Comprehensive mental health care crumbling

By Holly Hemsley

Waiting times for mental health care need to be fixed (Image: Unsplash)

The current waiting list to be seen by NHS Psychology is anywhere between 18 weeks and two years, depending on severity of mental health symptoms. For a diagnosis of ADHD or Autism (or AuDHD) patients are looking at a wait of one to five years, with women significantly less likely to successfully gain a diagnosis after the wait.  

The NHS claims to keep a concise record of each of their patients' medical history, however, many feel that each time they reach out to their GP regarding mental health, it feels like they are starting all over again.  

What is causing this gap in mental health support? Is underfunding and limited resources only to blame? Or does stigma surrounding mental illness still impact the quality of 21st Century medical care? 

According to the Scottish Government website, a person's core Adult Health Record that GP’s can easily access when meeting with a patient, does not contain any psychological or psychiatric information, or any information regarding mental disability or additional support needs. This information is stored in speciality records, Clinical Psychology Records, and should be stored within the patient’s core Adult Health Record. 

If a Clinical Psychology Record was opened when one was under the age of 18, this record will only be kept until 25. This means that unless a new Clinical Psychology Record is opened, all previous information regarding a patient’s mental health history in childhood and adolescence will be inaccessible to GPs.  

It seems that there is a lack in department or individual communication within GP offices surrounding mental illness. For example, patients being encouraged to medications that their GP is unaware they have previously tried, resulting in a stagnation of care. Another example would be children using CAMHS services turning 18 and not having further counselling set up for them after the CAMHS sessions have finished. This can lead to vulnerable young adults having to be re-referred to NHS psychology, meaning longer waits for support for an ongoing long-term issue.  

Better comprehensive mental health care needs to be standardised (Image: Getty Images)

See Me Scotland ran The Scottish Mental Illness Stigma Study which revealed that of those who had experienced stigma within mental healthcare services, almost 60% had avoided using emergency services such as ambulances and A&E due to their fear of discrimination or prejudice. Most respondents also reported that they had felt ignored or dismissed by GPs when attempting to express the severity of their mental illness struggles, with some even claiming they had been pushed into taking medication they did not want to take. 

It's a common story. One goes to the doctors for stress-induced migraines and leaves with a prescription for a beta-blocker. One has periods of extreme highs and lows, and it's the copper coil that's suggested by their practitioner. One books an appointment for low mood, and is prescribed an SSRI, with no information about how to taper onto the medication or its possible side effects. It seems GP offices are treating the symptom and not the cause. 

This can be observed clearly in the NHS tightening the requirements for ADHD and ASD diagnosis’, making it more difficult for those high-masking or highly-able individuals to be taken seriously about their symptoms. The BBC shared that this is due to Health Secretary Wes Streeting believing that mental health conditions were being "over-diagnosed" in the UK. Patients do not have a right to a second opinion, meaning that if they are denied an ADHD or Autism assessment, they cannot continue to pursue one. 

Preventing more diagnosis from taking place will reduce the number of patients diagnosed with ADHD/ASD/AuDHD but will not prevent them from struggling with these conditions. 

Communication between specialists and GP’s causing dire issues (Image: Getty Images)

If a patient is successful in being seen by a psychologist or being able to begin counselling through NHS Psychology, there are further unavoidable complications. For example, if an individual misses three (non-consecutive) counselling appointments, whether explained prior to missing them or not, they will lose their slot. Time blindness, memory problems, high stress or depressive periods etc, could all be factors in one missing an appointment, and there is no additional understanding offered to these individuals, due to stigma - they are simply put back on the bottom of the waiting list. 

The NHS requires an updated system and mandatory training for mental health care, not records that a GP hasn't even skimmed before their next appointment. The UK government not only needs to allot more funding to the NHS, especially to its mental health care services, but also take into account the leading research surrounding stigma and medical prejudice.