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Accessing mental health services

Accessing mental health services

GPs and counselling

If you are concerned about your mental health, you should first visit your GP. GPs, in combination with counsellors, can successfully treat some less complex mental health conditions, such as mild to moderate depression, anxiety, and some eating disorders.

Your GP will be able to prescribe any medicines that are needed to help with your symptoms and refer you to a counsellor.

Cognitive behavioural therapy (CBT) is an increasingly popular type of therapy that is used to treat a wide range of mental heath conditions.

CBT is based on the assumption that most unwanted thinking patterns and emotional and behavioural reactions, are learned over a long period of time. The aim is to identify the unhelpful thinking that is causing the unwanted feelings and behaviours before learning to replace this thinking with more realistic and balanced thoughts.

A course of CBT therapy can consist of 5-20 weekly sessions, with each session lasting between 30-60 minutes.

A number of interactive software programmes are now available that replicate some of the functions of a CBT therapist. One example is the 'Beating the blues' programme, which has been approved by the National Institute for Clinical Excellence (NICE) for treating depression, anxiety, and phobias. 

Care plan approach (CPA)

If you have a more serious mental health condition that requires access to specialised mental health services, you will be entered into a treatment process that is known as a care plan approach (CPA). A CPA is essentially a way of ensuring that you receive the right tailored treatment for your needs.

There are four stages to a CPA:

  • assessment - where your health and social needs are assessed,
  • care plan - a care plan is created in order to meet your health and social needs,
  • a care coordinator is appointed - a care coordinator, sometimes known as a keyworker, will be your first point of contact and will monitor your care, and
  • review - your treatment will be regularly reviewed and, if needed, changes to the care plan can be agreed.  

Assessment

The purpose of an assessment is to build up an accurate picture of your needs. As different professionals and agencies provide a range of services, your assessment will probably be carried out by more than one person. For example, a social worker, a psychologist and your GP may all be involved in your assessment.

During an assessment the following points will be considered:

  • your psychiatric symptoms and experiences,
  • your psychological thoughts and behaviour,
  • your physical health and wellbeing,
  • your housing and financial circumstances,
  • your employment and training needs,
  • whether you have a history of drug or alcohol use,
  • whether you pose a risk to yourself or others,
  • your culture and ethnic background,
  • your gender and sexuality,
  • whether there is anyone who depends on you, such as a child, or elderly relative, and
  • your hopes and aspirations for the future.  

Care plan

In its most basic form, a care plan is what different people or agencies agree to do in response to your assessed need. It also provides a record of your progress.

The care plan is drawn up for your benefit, so you will be encouraged to contribute your own wishes and desired outcomes to the plan.

As part of the plan you may wish to consider what steps you would like taken in the event of a future psychiatric crisis such as:

  • who needs to be contacted,
  • where you would like to be treated, and
  • what help people who are currently in your care, such as your child, would require.  

Care coordinator

Your care coordinator will be your first point of contact between you and the various healthcare professionals who are involved in your treatment. They are also able to explain how the different services are responding to your needs, while relaying any concerns or questions you may have to the appropriate person

Ideally, your care coordinator should be someone who you feel comfortable talking to and being with. For example, they may be a social worker, occupational therapist, or a community mental health nurse.

You may be able to have some input into who becomes your care coordinator, although this may not be possible in all cases. 

Reviews

Over time, your personal needs may change, so it is important that your treatment is reviewed on a regular basis.

During a review, you, your care coordinator, and other professionals who are involved in your care will meet to discuss your progress, and discuss whether your care plan needs to be changed to better meet your needs.

It may be possible to hold a review at your house, or in a neutral place, such as a community centre. If you wish, you can bring a friend or relative to a review for support.

Some people prefer to bring an advocate to their review. An advocate is someone who will represent your views and interests during the review process.

Advocates can be voluntary, such as mental health charity workers, or professional, such as lawyers. Your care coordinator should be able to tell you what advocacy services are available in your local area.

Comments

The 3 comments posted are personal views. Any information they give has not been checked and may not be accurate.

goodluck said on 12 March 2014

I also agree with the below comments. I would never ask for help from NHS mental health in a crisis or otherwise after some horrendous experiences. Do not expect compassion, do not expect to be validated, do not expect to be listened to. Expect to be treated like a drain on the system, a malingerer, a liar, someone who simply needs to 'think' differently. I would like to think that I have been unlucky but after several separate incidents from different trusts I see it is a pervasive problem.

I also feel sorry for those who work within the system who genuinely want to do good but can't due to the restrictions on them. I have come across many therapists now in private practices who left the NHS out of despair at how patients were treated and their inability to really do good. If you are reading this and need help there are many therapists who offer low-cost treatment options and you can look them up on sites that list fully registered and qualified practitioners.

And if anyone else has read these comments and have had a similar experience please leave a comment of your own. I feel quite sick when I go to NHS website pages and see the pictures of smiling people, read the compassionate article, see such corporate taglines such as 'your NHS, your choice' when the reality is closer to a nightmare. The more people who complain and make a fuss the more chance we can change this appalling and shameful situation.

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bluebright said on 04 September 2013

I totally agree with the previous comment. I find the people who work in my mental health team to be cold and uncaring. I recently attended a mental health assessment and it was more of an assessment on how they could catch me out lying. I was told how I felt was 'normal'.

After seeing me for no more than 5 mins I was being told how, it's my circumstances that are making me feel down, because feeling suicidal and depressed is to 'vague'. I was told I wasn't ill enough for any support from the mental health team, but I shouldn't drive because I am a danger to myself and others.

I will never use the mental health services provided by the NHS again, because they leave me feeling worse than how I felt before.

In my opinion people who work with mentally ill should be calm, warm and approachable. If anything they are the complete opposite if you get upset or angry, they don't try to calm the situation they argue back and make it worse.

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noltanner said on 30 June 2013

If you are seeking psychiatric help, you need to know that the way psychiatry is practiced is totally at odds with the whole “lying down on the sofa” image. It is far more adversarial than that.

I felt I was being blamed for my illness. The psychiatrists didn’t acknowledge that any of it was beyond my control – they concentrated exclusively on questioning my attitudes.

They didn’t even seem to recognise that I was in any distress. They just said things like “don’t you think it’s time you started making an effort to change?” and “don't you think you're being a little bit self-indulgent now?”

At a time when I was least able to help myself, they just offered me patronising advice about how I needed to sort out my own problems.

Objections are met with false apologies (“I’m sorry you feel that way” etc), and explanations of how you've got the wrong impression. They change nothing at all.

It’s pointless complaining, too. Psychiatrists are inclined to question what you say rather than to look for any value in it. Proving that they did any damage is impossible, and I don't have the resilience to keep fighting until my voice is heard.

Psychiatry made me much worse. But it's easy to dismiss what I'm saying. After all, I'm a nutter, aren't I?

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Page last reviewed: 12/09/2011

Next review due: 12/09/2013

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