Norway was recently pushed to revolutionise their approach to mental health treatment by the UN Committee Against Torture. With their new methods focusing more on therapy, such as Cognitive Behavioural Therapy, rather than medication, it’s worth looking at whether this is what the future should hold for everyone. If you have ever been in the difficult position of approaching health services regarding your mental health issues, or have others do so on your behalf, you’ll likely be aware of the how the process goes. Initial appointments with GPs, then nurses and psychiatrists. Sometimes the Crisis Team, that can visit your home to provide support, are involved. Depending on your experience, and severity, you could even be sectioned, meaning you would be kept in hospital under the Mental Health Act 1983.
It can sometimes feel intrusive to have so many unfamiliar faces asking you every detail of your life, especially when you are confused or don’t even believe that you are ill. A mental health breakdown can make you experience delusions or hallucinations. It can be hard to accept that you need to start taking medication, and this process of prescribing medication can begin even before the professionals are clear on what your diagnosis is. There can be significant side effects, such as weight gain, extreme drowsiness and a-motivation.
Yet this experience can vary considerably from case to case. Maybe you’ll receive a diagnosis, or perhaps it’s a one-time, circumstantial issue with your mental health. 40% of people that experience a psychotic episode, will never experience one again. The pressure put on a somewhat strained service can mean that your issues take time, and a variety of approaches, to solve. On the NHS, there are often waiting lists for Cognitive Behavioural Therapy (CBT), where certain patients are given priority depending on the severity of their condition.
One positive thing that’s come of the Covid-19 crisis is the opening up of a discourse on the state of society’s mental health. However, there is still shame and stigma attached to the serious troubles people may face with their minds. Therefore, is now the time to consider what can be done to improve the healthcare process, in what can be a difficult or traumatic experience for patients? Norway’s previous approach included patients being isolated and forced to take medication. In the UK, you have to take medication once you are sectioned, but when not sectioned, the choice to take medication is your own.
Prompted by the UN Committee Against Torture, Norway have started to provide options rather than forcing a certain type of treatment on patients. There are definitely many positives to this move, giving patients a sense of freedom and independence. If they decide to take medication, they will be accepting the side-effects themselves, they won’t feel like there is only one route, with life-changing consequences. On higher doses, lack of motivation and a groggy mind can affect your work and your relationships.
For some, talking is the best way to address a root cause to their illness. CBT, for example, can give you steps to recover, helping build methods of working through stress and anxieties. Knowing the science behind your brain can be vital to preventing fight, flight or freeze responses, becoming aware of why you experience adrenaline, heightened senses and a speeding heart rate.
Learning to live mindfully can improve how you adapt to difficulties in the future. Living through a mental health breakdown can sometimes push you to be aware of the best way for you to cope. These lessons aren’t something you absorb through medication.
But sometimes timing is key with being given a course of therapy. Patients coming out of an episode can feel shell-shocked, and on a bit of a low after an experience that can make you feel excited and elated, in the moment. Perhaps a system where patients decide when they receive a course of therapy, based on when they feel most like talking, could be better.
Yet, does Norway’s move towards therapy belittle the positives to being on medication? If you are already at the point where you are feeling paranoid, or elated about a reality that isn’t true, could a medication-free treatment really help? It’s hard to know how they would be able to reason with voices and hallucinations, but it will be interesting to see the advances in drug-free treatment and whether there is really an alternative
To move on, and function in society, medication is currently the best way to bring patients back to reality. For many, the side-effects would be worth being able to return to normality. Perhaps we should be more open about the positives of medication, and normalise being reliant on it.
I can’t help wondering, could severe mental health issues be prevented if CBT ideas and more mindfulness was part of the school curriculum? Maybe it could be easier to be referred to mental health teams. Wouldn’t it be best for everyone, if more preventative steps were taken?
Today, there are increasingly many stresses that can put pressure on your mind. If there was more education, and therefore less stigma, fewer people could find themselves in the position where treatment is necessary.
Words by Annie Gray
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