1 in 4

A client greeted me this morning with a cheery, ‘happy new decade’ as they walked into my office. I was a bit distracted as I was concentrating making their usual coffee as it was said, but it reminded me that we have not just transitioned to a new year, but into ‘the twenties’.

As a child the twenties meant to me silent black and white films featuring people with gaunt, pale faces, really black rimmed eyes and lips dancing the Charleston, or alternatively, the start of the great depression, where the global economy tanked in 1929 and didn’t recover in any real sense until after the second world war ended.

It felt a bit strange to think we are in a new ‘twenties’ and I also began to wonder what has changed and what we have learned in the last one hundred years. I think it is safe to say that cinema has moved on apace, we now have colour and sound and 3D and super max HD HiFi Bluetooth mega noise clarity enhanced virtual reality first person perspective mega goggles and immersion (or something like that anyway) and the Charleston is largely confined to Strictly Come Dancing (which is probably for the best).

However, when I read that one in four young people are being denied treatment via the NHS for mental health related issues after they have been assessed, I do wonder how advanced we really are. I wish I could say reading the article below was a surprise to me, but it isn’t. I hear similar stories almost weekly from adult clients, or through hearing about the experiences of clients my supervisee’s are working with currently.

To describe access to treatment for mental health conditions as a ‘lottery’ through the current system is an understatement. Firstly, people seeking support around their mental health have to be lucky enough to have a good GP who understands mental health well enough to make the appropriate referral for assessment or to an appropriate counselling service. Then people have to hope that the local NHS providers are suitable for them and have a waiting list of less than six to nine months. Following an inevitable wait to see someone they have to hope that once they have been seen or assessed for the service, there are available counsellors or therapists that are trained to a high enough standard and are experienced enough to help.

I have heard so many times of clients turning up for counselling appointments, only to be told that the counsellor does not feel experienced enough to support the client or the client starts counselling, only for their counsellor to move on from the service before their counselling is complete.

These experiences can significantly negatively impact an already vulnerable persons mental health and often this kind of experience exacerbates the issues that were already there. There is also a high risk of people who were not experiencing trauma related issues, to develop them as a direct result of their treatment.

This is bad enough when it happens to adults, but to read in black and white that it is happening every day to vulnerable children saddens me intensely. Especially when it could be so easily avoided if the vital services that vulnerable young people and adults need were actually funded properly. I am not going to go political here, successive governments of all different flavours have stripped the funding away from mental health services for the sixteen years I have been in the field and it was happening before then too.

Mental health isn’t seen as a priority by those that crunch the numbers and their managers in the NHS and this ambivalence then gets passed onto the politicians that trust the managers and NHS to know what they are talking about. If a politician is told you can spend a billion pounds on talking therapies and services which will offer long-term solutions to a majority of people with mental health issues and have a high success rate, but some will take anything up to four years sometimes to get all the way well, or you can spend a few hundred million on medication and a specific kind of talking therapy that offers good (ish) short-term results, so some of the people will feel a bit better for a while, but they may come back into the system a couple of years down the line when they feel unwell again (but you might not be in charge then). Which one is the politician going to pick?

Well, the cheap, short-term solution obviously. The one that makes them look good, gets them a better job in the government and leaves it to their successor to pick up the pieces when it all falls apart.

This kind of short termism and blinkered view of mental health has been crippling the essential support providers within mental health services for decades and yet it doesn’t change. If anything, it is still getting worse and I don’t have any faith or belief that things will improve in the near future.

I have never worked for the NHS, I think it would break me to have to offer such limited services to people I know need to be supported in ways that the NHS can’t currently afford or provide. This is why I work in private practice, I can choose how I work with my clients based on what they need and my decisions are not grounded in financial restraints and a medical model view that all mental health issues are based on neurological deficits.

I know that at some point I will be in a position to fight for change within the NHS and the support services around it, there are already some amazing counselling services that operate outside of the NHS that pick up a lot of the people who fall through the gaping cracks in the NHS’s service provision and thank goodness they are there.

Hopefully, one day, the funding will be there so that people do not have to fight and kick and scream to get the support and treatment they need around their mental health.

The link to the article that inspired this blog is below:


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