Differences between U.S. And UK

M

Mastiff mom

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#1
As I read posts from members in the UK, and what they experience as mental health patients, it seems things are handled very differently there than they are here. I can only speak from my own experience and observations. Here, when I am a serious danger to myself, I check myself into my favorite ( and I use that term loosely) hospital. It's a private hospital, with some good doctors and staff. The food is pretty good and they have many activities, such as: yoga,dance therapy, art therapy, expressive therapy, group therapy,etc. You see your psychiatrist every day, stand in line for meds at the nurse's station and have a one on one meeting with a staff member every day. You also have a social worker who arranges formal family meetings to discuss progress and aftercare. You are checked for every 15 minutes so your safety and whereabouts are known at all times. Something that I find frightening is that all different diagnoses roam the halls and lounge together, even if one has shown a propensity for violence. I was attacked during one stay by a huge 400 pound man--with no warning he slammed me up against the wall and tried to make me fall as I escaped him. When a patient acts out they are sent to the quiet room. If there is assault involved, they call a code 6 and security guards arrive. Sometimes if you are really in a fit they give you what we jokingly call,"the booty juice". That will knock you right out . They can also strap you down.obviously these are things you want to avoid! They use a numerical system, self reported am and pm--you give a number for your safety level in hospital and a number for outside--1 means, I plan to follow through on suicidal plans, 10 means I'm completely safe. Usually the really manic people come in and say," I'm a thousand and one!!!" There are also the poor souls who arrive in handcuffs because they were having a bad time, called a hotline and the minute you say suicide or anything like it, the police arrive at your house and off you go to the mental hospital. After 3 days of observation they are almost always released. This is not a complete picture of the mh situation here-- obviously it is much harder on those who are impoverished. I would very much like to know what the situation is where you live. Any input is appreciated.
 
Jaminacaranda

Jaminacaranda

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#2
Very interesting, Mastiff mom. Do you have to buy medical insurance for this? If so, how expensive is that? Do you know what happens to people with MH problems who can't afford medical insurance? I imagine nothing - until they do/threaten to do something dangerous to others, and then law enforcement kicks in?
 
M

Mastiff mom

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#3
No, they do accept those with no insurance- they must accept anyone who is suicidal. I have very good private insurance and been encouraged to check out before I was really ready. Those who need long term care and are impoverished are more than likely faced with state hospitalization, if they have no one to care for them.
 
M

Mastiff mom

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#4
I guess things are not so good over there. I was just trying to share my own experience but feel it pissed some people off. Depressing.
 
Jaminacaranda

Jaminacaranda

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#5
I think it's interesting to compare the two systems, and to consider alternatives. I don't have very much personal experience, but I like to learn from others. Here in the UK the government is cutting financial support for MH services, and people are suffering because of that, but I'm not sure the situation here is so very different. You can access treatment in the UK if you have money - if not, you have to be in crisis or very ill to get any 'free' treatment although GPs will prescribe pills of various kinds freely. At least, that is my understanding of the situation. I used to work in a men's prison and over half of the inmates had mental health problems that were essentially untreated.
 
M

Mastiff mom

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#6
That is terribly sad. I think all people struggling with these issues should know as much as they can regionally,nationally and internationally. Here, they will not give you a bed in hospital unless you are suicidal. But despite all the activities (some of which are therapeutic), it is still much like a holding tank. I just wonder how it works across the pond- do you have to see a gp first to get a referral to a psychiatrist? What are the hospitals like? Do you come out better than when you went in? I just have a lot of questions and would appreciate hearing from anyone about their experience.
 
FallenAngel

FallenAngel

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#7
The hospital that I use for my care is stretched very thin. The workload that the doctors and nurses experience must be ridiculous. Patient lists are overflowing and the waiting lists are even worse. Unfortunately like many other hospitals and areas of care up and down the country they are facing cutbacks to the service. Just as quick as patients go in, they are discharged with medication and thank you very much. The area that my local Mental Health NHS Hospital covers is nearly 100 miles give or take and that might not include other patients who might be transferred or referred to our care. It's really asking a lot.

I don't blame doctors or nurses. Their hands are tied and can only operate with the resources they have. You could argue they might discharge too early and not offer the care and support required, then on the other foot if they put more into the care, patients still waiting don't get seen, so it's quite the vicious cycle as you can imagine.

I am not a fan of the care I have received. I try to work with my doctor and nurse and it seems the medication route is the solution in their eyes. I just wish there was more interaction and exploration of the possible alternative treatments that I could benefit from. Sadly money dictates that.
 
