Creating an holistic approach to mental health care….

There has been a sharp rise in the last twenty years or so in the incidence of mental health issues in the UK. Recent figures suggest that one in two people in the UK will have mental health concerns at some point in their lives, and one in four will experience severe mental health issues requiring medical intervention. Certainly within my own social circle I know very few people who haven’t already required some form of support be that pharmacological or therapy based. The most common form of mental health issue is depression, accounting for some eighty percent of all mental health conditions seen by GP’s although some of these may well be symptomatic rather than the root cause. The whole issue of mental health is still considered something of a taboo subject and there is still a significant proportion of the population who feel uncomfortable discussing their mental health.

This would suggest that the figures for those with mental health concerns may actually be even higher. The current practice from initial GP consultation is to carry out a brief questionnaire based analysis of mental state and to prescribe a pharmacological course of treatment with an emphasis on restoring the brains neuro-chemical balance. This is generally done without recourse to neuro-chemical testing or brain function imaging and consequently it can be argued that it is being treated as a one size fits all solution in the first instance. This does not seem like a successful strategy, but seems more to be conditioned by availability of resources. There is a severe shortage of well qualified and trained therapists and counselors within the NHS and consequently appointments to get this additional treatment are limited.

It can also be argued that the current practice of employing “talking” therapies is of limited benefit. Techniques such as NLP and CBT, whilst extremely popular are as yet medically unproven and it is my opinion that they will be found wanting, being predicated as they are on the brain functioning in a “normal” manner and therefore being susceptible to therapies of this type. I suspect that this is often not the case in patients presenting to such therapists. Certainly, in my own experience, I have found that such therapies are of limited benefit unless they are combined with positive action to alleviate the root cause of the mental health condition. This issue of dealing with the cause rather than simply treating the symptoms is one that is an issue throughout the medical profession and is at the heart of my perceived need for an holistic approach.

A patient presenting with mental health concerns should be considered as a whole being interconnected with a network of factors externally any or all of which can have an influence on mental health. As an example, a patient with acute depression may be experiencing feelings of isolation, loss of self esteem, loss of appetite, sleep difficulties, feelings of anger and so on and each of these need to be understood as symptoms rather than causes. The role of the medical professional should be to establish what the root cause of the depression is. This can be a physical cause such as changes in brain chemistry brought about be physical damage to the brain, changes in diet, changes in metabolism and so on, or psychological causes such as stress. Establishing the underlying cause of the condition is, in my opinion crucial to successful treatment, and also to preventing a recurrence of the condition. Without an understanding of the deeper significance of the condition how can a medical professional possibly hope to resolve the problem in the long term.

Once the underlying causes are properly understood, a process that can take a significant amount of time and effort, an appropriate course of remedial action can be taken combining treatment of the underlying cause and simultaneously reduction of the effect of the symptoms. I would agree that there is an argument that in treating the symptoms initially it is possible that it becomes easier to find the root cause, as there is a case that can be made that the symptoms can mask the cause, however in my experience this is often not the case, and more often once the symptoms are even in part addressed the patient is considered to be healed as a whole. To my mind this is just not the case…..