Sunday, January 17News For London

Mental Health: Is the treatment gap affecting you?

Samantha is on medication and has been waiting for nearly five months to see an expert for her psychotherapy session. It has been difficult for her, but she wants to keep her hopes high. “I’ve been feeling the blues for quite some time now, and my medicine is not helping me much,” she says.

Samantha has dysthymia, which is a form of depression. The symptoms of dysthymia are milder than major depression, but last longer- sometimes for years. The disorder responds to talk therapies more than medication. But unfortunately, the waiting period for Samantha is long and she is on heavy medication. When asked about it, she explains: “My medicine is helping me, but I feel worthless and uncared for, almost every day. I feel like talking to someone because I realise I’m young and want to live a happy life like everyone else. Sometimes I feel it’s impossible.”

Sadly, Samantha’s experience is not unique. One in 10 people have been waiting for over a year to receive proper treatment. More than half of them have been waiting for longer than three months. The mental health charity Mind has recommend that this waiting time should be reduced to 28 days, and even shorter in emergency situations.

Moreover, every year 1 in 4 adults in Britain experience a diagnosable mental health issue. About a third of all affected receive no professional help, according to Fundamental Facts About Mental Health – a report by the Mental Health Foundation.

It stands to question that if these figures referred to cancer patients for example, the general public might be more concerned.

However the next steps in the NHS’s Five Year Forward View plan, promises more spending on mental health treatments. This would lead to 200,000 more people accessing psychological or talking therapies for common mental health conditions by 2018/19. An extra 49,000 children and young people will be treated by community services.

But facts alone, cannot satisfy Samantha. Certainly she is on medication, but does this really suffice?

Anne Cooke, a Consultant Clinical Psychologist who previously worked for the National Health Service said:

“Obviously medication can help, but a lot of drugs have not been tested properly. There are a lot of young people on medication at the moment but we don’t really know what the effect of this is going to be. It is vital that therapy is available. Especially if a young person is going through something in life, medication is not going to address that directly. It would be good to have a psychologist in every GP surgery so that people can see a psychologist straightaway, don’t have to wait for a long time, and don’t have to take medication just because nothing else is available.”

The Five Year Forward View also plans to place an extra 1,500 mental health therapists alongside GPs in the next two years.

YouGov research has revealed the wide prevalence of anxiety and depression in young people today. 74% of students who reported having anxiety related problems also had suffered depression related problems.

The shaded portion represents restlessness, excessive worrying and agitation. [Graphic: Megha Sharma]
According to guidelines from the National Institute for Health and Care Excellence (NICE), the best way to treat depression is through Cognitive Behaviour Therapy (CBT). The number of sessions often depend on the severity of depression. Mindfulness CBT is recommended once a person has recovered and has had about 3 or more bouts of depression in the past. Essentially, it helps a person understand their thoughts and feelings better.

For Anxiety Disorders, it recommends getting psychological therapies and medication. However, for long term recoveries, talking therapies are deemed to be the most helpful.

A treatment gap occurs when many individuals in need of particular services are not using them. There can be several reasons as to why that might happen. The contributing factors put in two broad categories, would be:

  1. Structural and Financial aspects- that include hard eligibility rules, availability of services, financial aspects of the system etc.
  2. Personal and Social aspects- that include individual choices, stigma, discrimination etc.

While on personal level it is hard for the youth to contribute to the development of structural and financial aspects, it is achievable to comment upon and bring a change in personal and social aspects. Two years ago, a whopping 9 out of 10 people with mental health problems experienced social stigma and discrimination. Fortunately, with education and growing public awareness, the condition has started to improve. Is experiencing social stigma, and not being able to seek help from experts and friends, a fair thing to be happening in a first-world nation?

While Britain as a whole experiences a treatment gap quantitatively, through a lack of resources; it also experiences the same gap qualitatively in some areas. High-quality care is not received by a lot of individuals with respect to therapeutic techniques. Sometimes, medication is prescribed straight away in place of offering therapies, which does little in boosting long term recoveries.

However, it’s not just a low point for Londoners. Besides the NHS Five Year Forward View, people might also benefit from the government’s £1.5 million programme designed to open up employment opportunities for young Londoners with mental ill health. City Bridge Trust, the charitable funder for City of London Corporation, sought to help these people find and maintain employment. The trust is already working in partnership with the Center for Mental Health.

On asking Cooke about the overall situation, she replies: “Funding has been cut and cut and cut for mental health services throughout the country. So, there’s very little available. There are very long waiting times, and even if you get through the waiting list – you can probably only see someone just once or twice which is not enough. Moreover, if people have to go to hospitals for a treatment, they are travelling right across the country.”

[Featured Image: CC BY-SA 2.0]

[Sub-editor Tom Geggus]