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  #1  
Old 20th June 2021, 21:33
Sunrise Sunrise is offline
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Default Does mental health support mainly focus on short term issues?

I think a lot of mental health issues start as a short term thing, and the idea of a lot of therapy is to basically nip it in the bud before the rot sets in. When it does become more long term any help seems to focus less on getting better and is more about it not getting any worse.

It feels like the goalposts are moved completely if it becomes long term. It's like you get to a point when you realise that you're not going to make a full recovery and you need to accept the condition you're in and just try and manage it the best you can. But that is a completely different scenario to getting better and making a recovery. The way you would have to approach those two different situations would be vastly different.

I wonder at what point doctors make that call? I wonder what criteria they use to decide when someone is past the point of getting better and it instead becomes about managing the symptoms and trying not to make it any worse.

I've had mental health issues that have profoundly affected my life for about 20 years now. It is very much a long term issue for me. But I often wonder how it got to this stage. I've been in and out of mental health services for 2 decades. Why didn't I get better? And at what point did it stop being a short term issue I could recover from and become a long term one that I need to manage? Should I just blame myself?

If I went to my GP now and asked for help with this, I'd be treated very differently to someone asking for the first time. I almost feel like I've been written off. I wouldn't be offered any method of recovery, it would be a method of management. It would be a stronger dose of medication rather than any sort of therapy, which is basically the opposite treatment. Medication to numb my feelings rather than therapy to improve them.

Has anyone ever felt like this? Is acceptance the key?
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  #2  
Old 20th June 2021, 21:52
indignant misanthrope indignant misanthrope is offline
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Default Re: Does mental health support mainly focus on short term issues?

I had to come to accept that I have a personality disorder which is something very different from depression or another condition, which is seen as temporary and treatable. I consider myself to be untreatable which might seem a depressing prospect but is more than likely much easier to deal with than a regular person due to who I am. I think for most people it would be considered catastrophic, and I suppose I should consider myself fortunate for not being susceptible to that mode of thinking. the times I experience hardship, pain and misery is by and large when I am around other people. I don't know your particular circumstances but if a change is something you want I hope you find that, sunrise.
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  #3  
Old 21st June 2021, 07:13
Sunrise Sunrise is offline
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Default Re: Does mental health support mainly focus on short term issues?

Being diagnosed with a personality disorder was probably the exact moment it changed for me from a short term issue to a long term issue. It went from being an illness I could recover from to being a part of my personality, a part of my core being.

It's probably what personality disorders are really. Mental illness that can't be treated. It can be managed, but not cured. Any sort of help or support I've had since then has been about managing the condition and making sure I don't go any further downhill. Getting any better is no longer discussed.

I'm not depressed and don't suffer from depression. It's more that I no longer have any sort of ambition, and that living a regular life is no longer the goal and it's become more about survival and damage limitation.

What I find odd is that having this survival mindset would be seen as a terrible way to deal with a short term mental health issue, but it's probably the best way to deal with a long term one. I suppose my problem is that I compare myself too much to people with very different issues. I get frustrated by how unhelpful I find a lot of mental health treatments, but then it's probably not actually aimed at someone like me. 6 weeks of CBT is probably about as helpful as having a leg amputated, I would be being given a medical procedure I don't need used to treat a condition I don't have.
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  #4  
Old 21st June 2021, 12:52
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Default Re: Does mental health support mainly focus on short term issues?

if you join anxiety uk you can get reduced therapy
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  #5  
Old 21st June 2021, 12:56
indignant misanthrope indignant misanthrope is offline
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Default Re: Does mental health support mainly focus on short term issues?

Quote:
Originally Posted by Sunrise
Being diagnosed with a personality disorder was probably the exact moment it changed for me from a short term issue to a long term issue. It went from being an illness I could recover from to being a part of my personality, a part of my core being.

It's probably what personality disorders are really. Mental illness that can't be treated. It can be managed, but not cured. Any sort of help or support I've had since then has been about managing the condition and making sure I don't go any further downhill. Getting any better is no longer discussed.

I'm not depressed and don't suffer from depression. It's more that I no longer have any sort of ambition, and that living a regular life is no longer the goal and it's become more about survival and damage limitation.

