I am new to this community and wow! you guys have quite the following and participation.
I live in the US and I would like to know what getting treatment for mental illness is like in other parts of the world. What criteria needs to be met in order to be seen by a psychiatrist? What resources do you have for a someone who has limited ability to pay for services? Do you have mental health-specific databases online to search for these services?
I'm curious to know about these things so I can better help answer your questions.
Thanks!
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EmmyLoop
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I'm not a counselor, but I have my own experience with mental illness and finding resources to get treatment. Most people on HU forums are from the UK, so I thought if I learn about healthcare in other countries, I can help people from other countries. For instance, in the US, depending on your insurance, you can either go straight to a psychiatrist for mental illness, or your primary care provider must refer you to a psychiatrist before the insurance will pay for it. In most cases I read on this forum, people advise others with mental health issues to "go to your GP" rather than "go to a psychiatrist". I assume a GP is a general practitioner in the UK as it is in the US. Here, a GP is not specially trained to treat psychiatric disorders. A GP is someone you'd go to for a sinus infection. So, I thought maybe in the UK, you had to see your GP who, if you met certain criteria, would refer you to a mental health specialist.
There are a number in here from other countries apart from the UK and there is usually someone here who can help them. Often in the USA it depends on which state you live in as to what's available so it's probably better to let those with local knowledge and experience help them.
Also if you look under the pinned posts you will see helpline numbers available for the UK, USA and international.
I am in the UK and used to work in the benefits system for example so I know how it all works and the benefits available.
I shall treat your response with the contempt it deserves ie ignore it. The point I am trying to make Emmy is that someone new coming in and assuming we all need help does come across as patronising whether you meant it that way or not. Even if we do suffer from mental health issues it doesn't mean we are hopeless or helpless or require any assistance from you or other professionals online.
This is a support forum and like I said we all help and support each other. If we need medical advice we go to our own medics or lots of info is available on here provided by the site owners.
We are in the UK Emmy, Here the NHS picks up the tab generally although Mental Health is a Cinderella Service and sometimes the slack and CBT are picked up by charities
Could I ask what is your interest regards our system are you a health worker, nurse or doctor ?
I'm a nurse, but I have my own experience with mental illness during which I needed substantial help navigating the mental health care system. The US has many services available for most all people to take advantage of, but I find there's a knowledge gap between the existence of these services and the people who need them. I see a lot of people suffering thinking there's no one to help them; yet there is help, they just don't know about it. On this forum I see many people seeking help, feeling helpless, and I could recommend helpful resources my country offers if they're local, but they're usually not. I figured if I get to know more about mental health services in other countries, I would be better able to help the people who contribute to this forum.
In the UK we seek referral from our GP (Family Doctor), They facilitate all mental care and they then arrange specialist assessment if and when required. We can go to the NHS Specialist, some people go Private Practice, the patient will then be charged via insurance normally. Most people will avail themselves of NHS Treatment. A GP can if and when required can generally send a patient to Private Practice if the need arises. That charge in some cases will be picked up through the GP Practice. This is done only on occasions if the need or urgency requires.
Mental Health Services in the UK will be hopefully part reformed in the near future.
We go to our Surgery where the GP assesses the Patient needs, medication and or referral. The Patient can arrange CBT on their own and in this way the patient does not need to see a GP. A letter after treatment will be given to the patient and if required to the GP, this service will be ten/twelve Sessions, then decisions are made on a way forward.
If the GP is approached and a referral is required they will refer to various options including above. Normally twelve sessions of one hour each are given and a decision will be made after that Treatment Pathway. Before the appointment for first session the Patient is called and a discussion is taken over the phone, this can dictate the type of CBT given
There are other pathways for emergency or information, this can introduce various NHS, Social Team outlets, this opens up further treatment plans including Crisis Teams
We have a system called Medicaid in the US which sounds most closely related to what you just described. It's based on income so not everyone qualifies for it.
