Why is Mental Health Care Getting Worse?
Before I start this I want to be clear this is my own view, my experience, nothing more.
About a year and a half ago, I had the worst breakdown of my mental health, that I’d had in a long time. It was not long after Sally’s death, and I had neither, dealt with it and I tried to adopt another dog. I’ve never really spoken about that time till now as it was so hard.
Before the Breakdown.
The pup we tried to adopt, was from a small rescue, who sadly didn’t tell us the truth about the pups trauma or full background. In the short time we had him in our care we came to realise he had been abused before being brought to the UK, this included having his tail cut off and from his teeth it seemed highly likely he was younger than we were led to believe too.
We were his second home, in fact another dog he had been brought over with had the same issues in needing rehoming. We were told he was a brilliant dog, well trained and loved his crate.
From the get-go it was a mess, we didn’t know he was from abroad when we choose to adopt, however once we were told I felt it was too late to back out. From day one, we noticed slightly aggressive tendencies, at first towards Ash, but in the coming days more aimed towards me.
When he was good, he was very very good and could make many people melt at the sight of him. However, the truth was he could just change, something would frighten him, a closed door, a noise he didn’t like; bedtimes were the worst.
He refused to settle on many occasions, and I would be out throwing balls in the garden, in tears just hoping he would calm and sleep. However, one night it become very clear we couldn’t deal with his issues, when I was in bed, I put on my wrist support only for him to attack it.
Luckily, he bit my wrist support and not me. However, the incident threw me over the edge. Sal was gone and I couldn’t care for this sometimes-lovely dog who needed something more than I could offer.
The Breakdown Hits.
The next day in bits and completely suicidal I ended up in my doctor’s office and was referred back into the mental health system.
It took me a long time before I got an appointment, then the follow up was 6 months later, when a care plan was put into action. I thought we were going through part 1 and there was a plan of action on how to bring myself back into a stable place.
However, what I found out the other week was there was no part 2, part 1 was for me to attend two online courses and then that was it.
The Good.
Now don’t get me wrong, I can also say that it has been a benefit in some respects. One of the courses I did was DBT (Dialectical behavioural therapy) to help with my BPD (borderline personality disorder) and that wasn’t something I was offered before. It had only been CBT (Cognitive behavioural therapy) which is something I find doesn’t really help me. So thumbs up for them starting to look at approaches such as DBT.
That said it was a small course. While many places use a very in-depth, all focus on DBT approach, which can be done as a day patient or in patient and lasts for months. I was offered 1-2 hours a week for 12 weeks.
As someone who cannot visualise anything in my head I was also pleased to find out that meditation mindfulness is not now all about visualisation.
The Bad.
So here I am a year and half on, having taken part in two courses. One which gave me a brief insight into coping strategies but has no follow up, and the other which taught me a little about Bipolar. And I am still not sure if it has been added to my diagnosis or not? No one can seem to tell me, as the first psychiatrist I saw left and the second one has gone back to his old location.
From the courses, there was very much a focus on: “ if you feel bad ring a help line” or coming back into the service as a very last resort.
As such I’m at a loss. What is the point in asking for help? When all they do with you is tick boxes. Ah yes Sarah completed the courses we put into care plan, so we can send her back out into the world now.
I find it a very strange situation, to send someone who is openly struggling back into the world without having had much help.
I’m at a loss of what I do next, do I go to the doctors and get referred back in, and get stuck in what seems like a revolving door? Do I try and carry on alone?
Why is treatment for mental health getting harder to access, and more focused on short term quick fixes? Is online therapy with BetterHelp a worthwhile choice?
Images use in this post are stock images licensed under CC0.
Pin it!
I totally disagree that the abysmal care is due to lack of funds.
Millions is poured into NHS mental health fids, but totally misspent. I have been hospitalised three times, each time to receive no care whilst an inpatient because ‘you need to be an outpatient to have psychotherapy’. There is no evidence at all.
To be hospitalised for ten weeks at the longest stretch and them pretend there was no feasible way of doing any psychology?
Money is spent everyone on tokenism projects and offering short-course therapy to those not very unwell. The most unwell get passed around and passed around, everyone saying you are ‘too unwell’ to help.
It is a disgusting system and absolutely would not stand up if it was physical health care.