What I find odd is that having this survival mindset would be seen as a terrible way to deal with a short term mental health issue, but it's probably the best way to deal with a long term one. I suppose my problem is that I compare myself too much to people with very different issues. I get frustrated by how unhelpful I find a lot of mental health treatments, but then it's probably not actually aimed at someone like me. 6 weeks of CBT is probably about as helpful as having a leg amputated, I would be being given a medical procedure I don't need used to treat a condition I don't have.
I suppose I think of it more as personalities rather than illness, i'm a bit reluctant to call myself ill unless I am going through a rough patch. the rest of the time I think I am just myself... in some ways it sort of liberated me knowing what I was dealing with. previous to that life was a fight and life was confusing. the unending feeling of doing my best but nothing changing was very demoralising. thinking I needed to change myself induced a neurosis and a constant state of dissatisfaction with myself.

knowing what I was dealing with, where the limitations and boundaries are helped me to plan my life better and to stop putting myself into situations I was never going to be able to handle. the frustration of being in those situations was such a drain on me. it took everything out of me, emotionally and in terms of resources. time and effort with no hope of reward. I guess I started to realise what is unrealistic and this is leading on to wondering what is realistic. yes, maybe some dreams have been forsaken in life, but those dreams were never realistic. they turned out to not be grounded in reality when I knew what diagnosis I had.

I think its possible to still have ambition, but it needs to be managed with expectation, knowing our boundaries, being sympathetic and honest to ourselves. we might not conquer the world! but we can still set personal goals that are within our boundaries,limits. I would say try to reframe some things in a way that is personal to you.

in terms of the original question you asked, you are right I believe. I think it focuses mainly on one group.
there are lucky people who only have anxiety for a short spell in their lives or it can be cured by various techniques or it might be something was always missing in their lives and once they found it their anxiety subsided. for a lot of sa sufferers it's always going to be there and be a part of them, but over the years it's hoped we make it more manageable. I think most recovery focuses firstly on the group that can be cured and explores finding that solution which is personal to them. this is usually easier to do and requires less investment into a person and less resources to dedicate. so most recovery services go with this to start out.
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  #6  
Old 21st June 2021, 23:06
Sunrise Sunrise is offline
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Default Re: Does mental health support mainly focus on short term issues?

Interesting post. I think I would find your approach helpful, in fact I think I already do try to take that sort of approach to an extent.

I think if I could I would live a very isolated, insular existence. But I can't because I still have to do normal things like go to work and mix with others. I think a problem I have is that I simply don't mix well with other people. I do try, but I have such a bad relationship with the people I mix with on a daily basis it's just nothing but stress and conflict.

I feel like I'm constantly reminded of what an awful person I am. But these days I'd rather just avoid things than try and change. I don't have much faith in my ability to change in that way. I don't have realistic goals. I'm a fantasist, the life I want doesn't exist. I have far too many narcissistic traits, although not in the hedonistic way most people associate with the term. I think I'm classed as a compensatory narcissistic, although being able to admit to it is probably unusual.
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  #7  
Old 22nd June 2021, 14:59
indignant misanthrope indignant misanthrope is offline
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Default Re: Does mental health support mainly focus on short term issues?

^
I hope you can apply it in a constructive way. oh yes, I agree with you on wanting to get away from everything and everyone. I have wanted a completely isolated lifestyle for a very long time now. it's not commitment that holds me back it's more security and/or my capability to be so self sufficient. that's been something which has been a real test in life. I hope to get there before I die. I generally avoid mixing with others, connecting to others part of life. i've been there, done that, and the t-shirt didn't fit! all I really need is a way to earn a living without relying on other people.

I suppose one way to think about this all is to not put more faith in other peoples opinions of you than your own. if you have narcissistic traits this might be slightly easier to apply. you come across a decent person to everyone on here and quite often I wonder if we are simply taking others judgements and applying them to ourselves and sort of overruling our own evaluation? if we know we are a good person deep down, then we really have nothing to worry about if someone doesn't like us, because we know the truth about ourselves. the problems occur when we take other peoples judgements (which are quite often ignorant) about us and form a value of ourselves based on that.

I suppose if we are doing something really bad in life and we know it's bad then we will need to work on that to become a better person. but if it's just a case of someone judging us assuming we are bad when our motivations or actions were never negatively intended then we've adopted their belief or projection.
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  #8  
Old 22nd June 2021, 19:53
Sunrise Sunrise is offline
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Default Re: Does mental health support mainly focus on short term issues?

I could talk at length about my experiences and thoughts and how I feel. But I guess my whole point is that the sort of things I want to talk about, and the sort of things I think and feel, aren't the sort of things that most therapists seem to cover. Therapists are there to treat anxiety, I can't talk about narcissistic traits or why I'm such a horrible person! They don't want to hear about that type of stuff.

