Let’s look at some of the reasons people suffer with depression, anxiety or other mental health issues.
They may have core beliefs that leave them already feeling….
they are not worthy
they are a burden
they are not good enough
they have reasons to feel ashamed and embarrassed
They may also have a history of issues that have led to their mental health problems, particularly if they have come from a dysfunctional family background….
have been significantly abandoned in the past
have been let down by poor parenting
have been brought with parents with mental health issues
have suffered loss or bereavement from an early age
have never been listened too or understand as an individual
have never felt like anybody cares
Many of my self-referrals are coming with these beliefs or backgrounds. But the issues no longer presents to me in their original form but one that has been reinforced by the NHS system, making them more rigid.
Most of the time my clients know what it is they are wanting and needing and try to access it. They are told the first person they should see is their GP who offer them meds or a waiting list for CBT. They wait months for an assessment to then possibly be put on a waiting list of up to 18mths for treatment. My clients come telling me they do not want to go onto medication as a solution, they do not want to be filling out CBT homework forms alone at home and that they feel the only way to be heard and responded too is to become regularly suicidal (one attempt apparently does not warrant a referral into the mental health service). Given how long they have to wait without any other form of support it is no surprise that they may reach a point of suicide.
Because of the nature of their issues what they actually want is somebody to be there to listen to them as an individual at that moment and to try and help them understand what is happening to them so they can work out their own solutions for moving forward. What the current system does it take all of this power away from them, disempowers them from knowing what is best for them and thus makes them worse, left truly believing the negative beliefs they are toying.
I have clients who have come suffering symptoms which for them are extreme and beyond the norm for them and which they are finding really scary, particularly when having what could appear to them to be psychotic episodes or hearing voices. Having been through the system they have been told there is nothing clinically wrong with them and so do not warrant treatment. Whilst clinically there may be nothing wrong with them their symptoms continue and so still believes there is something wrong but gets no support in helping them understand this. An ‘expert’ telling them so does not always make the symptoms magically go away. They need a period of support where their experience of their symptoms is taken seriously enough so they feel safer and calmer to understand where the symptoms have come from, thus hopefully making the symptoms settle.
So why is it so hard for the NHS and government not to see this? What counselling provides is actually really simple and what clients really want is also really simple, they just want to be ‘heard’ and feel somebody has their back in trying to empower them to find their own way through. Yes it is more complex than that but this has to be the starting point for progress to start to be made. Our work is made doubly hard because we firstly have to undo all the damage the NHS system has done to them to reinforce their negative beliefs.
Trust me, I fully understand that there are huge demands and waiting lists to contend with, I have them myself. I used to have complete faith, almost a god like “the NHS are the experts and must bow down to what they say” belief myself and I want to support them. But these views are coming directly from my clients and they are being explicit about feeling completely let down and why. If I am doing my job and listening to my clients then it becomes my role to become advocate for them and all those still currently struggling with the system. I get the need for evidence based practice but how much more evidence do you need than those who are abandoning the NHS system and desperately struggling to find funds to pay for the service they really need privately.
I did a short period of work with CAMHS and provided a Primary CAMHS service which was 6 sessions of counselling. I found this hugely effective for the clients and rarely did the client need to be referred on. Within this counselling space the CBT work can be done or further referrals can be made but surely the service should be not about reinforcing clients beliefs that they are not good/sick enough clients, that they are a burden, that they are not important but showing them as a whole system that we care.
If all clients were offered this from the offset instead of medication or isolated CBT form filling the service would be providing just what the clients need, somebody to listen to and understand them and to not feel so alone and abandoned. If they feel anxious or depressed why not work with this now than wait until they are actually suicidal to then be treated. Too many of my young clients are coming in telling me this. If they can see it why can’t the ‘system’?
