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Understanding mental health services

Your GP
Your GP is often the first point of contact for mental health concerns. They will assess your needs and discuss treatment options. GPs can provide initial support such as prescribing medication, advice, or referring you to a mental health specialist or service.

Primary care
Provides short-term support through counselling, Cognitive Behavioural Therapy (CBT) or group therapy, and Access to Psychological Therapies (IAPT) services, which offer therapies. Usually lasting 6-10 sessions.

Secondary care
If your condition is more complex or doesn't improve with primary care you may be referred to a Community Mental Health Team (CMHT). This includes psychiatrists, psychologists, social workers, and mental health nurses; and comprehensive assessments and tailored care plans. For example, ongoing management of conditions like bipolar disorder or severe depression.

Specialist or tertiary care
Severe, long-term, or rare mental health conditions require specialist services, such as inpatient care for eating disorder clinics, and forensic mental health services. Also, pathway to a specialist centres for treatment-resistant psychosis.

Hospitals
Hospitals with Emergency Departments (ED) have Mental Health Departments. If you have been admitted by ambulance, the ED team can refer you, but this not a given. If you are a walk-in ED patient, you will need to be triaged first before a mental health team will see you. This may include many hours wait and some cannot do this if they are GHB dependent - so leave to find a dose to stabilise themselves.

Assessments, diagnoses and treatment options
You may be asked about your symptoms, medical history, lifestyle, and personal circumstances. Assessments might include questionnaires, interviews, or physical health checks. A diagnosis may be provided, although not all services focus on labelling conditions. Treatment plans are often developed based on needs rather than formal diagnoses. Common options include CBT, interpersonal therapy, or trauma-focused therapy. You may be prescribed anti-depressants, anti-anxiety medication, or mood stabilisers, depending on your condition. Services may also connect you with peer support groups.

Challenges
Waiting times for therapy or specialist services can vary significantly, ranging from weeks to months. Some areas may have limited availability of services, particularly for less common conditions. Navigating the system can be complex, especially if your needs span multiple services.

Your rights as a patient
Mental health services under the NHS are free at the point of delivery. You have the right to be involved in decisions about your treatment and to seek a second opinion if needed. Your information will be kept private unless there's a risk of harm to yourself or others.

Alternatives to NHS services
You can seek private counselling or therapy if you prefer not to wait for NHS services but there will be a cost. Organisations like Mind, Rethink Mental Illness, or YoungMinds offer support, helplines, and community programmes. Digital platforms like BetterHelp or apps like Calm and Headspace can provide remote therapy and resources.