What to Do If You Can’t Afford Therapy
Money shouldn’t have the power to prevent access to care
In the UK, approximately one in six adults suffers from a common mental health disorder, according to statistics at the Mental Health Foundation. Even if we don’t all suffer from mental health issues, life throws many obstacles at us, from work stress to loss. Therapy is free on the NHS, although waiting lists are often long. Not everyone can afford private therapy. So what can you do to help yourself?
If you are experiencing suicidal thoughts or self-harming, it’s important to talk to someone as soon as possible. That can be your GP, a friend or family member, and/or Samaritans. The Samaritans helpline is open 24 hours. Their number is 116 123. The listener will not judge you or apply pressure. According to the NHS, a mental health emergency should be taken as seriously as a medical emergency. A mental health emergency, or crisis, often means you don’t feel able to cope with your situation, or feel out of control. You may experience suicidal thoughts. In a mental health emergency, you can go to A&E or get an emergency appointment with your GP.
Whether you are struggling with a mental health condition or a difficult set of circumstances in life, you are entitled to free therapy from the NHS. This includes counselling, psychiatry, cognitive behavioural therapy (CBT) or other forms of therapy. To see a therapist, your GP can refer you or you can self-refer. Unfortunately, NHS waiting lists can be very long. Sometimes you do need to chase up the NHS for referrals to specialists, which can be difficult when suffering from a mental health condition such as depression or anxiety. If you feel you need urgent mental health support, you may want to seek help elsewhere in the meantime. You don’t necessarily need to see a specialist to be prescribed antidepressants—your GP can do this.
Support groups offer a safe space to talk for a group of people with a shared mental health condition, trauma, or difficult situation (such as bereavement.) These are often facilitated by a trained counsellor or therapist, or someone with firsthand experience of the issue at hand. Group therapy can help you feel less alone and learn more about what you’re currently going through from others in the same boat. In a good support group you won’t feel judged but listened to and understood. Support groups can help tide you over while waiting for an NHS referral. They can also offer emotional support in addition to one-to-one therapy. Most mental health illnesses have a related charity or association which lists support groups. OCD Aaction, for example, has listings for local support groups in Britain and Ireland, as do Anxiety UK, and Bipolar UK.
Lulu, now 25, struggled with issues including anxiety and depression at university, but couldn’t afford private therapy. Instead she had to take some time out to try and stabilise her mental health. Says Lulu: “I joined an online support community from the charity Mind called Elefriends, which was a little haven of support for a while! I didn’t feel any pressure or guilt for the way I was feeling. I felt I was helping other people, too, while being listened to.”
While private therapy might seem unattainable, there are low-cost options out there. I spoke with psychotherapist, couples counsellor and author of The Phone Addiction Workbook, Hilda Burke, who assured me that there are many ways to access therapy in metropolitan areas such as London.“While I was training—and indeed for two years after I qualified—I volunteered at a wonderful low-cost counselling centre run as a charity, Help Counselling, in London’s Notting Hill,” she tells me. “Clients there paid anything between £5 and £30 per session depending on what they earned. Most accredited therapy-training institutions insist that their graduates have at least 200 hours of therapy work under their belts to graduate. A good place to start is by contacting therapy-training institutions.” For those who don’t live somewhere where there is access to low-cost therapy, some of these institutions may offer Skype sessions.
“At first I felt a bit funny about self help books, but looking back they were very helpful,” says Lulu. Self help books range in quality, from helpful to potentially counterproductive. You cannot self-diagnose with a self-help book. Most mental health conditions must be diagnosed by a psychiatrist or medical professional. What self help books can do is help you understand a specific condition you have been diagnosed with, or come to terms with a difficult situation. They can help you see more objectively and understand the mechanisms behind anxiety, sadness and trauma. Self help books can also help you learn new coping strategies to replace harmful ones. Mental health charities often recommend tried and tested self help books on their respective websites.
Mindfulness has got a lot of press in recent years for its ability to improve our mental wellbeing. In particular, research shows that it can be effective in managing anxiety and depression. But what is it? Put simply, mindfulness is the ability to be fully present in the present moment, not overreactive or overwhelmed by what is going on around us. It can help interrupt ‘autopilot mode.’ Mindfulness derives from the buddhist practice of meditation. In its simplest form, it involves focusing on your breath to anchor yourself in the present. Today, there are many resources and books that introduce mindfulness and meditation. In most towns you can find meditation classes at community spaces or buddhist centres. There are also some amazing apps out there such as Headspace or Calm which help you introduce mindfulness into your routine in a manageable, fun way.
We’ve covered self help books, but what about reading books not written with self help in mind? In my own life, I have found reading novels the best form of therapy and method of relieving stress. Every difficult situation we encounter has likely already been described by an author of fiction. A good book also allows you to better understand the other people in your life, their motives, and gain empathy.
The School of Life offers a Bibliotherapy service where a bibliotherapist prescribes books to help you deal with your situation after a consultation, which can be done in person or via Skype. If this sounds interesting but you can’t afford the price tag, Dr Paula Byrne runs Literature and Mental Health: Reading for Wellbeing, a free six-week course on Future Learn. In the course description, they quote Dr Samuel Johnson, an 18th century writers who suffered from severe depression: “the only end of writing is to enable the reader better to enjoy life or better to endure it.”
Feel the Fear and Do it Anyway by Susan Jeffers (Lulu’s pick)
The Things You Can See Only When You Slow Down by Haemin Sunim
Mindfulness: A Practical Guide to Finding Peace in a Frantic World by Dr. Danny Penman and J. Mark G. William (Lulu’s pick)
The Novel Cure: From Abandonment to Zestlessness: 751 Books to Cure What Ails You by Ella Berthoud and Susan Elderkin
The Anna Karenina Fix: Life Lessons from Russian Literature by Viv Groskop