seeing their GP in the first instance, although you can do a self-referal to a CMHT.

Hope this information helps some.

[Doh2007]

I'm so glad to hear this. I've always worried that my UK friends weren't getting enough help. This is good news indeed.

[sunrise]

Hi pegasus. Can you explain what the NHS is? (What does that stand for?) Is it like a public system of healthcare? Is it free or subsidized by the government? Is it for everyone? If you go outside the NHS, is it always 100% out of pocket, or does one's private insurance cover the fees?

So there is a shortage of therapists in the UK? Is that because there was no demand for them (NHS wasn't hiring them) so people didn't study to become T's? Does a low intensity therapist get different training from a high intensity therapist?

What is a CMHT?

Right now, if someone in the UK wants to see a therapist, how do they go about that? Do they call up the therapist's office and make an appointment, like you can do in the U.S.? Or is there a lot of red tape to deal with?

I am glad things are looking up for expanding mental health services in the UK. Thanks for the post.

[pegasus]

Originally Posted by sunrise

Hi pegasus. Can you explain what the NHS is? (What does that stand for?) Is it like a public system of healthcare? Is it free or subsidized by the government? Is it for everyone? If you go outside the NHS, is it always 100% out of pocket, or does one's private insurance cover the fees?

So there is a shortage of therapists in the UK? Is that because there was no demand for them (NHS wasn't hiring them) so people didn't study to become T's? Does a low intensity therapist get different training from a high intensity therapist?

What is a CMHT?

Right now, if someone in the UK wants to see a therapist, how do they go about that? Do they call up the therapist's office and make an appointment, like you can do in the U.S.? Or is there a lot of red tape to deal with?

I am glad things are looking up for expanding mental health services in the UK. Thanks for the post.

The NHS stands for the National Health System which was brought in some 60 years ago to provide free health care for all, athough ultimately we all pay for it through our taxes.

I feel that there has always been a stigma attached to having mental health problems and many people are not sign posted in the right direction.

In primary care services, one had to go to their GP and be referred to a counsellor that may have been attached to the surgery. Or for more serious problems a referal had to be made to the Community Mental Health services. In my view, you had to jump through many hoops to get a referal to CMHT, ie being passed on to psychiatric services. Getting an appointment to see a therapist meant being put on a long waiting list.

Don't ask me too much about it but there was a study done and something called the Lord Layard report. This report found that talking therapies are the way to go, particularly CBT. Horray, for finally working out that just bunging people on meds is not a good solution.

After this report came out, there has gradually been a shift toward talking therapies. The low and high intensity therapists (as far as I know) will be in the Primary care services. ie the first point of call. Low intensity therapy is CBT based and uses a variety of computer based progrmmes, face to face counselling and telephone support. High intensity therapy is the next step with a more qualified therapist, again using mainly CBT.

There will still be Community Mental Health Trusts (CMHT) for the more specialized work, and I'm thinking that this is the area that clinical psychologists will still be the main domain. Some clin psychologists may become high intensity therapists but are expected to take on more of a leadership role within the health service.

Anyone wanting therapy needs to be seeing their GP in the first place, but there are also voluntary services that provide therapy. Depending on the problem people are sign posted in the right direction.

Outside of the NHS people can have therapy privately but obviously that is for people who have the money to do that. I don't know the situation on health insurance and whether that would pay for it.

More information on Improving Access to Psychological Therapies can be found in this link >>>>>>>>>>>>>>

http://www.iapt.nhs.uk/

[pachyderm]

Originally Posted by pegasus

...The government is ploughing in money to bring in more therapists....

Forgive me for saying this, but... more is better?

I'm sorry, but I feel the "system" at least here in the US has little clue on what "mental illness" is or how to treat it successfully, so I think more of the same is very close to useless. And "useless" is maybe worth less than nothing, because it pretends to be "something".

[allthegirls6]

I dont know much about it but i remember reading that the aim of this was to stop treating people with depression and medicate them instead. Im very suspicious about the government ploughing money into anything. It seems unlikely that the object is to help people, usually the object is to save money.

I was reading an article about it on the BACP website and they were calling counsellors top arms as it would end up excluding more people.

[Onzichtbaar]

I'm originally from the UK (I live in the Netherlands now) and became ill while in the UK.

Unlike in the US, the majority of people in the UK have no health insurance. This is because the NHS is free for all. Private hospitals do exist but the majority of people receive health care at the NHS hospitals.

I was at university when I became ill with severe depression and severe social anxiety - I wasn't eating (I'm 5"7 and my weight fell to 100 pounds), I was sleeping 16+ hours a day, experiencing panic attacks, nightmares etc. I think I'd been depressed for a long time in truth. I went to my GP. He put me on Prozac and told me to come back in a few weeks. I already felt suicidal but starting the meds made me feel worse and I overdosed two weeks later. I was given a psych assessment at the hospital and they said I would receive an appointment with a pdoc in the post. They didn't bother to inform my GP about what happened and the appointment never materialised. I was at university at the time, and after this returned to my hometown.

I visited my hometown GP and she said there was no point in referring me to the counselor - that I wasn't serious enough - so I asked whether she would make a referral to a private psychiatrist instead. Even this she dug her heals in about. Eventually after much persuasion she agreed and wrote a rather non-committal letter to the pdoc who I then had to pay several hundred pounds for an appointment (fortunately my parents had some limited private family insurance to claim back this cost). I simply wouldn't have been seen by a NHS therapist or pdoc because of the GP - and in my area the waiting time is something like 4 years!!! I don't know what happens if someone is psychotic or has a very very serious condition. I hope for them that they are given more help. I felt like the GP I saw found me pathetic and not worthy of help. She didn't even consider prescribing more meds.

I saw the pdoc 2 weeks later (even with private services there is a wait) and he diagnosed severe suicidal depression/social anxiety and prescribed meds and deemed that long-term therapy would be necessary due to the underlying abuse/trauma. He suggested strongly I leave my home situation - my mother was my abuser. Fortunately for me my boyfriend is Dutch and so I could come and live with him - the pdoc basically said "well at least you will be able to get the necessary help in the Netherlands".

From my experience, the situation is very poor in the UK in terms of mental health care, especially in the West of the country where waiting lists are literally years. I doubt I would still be alive if I hadn't had the possibility to leave the UK. I now see a therapist twice a week - I've been seeing him for a year and a half now. I'm gradually making progress but I've been unable to work during this time. I also see a psychiatrist regularly.

I think at the very least, GPs need to be better trained in helping their depressed/suicidal patients. At the very least to point them in the direction of private help, if NHS services are too overloaded.

Onzichtbaar