Rod Whiteley

Rod Whiteley

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#8
A few people in the UK have recurrent crises and are repeatedly hospitalized. This mostly keeps them alive, but it doesn't really help. Many people with mental illnesses here only see their GP for medication and perhaps counselling. Many others are treated by community care services, paid for by government through local agencies called Clinical Commissioning Groups (CCGs). So my local CCG operates a bit like your local government's Department of Behavioral Health (DBH), except that a CCG usually commissions most mental health care from one or two big local providers, while your DBH commissions a larger number of smaller community providers. And a CCG covers all kinds of healthcare, not just mental health. Services are similar, with crisis teams and so forth, except that your DBH seems to be involved in affordable housing for people with mental illness, a great idea that hasn't caught on in many places here.

There are only a very few private mental hospitals here, and many of them specialize in holding mentally ill criminals securely. But there are many private psychotherapists, counsellors, psychologists and psychiatrists here. I would say they charge roughly the same in pounds as their US equivalents charge in dollars, so relatively speaking private treatment is a bit cheaper in the US.

Getting to see a psychiatrist is not easy here. Most people only see GPs, nurses, social workers etc. You can get into the public system either through your GP, or in most places through a local mental health helpline. For example, here in Gloucestershire the local helpline is called "Let's Talk". If you call it and you're seriously ill, then it's possible you could get to see a psychiatrist without having to see your GP for a referral first. If you have insurance it's probably unusual for an insurer to pay for a psychiatrist without a GP referral first.

The quality of care is probably much the same as in the US, which is to say very variable. I visit the US from time to time and talk to a lot of mental health professionals, and I never get the impression there's a great difference in quality or outcomes.
 
A

Amy Pond

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#9
As I read posts from members in the UK, and what they experience as mental health patients, it seems things are handled very differently there than they are here. I can only speak from my own experience and observations. Here, when I am a serious danger to myself, I check myself into my favorite ( and I use that term loosely) hospital. It's a private hospital, with some good doctors and staff. The food is pretty good and they have many activities, such as: yoga,dance therapy, art therapy, expressive therapy, group therapy,etc. You see your psychiatrist every day, stand in line for meds at the nurse's station and have a one on one meeting with a staff member every day. You also have a social worker who arranges formal family meetings to discuss progress and aftercare. You are checked for every 15 minutes so your safety and whereabouts are known at all times. Something that I find frightening is that all different diagnoses roam the halls and lounge together, even if one has shown a propensity for violence. I was attacked during one stay by a huge 400 pound man--with no warning he slammed me up against the wall and tried to make me fall as I escaped him. When a patient acts out they are sent to the quiet room. If there is assault involved, they call a code 6 and security guards arrive. Sometimes if you are really in a fit they give you what we jokingly call,"the booty juice". That will knock you right out . They can also strap you down.obviously these are things you want to avoid!
No they don't strap you down here in England. They are not allowed to do that. But I read that a lot of other counties do it. I only found out a few weeks ago that patients having surgery under local anesthesia in America are strapped down. That's wrong and show you how primative the USA is.
 
tiltawhirl

tiltawhirl

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#10
Mastiff Mom,

There is a great deal of difference in the care you receive depending on whether you have insurance or not.

When I had good private insurance, I had a good stay as you described.

Since then I have been in a few public/state hospitals and there is a night and day difference. It feels and more resembles being an inmate.
 
C

Christobel

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#11
I have been in both NHS mental hospitals, and a private one (self funded). Your description of a private hospital in my opinion matches fairly well with how things are over here. My first admission was in Buckinghamshire. I was in a closed ward as I had tried to commitsuicide while on the ward. I too was attacked by a female patient who had temporarily 'lost it'.

The private hospital was not much different from what you describe in the U.S. One of the patients was actually a psychiatrist. I was not treated any better there, and suffered a nasty sexual assault.

I think on the whole I have been well treated in UK hospitals by the professional staff and was not discharged before I was ready to cope. I was one of the lucky ones, as I had family to help me cope. I feel so sorry for those who are struggling alone, both in the UK and U.S.
 
A

AntipsychoticREFUGEE

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#12
Hello Mastif mom! I can only tell the difference between finnish and British psychiatry which is like day and night. Here in Britain psychiatric ward doctor, nurses and support workers come to talk, asking how you are, how about the meds can you live with it and so on. In the country I left behind just overdose of anti-psychotics and the shrink just expects you to cope on because the previous patient didn't complain about the same med/dosage. I wouldn't be typing this without the British psychiatry, can't thank them enough by words! I tried suicide and now when the "lobotomy" in head has got worse mind is getting dark again but is the reason the realisations around my suicide attempt, additions and life in general or the anti-psychotics or both together, the hatred is now extrovert rather than suicidalish! Part of DID-shit, dunno?