Referrals from a GP
A psychiatrist is a doctor specialising in mental health. Psychiatrists have expertise in finding the right treatment for you, including what form and dose of antidepressant or other medication is best for you. A few psychiatrists also offer some ‘talking therapy’ themselves. Psychiatrists might arrange a ‘package of care’ which includes referral to some of the other mental health services listed below.
Clinical psychologists are trained in assessment and treatment of psychological problems. They would usually offer cognitive behavioural therapy (CBT), a form of therapy which focuses on changing unhelpful thinking and behavioural patterns. Many of the strategies on this website are based on CBT principles.
Psychotherapists offer talking therapy similar to that offered by counsellors, though often more in-depth. An NHS psychotherapist might offer short or longer-term therapy, individually or in a group. Like counsellors, psychotherapists do not all work in the same way (See ‘How does counselling help?’).
Community psychiatric nurse/team
Particularly if you are seen to be at risk, a member of the local crisis team or community psychiatric team may act as an ongoing ‘contact’ point with the mental health services. They would sometimes arrange regular visits or phone calls to keep in touch, or give you a number to phone when you need some support.
Child & Adolescent Mental Health services
In-patient residential care and therapeutic communities
In-patient, residential care is often the favoured approach for treating addiction and is also available privately, for those who can afford it, for a range of other mental health problems including depression.
Sometimes, if you are seen to be at serious risk or are considered very vulnerable, it could be recommended for your own safety that you spend time as a residential in-patient at a hospital or other centre. In some cases, if a doctor considers you to be severely at risk or temporarily unable to make decisions for yourself, you may be ‘sectioned’ ie. required by law to become an in-patient (see below).
What is ‘sectioning’?
The Mental Health Act 1983 makes provision for doctors (and some other designated professionals) to require a person who is a serious and imminent risk to themselves or others to become a hospital in-patient. This is seen as a last resort when it is the only way for the person to be kept safe and treated, or when it is necessary for the protection of others. This step is usually only considered when it seems that the person is sufficiently vulnerable or out of contact with reality (psychotic) to make it impossible for them to make a clear decision for themselves.