Hi EmmyLoop, generally speaking in the UK everyone has to go through their GP to get a referral to a specialist, consultant etc. That should happen when the illness is beyond the GP's expertise! The only other possibility is if you're seen or admitted to hospital via A&E for something serious you should be seen by a consultant? Unfortunately the NHS is like a lottery depending exactly where you live in the UK. It ultimately comes down to your Local Health Authority which in many areas are under funded, under resourced and don't have enough time. Obviously if you can afford to go privately that's a whole different kettle of fish!
Hi, I'm in France. We've accessed Mental Health care through two channels. One is the obvious one of referral through a GP - usually takes a couple of weeks. The alternative is to go straight to a Community Psychiatric Team: a phone call to their number on a poster in a local hospital put us through immediately to a CPN, who performed a 'triage' on the phone to judge the urgency of response needed. We got an initial appointment for six days later, but if the need had been overwhelming there would have been a response that day.
We live in a deeply rural area, so the nearest psychiatric hospitals (a choice of two) are thirty and sixty miles away. The latter hospital is quite large, and provides excellent care in a peaceful setting. Our services are really pretty good, though I have heard it said that 'in France it is 'easier to get into a psychiatric hospital than out of one'.
A person already registered in the healthcare payment system (there is no 'National Health Service' here) will find fees fully covered. I can't tell you the cost of a hospital stay, but can tell you that 45 mins with a psych if you aren't in the system will cost you 25 euros (£22), or about ?35 dollars US? - the same as a GP appointment.
Hope that tells you enough - ask, if I can tell you anything else. The obvious point one should make is that services through the medium of English are inevitably patchy - but they are available.
Thanks for the info in France. Here in the U.S., we depend primarily on private insurance companies to pay for health care, to which a monthly fee is paid. Even then the patient is expected to pay a deductible, co-pay, and usually 20% of costs, depending on the insurance. Health care here is quite costly, and many can't afford it. There used to be 'free clinics', but it seems those have given way to what is called payment on a 'sliding scale'. Even the poorest have to pay something. If one is completely destitute, they might be able to get on a government paid health care plan called Medicaid. Because so little is actually paid to a doctor, more and more are refusing to accept Medicaid. The doctors say, payment doesn't even cover their overhead costs. At least, that is the case in my state. So often, people wait until their conditions are so severe they end up in the ER.
Mental health access in France seems to me to be most similar to the US pathways. Once you are admitted inpatient (staying the night) in a mental hospital, you are there for at least 72 hours. You can't just leave at will.
I think this is a very interesting and caring question and people should be less "suspicious" of it!! I'm in the UK, so that has already been described. I've noticed we've had people on here from India and many other countries. Me too I would be interested in what healthcare services are like in those areas. I have a Philipino friend. She's no longer in the Philipines but in that country you have to pay for all your medication and if you can't afford it then you go unmedicated. She said she would probably be dead by now if she was in the Philipines as she is bipolar and needs her meds to keep her stable. There is a lot of poverty in that country. She spent time in a psychiatric hospital there but it was more like a prison is how she described it but that is just one person so I wouldn't like to generalise. I thiink although the UK is very underesourced it is a lot better than some other countries.
Also I think although I say UK that the system in Ireland is different from that in England as I have a friend from there and I think maybe there you have to pay to see a psychiatrist?
Can anyone from Ireland confirm? I get to see mine on the NHS,
Thanks so much for your support Gemma. Besides when it was taken in a negative context, I got great responses to this question. It's heartbreaking to hear about your friend's experience in the Philippines. Our US insurance companies were not required to pay for mental health until just a few years ago. It was difficult to see a psychiatrist at the free clinics and I suffered a lot because my obgyn was treating me for depression and I was never diagnosed with bipolar 2 until about 5 years ago (I'm 39). Thanks again.
The reason we recommend seeing a GP first is to rule out any under lying physical problem and also to be directed to the correct Doctor or Specialist. As a nurse you should know this it is the same in the States where I also live. People on site usually share their stories and support each other. Direct questions unrelated to a specific post can seem rather intrusive. Pam
It is true there are many here who don't know how to seek help or what is available. This is mainly the youngsters. There are many of us older ones to help and we all support and help each other. Can we help you at all? I presume you suffer from a mental health problem or someone you love does?
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