Navigating Mental Healthcare in the UK

Finding one’s way through a new country’s healthcare system is not easy, especially when it comes to mental health. It can be confusing, scary and might even feel dismissive.  So here is simple guide to navigating mental healthcare in the UK.

a.       First point of contact

b.       Preparing for the doctor’s visit

c.        Getting therapy

d.       Getting diagnosed

e.       Taking a sick leave/accommodation at work

f.         Hospitalization & emergency

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a. First point of contact

In the UK, your GP (General Practitioner) is usually your first stop. They manage both physical and mental health concerns and can refer you to mental health professionals like psychologists, counsellors, or psychiatrists.

Be clear and honest about how your mental health is affecting your life. GPs often have limited time, so make the impact on daily functioning clear (e.g., work, sleep, relationships).

If you don’t have a GP yet, you can register with one, use NHS Find a GP (https://www.nhs.uk/service-search/find-a-gp/) to search.

You can also talk directly to a psychologist without talking to GP first by using self-referral. You can find one here https://www.nhs.uk/nhs-services/mental-health-services/find-nhs-talking-therapies-for-anxiety-and-depression/ .

This might be the preferred way if you are sure that anxiety or depression are the problem, and your only request to the doctor is therapy (rather than medication or time off work).

b. Preparing for a doctor’s visit

Doctors receive a lot of requests and will interpret yours based on their experience, that might be predominately local. And if you are from a culture that tends to minimize personal experiences and pain, you need to make sure they get the full picture.

It might be useful to:

·       Write down your symptoms, when they started, progressed, and how they affect your life: mentally (focus, mood, thoughts, contact with environment), physically (sleep, eating habits, energy, pulse, breath), in relationships.

·       Consider browsing through NHS a to z conditions https://www.nhs.uk/health-a-to-z/conditions/

·       Take a mental health test available online. E.g., here are the tests from Mental Health America. Note, that their tests are not supposed to diagnose you – much more goes into diagnosis than a short test – but might help to find the language or assign words to what you are experiencing.

·       Talk to your preferred LLM (e.g., Chat GPT) about your experiences and discuss what is reasonable to mention to a doctor. This will help you to formulate and also pick up on things that might feel irrelevant or too small, but are, in fact, important for the discussion.   

·        Bring any relevant medical or mental health history.

·       Clearly ask what you’re hoping for (e.g., therapy, diagnosis, medication)

·       Practice what you would like to say with a friend, family member or yourself.

Remember, you always have a right to a second opinion. If you feel, that the situation is not addressed seriously enough, raise that. You can also bring someone else with you to advocate, if you afraid of not being able to communicate your needs properly at the moment.

c. Getting therapy

Therapy, or therapy in combination with medication is a go-to way to address mental health problems. The problem is, waiting list for therapy can be long, depending on the professional’s availability, place and type of the issue. Timelines really vary; this is something to ask your GP to get an answer for the specific case.

You can also look for a therapist here https://www.nhs.uk/nhs-services/mental-health-services/find-nhs-talking-therapies-for-anxiety-and-depression/ . Whether you have a referral from a doctor, or you would like to make use of self-referral.

Language and cultural background matter - feel free to look for someone who speaks your language or understands your context.

You can, however, get a therapist or counselor or even a coach outside of the system and pay out of pocket. Good thing – you get more choice and probably more urgency. Downside – you need to pay.

To keep in mind – counselor and coach are not protected titles in the UK, what means

a) there is no standard, and you need to check for their education/certification yourself to see if this is enough for you

b) they are not allowed to work with complex mental health issues. You can use them as overall mental health support, e.g., for stress, burnout, mild anxiety – as long as this does not cross clinical red lines. Example of red lines – suspected disorders, self-harm, unstable states, trauma.

Also, consider getting remote therapy. It is often cheaper and allows to find a therapist speaking your language and having common cultural background.

d. Getting diagnosed

GPs or psychiatrists can give you a formal diagnosis, but it’s not always automatic. Some NHS therapy services may treat symptoms without giving a diagnosis unless absolutely necessary.

If a diagnosis is important to you (e.g. for work, accommodations, or understanding yourself), ask directly. You may be referred to a psychiatrist—note that this can take time.

Private assessments (especially for ADHD, autism, PTSD) are faster but costly. Some charities offer subsidized diagnostic services

e. Taking sick leave at work

If mental health affects your ability to work, you can take sick leave: your GP can sign a fit note (used to be called “sick note”). You don’t have to give your employer details—just say you’re unwell.

For long-term issues or workplace adjustments, your employer might refer you to Occupational Health. They help evaluate what support or adjustments you need to stay at or return to work. You can also speak to ACAS (free legal advice on employment): www.acas.org.uk

f.       Hospitalization & Emergency

If your symptoms are severe (e.g., risk to yourself or others), hospitalization may be needed. This usually goes through the GP, but in urgent cases, you can also call 999 or call 111 for non-urgent medical advice.

You may have a concern that you might get “blacklisted” or your employer will be informed. This is not the case in the UK. Information about place/reasons hospitalization is not going to be shared with employer: just that you are sick. This even applies to your partner and family – any information will be shared only if you allow it. A mental health admission does NOT appear on a basic or standard DBS check.

In rare cases it might appear in enhanced DBS checks, and only if the police were involved and deems it relevant and necessary for the role (e.g., working with children or vulnerable adults). Even then, this is rare, requires serious legal reasons, and you can appeal it.

Here some other contacts you can leverage:

-          Text “SHOUT” to 85258 (crisis text line, 24/7)

-          Call Samaritans 24/7: 116 123 (free)

-          Mind Infoline: 0300 123 3393, 9am to 6pm, Monday to Friday (except for bank holidays).

You can find even more here https://findahelpline.com/countries/gb