Mental Health and the NHS

 An Interview with Dr A by Isla Geddes

Mental Health

The NHS is one of our most precious national resources. Since 1948, NHS staff have cared for our physical health, offering free care at point of service. With awareness of mental health issues on the rise in recent years, there is ongoing discussion about NHS treatment options for mental health. For the 1 in 4 of us experiencing a mental health issue in our lifetime, the free resources available on the NHS can be life-saving.
A few weeks ago, I sat down to interview an NHS GP Dr A (anonymous for the sake of this blog) about the issue of mental health; we spoke about the umbrella term “mental health” and what treatment options are currently available on the NHS. Here is what they had to say.

1.  Medically, what is meant by the term “mental health”?

 
I think it’s anything to do with your mood, your thoughts and your feelings. It’s difficult to make physical and mental health distinct; they’re very intertwined and I actually think it’s really unhelpful to make them too distinct. If you’re going through mental health problems, that will often affect your physical health and vice versa. So it’s difficult to define it exactly but I would say it is an ongoing issue with mood, thoughts, feelings and/or interactions with others.
I think it’s important with some mental health issues to stress that people will go through mood fluctuations situationally in their lives. For example, if your mum has died, you are bereaved - but being sad because something bad has happened – that is a normal human reaction, it doesn’t mean you’re ill. Yes, you definitely need coping strategies for those things but mental health issues are often different things. It’s important to remember that it’s totally normal to feel sad if something sad has happened, or stressed if you are going through a stressful time but  things like depression are more an ongoing mood issue without an ongoing trigger, as it were (they can start with a trigger).
 

2.  How common are mental health issues?

 
I think 1 in 4 people in their life will be affected with mental health issues in their life – I would say personally my experience would suggest it’s more common than that, but that might just be my social circle! I would say about 80-90% of my friends have experienced a mental health issue at some point. And it’s on the rise in young people but everyone is able to experience an issue.
 

3.  A lot of people will experience more than one mental health condition at the same time. How normal is this?

 
That’s really common! When we put in our data following an appointment to the computer it’s really common to group things like anxiety and depression together. You often get depression and dementia together as well. It’s less common, but depression and things like schizophrenia can sometimes be associated – but I would say definitely, the most common is the depression and anxiety being experienced together.
 

4.  What would be your first piece of advice for someone suffering from a mental health condition?

 

I think if you have supportive friends and family, definitely tell them. The worst thing you could do is sit on your own with bad thoughts and just get worse and worse and worse. So I’d tell friends and family but also try and see your GP as well because that’s what we are here for. We’re here to signpost you to where you can get help – and letting you know it’s okay to not be okay as well. I think a lot of patients come in and apologise for wasting my time, and I’m like “you’re not wasting my time! If you’re feeling rubbish and it’s affecting your life then that’s literally what we’re here for!”. Usually people who say that are the people who really need help!

In my GP surgery we see people on the day which is brilliant but in others where you have to wait – there are useful things you can do while you wait for your GP appointment, such as looking at the resource I’ll show you later. [These can be found at the end of this blog]

 

5.  What options for treatment are currently available?

 
So, medication is one. Depression is often a chemical imbalance in your brain and so for some people medication can help to rebalance that. But it’s not really an ideal long-term solution. Sometimes people are on medication for a really long time, but I personally think the best thing we can do is help you to manage your thoughts and feelings healthily and if there is a specific trigger, to deal with that triggering issue. I think the best thing the NHS offers is talking therapies – which in Bristol you can actually self-refer for – and they can teach you CBT (Cognitive Behavioural Therapy) where they teach you about thought patterns. When you’re having negative thought patterns, this can help you to combat those.
It's almost like brain training, but it can help you to get out of the negative thought cycle which is really helpful.
Exercise has loads of evidence to support it’s helpfulness – in my personal opinion it’s one of the best things you can do for depression, and it’s good for your physical health as well.
Anti-depressants are an option – but many people I see actually specifically request to not have medication. They can be helpful in the short term. For example, getting talking therapies can often involve a long waiting list, and by the time your course starts it will last another six weeks. That then takes you a few months to practice these so you feel comfortable which can add up to a long time! In the short term, some people might find it helpful to go on an antidepressant to lift your mood and help you get the motivation to engage more in the talking therapies. They can work really well together.

6.  What are the best ways individuals can support their loved ones going through mental health issues?

 
I think – for one, having a relationship with someone where they feel comfortable talking about their mental health is really important.
It’s difficult for those who have depression, as part of it can include thoughts that people don’t like you, you’re a burden or things like that. So it’s easy for me to say “tell your friends and family” but you might not want to tell anyone you are depressed – or you might not even have worked out that you have depression. So, I guess, as a good friend and family member asking someone how they are and being direct about it – specifically asking them. For example, “how are you doing with your mood?” “I know work is stressful – how are you coping?” or you can literally ask them “how is your mental health?” although obviously that can sound quite clinical.
As good friends, we need to have the guts to ask people how they are doing, because not many people will volunteer it so you need to be brave. And making it clear that you care is so important too!
 

7.  Are there any resources you would specifically recommend?

 
There is talking therapies you can access in Bristol – currently run by Vita Health, but you can access it. There are loads of good apps (there’s one called Calm and one called Headspace). For young people (I think it’s like 11-25) there is a group called Off the Record which is really useful.  Practicing mindfulness can be really useful in managing thoughts and emotions so I would definitely recommend that. You can buy books about CBT, you can do online courses, there are individual (1:1) courses and group courses.  There is loads of things like that. As I said earlier, sign up for a gym or just do some general exercise – go swimming, dancing, walking to work etc. That can make a huge difference.
 
Our discussion was really positive and helpful. The discussion highlighted to me the range of options for treatment available on the NHS, as well as how important it is to get talking. Even if you yourself are not experiencing a mental health issue, asking others and chatting to those you love about how they are doing is really important. Finally, the major take away from this discussion is the fact that those who are struggling are not alone. The statistics are staggering – approximately a quarter of us are dealing with issues relating to mental health. To conclude this interview, I asked Dr A to give me a few links to different resources I could include here. There is help on offer – and some of it is only a click away!
 

Dr A’s Helpful List of Links:

 
 

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