# England & Therapy



## Monroee (Aug 26, 2009)

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## Lisa (Jul 8, 2006)

Britain has the National Health Service. It is for everyone and free at the point of service. Tax payer funds the NHS so the budget is limited. Very limited. The money that is there is regularly shifted from one area of the system to another. Services are often inadequate b/c there is never any real money.

Britain has actually seen a huge mental health offensive by the (last and now out of office) government ('New Horizons'). They have for a number of years now trained 1,000s of new therapist (CBT) to match the need in the population (30% of Brits are in need of treatment - a figure comparable to those of other developed nations). The number of sessions offered to patients is very limited. In some cases as little as 4, the patient is then discharged and counts as treated (that is really true).

The new government (they have been in office for about 1 years now though) have actually reduced funding for the NHS so there is little hope for 'New Horizons'. If you are a trained CBT practicioner then it would probably not be hard for you to get a job but prepare yourself for lots of frustration.


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## Monroee (Aug 26, 2009)

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## Lisa (Jul 8, 2006)

I dont know how much they make working on the NHS. I know that in private practice they make betwen 30-50 pounds sterling per session. They usually have a sliding scale whereby those clients on a lesser income pay less.

Some people get more than 4 sessions but the NHS does a lot of research and they recommend very little therapy. That 4 session thing is from of one of their own publications. Remember everything is funded by taxes and has to be effective AND efficient (cost).

Check out the NICE (National Institute for Clinical Excellence) website. They publish most of their studies and treatment recommendations. The system can be pretty grim for patients but in the context of public health care management and cost control Brits really are in charge.


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## Lisa (Jul 8, 2006)

JoinMartin,

would you have some more info on the standard regulation thing? I'd be interested.

Lisa


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## britisharrow (Jun 18, 2009)

You go to your GP who is your first port of call for anything non-urgent. You tell him what is wrong. If your problem is psychiatric he will make either a Priority 1, 2, or 3 referral.

Unless you're caught trying to jump off a bridge, expect to wait 1 - 2 months from first speaking to your GP to meeting your psychiatrist. During this 2 month wait the GP may put you on some psychiatric medication.

Referral to psychology, 3 -4 month wait.

Admittance to Acute In-Patient Care, i.e. the mental ward: you have to literally be in the middle of trying to do yourself in or dancing around the room tearing your hair out before you've got a ghost of a chance of getting a bed in there. You don't want to go into an NHS psychiatric ward anyway, I've been in two for several weeks and yea the food's okay but it's damn depressing.

So in conclusion, if you are suffering from acute psychiatric illness but do not have suicidal ideation, you will wait a month or two for a psychiatrist to see you. In an emergency you will be seen by the Out of Hours Community Crisis Team.

This is all based on personal experience within two separate NHS districts.


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## odd_one_out (Aug 22, 2006)

If you work as one here you'll be mostly above accountability. You can do whatever you want in that case, such as mind rape. The negative side of moving here is you'll likely require those same systems if you have mental health conditions.


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## britisharrow (Jun 18, 2009)

EarlGreyDregs if you really want to come to the UK then be in for a shock. Take whatever you've heard about this green and pleasant land and rip it up.

Grafitti everywhere, graveyards vandalised, dog **** all over the streets and no community. I've been in London and I've been up north and the UK was fed to the dogs years ago.


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## odd_one_out (Aug 22, 2006)

I never said that about rape - no making assumptions. My issue last night was related to what had just happened to me. I'm sick today because it kept me up till about 2am sorting out an independent advocate to help. I posted about it in the What's bothering you right now thread just before my first post here if anyone's interested. I'm well aware and have much experience of such associations and using official channels to keep professionals in check and accountable. But in practice, a lot of the time it's just so inadequate as to be worthless. The system is really ****** up and no, it's not just my experiences because they're pretty common. Whole system needs an overhaul and there aren't the funds to do it. Just read around a bit and you'll learn more. I'm so exhausted with this topic and it's really not up to me to explain the systems further. I'm also sick of lack of understanding and fake empathy.


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## britisharrow (Jun 18, 2009)

On the subject of accountability, there is absolutely no doubt that British doctors are held much more accountable than anywhere in the USA. This is partly why you see so frequently on these forums Americans treating medication like candy, will I mix this or should I ask for that?

The General Medical Council UK is the regulatory body for medical practice and it is very stringent.


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## nemesis1 (Dec 21, 2009)

I had to wait 4 months to get in to therapy, and when i finally did it was pretty much a waste of time.


