Mental health: ethnic minority experiences

Talking therapies & ECT for mental health problems

In addition to medication, a range of treatments are available for people with mental health problems. Rethink Mental Illness and the Royal College of Psychiatrists provide information about the range of treatments available, some of which is adapted here.

Talking Therapies

  • Psychotherapy involves talking to another person and sometimes doing things together. 
  • Psychodynamic psychotherapy involves talking about past experiences and how they affect the present.
  • Behavioural psychotherapy involves spending time in a feared situation or learning techniques to reduce anxiety to try to change patterns of behaviour.
  • Cognitive Behavioural Therapy (CBT) involves talking about how what you do affects your thoughts and feelings and aims to get rid of destructive ways of thinking.
  • Family and relationship therapy focuses on relationships and involves all the people concerned, either a couple or the whole family.
  • Individual psychotherapy involves one patient and one therapist.
  • Group therapy involves several people with similar problems meeting together with a therapist.
Counselling aims to improve self-acceptance and can help people deal with conflicts or to make decisions. In counselling, people can talk about their thoughts and feelings without fear of being judged or criticised.

Creative therapies
  • In art therapy, clients' responses to the created art are thought to reflect their concerns and conflicts. 
  • Drama therapy aims to help clients to tell their story, solve problems and improve interpersonal skills and relationships. 
  • Music therapy uses music as a means of communication and expression and to facilitate positive changes in behaviour and emotional wellbeing.
Art, drama and music therapists are trained in art, drama or music and therapy.

People wanted to try talking therapy because they wanted to talk to someone and hoped it would help, including one woman who was hopeful even though she realised that “they won't have a secret recipe”. Some were willing to try talking therapies even though they didn't know if it could work or had tried it before, while others felt that talking with others is helpful, even though talking therapies didn't work for them personally. One woman was worried about how long she might have to have therapy, partly because she felt, “therapy was for the mad people”. 

People had mixed opinions about talking therapies. Some had found them helpful and thought that they were “the only way to get oneself moving forward”. Others experienced mixed results. One woman with schizophrenia said CBT “improved my quality of life quite immensely”, although it was difficult to use when she was unwell. One man with anxiety disorder said that CBT helped him to become aware of his anxieties but trying to replace his patterns of thinking didn't work (see Shaukat's story). He doubted whether CBT made much difference but said it was difficult to tell because he was also attending support groups.

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Therapy can offer an environment to talk about difficult or sensitive issues, and many people described needing to talk about abuse, bereavement, or feelings of anger and valued the opportunity to talk about their feelings, “I have to take that out of my chest and I feel better then”. One woman benefited from writing letters to family members and reading them aloud in group therapy. Many people valued the improvements in their understanding, being able to unpack their feelings, and felt as though talking therapy gave the “power back to me, not to my symptoms” and helped them feel calmer. 

The therapists' background - ethnicity, class, spiritual beliefs or education - and their approach or attitude may also affect the relationship between clients and therapists. Some people found these characteristics made their therapist difficult to relate to, while others found them irrelevant. 

Many people praised the skill and approach taken by their therapist, and this was what often made the difference between a good and a bad experience. The main things that people valued from their experience of talking therapies were having someone to talk to who listened, seemed to understand and believe them, and helped them to feel empowered in the session. Many people tried more than one therapist before they found the right one for them.

Although talking therapies are available free on the NHS or from voluntary organisations, there can be long waiting lists. Some people had asked their GP for talking therapy and had to wait for at least 6 months, others hadn't asked and hadn't been offered any. One woman said she was finally on the waiting list for psychotherapy after waiting 22 years for a referral. It is possible to pay to see a therapist who works privately but some couldn't afford it, although many therapists offer a sliding scale of payment based on what the person earns. One woman who had been having psychotherapy since she was a child thought that there was a difference between the psychotherapists working for the NHS and those working privately. A few people described feeling pressured into having talking therapy, including one man tried it even though he didn't think it would help because he was worried he wouldn't get any further help. 

Others thought that talking therapies were “a waste of time” and “don't work”, including one woman who said her counsellor and psychologist “couldn't help me; nobody really knew what to do with me”. A few people said that the creative therapies they had tried hadn't helped them, including one man who said he wanted to do “proper drama”. Talking therapies can only work if people are willing and able to talk about their experiences, which some people found difficult, “I knew I needed to talk to someone but I didn't really know what to talk about.” 

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Some people found it a drawback that counsellors only listen and do not offer advice in their sessions. Therapy can also be a slow, time consuming process and “hard work”. Some people preferred medication because it provided a quicker fix, or when talking therapies didn't help [see Ali above].

A few people had also done some counselling training [see Jay, above and Nelsy, below], and from this experience, one woman concluded that language and communication were crucial for therapy.

For some people, talking therapy caused distress, including crying and feeling “down”, tired, stressed, or empty, “it just opened a hole, and it's left me with that hole really”. People welcomed the support of other people in group therapy, although one woman also described feeling angry when she didn't get the opportunity to speak during a session. Some people who felt this way thought that the six sessions they received were inadequate, including one woman who was left with suicidal feelings.

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ECT (electroconvulsive therapy)
ECT can be used to treat severe cases of mental illness and involves passing an electrical current across the person's brain under anaesthetic. Only one person had experience of ECT, and he found it helped him (see our section devoted to experiences of ECT for more information).

Other people had not tried ECT. Some definitely didn't want to try it because they had heard it could cause memory loss, including one man who was afraid after seeing people who had tried it and said: “It's basically turned them into the walking dead”. Others had mixed feelings about ECT and had considered it because their medication was not working, although one man said, “I first want to know what it does, what's it for?” Another man asked for ECT, even though he was worried about the damage it might do. As he said, “I've only got one brain, unlike two eyes and two ears.” However, his psychiatrist refused.

See more experiences of ECT.

Last reviewed September 2018.

Last updated June 2015.


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