Those suffering seriously with illness but able to, apparently, from the outside, function relatively well, may need a health crisis before they find their care needs being met. The assumption for such individuals (often internalised by the person themselves) can be that as long as they are able to perform the basic tasks in their daily lives, they do not need or deserve resources or attention.
Delaying or denying treatment to such individuals until a breakdown or peak of crisis can mean greater personal harm for the individual and more costly and extensive treatment needed for the individual. From all perspectives, a more attentive and early intervention approach is sorely needed from the healthcare system.
Individuals must, in the absence of a well-funded and effective healthcare system, be advocates for themselves. This means, overcoming internalised stigma of seeking help and overcoming barriers to access placed in their way, whether from commitments such as employment or by resource-starved healthcare systems. For individuals experiencing social anxiety or depression symptoms, this need to be assertive and an effective communicator can be an unassailable barrier to receiving necessary attention and care.
“i end up feeling guilty for needing that appointment,” a blogger writing about their mental health journey shares. “i am always aware at how stretched the GPs are and dont want to feel that i am wasting their time.”
Work and other commitments can make attending an appointment difficult. As a fast food worker explained, she is given her shift times from week to week, meaning that it is “almost impossible” to schedule a doctor appointment in advance.
In the UK’s NHS, patients are typically entitled to 10 minutes to see their doctor and with internalised self-doubt and busy waiting rooms, patients may feel pressurised to accept less than this. For individuals with mental health issues, such as anxiety, communicating with a doctor effectively under this pressure can be difficult. This is exacerbated in cases of multi-morbidity, where multiple illnesses are present and interact, making understanding, diagnosing and treating more complex.
GPs (General Practitioners) in the UK report being overwhelmed by patients to the extent of their judgment being affected by fatigue and irritability. One in 10 reported seeing some 60 patients in one day, double what they consider to be safe. Medics surveyed were working an average 11-hour day, including three hours of administration. One Hertfordshire GP said: “There is a point where I feel cognitively drained; after about 20 patients, there is not an iota of empathy left.”
Social anxiety disorder is typically treated on the NHS with Cognitive Behavioural Therapy (CBT). Having completed a self-report questionnaire on anxiety and depression, an individual who passes a certain threshold is referred to therapy. As the mental health journey blogger writes: “you are restricted to how many appointments you are allowed to have and the waiting list is huge. For some people Therapy needs to be longer term, but that isn’t always available to the people who APPEAR to be functioning well. Going private is so expensive and out of my price range, so it isn’t really an option for me.”
Increasingly, mental health sufferers in UK who have not reached peak crisis point, must turn to private treatment whether in the form of counselling or therapy. The cost of private treatment and the challenge of identifying suitable and legitimate treatments from the vast array available can be barriers. Without intervention or treatment, individuals may struggle with their illness medically untreated, doing long-term and, potentially severe harm to themselves – until a crisis or breakdown makes them visible to the healthcare system and to themselves.
Image designed by Anna Vanes.
To read the full blog-post ‘My View on the Mental Health System‘ written by a blogger recording their mental health journey, click below: