State-Regulated Mental Health Threatens the United Kingdom

April 26, 2009 • By Noah Rubinstein, LMFT, LMHC

A GoodTherapy.org News Update

Mental health care in many parts of the world, including the United States, enjoys a professional freedom capable of growing and helping clients thrive, safe in the knowledge that their information is confidential, and that their choice to seek therapy –and a specific therapist– is their own. Yet some places do not enjoy such freedoms, or, at least, such freedoms are threatened. It may seem peculiar that one such nation is the United Kingdom, as it is usually associated with modern regulation and thought in terms of the medical and professional fields. However, lawmakers there are considering the construction and passage of a measure which would fundamentally change the nature of psychology and psychiatry as the modern English-speaking world knows the subjects.

The measure would place control of mental health practices in the hands of the State, assigning clients to professionals who qualify based on a battery of standardized protocols and plans of action for sessions. Published Thursday in the national newspaper The Guardian, a letter drafted by a group of concerned professionals and associates strongly warns against the consequences of such a measure. Standardizing therapy sessions, the group argues, undermines the essential individuality and creativity of psychotherapy, allowing no room for personal care or adaptation. The letter describes a scenario in which clients are treated as cookie-cutter cases, and therapy itself is understood as a static process with identical, predictable results across the board.

The letter offers a space for professionals and concerned parties in the UK to sign their name to the statement, which they hope will send the message to lawmakers that psychotherapy is largely dependent upon the creation of a workable and meaningful client-therapist relationship.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

11 comments
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Rosie
April 26th, 2009 at 4:46 PM
I think for those who have lived in the U.K they will know that even for physical health problems you get assigned to a doctor based on availability, area etc. Noone has an assurance that they will be connected to the same physician till the end of the treatment. It is the way NHS works. It makes it more complicated when it is mental health.

Reply
Ted
April 26th, 2009 at 11:26 PM
I think rosie is right about it. The medical system in U.K sucks anyway. Even less developed countries especially Asian countries like India, Singapore, Malaysia have better rules and facilities for medical care.

Reply
Caroline
April 27th, 2009 at 5:01 AM
Yuck! What a horrible scenario to consider. I like being able to choose my own doctors not just get whoever has an appointment time for me.

Reply
Anna
April 28th, 2009 at 1:42 AM
I am so glad I Live in the States where I have the freedom to choose who I want to go to. That’s sad that the People of UK don’t get much of a choice. It would be nice to see that change.

Reply
Phyllis
April 28th, 2009 at 1:51 PM
But at least there they get care when they need it and do not have to worry about whether the insurance that they have is going to pay, or really about having anything like medical insurance at all. Maybe it is the overpriced system that we have here that needs to change and not theirs. Are there things about nationalized health care that some of us would not like? Of course there are. But at least they have it when they need it which is more than I can say about the millions in this country who need care but cannot afford our privatized system. Maybe we could come up with some sort of compromise system that will allow the differing ideologies to meet somewhere in the middle? But something has to be done because there should not be people who die because they cannot afford to seel treatment or see a doctor.

Reply
Hollis
April 29th, 2009 at 3:29 PM
My husband is from Canada who also has a socialized medical system and he thinks that the United States in insane for not offering more to the citizens. You may not have a choice of doctors there but you do get cared for when you are ill with no fears about a bill in the mail later. I know there are pros and cons, but we have seriously considered moving the whole family to Canada in large part due to issues like this. Watch Michael Moore’s Sicko and you will see if you do not already know that there are serious issues in the medical and insurance industries in the United Sates.

Reply
Angie
April 30th, 2009 at 1:42 AM
Phyllis and Hollis has really opened my eyes about the medical help here in the States. I didn’t realize the difference until it was mentioned. Maybe the UK and Canada are doing things that we should be doing.

Reply
Allison
May 7th, 2009 at 2:49 AM
There seems to be mixed feelings about the UK and them not having a choice in doctors, and I can understand the feelings of not having the fear of being rejected or turned down, I think I would still love to have my freedom of whom I use as a doctor. Most of the time if it’s an emergency, my doctor can usually squeeze me in.. I know this may not be true for everyone, especially if no insurance is present.

Reply
Karen
May 7th, 2009 at 3:49 AM
you have a great point

Reply
Andy
June 5th, 2009 at 9:18 AM
Err I grew up in the UK, you choose the doctor you want in the exact same way as you do in the US. The only difference is you don’t have a bill when you leave.

I took my wife to the UK while I was waiting for my Visa, and I’ll give you an example of the difference between the two systems.

We chose our doctor and went in to discuss my wife’s medical needs, but he didn’t feel he had enough time to talk over my wife’s medical records that day. So he arranged to swing by our house in the evening to discuss it all. Unfortunately we were at a parent teacher conference that night, so after waiting 30 minutes for us to return, he came back several hours later. He then stayed until he was satisfied he had the information he wanted to start my wife on a treatment program for her disability. At 2am he left and gave my wife the number of the on-call doctor every doctor’s office in the UK has if you need medical treatment out of hours. Of course there was no bill for this as my wife qualified for National Health Care.

When it comes to specialised treatment it’s exactly the same too. You get referred to the specialist recommended by your regular GP and who that is depends who is available in your area.

You have to remember that medical care in the UK is geared towards prevention of illness and making sure you don’t need to return to hospital or surgery if that does become necessary.

In the US health care is for profit. Hospitals treat you for the condition they diagnose when you arrive, they certainly don’t care about other conditions because those are opportunities for further profit with more visits and more surgeries.

Yes it is a bad idea to constrict mental health practices to standardised care, but I seriously doubt it will come to anything. The current party in power in the UK is in as much trouble as the Republican Party in the US and they have an election next year. Most of the reasons they’re in this much trouble are down to their insistence on creating bureaucracies such as this standardised mental health care deal.

Reply
Lila
June 14th, 2009 at 8:39 AM
Thanks so much Andy for clearing this up. The UK right now sounds like the better choice. Guess we can’t really judge the UK until we actually know the facts. Thanks again, Andy

Reply

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Rosie

April 26th, 2009 at 4:46 PM

I think for those who have lived in the U.K they will know that even for physical health problems you get assigned to a doctor based on availability, area etc. Noone has an assurance that they will be connected to the same physician till the end of the treatment. It is the way NHS works. It makes it more complicated when it is mental health.

Ted

April 26th, 2009 at 11:26 PM

I think rosie is right about it. The medical system in U.K sucks anyway. Even less developed countries especially Asian countries like India, Singapore, Malaysia have better rules and facilities for medical care.

Caroline

April 27th, 2009 at 5:01 AM

Yuck! What a horrible scenario to consider. I like being able to choose my own doctors not just get whoever has an appointment time for me.

Anna

April 28th, 2009 at 1:42 AM

I am so glad I Live in the States where I have the freedom to choose who I want to go to. That’s sad that the People of UK don’t get much of a choice. It would be nice to see that change.

Phyllis

April 28th, 2009 at 1:51 PM

But at least there they get care when they need it and do not have to worry about whether the insurance that they have is going to pay, or really about having anything like medical insurance at all. Maybe it is the overpriced system that we have here that needs to change and not theirs. Are there things about nationalized health care that some of us would not like? Of course there are. But at least they have it when they need it which is more than I can say about the millions in this country who need care but cannot afford our privatized system. Maybe we could come up with some sort of compromise system that will allow the differing ideologies to meet somewhere in the middle? But something has to be done because there should not be people who die because they cannot afford to seel treatment or see a doctor.

Hollis

April 29th, 2009 at 3:29 PM

My husband is from Canada who also has a socialized medical system and he thinks that the United States in insane for not offering more to the citizens. You may not have a choice of doctors there but you do get cared for when you are ill with no fears about a bill in the mail later. I know there are pros and cons, but we have seriously considered moving the whole family to Canada in large part due to issues like this. Watch Michael Moore’s Sicko and you will see if you do not already know that there are serious issues in the medical and insurance industries in the United Sates.

Angie

April 30th, 2009 at 1:42 AM

Phyllis and Hollis has really opened my eyes about the medical help here in the States. I didn’t realize the difference until it was mentioned. Maybe the UK and Canada are doing things that we should be doing.

Allison

May 7th, 2009 at 2:49 AM

There seems to be mixed feelings about the UK and them not having a choice in doctors, and I can understand the feelings of not having the fear of being rejected or turned down, I think I would still love to have my freedom of whom I use as a doctor. Most of the time if it’s an emergency, my doctor can usually squeeze me in.. I know this may not be true for everyone, especially if no insurance is present.

Karen

May 7th, 2009 at 3:49 AM

you have a great point

Andy

June 5th, 2009 at 9:18 AM

Err I grew up in the UK, you choose the doctor you want in the exact same way as you do in the US. The only difference is you don’t have a bill when you leave.

I took my wife to the UK while I was waiting for my Visa, and I’ll give you an example of the difference between the two systems.

We chose our doctor and went in to discuss my wife’s medical needs, but he didn’t feel he had enough time to talk over my wife’s medical records that day. So he arranged to swing by our house in the evening to discuss it all. Unfortunately we were at a parent teacher conference that night, so after waiting 30 minutes for us to return, he came back several hours later. He then stayed until he was satisfied he had the information he wanted to start my wife on a treatment program for her disability. At 2am he left and gave my wife the number of the on-call doctor every doctor’s office in the UK has if you need medical treatment out of hours. Of course there was no bill for this as my wife qualified for National Health Care.

When it comes to specialised treatment it’s exactly the same too. You get referred to the specialist recommended by your regular GP and who that is depends who is available in your area.

You have to remember that medical care in the UK is geared towards prevention of illness and making sure you don’t need to return to hospital or surgery if that does become necessary.

In the US health care is for profit. Hospitals treat you for the condition they diagnose when you arrive, they certainly don’t care about other conditions because those are opportunities for further profit with more visits and more surgeries.

Yes it is a bad idea to constrict mental health practices to standardised care, but I seriously doubt it will come to anything. The current party in power in the UK is in as much trouble as the Republican Party in the US and they have an election next year. Most of the reasons they’re in this much trouble are down to their insistence on creating bureaucracies such as this standardised mental health care deal.

Lila

June 14th, 2009 at 8:39 AM

Thanks so much Andy for clearing this up. The UK right now sounds like the better choice. Guess we can’t really judge the UK until we actually know the facts. Thanks again, Andy