Mental Health Awareness Week: How to access free and private therapy in lockdown

Whether you're already in therapy or considering seeking help for the first time, these are the steps you can take

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As the UK emerges from lockdown, the effects of the pandemic have continued to have a negative impact on many people’s mental health.

From health anxiety and social isolation to financial concerns and disruption to daily routines, almost every aspect of life was impacted by the coronavirus crisis and left many fighting feelings of stress, depression and loneliness; figures from the Office of National Statistics show nearly half of Brits are suffering with anxiety.

For those who need urgent psychiatric care, or are experiencing a mental health crisis, there are options to see NHS staff face-to-face (albeit with extra measures in place). You can find your local NHS urgent mental health 24-hour helpline here. But what about for others looking for support?

“While many people will recover naturally from the experience of Covid-19 with support from friends and family, a significant proportion of people will need help with unresolved loss, bereavement and the effects of social isolation, loneliness, relationship breakdown as a result of the pandemic,” Hadyn Williams, chief executive of the British Association for Counselling and Psychotherapy (BACP) tells The Independent.

“We would expect to see the numbers of people seeking therapy increase in time, as the situation progresses and moves on from the initial phase of shock and denial. The mental health consequences of this pandemic will affect many people for a long time, and it’s vital that they can access therapy when they need it.”

Getting mental health care is especially important right now but with clinics forced to close their doors in line with government guidelines, is it still possible to access support? And if so, what is the best route to take?

Whether you are already in therapy and concerned about moving forward, or you are considering seeking help for the very first time, here is everything you need to know.

Is coronavirus causing more people to access therapy?

According to a recent study of almost 2,000 people, conducted by the BACP, counsellors are seeing an increase in people seeking therapy due to the pandemic, as they struggle to cope with its effects in addition to the variety of other reasons for which people normally seek help.

The research showed that 98.6 per cent of counsellors say coronavirus has come up in therapy with both new and regular clients, and that the most common effects of coronavirus on their clients’ mental health have been social isolation (77.6 per cent), concerns about important people in their lives becoming ill (74 pre cent), distress over watching the news (64.2 pre cent) and financial problems surrounding income in their household (62.8 per cent).

Despite a surge in the number of people reaching out for help, the Royal College of Psychiatrists has warned that mental health services could be overwhelmed by a "tsunami" of referrals when the lockdown measures end.

Professor Wendy Burn, president of the Royal College of Psychiatrists said: “We are already seeing the devastating impact of Covid-19 on mental health with more people in crisis.

“But we are just as worried about the people who need help now but aren't getting it.”

Can you still access free therapy through the NHS during lockdown and how long is the waitlist?

The most effective way to access free therapy in the UK is through your GP, who can help you decide what type of therapy may be best for you and refer you to an appropriate local service, which is usually offered through the Improving Access to Psychological Therapies (IAPT) programme says Fiona Ballantine-Dykes, deputy chief executive of the BACP.

Most GP surgeries are offering telephone or video consultations due to the current pandemic and you should use your appointment to be honest and open, and explain how you have been feeling.

Waiting times for counselling across the NHS will vary, however Dr Michael Sinclair, consultant psychologist and clinical director of the City Psychology Group, says there is a concerted effort to keep waiting times low and support such (mental health) patients as soon as possible.

“For more serious cases (depending on presentation) which require secondary care intervention, then the GP referral to subsequent appointment taking place is typically between one to three weeks,” Sinclair explains.

If you were already receiving therapy before lockdown, the best thing to do is to speak to your counsellor about what happens now and how you continue with therapy given the current situation. “It’s a decision you need to make together,” says Ballantine-Dykes.

“There’s not one definitive answer that will be applicable for every client and counsellor, so discussing the situation with your therapist is vital.”

How are counselling sessions being conducted?

In line with government guidelines, many clinics are closed at present, so you may not be able to have an in-person session with a mental health professional.

However, Ballantine-Dykes states that many counsellors have adapted quickly to working online or by telephone, even if that is not a service they previously offered.

For the most part, video-conferencing applications, such as Zoom, VSee and Doxy.me are being widely used by online therapists but this can vary depending on the counsellors “style” of therapy.

Rosie Weatherley, information content manager at mental health charity Mind, says it is also important for the person seeking help to ensure they are comfortable receiving therapy in this way.

“Remote appointments can cause us extra anxiety, especially if we’re not used to talking to people via video or phone,” she explains. “If the technology is going to be problematic for you, or if you feel more comfortable using the phone rather than an online platform, ask your healthcare professional if your appointment can take place via the phone.”

Weatherley adds that people should make sure they are in a confidential space during a remote counselling session. If you live with others, go to a different room if possible so you won’t be overheard and if you have any concerns, talk this through with your healthcare professional.

What other free therapy options are available?

If you are faced with a long waiting time for therapy on the NHS, there are other routes you can try. The first is through work.