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## tutliputli (Feb 22, 2009)

I've seen a few different therapists and have always found them to be very good. IMO, it's the GPs (general practitioners, the first point of contact for any health problem here in the UK) that are not so helpful. It seems wrong that one should have to visit a GP first when they can deny you access to psychologists, psychiatrists or therapists. A GP once told me 'you don't have a problem, it's just your personality', at a time when I really needed professional help for social anxiety and depression.


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## TheExplosionist (Apr 13, 2009)

There are only 3 psychologists for the area where I am. 
That's roughly 1 per 50,000.

Mental health in England is regarded as something to be put into a dark corner and not be talked about.


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## Lisa (Jul 8, 2006)

tutliputli said:


> I've seen a few different therapists and have always found them to be very good. IMO, it's the GPs (general practitioners, the first point of contact for any health problem here in the UK) that are not so helpful. It seems wrong that one should have to visit a GP first when they can deny you access to psychologists, psychiatrists or therapists. *A GP once told me 'you don't have a problem, it's just your personality',* at a time when I really needed professional help for social anxiety and depression.


That is such a terrible thing to say to a patient. Doctors who are training now are required to take 2 courses in Psychology as part of their education so that should solve the problem of prejudice and cluelessness in the next few years.


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## tutliputli (Feb 22, 2009)

Lisa said:


> That is such a terrible thing to say to a patient. Doctors who are training now are required to take 2 courses in Psychology as part of their education so that should solve the problem of prejudice and cluelessness in the next few years.


Yeah, they certainly need to have more knowledge of psychological problems. It's unfair to the patients, especially when it can take a long time to work up the courage to go and talk to a doctor about a mental health issue.


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## odd_one_out (Aug 22, 2006)

joinmartin said:


> and that being mostly above accountability means they can do whatever they want, including something you refer to as "mind rape".


You implied I'd said the therapists _as a rule_ rape people's minds. I didn't.



joinmartin said:


> I respect you and your experiences and the experiences of other people a great deal. However, I will stand up for what I know to be the huge number of professional people who work incredibly hard and are ethically sound who put themselves through a heck of a lot to become therapists and do their best to help other people.


You throw around this word _respect_ a lot. I haven't felt any respect or empathy in any encounter we've had on any issue I've mentioned (including when I'm being very rational) that you happened to respond to. Quite the contrary.

I stated above what prompted me to make that 1st post. I thought I'd made clear the state I was in last night and why. It's ongoing and been long term, what I've been dealing with, and I'm certainly not alone in the system causing harm - it's pretty common in various ways. It's normal to not persistently remain perfectly calm and rational throughout such experiences. I doubt anyone's bothered to check what I was talking about (not that I really care since my doctor knows what happened, as do those close to me. I also don't have to prove or even bother to convey in a purely rational way over the internet the effect of these experiences.)

If you'd rather focus on defending the profession than figuring out what prompted my (as a member who tends to be highly rational) post, then that's your choice. I'd just prefer you not claim to respect my experiences. You appear to respect your colleagues far more than people like me.



joinmartin said:


> We can't change people. The change comes from the client. We work with the client not on the client and if the client has any concerns then they absolutely must feed these back to the therapist. Indeed, we are trained in hearing and responding to such feedback and it really does help the session. And there remains a strongly upheld complaints procedure in place and moves towards more regulation where we can possibly get it sorted.


This is not related to my issue.


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## TheoBobTing (Jul 8, 2010)

I've seen my CBT therapist about 25 times, for about an hour each time. I don't think I had to wait around for all that long before first seeing the Mental Health Nurse who then passed me on to the CBT therapist. Seeing any NHS psychiatrists has been very different though. In my area apparently they generally only want to give you a psychiatrist appointment if you think you're a chipmonk or something. But my CBT therapist did manage to pull some strings and get me an appointment with an NHS psychiatrist, which is more than my GPs managed to do.

You get regional differences with the NHS though, so other areas are probably different. There is of course private mental health care, but that's more of a niche thing over here so there might be limited private vacancies.


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## cellophanegirl (Sep 21, 2009)

Question: how much would it cost to see a private therapist outside of the NHS? Even on the health care plan I'm on (my mom's) now, it's still about a $20 co-pay per session (or was when I was actually in therapy).


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## britisharrow (Jun 18, 2009)

cellophanegirl said:


> Question: how much would it cost to see a private therapist outside of the NHS? Even on the health care plan I'm on (my mom's) now, it's still about a $20 co-pay per session (or was when I was actually in therapy).


A private therapist would cost around £70-£100 per session ($120-$160).

There are voluntary organisations if all someone wants is to talk to someone.


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