The Dilemma of Public Vs Private Mental Health Care

So having being dealt disappointing cards by the NHS that left me defiant in my plea to never attend therapy and reluctant to trust anybody again, a few years later I was ushered into private therapy.

Suffering with a mental health disorder for almost 8 years now, I have been at the hands of both the nurturing and the dismissive, warping my view of the definition of the word 'care'. It is such an ambiguous word, defined by the giver and interpreted by the receiver. And when it comes to treating mental health, there are just two options of care. Public or Private. You either pay or you don't. It's either good or it's bad.

But is this really the case? Can an entire grey area be pigeon holed with something so black and white? I think the best place to start is at the beginning of my experiences, with the free services from the NHS. Unfortunately, the word service is extremely fitting here; a cold, quick-turnaround service, reminiscent of times spent ordering drinks from a nightclub. You queue for an age and when you finally clock eye contact with the bartender and reluctantly give him a quick smile, he can't hear what you're saying, gives you the wrong drinks and moves on to serving the girl next to you before you have chance to deliberate.

I'm sorry. I cannot call it care.

I was passed from pillar to post seeing various 'experts' before being referred to a Birmingham clinic whereby I had five sessions. Let me reiterate; five sessions. Each session was an hour. At this time I had had my eating disorder for four years. Don't worry, I'll do the math for you - the NHS rationed my treatment to five hours in order to cure a then four year battle with anorexia binge-purge subtype.

At the time, the NHS was under a lot of financial pressure due to the £1 billion spending cut issued by the government. The number of cancelled operations from April 2011 rose to 250 within seven months and the number of casualty patients left waiting for a bed for more than four hours doubled. If physical care was spread thin, it was inevitable that treatment for mental health would slowly disapparate into the o-zone, left to waft under people's noses every now and again, normally when a celebrity tragically ends their life. The treatment itself was clinical with an air of desperation; after my third session I had doctors trying to urge me into taking anti-depressants and join group therapy. Group therapy!? No trust had been established and no respect had been earnt. They were just desperate to put numbers on a spreadsheet.

However, here is where it gets really fun. With the NHS, it's like a Christmas cracker. You just don't know what you're going to get! Your friend gets a fairly decent, sturdy pair of nail clippers and a mirror. Then when it's your turn to pull you receive a button, or something equally pathetic. An extremely close relative of mine who has suffered with the same disorder for over thirty years, only has good things to say about her recent care with the NHS. The nicest therapist. The most patience. I guess it was luck of the draw.

So having being dealt disappointing cards by the NHS that left me defiant in my plea to never attend therapy and reluctant to trust anybody again, a few years later I was ushered into private therapy. Of course, when I say ushered, I mean months of talking about it before actually beginning the profile evaluation process. This is important. Many of the profiles you might come across will be a sales pitch of their expertise, announcing certificates you've never heard of. Impressive, but to me, it was irrelevant. (I naturally assume that by having a profile on British Association of Counselling & Psychotherapy you've got your fair share of qualifications under your belt and possess the skills I do so require/most definitely need). What's glorious about this though is the freedom of choice. After making an initial contact, it's likely a few emails back and forth will occur to establish what's wrong with you - to put it bluntly - so the counsellor can determine how to handle you - again, to put it bluntly. The glory doesn't stop there though. You can choose to opt out! But hopefully, the right choice has been made and you'll be on your way to booking an appointment and getting better.

But unfortunately, that's a load of bullshit. Sorry.

From my own experience I can safely say that paying for therapy doesn't necessarily mean that counsellors perfect for you will be passed your way. After having seen my holistic counsellor for eight months and made significant progress considering my previous state, it was decided - a mutual decision between myself and her - that I would begin Cognitive Behavioural Therapy (CBT) alongside. So again, I'll do the math for you; £170 every month spent on treatment. It doesn't seem much, but when somebody else is paying it can make you feel extremely guilty for just not being normal in the first place! And if you're paying yourself, well, nobody likes paying for anything. But here's where the glory ends. This time I didn't get to choose my counsellor. You'll find that many CBT therapists exist within an association and you're allocated somebody based on a brief update of your circumstances and availability.

You know where this is going.

It didn't work out. Sadly, I didn't feel a positive rapport which is imperative for people with mental health disorders where the feeling of rejection is something that haunts them daily. So alas, CBT is no more. I have reverted back into my shell and become dubious once again. There is a shadowy perception of private therapy; an entire grey area where the lines between money and health become blurred, and you find yourself instantly questioning the commercial value of this service - "Am I getting my money's worth?"

Despite this, there are many benefits to private therapy such as:

  • A soothing, less clinical environment
  • More freedom of choice
  • More freedom of attendance
  • Specialists in different areas of mental health
  • No pressure from the government to meet unrealistic targets

Private therapy is just as complex and mysterious as services from the NHS. It's just with the NHS you need to coax them out of hiding from their labyrinth of elusive treatments, and by that time, it could be too late.

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