Therapy isn't for people like that, for people like me. Therapists would more likely advise to avoid people like me. The sort of things I discuss are generally topics they want to avoid, unless it talking about how "toxic" we are.

Therapy talks about things like if you hit rock bottom then the only way is up, but I don't think along those lines. I'm not at the bottom, I'm not really anything. I'm not going to go up or down, I'm not going to go in any direction. Trying to be at peace is my only real ambition.
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  #9  
Old 23rd June 2021, 02:02
AnxiousExtrovert AnxiousExtrovert is offline
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Default Re: Does mental health support mainly focus on short term issues?

From my own experience I feel very much like most mental health 'help' is short term targetted.

I kind of out of nowhere got extremely ill when I was younger. I had been dwelling and feeling depressed for a while but was getting on with it. I guess the dwelling was trying to figure out how I feel about certain things and why some things keep going wrong.
I had my first proper and severe panic attack one night and due to lack of support and lack of understanding from my family, my distress from that initial panic attack spiraled into constant panic attacks for over a week without rest bite and sleep.

Needless to say I was in an extremely bad way and I knew it and that was why the panic attacks were constant. I felt something needed to change and I needed help. To cut a long story short I did get some help and get myself significantly better. To be honest the biggest factor in getting better was having some goals and visualizing a positive future. It was far easier to put the numerous traumas, dilemmas, toxic people situations to the side in my mind once I had some path to safety and a believable goal of a better state of mind. The panic attacks and anxiety was far easier to manage and fight once there was hope.

I was getting some support too from the mental health team although it wasn't really adequate in hindsight because one of the biggest issues I was facing was the instability and toxicity at home. It had always been there but when I wasn't ill I was able to handle it, navigate around it and protect myself. It probably was a significant factor in me being under so much stress and vulnerability for me to become so acutely unwell in the first place. Now I had been so unwell and was rehabilitating, that home situation was like skating on thin ice.

It's a very long story what happened since that episode but I did get myself remarkably better and a big part of that was the support or belief I had it.

In the many years since then I have had relapse due to significant events which were genuine and obvious stressors regarding the family situation and some other events. The mental health help was severely lacking then and it hasn't been much better since. It does often feel that if the initial steps they offer don't help, and from my experience it's clearly a band aid for something else going on which is often very obvious too. Then the help is lacking besides a hospital admission.
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  #10  
Old 23rd June 2021, 17:27
biscuits biscuits is offline
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Default Re: Does mental health support mainly focus on short term issues?

Of course. It’s overstretched and underfunded.

How can any adult overcome anything after only 6 sessions?
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  #11  
Old 23rd June 2021, 18:52
AnxiousExtrovert AnxiousExtrovert is offline
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Default Re: Does mental health support mainly focus on short term issues?

Quote:
Originally Posted by biscuits
Of course. It’s overstretched and underfunded.

How can any adult overcome anything after only 6 sessions?
I do think there are certain mental health issues that can be overcome in 6 sessions. And perhaps with certain anxiety conditions if its caught early enough and the cycle of anxiety is stopped early enough then it may not progress.

But the idea that 6 sessions of CBT is the fit all approach treatment option is mind boggling to me. Sometimes there is a clear story or reason why someone is mentally unwell. I'm sure I am not alone but the idea of feeling supported and hopeful that I can overcome my problems in 6 sessions I find not only a pressure but extremely frustrating.
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  #12  
Old 23rd June 2021, 19:14
Dougella Dougella is offline
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Default Re: Does mental health support mainly focus on short term issues?

^ Yes I think if someone is having a mental health problem that is on the milder end of say depression or anxiety, or something that is affecting them in a specific situation it could possibly be helpful. But for anything more serious, complex or long term it's nowhere near enough and CBT is totally unsuitable for many conditions anyway.
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  #13  
Old 23rd June 2021, 22:36
Sunrise Sunrise is offline
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Default Re: Does mental health support mainly focus on short term issues?

There doesn't seem to be much in the way of long-term help available at all on the NHS, apart from medication. For milder issues a handful of sessions of talking therapy/CBT tends to be offered which is mostly aimed at people going through a rough patch who are otherwise mentally healthy. For more serious conditions most help seems to be medication based, and unless someone is seriously ill to the extent that they're considered a danger to themselves or others little help is offered and what is on offer is more about stabilising their condition rather than improving it.

