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Private Mental Health Care or Public Health Service? How to Decide

private mental health care

By: Victor

The rise of Skype therapy now means that booking private mental health care is more accessible and affordable than ever.

But the NHS (public health care in the UK) still provides a good service to many people.

What are the main differences you need to know between public and private mental health care?

Private mental health care vs NHS counselling 

The main differences between a privately booked therapist and one booked through the national health service (NHS) are around:

Here are good questions to ask yourself before you book private mental health care or call your GP.

How fast do I need help?

Private counselling can be very fast. Assuming your preferred therapist is taking clients, you generally will be offered a session within a week or so. 

(Our new site can see you talking to a registered and qualified therapist within 24 hours).

Depending on your area, NHS counselling for things like anxiety and depression can be quite a wait. Some boroughs in London report waits of up to or even over a year for in-person sessions.

How much am I willing to pay for therapy?

The main benefit of going through the NHS is, of course, the free price tag. But if you need help now, then waiting months for free therapy can actually end up costing you.

Being depressed or anxious can mean you overspend money to feel better, don’t manage to find new clients for your business, drop out of school after paying tuition, or even lose your job. So in some cases getting help you pay for saves you a lot in the long run. It’s worth thinking through – read our article “How Therapy Can Make You Money“. 

There are also various ways to find therapy to suit your budget. Skype therapy is often cheaper, or you can find low cost counselling with a trainee therapist. And do check your work insurance policy to see if any sessions are covered. Read our article ‘Free and Low Cost Counselling” for more.

Do I want a good therapist? 

This one has nothing to do with whether a therapist is private or through the NHS. In fact many therapists work both privately and with NHS clients. So you’ll find some truly great therapists within the NHS.

How many people do I want to go over my issues with?

With a private therapist, you go through your mental health history just with him or her.

With the NHS, you might have to talk through your mental health history with several people. First you discuss things with your GP. Then you receive a call from a mental heath practitioner who takes your entire history over the phone. If you are lucky enough to be offered a therapist, he or she will need to hear the whole story again.

On a good note, you can avoid some of this palaver if your area is covered by the self-assessment services the NHS has been rolling out. Applying can be as easy as filling out a form online. Try putting your post code into the NHS IAPT tool, which will pull up all mental health services in your area, clearly stating which ones can be self-referral.

Do I think a self-help course might be enough to help me?

If you feel you are only struggling with mild depression or anxiety  and decide to use the NHS, you might be offered a free online mental health program instead of sessions with a therapist. This means you work through a series of exercises on your own time and tend to have email access to a mental health professional.

These free online mental health tools and self-help courses have been shown to be effective. And they are something you can be offered with little to no wait time. They might be perfect for you, especially if you find the idea of talking to someone intimidating. 

How much do I value my privacy?

All therapists, whether booked privately or through the NHS, respect your privacy.

But sometimes with the NHS you are required to go to an ‘introduction session’ after your phone assessment. This will be held in a public health space such as a room at a local health centre and you’ll be placed with other members of your local community also seeking support. If you like privacy, this can be an issue.

What do I want on my medical record?

Nobody has the right to access your medical records without your consent, barring if you make an insurance claim. So yes, with the NHS it all goes on your record, but it should not cause problems.

But if the thought makes you anxious, then rest assured that if you book therapy privately it does not go on your medical record. The only reason it would would be if you booked with a psychiatrist and decided to go on medication. Most psychiatrists want to confer with your GP about this.

Do I want to choose the type of therapy I try?

private mental health treatment

By: Alon

If you book privately, you can choose any type of therapy you want. .

The NHS, on the other hand, will give you the type of therapy they feel best. And they tend to use a limited variety of therapies, veering toward shorter-term, cost effective therapies, like cognitive behavioural therapy (CBT).

Do I want to choose the therapist I work with? 

With NHS counselling, you are assigned to a therapist. But with private therapy you are in charge. If after several sessions you decide a therapist isn’t for you, then by all means find another one.

Do I think I need medication?

A counsellor, psychotherapist, or counselling psychologist in the UK does not have the power to prescribe medication. If you need medication you will be referred to a psychiatrist. Even if you book a psychiatrist privately, they usually want to contact your GP and let him or her know you are taking medication.

Is the mental health diagnosis I think I need recognised by the NHS?

The NHS does not easily recognise all mental health conditions like, say, America. A key example here is adult ADHD. While treatment on the NHS is now available, getting to it is notoriously difficult. Many GPs are still loathe to recognise adult ADHD as a real problem and might simply refuse to refer you one of the limited ADHD psychiatrists or centres available. The waitlists are extremely long, and there is no self-referral.

How long do I want to be in therapy?

Again, the NHS veers towards shorter-term therapies. If you feel you want to be in open-ended therapy that finishes when you decide you are ready, or want to try a long-form therapy, then private mental health care is probably the way forward.

In Summary…

The NHS is a great resource for many people and it is wonderful it exists. But if you can afford it, private therapy does offer more options and privacy.

Remember that the most important thing is that you DO reach out. 

If you feel the NHS can provide what you need, and you have the courage to speak to your GP, then you can always get yourself on a waitlist and seek a private therapist in the interim. You can then decide when a NHS therapist is offered if you’d rather make the switch.

Harley Therapy now offers therapy for all budgets and all locations (anywhere in the world via Skype and phone) on our new sister site, Why not see if it is a fit for you? 

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    Dr. Sheri Jacobson


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