I’ve been waiting a year because of COVID to begin a course of what I think is something like DBT but it’s baby sister which begins next week. I’ve had CBT in the past which was helpful in some respects but not in others – it very much depends on the psychologist you have I think and how they approach your issues. It also makes a difference as to where you are in your mental health at the time. If you’re feeling really unwell it’s not going to be very useful, you have to be well by which time you don’t feel like you need it – a real catch 22 situation. I’m very concerned about how mental health services are going to be even more pressurised after COVID because now people are being told to self-refer for talking therapies etc which ok may be ok for some for there is the obvious flaw in that how do you decide if you need talking therapies yourself? It kind of makes a mockery of those of us who haven’t been able to access services for months with severe mental health conditions and the Government are now saying oh everybody will have access. I’m not saying people who’ve come through COVID etc don’t have mental health needs. Even within my health area services are different just a few miles away. It’s all very upsetting.
We’ve had self-referral around here for a while, which is how I got stuck in the CBT rut as that’s basically all they offer so I would go to the doctors who told me to self-refer to the therapy services, who would offer CBT, which I know now doesn’t work before of my particular issues. It was only when I was seriously suicidal and a complete mess I got sent to the more intensive services, which have now discharged me even though I admitted to being a bad place. It’s a crazy system which as you say is likely to become worse do the strains of COVID. I hope the course you get helps you. I’ve definitely taken some things from DBT which have helped.
There is a lack of funding for the NHS, unfortunately it is not “fashionable” to favour mental heath so the money goes elsewhere
Definitely – I do feel for the NHS as they are so underfunded in so many ways.
It is very sad there is a huge lack in funding for mental health service, well done for talking about mental health on your blog, I think it is important to raise awareness because everyone knows someone that is going through mental health
Thank you it does help to talk about it find, it makes me sad that the funding is just getting worse.
I can really identify with CBT not working, it’s hyped up and made to sound like the ultimate thing but it really has little depth to it. I don’t think the general mental health system was ever very effective in the first place, and i’ve always found alternative type methods most beneficial.
I’ve got alot more from people who aren’t ‘certified psychologists’ but practice other methods, doing Inner Child work sessions was a big one for me.
It’s a challenge because being suicidal is a pretty serious thing, so in that case it’s hard to say ‘yeah just go and do this method’. But it might give you a place to start researching, especially since you’ve already been doing courses and practicing things yourself.
Inner Child work is awesome, and Somatic Trauma work. I did a few courses from Irene Lyon and continually recommend her material since as it’s awesome. She has a ton of free youtube videos.
Honestly, I think it is crazy they send people to it who it will never work with, what a waste of money! It definitely has never been good, but it just astounds me that is being left to slip backwards and support taken away. I get it’s all to do with money, but I still can’t understand why.
I am most definitely up for looking at other methods. I often think the most help I got in my months in hospital as a teen came from the other patients, yes in some ways it made me worse as I would pick up on feelings, but seeing the strength of others is often a big thing too.
Mental health professionals often seem to be stuck in a box that needs thinking outside of as every patient is different, no one experiences mental health issues in the same way, even with the same diagnosis.
I will have a look at all you have mentioned that you so much, that really is helpful to me.
This is so sad to hear. Totally different situation but I used to work as a secretary in criminal law and there was this one young lad who had been diagosed with a personality disorder, he kept comitting crime because he was homeless and felt better in prison but he really should not have been there but they did not know where to send him or who could help him so he just kept going in and out of prison like a criminal when really he just needed some help. It’s a sad situation. I hope you feel better than you did and one day you will get what you need in the form of some kind of counselling whatever that may be.
Oh gosh that is such a shame, I am sure it is a common thing as well for people to commit crimes to get a warm roof and food at times, especially with mental health issues, they can really mean you struggle with everyday things.
Lack of money is the main one. Its not going to improve either. The pandemic is going to leave more health issues. My second son has a diagnosis of bipolar type 1 with rapid cycles. We are also waiting for a confirmed diagnosis of high functioning autism. A wait which was one – two years. It will now be 6-7 years unless we can pay the thousands for a private diagnosis. The services aren’t joined up or personal anymore. It is tick box exercises. The last time my lad had a flare up of his bipolar I had to do the chasing for his psych and various. They did come out to see him. They stayed involved in crisis with his CPN for 4 weeks. There is so many much worse. He has a home and support so not seen as needy as others
It’s so hard I think Bipolar (perhaps Cyclothymia) has been added to my diagnosis but I’m still not sure, which on its own really makes me feel a little out of control. I did ask and didn’t get a really helpful reply, I like having a name as at least I know what I’m fighting then. It makes me sad, I had a permanent CPN for years, as if you were seen to have a condition which would be on going, they would give you on going support. Now it’s tick those boxes. I definitely don’t blame those on the bottom, it’s higher up and your right it is only going to get worse.
