THIS IS HOW TOUGH IT IS TO GET MENTAL HEALTH HELP WHEN YOU’RE AT YOUR LOWEST EBB
WHEN you are dealing with depression it can be difficult to imagine that treatment can actually help.
So when people eventually seek help and advice, they are often at their lowest point.
But people who have experienced that often “frustrating” process have described long waiting times and brief, “increasingly unfit” chats with their GP to diagnose a complex condition.
From being diagnosed, for any mental health condition, to receiving treatment can often be a longwinded process with various referrals and consultations.
Aaron Corria, from Cardiff Bay, almost took his own life after struggling to deal with his mental health problems.
Aaron, 31, first went to his GP to discuss his mental health around five years ago.
He said: “I was really put off by going to the GP, but when I did go and spoke with him it did feel like a lot of weight was lifted off my shoulders.
“But it is a long process. It felt like they were ticking boxes when I was speaking with them, making sure I wasn’t a high risk or a risk of suicide.
“And I understand that, but it means that they don’t really know someone before diagnosing them.”
After being placed on Prozac, an antidepressant which made Aaron feel “horrific”, he decided on a different tactic.
He said: “I then went private and went to see someone and after seeing them I felt like I was on the right track.
“It’s definitely frustrating that I had to do that, it’s one of those things where they’re just ticking boxes when they should be talking.
“It’s all about listening and knowing the person, and it’s hard to do that when you’ve only got 10 minutes. It’s hard to open up to someone in that position.”
Guidance provided to GPs includes a multiple-choice questionnaire aimed at judging the severity of depression.
The keen sportsman said he still has “ups and downs” and that during a tough time in March he went back to his GP.
He said: “I was referred to a clinical health therapist. It was on a waiting list of about four to five weeks.
“When it came around, it was cancelled. Luckily I’m quite clued up and knowledgeable now about mental health, but anyone else who was really struggling, [that] could be a real setback.
“It may be too late by then. If it’s someone waiting and they become suicidal or feel worse it may be too long to wait four to five weeks.”
The Welsh Government set a 28-day waiting time target from assessment to treatment in November 2015.
Latest figures show that in March 2018, 84.1% of mental health service assessments were undertaken within 28 days of referral.
One mental health practitioner for 27 years said the impact of the long-drawn-out process on someone seeking help will depend on the severity of depression.
Cardiff University mental health lecturer and chartered psychologist Dr Michelle Huws-Thomas said: “For people with mild depression, seeing a GP and being prescribed anti-depressants may help, albeit in the short term.
“If, however, the person is experiencing more moderate to severe depression, then some will deteriorate and become more vulnerable to self-harm, substance use, and even suicide.
“Particularly if the person is isolated, without loved ones and friends to support them.”
Laura Moulding, from Cardiff, has severe depression with psychotic symptoms and describes a “mixed experience” with waiting times.
The 21-year-old, now a Time to Change Wales “champion” campaigning to change attitudes towards mental health, first saw her GP at the age of 15, while living in England.
She said: “I saw a GP within a few days to a week. I was then referred to CAMHS (Child and Adolescent Mental Health Service), which took only a couple of weeks.
“It was beneficial for me – however, every appointment after that I was to be seen every month because all of their appointments had been booked by then.
“When I moved to Wales (aged 16), I had to wait until all of my medical folder had been transferred to my new CAMHS psychiatrist.
“This took over a month to sort out and then I had to wait an additional month or so before I could actually see my new psychiatrist.”
Once transferred to the adult mental health services, Laura said they took “weeks, maybe months” to respond.
Laura said: “This meant I still had to spend most of my time in CAMHS, despite being over the age range.
“In spite of all this time waiting, I received a letter saying I wasn’t ‘serious enough’ to be seen by the adult mental health team.
“This was a huge shock for me, especially as I still wasn’t well.”
After being picked up by another mental health team, Laura had to wait two to three months before seeing their psychiatrist – and would have appointments every two to three months.
Cwm Taf University Health Board said referrals to mental health services can often be “complex” and mean people have multiple referrals to different services.
They added that people have to attend a number of assessments which “cause delays and frustration for both patients and staff”.
A recent statement said response times are varied and, depending on how patients are referred, can range from four hours to 28 days.
In June, they started an assessment clinic pilot, where patients have assessments on the same or next day.
The approach means patients have quicker access to treatment and no longer have to attend multiple assessments.
Head of Nursing for Mental Health Phil Lewis said: “This has been a really innovative piece of work involving many different individuals and teams who have come together to make a difference to patients.
“Mental health services are complex and there can be inconsistency. For example, the target for response to routine work in mental health is 28 days, yet there were parts of our service which responded on the same day.
“When someone needs treatment, having to wait a long time or undergoing numerous assessments and seeing different teams is not helpful.”
The pilot has seen response times improve, with 24.4% of responses being within seven days of referral in April 2018 compared with 4.22% the previous year.
A health board spokeswoman said the pilot is proving “successful” and that the health board is looking to widen the scheme across Cwm Taf in the coming months.
Dr Michelle Huws-Thomas said long waiting times can worsen mental health conditions and impact on loved ones.
She said: “Without timely access to appropriate treatment, the individual and families suffer, engagement with GP services and local A&E departments (often referred to as “revolving door”) increases as people become more desperate for help. There is also research evidence on the detrimental impact on mental health such as long waiting times, which have life-threatening consequences for individuals and extreme burden for families.”
The Royal College of General Practitioners Wales said extra resources are needed to help with lengthy waits for appointments which are “already too common”.
Dr Rebecca Payne, chairwoman of the Royal College of General Practitioners Wales, said: “GPs recognise the importance of supporting patients struggling with their mental health.
“It is an important part of the GP training curriculum and the College has developed a mental health tool kit to help GPs diagnose and treat mental health problems. It is really difficult fitting a comprehensive review into a 10-minute appointment and RCGP Wales believe such short appointments are increasingly unfit for purpose.”
A Welsh Government spokeswoman said: “We are working hard to ensure that people experiencing mental health problems have access to appropriate and timely services as close to their home as practical.
“We continue to spend more on mental health services than on any other part of our NHS and have put in place more stringent waiting time targets to help us achieve that ambition.”