When I was last receiving help from the mental health team it was all about stabilising me. There was no talk of self-improvement or anything of that nature. It was all about making sure I didn't go down hill again. The idea seemed to be as long as I wasn't in danger, their job was done.

Any sort of improvements I've made have been down to my own perseverance. I actually felt like the mental health team I saw were almost holding me back, like I shouldn't be aiming for any more and my goal should be survival. I feel like that's the message I was given. They were basically telling me I was completely nuts and wasn't capable of living a "normal" existence, and as long as I'm not causing any trouble I should be grateful. It was basically the opposite to all the aspirational mental health stuff that seems popular these days.

I can't relate to the current trend of mental health awareness at all. I was never told I could reach for the stars or anything like that. Why do people say that there's so much help out there? There might be help for Prince Harry, but I was just made to feel like an invalid. I don't get it because it's so far removed from my own experiences.
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Old 23rd June 2021, 23:26
firemonkey firemonkey is offline
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Default Re: Does mental health support mainly focus on short term issues?

I have ASD + schizophrenia. I'm currently regarded as being almost in remission with some breakthrough psychosis. Secondary to that is rather severe social anxiety.

I'm quite a bit older than many of you . It's now about maintaining the level I'm at;rather than making a miraculous recovery. When you become a non acute, middle aged person with SMI you're shoved to the back of the queue re help and support.

The mental health workers here in Wiltshire are much friendlier and less blinkered, but in terms of actually doing anything to make things better - that mainly comes from support from my daughter and grandchildren.
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Old 23rd June 2021, 23:51
Sunrise Sunrise is offline
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Default Re: Does mental health support mainly focus on short term issues?

There's so much talk of "getting back to your old self" and things like that these days. The implication there seems very much that mental health issues are a short term thing. It's almost like having a cold, it's a temporary thing that you make a full recovery from after a short while

That's not me. There is no "old self" for me to go back to. This is who I am, my whole life revolves around being this way. I don't know another way of living. My development has been very stunted emotionally. I don't have friends or a support network, there's barely anyone who even tolerates me. I don't just need a confidence boost, my entire life has been built around mental illness and living a very reclusive life based purely around survival. I'm not lazy, I battle every day, it's not a question of motivation, but there doesn't even seem to be any sort of recognition that people like me exist. Is it just really rare? It's certainly not something your average therapist would consider discussing in my experience.

Can you only ever succeed at therapy if you're someone who has 100% unconditional faith in it?

There must be so many forgotten people out there. People who live very isolated, reclusive lives who don't have the social skills or emotional maturity to live a regular life. People who are too serious for CBT type therapy, but not serious enough that they're a danger to themselves or others. It feels like people like that are just consigned to the scrapheap, dismissed simply as losers who couldn't help themselves. I'm sure a lot would love to get out of that situation but they don't know how to. That's how I feel
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Old 24th June 2021, 01:05
AnxiousExtrovert AnxiousExtrovert is offline
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Default Re: Does mental health support mainly focus on short term issues?

I mentioned some of my back story because it gave some context into an initial success story regarding a very acute stage which I got some support for and I turned myself around pretty rapidly. The help wasn't initially intense enough because I was young and still at home. They were presuming I was being cared for at home.
But I did eventually get some help. And I tried so hard and succeeded in turning things around and functioning normally again. I was still having panic attacks after but I was coping and improving each day massively .

It was maybe 2 or 3 years later I became unwell again to the point of needing urgent help again because I went downhill. There were clear circumstances and reasons why I had become depressed and distressed again. The pattern was fairly obvious. But when I went for help again this time it wasn't adequate and I didn't know how to get in touch with the people from before. Part of my resentment and also confusion was that I was under the impression that my progress was admired and if I was showing signs of becoming unwell again then the help would be there. It was also apparent at this time my family situation was dysfunctional and that should have been an easy tell to see what was happening.

So I am assuming a lot of people who are having struggles that aren't resolving easily or are repeating, likely have similar stories albeit different circumstances. If a child at school is walking in with bruises all over them and having trouble focusing at school, you wouldn't have to analyse much to consider a course of anti depressants isn't a long term solution.
That obviously wasn't happening to me but it was clear I needed some trauma help or something more than cbt.

The services are underfunded as someone else said. And I understand that the services can't provide full on care and days of therapy for everyone who seems to be unhappy or having the blues. But in the situation like I described where it was clear I was really trying and succeeded a lot. The lack of addressing the bigger problem actually made the problem and treatment harder. And it made me lose a lot of faith. Offering a 6 week course of cbt in a situation like that is very distressing with a therapist you don't know and doesn't have time to know any of your story.
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Old 24th June 2021, 10:03
Dougella Dougella is offline
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Default Re: Does mental health support mainly focus on short term issues?