I did CBT after having my baby I was diagnosed with post natal depression and anxiety.I did telephone appointments just covering the questionnaires which didn’t help me at all then as I was no better I did 6 weeks of one to one sessions but all we covered were the questionnaires each week that was supposed to be it but they realised I wasn’t any better so I did another 6 weeks with another therapist that time thankfully more in depth but after that I was discharged only to have a breakdown a year later and be placed on medication but that didn’t help either as I started to drastically lose weight on it but as soon as I came off it the weight piled on and more.Thankfully I feel fine now but I’m worried that at some point I’ll breakdown again and nothing will help.
Those questionnaires drive me insane, I struggle to give them answers half the time as I just feel numb, I don’t see how they help at all most of the time, but then I guess it is back to just ticking boxing. I would dread when those sheets came out.
I am so glad you feel better now and managed to get yourself to a point where you feel better that is such a hard and incredible strong thing to do.
I completely agree. I went to the doctor with severe anxiety and panic attacks and was referred for CBT. The emphasis was totally on making me function in society, which would be really useful for someone struggling to cope at work or whatever, but it’s irrelevant to me as I can manage to do everything I need to, I just feel awful! Years ago I had counselling with a psychiatric nurse, which was much more helpful for me. I think the professionals involved are doing the best they can, there’s just not enough resources and freedom for them to tailor their services to the individual.
It’s just box-ticking oh you did this great off you go. I’m definitely not blaming those on the front line, they have to do what they are told and I’m sure many hate it as much as the service users.
However, it shouldn’t be this way, why are we going backwards not forwards? After coming out of the hospital at 16 I was given a CPN who I saw every fortnight – monthly for years. Then one day she told me she was leaving and I wouldn’t be getting a replacement as they don’t do “long term care” anymore.
I didn’t understand it when she told me and I still don’t understand it now.
I think the answer to ‘why’ is because they have little funds, they are so stretched trying to help so many people. It does not help us who need help though, but there is no easy solution, GP just want to feed you drugs, if you want therapy then they offer an online course which I found to be useless. I did Talking Therapies 30 mins per week, an online instant messenger style session, it took him an average of 6 mins to reply to my every response , so do the maths, I basically got 5 replies per week, and all it was, same questions, reviewing my weekly scores from preset questionnaire, how are you? arranging next weeks session, never any ‘work’ done or help/tools to resolve anything. I ended up getting more wound up during the sessions, could not believe it took him 6 mins per reply, can only assume he was chatting to several people at once, or watching netflix at same time, not sure? My daughter was finally diagnosed with schizoid affective disorder and they basically pumped her so full of drugs it ended up killing her, heart specialist and coroner could not believe the amount of drugs in her system, they said no wonder her poor heart gave up! You only have to watch many of these 9pm emergency service documentaries on tv saying most of their responses are now mental health related, the system needs a major investment to ensure the mental well being of this country.
I totally agree a lot has to do with funds when it comes to what people at the ground level can do. Which sort of leaves me wondering what is funding getting worse, why are whoever is in charge of getting the funds to the right place letting this happen?
Honestly, meds for mental health are awful – just one of my meds makes me gain weight stupidly, gives me heart palpitations, and has given me long term tremours. Then I have to have yearly checks for diabetes and my liver and kidney as it could affect that. However, what’s my other choice? To go with being healthier physically but not so mentally.
I’m so sorry about your daughter that is just utterly awful and heartbreaking.
Are there any charities that offer support services? Yes keep asking for help, despite the revolving doors, until they provide something that actually helps. Don’t let it get to crisis point.
Treatment, help, follow up, support…..it’s all gotten so much worse because of austerity and funding cuts. I’m lucky, I found a very local charity that provides support and counselling and thus have managed to avoid all but med reviews with formal services for the last few years. But I’ve seen the withdrawal of services they used to offer, that have been of benefit to me in the past, I’ve seen friends struggling to get any sort of help and then waiting lists that are even worse than what I experienced. There just isn’t enough money being given to the nhs to fund anything. So it’s short, sharp, stick a plaster on the wound by brief interventions and hope for the best. Repeat ad nauseam.
I don’t think there is around here, though I can have a look. You are so right in what you are saying, it is all about cuts and not being given what they need to offer a service. It amazes me that things are getting worse, that’s what I struggle to get my head around – I guess it’s the black and white of BPD, in my mind things should get better as time passes, not worse.