Psychiatric service users and mental health professionals have long
debated the merits of therapy as opposed to medication, or at the
very least therapy in addition to psychiatric drugs. And with the
safety of so-called “clean” SSRI (selective serotonin re-uptake
inhibitor) antidepressant drugs being brought into question by
users and professionals, the need for effective, client-focused
rather than “clock-focused” therapies seems ever more
A waiting list of six months minimum for NHS psychotherapy services
hardly serves users in need of crisis care well. By the time these
services are accessed by a client, their condition may well have
stabilised by a change in dosage or a change of drug, and the
underlying causes of their illness may not be addressed. This
leaves the sufferer at risk of relapse or recurrence when a
maintenance dose of medication is no longer sufficient. Worst
still, the disorder may not have stabilised in this interim waiting
period, leaving users who are unable to fund private practice
therapy in dire need of help which is, in the meantime, simply
GPs’ surgeries, often the first port of call for patients suffering
mental distress, should offer counselling as standard practice, and
not leave availability of such services up to the luck of a
client’s geographical area.
Recent legal action brought against producers of SSRIs in North
America brings into focus the danger of relying solely on
psychiatric drugs in the stabilisation of many mental illnesses.
These relatively few, highly publicised and disputed cases
highlight the fact that the drugs don’t work for everyone.
Therapies in place of medication have, in some cases, been shown to
be effective. Therapy in conjunction with medication, provided when
most needed, could help many more.
My own experience of psychiatric care has been, in the main,
positive, but also strongly informs my view of the above argument.
After suffering initially from depression, I developed
schizo-affective disorder and was treated successfully with the
right combination of drugs. At no time during my hospitalisation or
subsequent outpatient treatment was I offered talking treatment.
Eventually, when anxiety started to return, I requested
After an initial assessment, I waited six months before I was
offered a series of sessions, during which time I suffered a
relapse. It was only after my condition had stabilised again that I
started the psychotherapy. The few sessions I was offered – five in
all – limited effective discussion and I felt unable to get to the
root of my problems.
Had I been offered psychotherapy alongside medication, I feel I may
have avoided relapse. Treatment of the whole person in
client-focused therapy, with a holistic, broad-spectrum approach,
is essential for mental well-being.
Helen Waddell is a voluntary worker, freelance writer, and
user of psychiatric services.