Many employers are recognising the importance of promoting staff wellbeing during lockdown and are implementing initiatives such as Employee Assistance Programmes (EAPs), which enable staff to access confidential 24-hour telephone support and therapy sessions.

“There are increasing numbers of workers experiencing stress, anxiety and depression as a direct consequence of their job,” says Kris Ambler, workforce lead at the BACP. “We believe employers have both a moral and legal duty of care to their employees. This extends to their physical and psychological wellbeing and should include the provision of support, including talking therapies.”

Similarly, if you are a student, many universities and colleges offer counselling and wellbeing care, and are adapting their services to best support students during the pandemic. As a first step, students should contact their universities' wellbeing and support teams to check what help is available.

“Across the UK universities and colleges are recognising the uncertainty that Covid-19 has created for our students,” says Mark Fudge, a university counsellor and chair of the BACP’s University and Colleges Division. “As yet we're unsure of the emotional impact in the longer term, but at present services have responded to the significant changes and continue to support students digitally, or by telephone – whether they're still residing in halls of residence or have returned to their homes.”

We're unsure of the emotional impact in the longer term

There are also charities – including local Mind and Rethink Mental Illness branches – which offer free or low-cost therapy treatments, however the availability of these can vary significantly between locations.

Mental Health Matters (MHM) offers a telephone counselling service and talking therapies in some areas and you can also contact Mind’s InfoLine to see what services are available in your area.

Useful websites and helplines:

• Mind, open Monday to Friday, 9am-6pm on 0300 123 3393
• Samaritans, listening service open 24 hours a day, on 116 123 
• The Mix, free support service for people under 25. Call 0808 808 4994 or email: help@themix.org.uk
• Rethink Mental Illness, call 0300 5000 927 (open Monday to Friday 10am-4pm)
• YoungMinds, free support for children and young people. If you need urgent help you can text YM to 85258. It also offers a parents helpline on 0808 802 5544

Is private therapy an option and how much does it cost?

Just like NHS therapists, private counsellors have played a crucial frontline role in supporting people whose mental health and wellbeing has been affected in different ways during the coronavirus crisis and have adapted quickly to offering therapy online during the lockdown.

Opting for private therapy does enable you to choose your own counsellor, which is limited on the NHS, however the obvious downside is that you have to pay for it, and for many people, that is not an option.

According to Ballantine-Dykes, private therapists' charges can vary, costing anything from £35 an hour and more depending on where you live. She explains that some may offer a free initial assessment and possibly reduced costs for people on low income.

Sinclair agrees, adding that some people can also use private healthcare insurance to fund their treatment as most health insurances companies will fund counselling, psychotherapy, cognitive and behavioural therapy and psychological treatment.

Where can you find a list of qualified professionals for private therapy?

It is important to make sure that the practitioner you choose is registered with a PSA-accredited body, such as BACP. This means you know the counsellor or psychotherapist is highly qualified, adheres to high ethical and practice standard and fulfil continuing professional development requirements.

The BACP’s website offers a “Therapist Directory” which only lists profiles for counsellors and psychotherapists who are BACP members.

Sinclair adds that are various other trusteed lists and directories of qualified professionals, including counsellors, psychotherapists and psychologists online, including: Counselling Directory, Psychology Today, The British Association of Behavioural and Cognitive Psychotherapy (BABCP), The British Psychological Society (BPS) and The Association of Contextual and Behavioural Science (ACBS).

What should you do if you or a friend needs urgent help?

If you're feeling like you might attempt suicide, or you have seriously harmed yourself, it is an emergency. You should call 999 for an ambulance. “The NHS still wants you to do this during the coronavirus outbreak,” Weatherly insists. "Mental health emergencies are serious. You are not wasting anyone's time.”

If you need to talk, there are people ready to listen. You can call Samaritans any time on 116 123. Shout also offers a free 24/7 crisis text service. Text SHOUT to 85258.

Advice for people on a waiting list

If you are finding that you are on a long-waiting list, Weatherley says there are some things you can try to explore while you wait for your therapy sessions to begin:

• Reach out to a telephone support service. You could try to talk to a helpline or listening service about your mental health. 
• Self-help books. Your GP might recommend particular titles from a Reading Well scheme called ‘Books on Prescription’.
• Peer support. This brings people together who've shared similar experiences and can empathise with what you're going through. Many peer support groups take place online, including Mind’s Elefriends. 
• Try to keep active. Build physical activity into your daily routine, if possible. Most of us don't have exercise equipment like treadmills where we live, but there are still activities you can do. Exercising at home can be simple and there are options for most ages and abilities, such as cleaning your home, dancing to music or seated exercises. 
• Find ways to relax and be creative. There are lots of different ways that you can relax, take notice of the present moment and use your creative side. These include arts and crafts, DIY, mindfulness, writing, yoga and medication. 

You can find more tips about managing your mental health and wellbeing during the coronavirus outbreak here.