We’re talking about mental health more than ever, which has helped to encourage more people to seek help. But accessing that help isn’t always easy.
There can be several obstacles that stand in the way of actually using mental health services in the UK. NHS funding, where you live, your socio-economic background, and social stigma in your community can all present barriers.
The pandemic too has exacerbated the problems. Here are some of the ways people can be deterred from finding care.
For mental healthcare, having someone to talk to face to face can make a huge difference.
Mental health charity Mind found that of those young people who were given phone or online mental health support during the pandemic, almost a third (32%) said remote treatment made their mental health worse.
Niamh O’Connor, 22, from Merseyside, has anorexia and required hospital admission after her treatment moved online.
She said: “Lockdown made my anorexia a lot worse, I was trying to stay in control of everything, and my exercise addiction heightened. My treatment also went from face to face to telephone appointments, which I found anxiety-provoking and I couldn’t get my point across as well.
“Over the phone you can’t read their body language or see what their face is doing. It would make me really anxious if they said they were phoning at a certain time and then didn’t. I stopped answering the calls and disengaged, which meant I got discharged from all services and was left without anything. This led to my mental health deteriorating and I ended up going into hospital for five months.”
Jenny Tan, 18, from Surrey, who has an eating disorder, also faced a similar problem. “Because of the lockdown, my check-ins with clinicians moved to Zoom. As the restrictions got stricter the weigh-ins I have to do also stopped being in person. I wanted access to more help, including to dieticians and sessions in person,” she said.
“It felt quite isolating doing it over Zoom. I also had technical issues where a poor connection interrupted our conversations and made it difficult to get my point across, and sometimes the sessions didn’t start on time, so I was left anxiously waiting.
“It was also a struggle for my parents to access the help and support they needed, as the clinic could no longer hold the usual support groups and my therapist didn’t provide them with any information.”
The Royal College of Psychiatrists has warned that workforce shortages mean there is just one psychiatrist per 12,567 people in England.
The highest rates of unfilled positions are in the fields of addiction, eating disorders and child and adolescent psychiatry. The College said NHS workforce data shows there are 4,500 full-time consultant psychiatrists for 56.5 million people.
It has called for a long-term plan to grow the psychiatric workforce and said the government must invest in a further 120 core psychiatry training posts in 2022. And there should be an extra 7,000 medical school places on top of the existing 8,000 by 2029, it added.
Dr Adrian James, president of the Royal College of Psychiatrists, said: “The high number of people struggling as a result of the pandemic paired with the historic mental health backlog have created a perfect storm.
“We’re now looking at record numbers of people having to wait for life-saving treatment, with waiting lists getting longer every day.
“If the Government is serious about addressing long-term challenges in mental health, it urgently needs to significantly invest in our workforce so that we can ensure that demand for psychiatric care can at least be met in the future. We simply can’t win this fight without enough psychiatrists.”
Joey*, who is in his 30s, from London, is expected to work flexible shifts Monday to Sunday in his job, leaving little time to prioritise his mental health.
“Sometimes I think about it from a money point of view, because it’s more important that I get paid and keep my job than prioritise my mental health and take it easy. If I prioritise my mental health more, I might be out of a job meaning I might be out of a place to live, so I’d be homeless and mentally ill, which is a big fear of mine,” he told HuffPost.
“I’ve had a lack of support from my GP, I’ve been told quite bluntly by healthcare professionals ‘why do you feel like this?’ and ‘what do you have to be depressed about?’ When the first line of support is that kind of reaction, then it stops me from wanting to get help in the first place.
“Private healthcare is not an option for me due to how much it costs, I don’t have the luxury of being able to afford private therapy sessions.”
For Black, Asian and other ethnic minorities, the lack of cultural sensitivity they may face can prevent them from seeking help. While some have experienced medical racism, others have been deterred from services as they don’t want to spend time explaining their background in order for the health practitioner to understand them.
Dr Noha Abu El Magd previously told Huffpost: “Navigating the world with a chronic mental health condition as a Muslim woman of colour is complicated.
