Mental health issues — especially among young people — are on the rise, but so are the number of people willing and able to talk. Therapy shouldn’t be the preserve of the wealthy or privileged – that’s why we’ve launched The Therapy Edition, a series of stories on how to seek support and embrace it once you do.
For the past two years, Iain Ross has seen a therapist weekly. Not because a GP referred him, but because he sought out help himself. And he’s not alone.
In England especially, therapy is more popular than ever. There were 1.2m referrals to NHS England’s improved access to psychological therapies (IAPT) programme in 2014-15 and almost half a million more referrals (1.6m in total) in 2018-19 – that’s not even taking into account the huge numbers attending private therapy.
Brits might be known for their stiff upper lip and ‘Keep Calm And Carry On’ mentality, but data suggests attitudes are shifting and therapy is becoming more normalised. In recent years, mental health has dominated conversations in the media, it’s become the subject of multiple charity and social media campaigns, and countless celebrities have spoken candidly about the issues they have faced, most visibly perhaps the younger members of the Royal Family in launching their Heads Together mental health initiative to get people talking – and now the Every Mind Matters platform.
And talking we are. Data shared with HuffPost UK suggests more people than ever are spotting the signs that something isn’t right and taking it upon themselves to get help. In 2014-15, 39.1% of overall referrals to the NHS England’s IAPT programme were self-referrals rather than through a GP, and in 2018-19, this rose to a staggering 70.2%, according to NHS Digital.
Iain first sought help when he realised his relationship with his boyfriend was being impacted by his mental health struggles, the 27-year-old from Leeds decided enough was enough. “I had experienced quite severe highs and lows, for as long as I can remember really, but eventually got to a point where I knew it was taking a toll on my relationship, my work and my health,” he says.
He recalled a former colleague had spoken openly about having therapy so he asked them for a recommendation. The next thing he knew, he was sitting in an introductory session of a private clinic. “I immediately knew that it was something I should have done a long time ago,” he says.
More people like Iain are seeking help from counsellors or psychotherapists compared to five years ago, according to a series of surveys by the British Association for Counselling and Psychotherapy (BACP) to gauge public perceptions on the issue. This research revealed 33% of people in the UK sought help in 2019 compared to 28% in 2014.
Yet statistics show men are still less likely to reach out for help than women, and those aged 60 and over are far less likely to go to therapy compared to the younger generations. Jo Holmes, BACP’s children, young people and families lead, is concerned about this generational gap. “The older they are, the less likely they are to access therapy,” she says, noting this demographic may be dealing with huge events such as the loss of a lifelong partner or child, or their own health issues, without support.
There are many reasons why someone might speak to a professional – it could be to seek support navigating grief, depression, low mood, anxiety or stress at work. It might be to do with relationship troubles, post traumatic stress disorder (PTSD), disordered eating, or even because they’re not sleeping at night. The list is long and varied. So too are the different types of therapy you can access, ranging from psychotherapy and and behavioural therapies to art therapy.
Iain started having weekly cognitive behavioural therapy (CBT) sessions over the course of a year, where he explored how learned behaviour, habits and relationship dynamics affected his mental health. These became monthly from April this year, when he felt like he had more of a handle on things. He also learned CBT techniques which he’s adopted in day-to-day life.
Initially he found the prospect of therapy “terrifying” because speaking about his feelings was so foreign to him – something he’s since realised stems from his upbringing. However he has eased into the process. “I can genuinely say without exaggeration that it has changed my life,” he says.
The sessions cost him £50 (they recently went up from £45) and he reflects that he’s very lucky to be able to afford it. At first he questioned whether it was worth the money, but says: “I wouldn’t think twice about paying that for a meal out, or going for drinks, or a gym membership – and why was my mental health any less important?”
In some areas, you don’t need to get a referral from your GP to access Talking Therapies on the NHS – and the latest data from NHS Digital shows a huge number of people are taking matters into their own hands and reaching out for help. Both Vivienne Dandy, 26, from Birmingham, and Surena Chande, 28, from London, self-referred and were thrilled by the results, despite having very different experiences.
Vivienne, a parenting blogger, referred herself and had a phone assessment within a few days. Her first appointment, however, wasn’t until six weeks later – this is despite pressure from mental health charities for NHS England to offer therapies to all who need them within 28 days of requesting a referral.
She suspects she was struggling with postnatal depression at the time, but hadn’t been formally diagnosed. By the time the first therapy session came around she believes she was “through the worst of it”. “The counsellor said it sounded like I was in recovery,” she says. “I had two more sessions just to ensure that I was okay, before signing off from their services.”
