If you are being supported or treated by your GP or other health or social care professional for a serious mental illness you may be offered a psychological therapy – but you may find that you have to ask to get any psychological therapy or to get the right therapy for you. This short guide is designed to show you where to go and what to ask – and we provide some suggestions if you run into difficulty.
- Note that NICE ( the National Institute for Clinical Excellence) explicitly recommends psychological therapies as a treatment for illnesses including schizophrenia, bipolar disorder, depression, borderline personality disorder, and anxiety disorders
- Ask about any psychological therapy you are interested in but also ask what is available – if the choice is limited you may still be interested in what is available
- If you are refused a psychological treatment because your illness is “too severe” then point out that this is unacceptable and see the section below What if I am turned down? – and please let us know: we will take this up
- Receiving medical treatment for your mental illness does not mean you cannot also receive and benefit from a psychological treatment
- Some people pay for psychological therapies because it is not available from the NHS but we recommend that you start with the reasonable assumption that a treatment which you need should be available on the NHS – and follow the advice below
- If you do decide to pay for treatment then identify practitioners carefully through accredited professional organisations see Where can I get help?
Your approach to getting a psychological therapy will depend on whether you are using just primary mental health services (your GP and perhaps other services at that level) or both primary and secondary services (typically under the Community Mental Health Team or seeing a psychiatrist)…
If you are being supported only by primary care services…
Your first point of contact should be your GP. You can ask your GP (or at your GP surgery) about what psychological services are available which they can refer you to. If you do not have a GP see Where can I get help?
All GP practices should have access to psychological therapy services – this doesn’t guarantee that you will get a service but knowing what is available will help you to make a request: so ask for full details of what is provided even if there is a waiting list or if you are not sure it is suitable for you.
- The Welsh Government has set a 28 day target for accessing a psychological therapy at primary care level: you can remind your GP or surgery about this target.
- Point out to your GP or surgery that you have a serious mental illness so should be seen as a priority
- If the GP has nothing suitable ask them to consider referring you for specialist services: this is particularly important if what the GP can offer is only suitable for people with less serious mental health problems
If you are being supported by secondary care services…
Your first point of contact should be your Care Coordinator – this will typically be a nurse or social worker in the Community Mental Health Team or a psychiatrist but if you are not sure ask any of the professionals providing you with treatment or care.
If you are receiving secondary mental health services you should have a Care and Treatment Plan: this has a specific section for recording what treatments (or therapies – the same thing in this context) you should receive whether medical or psychological; you should be closely involved in writing or reviewing the Plan so this is a key opportunity to ask for a psychological therapy to be provided. You can also ask for a psychological therapy to be considered in any other discussions about your treatment including prescription or review of medication by a psychiatrist or other professional – it makes sense to discuss psychological therapy alongside any medical treatment.
- The Welsh Government has set a 26 week target for accessing a psychological treatment at secondary care level: you can remind your Care Coordinator about this target. We believe that the target should be the same as primary care level (28 days): please let us know if you are affected by the longer target as it will help us to make the case
- Insist on being involved in writing and reviewing your Care and Treatment Plan, including the section on treatments
- Record your need for a psychological therapy in your Plan whether or not it is available at the time – and if you don’t get the treatment immediately, keep asking
- If you identify a treatment you need but it is not currently provided by the NHS request your Care Coordinator to ask the NHS to fund the treatment specially for you
- Just because you are receiving secondary mental health services this doesn’t stop you also requesting psychological services provided by your GP/primary care
What if I am turned down?
If you are turned down for a psychological therapy whether because you are told you do not need it (and you don’t agree with this decision) or because it is not available or if you are told you will have to wait longer than the target waiting time (or before that if you think you need the treatment more urgently) please don’t give up. Here are some options:
- Ask your GP, surgery, or Care Coordinator to reconsider their decision: you could point out the NICE recommendations and the Welsh Government targets
- Contact your local mental health advocacy service
- Make a complaint (ask for details from your surgery or Care Coordinator)
- Get in touch with us