Mental Health Services Are Confusing

I think accessing mental health services for anyone can be really confusing, but especially if you’re foreign or don’t have a clue which way to go for help.

In Finland, growing up, my mother or school nurse referred me to the appropriate place so I don’t actually know what it’s like finding care there as an adult, but in the UK where I last lived, it was sort of maybe easy but not always so.

The National Health Service which is free at the point of service is overused and so if you don’t have a serious mental illness, the most you probably get in terms of therapy is 12 sessions of CBT.

I tried to access these services on multiple occasions – first at university through my doctor who sent me to counseling on campus (short-term, not very in-depth), then later on to more services in all the places where I lived. Every time I moved, my primary care service would change, and hence I couldn’t access or wait for a service I was referred to in the last place, so that was tough and a bit confusing.

In the end I ended up in an area where I received my 12 weeks of CBT, followed by a Borderline Personality group, followed by 18 months of psychoanalytic psychotherapy.

This only happened because I was persistent, and there was a trainee psychiatrist who needed patients so I was slotted in to get the psychoanalysis with him.

I don’t know how much this all helped, in the end.

My regular readers will remember that I also searched for a nonprofit that would offer counseling, and found Aurora Health Foundation, a nonprofit founded by a survivor-therapist whom I saw for a few years.

Then the move to the US happened, and in the beginning I sought private therapy with the help of my insurance company that would subsidize the cost of the treatment.

I saw this one lady for five sessions, and quit as she kept checking her phone during sessions and in general showed very little care, concern or interest in me and I felt disregarded.

I then started going to a survivor group and thought fuck it, I don’t need therapy.

Aaaaand then the crisis hit, and I ended up in psychiatric hospital here in Miami for severe depression and suicidal ideation.

There was no therapy or any intervention as such – they can just keep you and others safe from you, and give you medication.

I was not explained what my treatment options would be, but the social worker just referred me to outpatient psychiatric services in Miami Beach.

I have now had a few visits to the nonprofit community mental health center, and I am not yet sure how it will help me with my mental health issues – first and foremost, the resources are scarce and it seems that my treatment in any case will last maximum of 6 months, AND there is no individual therapy available.

You also have to take medication to stay in the program. Refuse meds, and you’re out.

In the intake session they asked me what my goals were and I started thinking about it: I don’t think I’ve ever really fully realized how severe my depression and anxiety are, I haven’t ever felt I could really ever be better (permanently, there have been many times when I’ve felt great for short periods of time), and I haven’t even envisioned a life where I could come to terms with my childhood, the abuse, the trauma and all that stuff…

So I said I would want to live life to the fullest, cope with, if not heal from, depression and anxiety and borderline, and feel like life is worth living.

I’m not sure if that makes sense at all, but really, as I have blogged before, change is possible IF you believe in it, AND if you work hard for it.

I am confused though about whether A) I even need medication B) I am receiving treatment in the right place C) if there would be something else available and D) which one of the options I should choose.

I have had a few Skype sessions with my former therapist in England, and while it’s nice to talk to someone who really knows you, I am not sure how effective it is over a bad connection with someone who isn’t physically there.

Plus, I’m here in the US now, would it be time to move on and find services here?

I also have been offered phone counseling for free of charge through a survivor organization, and again, I would like to try it, BUT is it effective over the phone?

Ideally, I’d see someone in person, but whom??? The last person I saw was shit, AND we now won’t have insurance as my husband quit his job, so cost is a real big issue………

Also, any nonprofit that offers low-cost services usually have time limits on the therapy, and i don’t want that.

So I dunno….I’m confused. I am open to receiving care and I’m motivated to change and work on myself, but it’s just really confusing trying to figure this system out..

That’s it. That’s where I’m at now. Unemployed, married for a year, severely depressed but I do want to live.



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