“I had begun to suspect I was experiencing symptoms of the bipolar spectrum. But as I sat in my appointment with my GP, I felt further and further from the ‘normal’ bipolar patient with each question. My doctor asked if I drank too often sometimes, if I’d experimented with drugs, if I’d been having problems with addiction to substances, if I’d had heightened sexual activity in the past few months, if I’d made plans to kill myself. To all of these I answered no. In no way did these questions consider my religious or cultural identity.
“Bipolar disorder is often characterised by episodes of mania – but as manic episodes go, mine were harder to recognise. I don’t drink for religious reasons, I don’t have access to hard drugs, and I have cultivated a high degree of discipline over myself. All these indicators of bipolar disorder presented to me just didn’t exist in my context due to the life I led as a Muslim woman. My pain, my need for help, went unattended because of my identity as a Muslim woman of colour.”
Podcaster and author Alex Holmes, who has written on the relationship between mental health and masculinity, tells us how in some communities, there’s still a stigma attached to receiving help.
“There are specific stigmas when it comes to mental health and masculinity in the Black community that speak to specific intersections of the community stemming from deep cultural shame around what makes you ‘strong’ or ‘resilient,’” he tells Huffpost.
“Masculinity in the Black community is hypersexualised by a white society that causes alienation within the community causing homophobic and heterosexist attitudes. This disconnection is destabilising and harmful. Mental health issues in the Black community are shunned because people don’t feel safe, psychologically or emotionally, in a lot of white spaces.”
Once these barriers are lifted, only then can people fully access the help they need, when they need it. But it will require a multitudinous effort, particularly from those in power.
HuffPost UK has contacted the Department of Health and Social care for comment on the issues raised and will update this article if we receive a response.
* Some names have been changed.
Help and support:
There can be several obstacles that stand in the way of actually using mental health services in the UK. NHS funding, where you live, your socio-economic background, and social stigma in your community can all present barriers.
The pandemic too has exacerbated the problems. Here are some of the ways people can be deterred from finding care.
Virtual contact
For mental healthcare, having someone to talk to face to face can make a huge difference.
Mental health charity Mind found that of those young people who were given phone or online mental health support during the pandemic, almost a third (32%) said remote treatment made their mental health worse.
Niamh O’Connor, 22, from Merseyside, has anorexia and required hospital admission after her treatment moved online.
She said: “Lockdown made my anorexia a lot worse, I was trying to stay in control of everything, and my exercise addiction heightened. My treatment also went from face to face to telephone appointments, which I found anxiety-provoking and I couldn’t get my point across as well.
“Over the phone you can’t read their body language or see what their face is doing. It would make me really anxious if they said they were phoning at a certain time and then didn’t. I stopped answering the calls and disengaged, which meant I got discharged from all services and was left without anything. This led to my mental health deteriorating and I ended up going into hospital for five months.”
Jenny Tan, 18, from Surrey, who has an eating disorder, also faced a similar problem. “Because of the lockdown, my check-ins with clinicians moved to Zoom. As the restrictions got stricter the weigh-ins I have to do also stopped being in person. I wanted access to more help, including to dieticians and sessions in person,” she said.
“It felt quite isolating doing it over Zoom. I also had technical issues where a poor connection interrupted our conversations and made it difficult to get my point across, and sometimes the sessions didn’t start on time, so I was left anxiously waiting.
“It was also a struggle for my parents to access the help and support they needed, as the clinic could no longer hold the usual support groups and my therapist didn’t provide them with any information.”
Shortage of therapists
The Royal College of Psychiatrists has warned that workforce shortages mean there is just one psychiatrist per 12,567 people in England.
The highest rates of unfilled positions are in the fields of addiction, eating disorders and child and adolescent psychiatry. The College said NHS workforce data shows there are 4,500 full-time consultant psychiatrists for 56.5 million people.
It has called for a long-term plan to grow the psychiatric workforce and said the government must invest in a further 120 core psychiatry training posts in 2022. And there should be an extra 7,000 medical school places on top of the existing 8,000 by 2029, it added.