The 26-year-old had cognitive behaviour therapy (CBT) which aims to help people manage problems by changing the way they think and behave. Yet despite the initial wait, Vivienne insists therapy had a positive effect.
“Voicing how I felt to a stranger who validated my thoughts made me feel so empowered,” she says. “The therapist focused on challenging negative thoughts which is something that I have struggled with for years, where self-esteem is concerned.” She still uses the coping mechanisms to this day and says she would recommend therapy to anyone.
“Voicing how I felt to a stranger who validated my thoughts made me feel so empowered.”
- Vivienne, 26
While certain therapies might work well for some individuals, it’s not the same story for everyone. According to BACP’s Jo Holmes, most people will know within minutes of a therapy session if it isn’t right for them. Surena was diagnosed with generalised anxiety disorder at 15 and, after years struggling throughout school and university, she later developed depression.
Originally placed in a CBT group session, she soon realised it wasn’t the right option for her. “The best way I could describe it was trying to fix a huge crack with a small plaster,” she explains. “I had a lot I had been through and wanted to get to the root of it and unpack it all before figuring out coping methods.”
Surena stopped attending the group sessions but only a few months later, her mum was hit by a car and hospitalised. It was at this point, with her mental health spiralling that Surena was offered six one-to-one counselling sessions through NHS Talking Therapies. “It couldn’t have come at a better time, and I stand by the fact that without those I don’t know if I’d be here today,” she says.
“While I know I won’t be ‘cured’ or absolutely fine going forward, I’ve already noticed major changes I’ve been making in day-to-day life. You realise a lot of the answers are within you, but speaking to someone about everything that’s going on helps you figure it out.”
“You realise a lot of the answers are within you, but speaking to someone about everything that’s going on helps you figure it out.”
- Surena, 28
Given that different therapy options work for different people, Jo Holmes, who was once a counsellor herself, advises anyone considering it to take a step back and think about what it is that you want to change in your life. Next, find the confidence to ask for help – this can be one of the biggest battles you’ll face.
It’s important to note that therapy will open the door to some issues in your life that might be difficult to relive or talk about. So you need to ask yourself: are you ready to do that? That readiness is key to successful therapy, says Holmes, as is connection with the counsellor or therapist.
You need to feel safe, not judged and if you don’t feel like that, you should find a new therapist. It’s also important to note that people with severe mental illness will work best with a therapist with relevant and specialist experience.
Holmes stresses that therapists cannot provide all the answers or solutions to problems. What they can do is work with you in order to explore what coping strategies or changes might have real impact in your life.
Jason Dexter, 30, from Sheffield, was having huge panic attacks and eventually reached crisis point two years ago. At first, he tried to access therapy on the NHS but was told by doctors there would be a 12-week waiting time. He knew deep down he couldn’t wait that long and, in the end, found a local private clinic in Sheffield where he began a type of therapy focused on behaviour processing and crisis management.
“I struggled heavily with understanding how I fit within society, and the type of person I was,” recalls Jason, who lost his mum at just 18. “I kind of lost my identity during my crisis months.”
In the past two months the marketing consultant has transitioned to EMDR (eye movement desensitisation and reprocessing) therapy and describes each £50 session as “a saviour”. Going to therapy has helped him work through issues but also re-process past trauma.
That’s not to say therapy hasn’t had its downfalls, however – initially he found therapy to be “useless” and battled against it a lot. EMDR has also meant a rise in the number of panic attacks he has as he navigates some of his past trauma.
His advice to others who want to get the best out of therapy is simple – “be honest, open and truthful,” he says. “It took me a little while to fully open up but you’ll get there. And take your time, nothing changes over night.”
How to get the most out of therapy, according to BACP’s Jo Holmes
- Be brave, take the leap.
- Use a trusted counselling directory to find a therapist. LINKS
- Contact the therapist and ask how much they charge per session, and whether they offer a free introductory session, if they offer reduced rates for people on low incomes, and whether or not they charge for missed appointments.
- The first session is very important so ask yourself, do you feel heard? Is the eye contact good? Do you trust the therapist you’re talking to? Do you feel like you’re on an equal level? Connection is everything.
- If there are things you’re holding back on, try saying them out loud in the therapy room. Sharing those experiences can help you build the confidence needed to speak to others outside of therapy.
- Trust the process.
- If you’re not feeling it, don’t worry. Try to find another therapist or type of therapy that works for you. You can find out about the different types here.