Open Access: Ties of the NHS to Mental Health

March 13, 2018

I spent my spring break in London this year—seeing family, mostly, but also doing embarrassing tourist stuff like taking pictures with the guards in front of Buckingham Palace. On a bus tour, the guide extols the virtues of the National Health Service (NHS), Britain’s socialized healthcare system. “It was set up for the people,” he says, “and [it was] one of the greatest things the government ever did for us.” My father, the ardent Republican, scoffs, while people from Europe cheer.

Personally, I’m far more interested in delivering healthcare than organizing it, and so I tend to stay away from debates about nationalized healthcare systems like the NHS, but on a college campus, that’s become difficult. The result is that I’ve heard a lot of people talking about the NHS, claiming that in the U.K., everyone gets the care they need on time, and while this is true for many, it disregards a crucial service: mental health.

I think everyone can agree that the NHS works for those who need to see a doctor once or twice a year for a check-up and maybe a few times for a cold. It’s great for regular care and also for emergencies—obviously, nobody will be waiting months to set a broken arm or to start chemotherapy for cancer. However, for mental health, the media is littered with stories of the NHS approving ten sessions of counselling a year for chronic mental health problems, patients waiting up to a year to be referred to a psychiatrist, and a lack of adequate sources (such as the correct therapy to treat a certain diagnosis). Mental healthcare in the U.S.’s privatized system is often inaccessible because of cost, but the NHS’s is inaccessible, period.

When mental health problems remain untreated, they fester and worsen. In the end, they require more aggressive and long-term treatment than they would if they had been adequately treated at onset. This not only impacts the sufferer’s life, but, in the case of the U.K., also puts a strain on the NHS’s budget—is it not more effective to pay for months of inpatient care rather than outpatient counselling?

The barrier to care availability is a lack of funds and qualified counselors. As such, General Practitioners often become de-facto psychiatrists, handing out antidepressant prescriptions while their patients sit on waiting lists. I could not imagine bringing up self-harm between discussions of blood pressure and how many vegetables I eat.

All of this paints quite a grim picture of life as an individual with a mental illness under a socialized healthcare system.

To be clear, I am not writing this as a condemnation of socialized healthcare. It has just become frustrating to hear people singing the NHS’s praises, while those who need the care it doesn’t provide sit silently. People with mental illness are too often ignored.

I hear a lot of calls for socialized healthcare on Georgetown’s campus. Many of them cite the U.K. as a prime example—a country where everyone is satisfied with the care they receive. I think this representation of socialized healthcare needs to change. Not only will a more honest representation be more convincing—not giving opponents low-hanging fruit—but it will also be more inclusive of people who need different things from our medical system.

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