Mental health is health. Most people will have a period in their life when theirs is poor, in the same way that most people will have a period when their physical health is poor, and the same things apply: some of it passes on its own, some of it responds well to treatment, and delay generally makes things harder rather than easier.
This section covers the practical side — how to get help in the UK, what therapy actually involves, how to tell a qualified practitioner from someone who has simply called themselves one, and where the things that are good for people stop being a substitute for treatment.
If help is needed now
None of the articles here are a substitute for talking to someone, and anyone in distress should not have to read a web page first.
- Samaritans — call 116 123, free, at any hour of any day. The call does not appear on a phone bill.
- Shout — text SHOUT to 85258 for a trained volunteer, by text message, at any hour.
- NHS 111 — call 111 and choose the mental health option, for urgent help and advice around the clock.
- 999, or the nearest A&E, if someone's life is at immediate risk, or if they have seriously harmed themselves.
A GP can also arrange an urgent appointment, and most areas have a local NHS crisis team reachable through 111.
Getting help in the UK
In England, it is possible to refer yourself. NHS talking therapies for anxiety and depression takes self-referrals through its own website — no GP appointment required, and no diagnosis required either. It is free, for anyone aged eighteen or over living in England, and some areas also take sixteen- and seventeen-year-olds; under-eighteens go to the children and young people's services instead. The service covers persistent low mood, anxiety of most kinds, health worries, social anxiety, panic attacks, phobias, obsessive-compulsive disorder, post-traumatic stress disorder and body dysmorphic disorder, including where those sit alongside a long-term physical condition.
Asking a GP to refer is the alternative, and it remains the main route in Scotland, Wales and Northern Ireland, where the arrangements differ.
A GP appointment for mental health is an ordinary appointment. It helps to write down beforehand what has been happening, how long for, and what has changed — sleep, appetite, concentration, work, relationships — because ten minutes goes quickly and it is easy to leave having said less than intended. It is also reasonable to ask for a longer appointment when booking, and to say what it is about.
Going privately is the other option, and it comes with a complication that catches a great many people out: in the UK, "counsellor" and "psychotherapist" are not protected titles. Anyone may use them, with no training and no registration whatsoever. Choosing a therapist sets out which titles are protected, which registers to check, and what to be wary of.
What helps
For most common problems the treatments with evidence behind them are talking therapies, medication, or both — and which of those is appropriate depends on what the problem is and how severe it is, which is the thing an assessment is for.
Alongside those, the ordinary measures genuinely matter. Sleep, moving about, time outdoors, cutting back on alcohol, company. UK guidance reflects this: among the first-line options for less severe depression, NICE lists guided self-help, group forms of cognitive behavioural therapy and behavioural activation, group exercise and group mindfulness or meditation, alongside individual therapies — and advises against routinely offering antidepressants as the first step at that level of severity.
Where this goes wrong is when the ordinary measures are offered as a replacement for treatment rather than as company to it. Exercise, yoga, meditation and a better routine help many people and are worth doing. They do not treat moderate or severe illness, and taking them up is never a reason to stop medication, cancel an appointment or put off asking for help. Anyone who says otherwise — a teacher, a practitioner, a website — is going well beyond what they know.
In this section
- The first therapy session — what actually happens, what gets asked, what confidentiality covers, and how it tends to feel afterwards.
- Cognitive behavioural therapy — what CBT actually is, as opposed to what it is usually said to be, and when it is not the right choice.
- Choosing a therapist — protected titles, accredited registers, who does what, what predicts a good outcome, and the warning signs.
- Yoga and mental health — what the evidence supports, what it does not, and where the sensible cautions lie.
More will be added here. Anything in this section that describes a condition or a treatment is general information, not advice about a particular person, and no article can take the place of an assessment by someone who can ask questions back.