Seeing the GP: Advice and tips for young people

Counselling and other talking therapies for mental health

Here, people talk about:

•    what is counselling?
•    being referred by the GP for counselling
•    referral to other services
•    counselling services at college and university

What is counselling?

Mental health issues can be treated in several ways, including with medication and talking therapies, such as counselling. Some people we talked to were referred for counselling by their GP. Others saw a counsellor at school, college or university. Counselling is about talking to someone who understands depression and other mental health issues and what can help. Counsellors are professionally trained to work with people on their personal and emotional issues, including anxiety, depression, eating disorders, and self-harm. All counselling sessions are confidential. The counsellor won’t tell the GP what has been said, unless they feel someone’s at serious risk.
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Being referred by the GP for counselling

Some GP practices (surgeries or health centres) have an onsite counsellor and people may be referred to them by the doctor, though waiting lists vary. If counselling or therapy isn't available at the surgery, the GP may refer the person to a local psychological therapies service. Aphra was referred for counselling by the GP and waited 3 weeks before her first appointment. She was also taking antidepressants. Before this, she’d had counselling several years earlier at school.
Nikki and Sophie, like Aphra, had seen counsellors at school before they got other help. When Sophie was feeling very low, tired, and had little motivation for friends, study or the things she normally enjoyed, she also spoke to a school counsellor. The counsellor had a four week waiting list, which was disappointing. After around eight sessions, the counsellor advised Sophie to see the GP.
Shane had informal counselling with his GP after he’d taken an overdose. He saw her weekly for five months, which was very helpful, but he disliked going to the chemist afterwards to get his medication. He had 30 minute sessions with the GP and said it felt good to be doing something to help himself. Shane’s GP also told him about local counselling services and charities that he could contact.
Referral to other services

Other mental health professionals that a GP might refer a person to include a psychotherapist, clinical psychologist, and psychiatrist. Other services include Child and Adolescent Mental Health Services (CAMHS).

CAMHS is an area of the NHS dedicated to supporting children and young people with emotional, behavioural and mental health issues, in both in-patient (hospital) and out-patient (day-care) services. CAHMS offer assessment and treatment to young people up to the age of 16 or 18, depending on the local service. The most common way to get an appointment is through the GP, but teachers and school nurses might also be able to make a referral.

Lucy was referred to CAMHS by her GP because of anxiety. She started feeling anxious around the age of 13 when she was at school. She often had to leave lessons because of it and later found it hard to go to most lessons. Her teachers suggested that she talked to a doctor. Being used to 10-minute GP appointments, she was surprised when the counselling session lasted an hour, which she liked. She felt uncomfortable in one of her sessions, though, because her dad wanted to sit in with her and then talk to the counsellor alone. After five sessions of individual counselling, she tried adolescent group psychotherapy.
Sophie was disappointed when individual counselling at school didn’t seem to make any difference. She thought that one-to-one counselling was the only option for depression but later learnt about group therapy and mindfulness meditation. She was referred by her GP to group psychotherapy through CAMHS. The sessions helped her see that she wasn’t alone in having and needing treatment for depression. Talking to people of different ages also helped her see that people can have depression at any age.
Lucy also went to a psychotherapy group through CAMHS and liked that she didn’t have to talk about serious things every time. She went for about a year and later had a few one-to-one counselling sessions.
What’s right for one person might not be right for another. Sarah disliked the idea of group psychotherapy and Aphra felt that peer support had its pros and cons – it was helpful for some people but had the potential to make others feel worse rather than better.

Auberon was referred to CAMHS by his GP too. When he turned 18, though, he had to move from CAMHS to adult services and had a long wait for CBT (Cognitive Behavioural Therapy). He was also under the care of a psychiatrist and only saw his GP when he needed to talk about his medications or get a repeat prescription:
Some people we spoke to said that their GP told them that their problems weren’t serious enough or high priority enough to be referred to CAMHS, including Siobhan. When Siobhan was diagnosed with depression and anxiety, her GP prescribed medication and told her about local services she could find out about. She chose to have online CBT.
Auberon, Nikki and Fran had all had care from psychiatrists in the past. Auberon had depression and had self-harmed. Fran had had psychosis at a younger age and her GP had referred her to hospital. Psychosis is a mental health issue that causes people to perceive things differently from those around them. This might involve hallucinations (hearing, seeing and, in some cases, feeling, smelling or tasting things that aren’t there) or delusions (believing things that are untrue – for example, thinking that there are devils in the room). Over the years, Fran had seen good and bad psychiatrists:
Counselling services at college and university

Counselling is usually available free of charge to students who are at college or university. When Susan found out about university counselling services, she was pleased that she could see a counsellor quickly and didn’t have to pay for it. Like Vinay, she was reluctant to see a GP about mental health as she didn’t want to speak to a different doctor every appointment. Being a medical student, she was wary of what other health professionals would think about her having counselling. She also felt that GPs weren’t the best professionals to talk to about mental health. Counselling turned out to be very different to what Susan had been expecting – she thought she’d be talking about the stress caused by an eye condition she’d had but ended up discussing many different things:
Vinay had spoken to the university mental health advisor and hoped that he could have more sessions after the summer holidays. It was helpful ‘having someone to vent to, and that’s what she promoted, was just the venting it and getting off your chest. And promoting this sort of energy sort of perspective about being positive and just calming.’ Sarah also used the counselling services at her university but ‘hated it, but I don’t think they were bad....It wasn’t that it wasn’t helpful, I just really hated it. But I don’t think that’s a sign that they were a bad counselling service.’
Some people prefer not to speak to a counsellor face-to-face but to email instead. This form of counselling allows people to take the time to think through what they’d like to discuss, and many find physically writing their issues down therapeutic. Sarah felt that email or telephone counselling might have been more helpful. She also felt that some form of talking therapy focused around an activity such as walking and talking might have helped more than sitting in a room and talking. Online counselling also offers people the chance to take their time to think and to be anonymous. Siobhan had online CBT and found it helpful. It was hard for to talk about her feelings and occasionally she texted the Samaritans. When Sophie finished her group therapy, she felt a lot better. Every now and then, when she felt she needed to, she phoned the Samaritans. Texts and phone calls are confidential.
As well as using counselling or other talking therapies for depression, the young people we talked to also said that a change in circumstances helped too. For Lucy, leaving school and going to college helped. Nikki recalled how moving house and going to a college where she made new friends made a big difference, as well as volunteering to raise awareness of mental health issues. Vinay said playing the guitar and writing songs was a positive ‘catalyst’, and he encouraged other young people ‘to channel their emotion and their feelings into some creative outlet’.

More young people talk about their experiences of low mood and depression here.
 

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