Ho un PTSD complesso ma una lista d’attesa significa che ho visto psichiatra solo una volta ogni 10 anni

The reason why mental health waiting lists aren’t coming down is because the treatment doesn’t work. Therefore, hardly anyone is ever getting discharged from treatment in order to free up space for those still waiting. It doesn’t matter how much funding is poured into nostrums that are ineffective – they still won’t work.

The reason that the treatment doesn’t work is because it is predicated on the assumption that a person’s psychological distress is caused by a brain malfunction, rather than a normal and natural reaction to life. As a society, we don’t seem to be ready to admit that life itself is bad, so if someone isn’t enjoying life, we look for the cause of that in their brain. But if the “treatment” is predicated on looking for the cause in the wrong place, then this is the inevitable result.

The reason mental health waiting lists don’t come down is because most enduring mental illnesses require long term therapy to effectively treat, and that sustained input is astronomically expensive to provide. I’ve lost count of the number of highly skilled HCAs I’ve worked with who have psychology degrees and are desperately trying to get one of the vanishingly few placements on clinical psychology courses, but ultimately we’re just not investing in training sufficient psychologists and therapists to meet demand and there’s no way the government (whichever party’s in charge) will sufficiently open up the purse strings to fund it on the necessary scale. I really don’t see anything changing in that respect any time soon, so we’ll just continue throwing antidepressants at people and fobbing them off CBT….

There is this crazy rumour going around that the NHS offers mental health services beyond a handful of pills. They don’t. I don’t know how this got started, and it’s obviously not true but people keep repeating it…

The worst thing about this is that if you’re at the point of needing a psychiatrist, you’re probably either already at some sort of crisis point, or you need your medication adjusted due to changes in your illness. Mental illness can change over time. This is dangerous in many, many ways.

First of all I want to commend this young lady. We have a huge problem with people taking up A and E beds, self harming in a non-discreet way, jamming up mental health beds and placing serious demands on crisis teams and hospital staff. She is doing none of these things, just struggling in silence and trying to bring attention to the dire state of NHS care.

I have complex PTSD too, I imagine she is being seen by secondary care and she needs bits of EMDR and psychodynamic or CBT. She needs a psychologist, and the two the team have probably have waiting lists going into the 100s. In a messed up way, a person taking antidepressants from their GP is likely to receive more medical care than someone unwell with schizophrenia, OCD, PTSD who should be regularly seen by a psychiatrist but isn’t.

I need some medication increased now but only the psychiatrist can do that. The next available appt is 2 months away. Imagine telling someone with asthma or diabetes just to live with it for 2 months. Because of this medical neglect, people with mental illness are also becoming physically ill too, whether that is through self neglect or self medicating

Everything she said about the Dr situation is true. We are so short of psychiatrists that my area don’t offer the 6 months reviews like they used to. You don’t get a review or follow up. Between 2016 to today I have been a service user and seen a huge decline in the service provision from barely there to non-existent. Everyone is applying for PIP to pay towards private treatment, the claims sky rocketing hasnt come out of nowhere

And we were the ones Kendall was going to get back to work. Thank God that hasn’t materialised

I am bipolar and saw a psychiatrist in 2016 (was diagnosed) then in 2018 and nothing since then. medication dose is very low. mood swings still bad. baffling that I get no help (GP will not do bipolar)

This is grim but sadly very common. EMDR therapy is highly effective for PTSD/CPTSD but near impossible to access on the NHS. Meanwhile people are handed antidepressants, benzodiazepam, mood stabilisers etc etc. freely by their GP in the hope it will help mask – but not treat the problem. Yes EMDR/a proper course of therapy is expensive, but is it expensive compared to repeated GP visits, medication, A&E visits, and ultimately suicide attempts/crisis, and long term unemployment. Its a mess.

Mental health treatment for anything more complex than a single incident trauma is essentially privatised at this point.  The biggest problem, imo, is the total unwillingness for the NHS to consider anything which isn’t prolonged exposure (PET) based as this is the “gold standard treatment” (I.e, the only one which has been funded and is easy to trial in a lab environment with no messy comorbidities). This, like any model of therapy, isn’t suitable for everyone. There are types of therapy we (as therapists) use in private practice which we, and our clients, find quicker, gentler and more effective than PET and don’t involve a narrative (unlike talking therapy) which often is non existent with early childhood or pre natal trauma. Trying to a) get funding for trials and b)convince the NHS to employ practitioners with this training (or train their therapists) is nigh on impossible. As someone in private practice who specialises in treating complex trauma, i, and many others, would probably work for the NHS in a heartbeat for less than I earn now, but as I’m not trained in CBT there simply aren’t any jobs available.  
The second biggest problem is the lack of long term therapy available. It’s not unusual for someone with CPTSD (if that’s what it actually is) to need 2,3 or 4 + years of treatment. Instead, they are put on SSRIs or antipsychotics and claim benefits for the rest of their life.