Dr Adrian James, president of the Royal College of Psychiatrists, said: “The high number of people struggling as a result of the pandemic paired with the historic mental health backlog have created a perfect storm.
“We’re now looking at record numbers of people having to wait for life-saving treatment, with waiting lists getting longer every day.
“If the Government is serious about addressing long-term challenges in mental health, it urgently needs to significantly invest in our workforce so that we can ensure that demand for psychiatric care can at least be met in the future. We simply can’t win this fight without enough psychiatrists.”
Lack of time/resources to prioritise health
Joey*, who is in his 30s, from London, is expected to work flexible shifts Monday to Sunday in his job, leaving little time to prioritise his mental health.
“Sometimes I think about it from a money point of view, because it’s more important that I get paid and keep my job than prioritise my mental health and take it easy. If I prioritise my mental health more, I might be out of a job meaning I might be out of a place to live, so I’d be homeless and mentally ill, which is a big fear of mine,” he told HuffPost.
“I’ve had a lack of support from my GP, I’ve been told quite bluntly by healthcare professionals ‘why do you feel like this?’ and ‘what do you have to be depressed about?’ When the first line of support is that kind of reaction, then it stops me from wanting to get help in the first place.
“Private healthcare is not an option for me due to how much it costs, I don’t have the luxury of being able to afford private therapy sessions.”
Racism/cultural misunderstandings
For Black, Asian and other ethnic minorities, the lack of cultural sensitivity they may face can prevent them from seeking help. While some have experienced medical racism, others have been deterred from services as they don’t want to spend time explaining their background in order for the health practitioner to understand them.
Dr Noha Abu El Magd previously told Huffpost: “Navigating the world with a chronic mental health condition as a Muslim woman of colour is complicated.
“I had begun to suspect I was experiencing symptoms of the bipolar spectrum. But as I sat in my appointment with my GP, I felt further and further from the ‘normal’ bipolar patient with each question. My doctor asked if I drank too often sometimes, if I’d experimented with drugs, if I’d been having problems with addiction to substances, if I’d had heightened sexual activity in the past few months, if I’d made plans to kill myself. To all of these I answered no. In no way did these questions consider my religious or cultural identity.
“Bipolar disorder is often characterised by episodes of mania – but as manic episodes go, mine were harder to recognise. I don’t drink for religious reasons, I don’t have access to hard drugs, and I have cultivated a high degree of discipline over myself. All these indicators of bipolar disorder presented to me just didn’t exist in my context due to the life I led as a Muslim woman. My pain, my need for help, went unattended because of my identity as a Muslim woman of colour.”
Stigma
Podcaster and author Alex Holmes, who has written on the relationship between mental health and masculinity, tells us how in some communities, there’s still a stigma attached to receiving help.
“There are specific stigmas when it comes to mental health and masculinity in the Black community that speak to specific intersections of the community stemming from deep cultural shame around what makes you ‘strong’ or ‘resilient,’” he tells Huffpost.
“Masculinity in the Black community is hypersexualised by a white society that causes alienation within the community causing homophobic and heterosexist attitudes. This disconnection is destabilising and harmful. Mental health issues in the Black community are shunned because people don’t feel safe, psychologically or emotionally, in a lot of white spaces.”
Once these barriers are lifted, only then can people fully access the help they need, when they need it. But it will require a multitudinous effort, particularly from those in power.
HuffPost UK has contacted the Department of Health and Social care for comment on the issues raised and will update this article if we receive a response.
* Some names have been changed.
Help and support:
- Mind, open Monday to Friday, 9am-6pm on 0300 123 3393.
- Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI - this number is FREE to call and will not appear on your phone bill).
- CALM (the Campaign Against Living Miserably) offer a helpline open 5pm-midnight, 365 days a year, on 0800 58 58 58, and a webchat service.
- The Mix is a free support service for people under 25. Call 0808 808 4994 or email help@themix.org.uk
- Rethink Mental Illness offers practical help through its advice line which can be reached on 0808 801 0525 (Monday to Friday 10am-4pm). More info can be found on rethink.org.
