An Approach to Overcome the Challenges Faced by Modern Mental Health Services

Like all areas of modern healthcare, particularly in industrialized nations such as the UK and USA mental health services are in crisis. The problem is twofold, state run services are oversubscribed and underfunded; while private services are for many patients simply unaffordable.

Developing countries also have problems with access to psychological care, though for somewhat different reasons. Cost and lack of state funded health systems is part of the problem, but the bigger issue is that there is still a big stigma attached to admitting that you need help to cope with the problems of life, this is particularly prevalent in Asian cultures where any form of mental illness is viewed as a form of weakness.

Modern life itself is the main causative factor in mental health today. The way that we live can be held directly responsible for the near epidemic level of anxiety and depression that we are now seeing in some places. This high incidence of ordinary people with issues puts a huge burden on mental health services. No longer is psychological intervention merely for so called ”lunatics”, slowly but surely individuals are seeing the importance of having a sound mind and at the same time are more aware of the impact that emotional disorders can have on overall health.

All of the aforementioned problems faced by modern mental health care can be solved in whole or in part by utilizing the correct therapeutic approach. Individual therapy is effective for many, but at the same time is very expensive; whether paid for by the state or the client themselves. One to one approaches also limit the amount of people that can be helped at any one time, by an individual practitioner.

By utilizing a group approach we can both lower costs to the state system and allow more patients to be treated at any one time. This is because client to therapist ratios are much higher in group therapy. Twelve patients to one therapist are not uncommon, nor so high as to prevent effective outcomes from being achieved.

Most people would view traditional group therapy as consisting of multiple individuals verbally expressing the nature of their problems or feelings in turn, with the occasional interjection by the hosting psychotherapist in order to guide the session. This is indeed the general way of things, such groups tend to meet on a regular basis for a set number of weeks and often to have a psychoanalytic slant to their therapeutic model.

In contrast to the typical group scenario, what I propose is more of a corporate approach to therapy. Instead of working in an overly clinical way, therapy can be conducted like an academic seminar or workshop. By taking this approach clients do not feel that they are being treated for an illness, instead they are able to look on the therapy as if it were simply any other type of business meeting that they are required to attend. This can be very advantageous, as one of the obstacles to overcome in order to make any type of group work effective is the participants own perception that they are being ”singled out” from ”normal” people because they are attending group therapy sessions. Another advantage of such workshops is that the whole process does not need to be a lengthy one, typical group therapy consists of a set number of sessions for a set number of weeks; some groups may in fact meet on an ongoing basis. At this point we must draw a clear distinction between proper group therapy and self-help support groups. Group therapy is always guided by a professionally qualified therapist, and has specific goals in mind and the aim is usually to achieve these goals within a specific timescale. Support groups on the other hand aim to provide a forum where one can talk with other who have experienced, or are experiencing a similar situation; often they are led by volunteers who have experienced similar things to the group members. They usually receive training in group methodology but are not qualified therapists.

Cost and time required for effective therapy to take place then can be reduced, so much so in fact that for some conditions only one meeting may be required. This comment will surprise many readers, but by working with the correct therapeutic model we can in fact achieve results in just one session. Cognitive-behavioral therapy and psychoanalysis based treatments have both proved to be effective in general group settings. Another form of therapy though can give the same measurable results, is Gestalt. Gestalt has been utilized for years in group settings, some professionals are actually of the opinion that it is more effective as a group therapy than it is as a form of individual therapy. Experientially based, this therapeutic approach relies on practical experimentation or exercises. The founder of Gestalt therapy, Fritz Perls primarily utilized his method in groups.

Practical exercises help patients to help themselves. The idea is to give them strategies and skills that can be applied in their everyday lives, in order to alleviate or at least better cope with their condition. Talking alone may help to get feelings and emotions out in the open, but unless these feelings and emotions are addressed there can be no improvement in mental health. In order to address them patients must learn to deal with them as they arise in everyday situations. Furthermore, clients find it easier to internalize their feelings and reflect, rather than having to undertake the daunting and sometimes embarrassing task of letting their defenses down in a room full of people that they do not know.

To conclude the majority of the mental health burden in modern healthcare consists of conditions such as anxiety, depression and stress. All of these are inter-related, which means a similar methodology can be used to treat them. Therefore, it is possible for us to have set or scripted workshops, which can be hosted on a regular basis by a trained therapist. By taking this approach we can increase the number of clients which can be helped at any one time and decrease costs to the system. The only initial development required is of the workshops themselves, a task which can be undertaken by any therapist with training in Gestalt methodology. Conducting therapy in this way even opens up the possibility for individuals to self refer, thus saving the general medical services time.

A final note now, I have personally utilized the approach detailed here in order to treat feelings of anxiety. That is using one off experience based therapeutic workshops. Out of 10 people in attendance, only one required follow up individual therapy in order to fully manage their condition. Good feedback was received from all participants and most scheduled to return for seminars on managing other conditions.

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