^ There is definitely a probem wth continuity of care. One thing I found is that therapists who work in the NHS often seem to be in training, so when they've finished that they move elsewhere and people can't go back to see the same person.
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Old 24th June 2021, 11:46
firemonkey firemonkey is offline
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Default Re: Does mental health support mainly focus on short term issues?

My therapy consisted of 2 trained therapists who adopted a 'If you want to be a good person...' approach, as though I was morally reprehensible, and an untrained day centre worker who told me I had low self esteem but then proceeded to constantly criticise me.
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Old 24th June 2021, 12:45
Dougella Dougella is offline
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Default Re: Does mental health support mainly focus on short term issues?

^ I assume that was also before you were diagnosed with autism? One particular therapist once talked about me "turning my life around", as if I was a criminal. Not helpful at all.
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Old 24th June 2021, 14:53
firemonkey firemonkey is offline
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Default Re: Does mental health support mainly focus on short term issues?

^ First trained therapist c1998. Second trained therapist 2002. Untrained day centre worker c2009.
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Old 24th June 2021, 22:30
Sunrise Sunrise is offline
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Default Re: Does mental health support mainly focus on short term issues?

I often wonder if the aim of mental health treatment is to help people thrive or just help them survive.

If it's the latter then I suppose it's basically worked for me. It's been successful in as much as I'm not considered a danger to myself or others.

If the purpose should be helping people thrive and make big improvements to their lifestyle then it's been less successful, but is that the purpose? I'm still a pretty awful person who can't form healthy relationships with others and struggles with a lot of the basic things in life as a result. But is that basically just my own stupid fault? The purpose of therapy isn't really to make people like me more, is it? As long as I can function on a basic level then I suppose they've done all they can at the end of the day and I should be grateful.

Therapy can cure me of anxiety but it can't cure me of being a twat. I suppose that's where the bpd diagnosis comes in. I have a lot of serious personality flaws, but that's not a mental health issue and it's not the job of any mental health services to fix that. It's also why I don't find CBT helpful as it's not low self-esteem, I really am that awful.
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Old 25th June 2021, 10:12
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Default Re: Does mental health support mainly focus on short term issues?

Mental health is everything, if it was funded properly the country would be a happier place, less crime, better education, more life choices, better physical health, better relationships etc
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Old 2nd July 2021, 03:33
AnxiousExtrovert AnxiousExtrovert is offline
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Default Re: Does mental health support mainly focus on short term issues?

I do understand the funding and treatment issue with mental health because it isn't something straight forward like other illnesses. Psychiatry is still very much in its infant stages.

Mental health is very underfunded though considering how wide spread it is and as discussed on this page I think some of the current treatment options are not good enough.

The biggest problem to me seems the identification of what is going on with the person. Their needs and problems. It seems to me that the first line currently is anti depressant prescriptions and 6 week cbt regardless of the person's history or problems. And hospitalization I presume if things are drastic.
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Old 2nd July 2021, 11:26
firemonkey firemonkey is offline
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Default Re: Does mental health support mainly focus on short term issues?

I haven't been an inpatient since March 1983. I left with my future wife. That last inpatient stay was my longest i.e abt 22 months. The 'betting' among MH staff was that I'd be back as an inpatient within 6 weeks.

The lack of funding for mental health has created a situation where those who function well most of the time, with acute episodes in-between, are prioritised over those of us who are not a danger to others or ourselves but are consistently functioning at a below par level.
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Old 2nd July 2021, 13:27
Dougella Dougella is offline
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Default Re: Does mental health support mainly focus on short term issues?

^ Do you think the support that you and your wife were able to give eachother kept you both from going back to inpatient treatment?
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  #26  
Old 2nd July 2021, 18:52
AnxiousExtrovert AnxiousExtrovert is offline
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Default Re: Does mental health support mainly focus on short term issues?

I can understand why there is a easily accessible protocol for short term acute problems for people without previous issues or milder issues.

But the one size fits all approach does become evident once you realize it hasnt fixed you or isn't suitable. And that is where the underfunding becomes evident because they do have more intense or specialised services to my knowledge but they are hugely stretched for places. The same goes for hospital treatment as the situation needs to be dire or urgent before that happens.
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