Compulsory detention or treatment
Most mental health treatments that people receive in hospital happen on a voluntary basis. People usually agree to be in the hospital and have consented...
Some of the people we spoke to had had talking treatments such as psychotherapy, counselling and cognitive behavioural therapy (CBT – an approach that challenges unhelpful thought patterns). Talking treatments can be arranged through GP surgeries, charities e.g. Mind or privately by searching online. Talking therapies come in many different forms, but they usually provide a space for someone where they can meet with a trained professional and explore their thoughts, feelings and experiences. Usually a counsellor or therapist doesn’t offer advice on what to do, but instead provides a space for the person to discuss things in more helpful ways, which can aid the person in finding their own way forward. Talking treatments are usually offered by trained health professionals such as counsellors, psychologists, psychotherapists, and psychiatrists.
Most of the people we spoke to had talking therapies as an additional or complementary treatment, rather than as a replacement for medication or ECT. However, at the right time in their recovery, some people felt that talking treatments could ultimately reduce the need for drugs and ECT in the future. More than this, some believed talking therapies were essential to their recovery. Suzanne had accessed counselling through her workplace and she felt that this had helped resolve a bout of depression, such that ECT wasn’t needed again. Jenny felt talking therapies helped address the problems she experienced more than ECT had done. Sue and Ian said there ought to be more psychological treatments available that are “backed up” by the use of medication.
Some felt frustrated that, while drugs were readily available through the NHS, talking treatments were not always offered, or there were long waiting lists. Some people said it was difficult to find out about what talking treatments were actually available.
Those who had had talking treatments often talked about the specific role it had played in their recovery. People credited talking therapies with a range of helpful results like helping them to better manage their feelings of anxiety and stress, coming to terms with difficult childhoods, finding ways to forgive those who had hurt them, and feeling better or “healed”. Tristan’s wife had counselling which helped with her recovery in particular ways. Counselling and learning about ‘mindfulness’ helped her become better equipped to stop her depressive and anxious thinking from reoccurring. She was able to see problems coming and avoid them. She didn’t have a substantial episode of mental illness after the talking therapy. Tristan and his wife are now very positive about the future. Helen had many years of counselling through a charity. She often had trainee councillors and felt able to “let out” the traumatic experiences she had gone through “in the safety of that room”. Her life had been a “living hell” but the counselling helped her to “get rid of all this horrible stuff” and get her sanity back.
The people we spoke to had experienced different types of talking treatments. These included: CBT (cognitive behaviour therapy), DBT (dialectical behaviour therapy), psychotherapy, CAT (cognitive analytic therapy), different types of group therapy, hypnotherapy, mindfulness and counselling (see MIND website for an explanation of the different therapies). People accessed talking treatments through a charity or the NHS or paid for private therapy.
Helen had a lot of talking treatments over the years. Although there was one psychotherapist she didn’t think was very good, her overall experience was positive: “And it does work, yes, it does work. Talking I think is the most important thing”. Sue, Jenny, Yvonne and Helen all emphasised the importance of talking about what had happened to them as children in order to help with their well-being as adults (for more see ‘Childhood’).
Some reflected back on the talking therapies they had had when they were children and teenagers, noting mixed experiences. Catherine Y had managed to access different types of both individual and group therapy when she was a teenager. Although she said in hindsight it was very good, as she was a teenager “there [was] an element of…[rebellion]” and she found progress very slow.
As the people we spoke to had often experienced severe mental distress over many years, progress in therapy was gradual. Additionally having a good ongoing relationship with the therapist was mentioned as important.
Shorter interventions, such as a block of six weekly sessions sometimes offered by GPs, while frequently helpful, might not be enough for those who have suffered all their lives. Similarly, longer-term talking therapy could be too deep for others. Sue’s psychotherapist felt she needed 5 or 6 years of therapy. When he discharged her, he said it was difficult for her to overcome the trauma she had been through both as a child and as an adult going through mental health treatments.
Sheila’s husband had two lots of talking therapy on an inpatient ward. The psychologist involved Sheila (asking her about her husband’s past and explaining how she was working with him). She also helped refer her husband to a therapist specialising in Obsessive Compulsive Disorder (OCD) and helped her to understand more about her husband’s diagnosis of OCD.
The timing of, and access to, talking treatments was seen as very important for some people we spoke to. Mandie turned down ECT because she felt talking treatments were what she needed. She waited fourteen months to have psychotherapy through her GP, which she said was too long to wait when so ill, although she managed to access counselling through a charity in the meantime. She felt that if she had had these therapies sooner, her illness would not have developed.
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