Can I Access OCD Treatment Through The NHS?
National Health Service (NHS) is the UK’s most popular health website with over 50 million visits each month.
Obsessive-compulsive disorder (OCD) is a universal anxiety condition, which means no one is immune from it. And, while OCD may manifest and be treated in various ways, the most common treatment approach involves a combination of cognitive-behavioral therapy (CBT) and exposure-response prevention (ERP) therapy, along with medication (i.e., SSRIs), hypnotherapy and hypnosis, lifestyle changes (i.e., a healthy diet, proper sleep, and regular exercise), and self-help tools (i.e., yoga, stress-management techniques, and/or online OCD treatment programs, like Impulse Therapy, which are designed to restore your health and well-being).
This OCD treatment protocol is not only common in the U.S., but also in England and other countries. In fact, in England, Wales, Northern Ireland, and Scotland, CBT is usually the first-line treatment for OCD, according to NICE guidelines. However, accessing CBT through NHS can be complicated, challenging, and confusing, especially, if these countries take different paths to OCD recovery.
It does not matter if you are struggling with OCD or supporting a friend or loved one with the condition, NHS mental health system can provide you with resources and support as you address your OCD needs. Although accessing OCD treatment through NHS can be tricky, this agency can be extremely beneficial for people struggling with OCD.
The key to success is finding the right OCD therapist – a mental health professional, who can help you better understand the origin of your OCD symptoms, help pinpoint your OCD triggers, alter your thought patterns, and teach you healthy coping skills and strategies, so you can reclaim your life.
If you would like to learn more about accessing NHS OCD treatments, you have come to the right place. This article will explain how NHS can help you get a grasp on your OCD symptoms, so you are no longer plagued with endless obsessions and compulsions.
How Can I Get Help with My OCD?
Feelings of shame and guilt can prevent people, throughout the world, from seeking OCD help. People in the UK are not excluded. The best way to look at OCD is to view it through the lens of other health conditions.
In other words, OCD is a mental health condition that requires assessment, diagnosis, and treatment – just like a physical health condition (i.e., hypertension, diabetes, lupus, asthma, etc.). So, there is nothing to be embarrassed about. You are not “tainted,” “insane,” or “deviant” because you suffer from a “condition.” You are also not to blame for it.
So, how can you get the help you need to manage, reduce, or eliminate your OCD symptoms?
Well, listed below are two main ways you can receive treatment for your OCD symptoms:
- Self-Referral – NHS allows you to “refer yourself” for psychotherapy. If you are wondering how to find an appropriate NHS therapist, click here for psychotherapists in your area.
- General Practitioner Referral – NHS accepts psychotherapy referrals from general practitioners.
If you think you may have OCD, share your concerns with your doctor. Understand that OCD will likely not get better without the right OCD treatment, support, and resources.
What is NHS?
NHS offers the following services:
- Doctor or nurse visits
- Surgeries and follow-up visits
- Modern treatments for injuries, chronic conditions, and illnesses,
- Midwife services for pregnant women
- Urgent care services – i.e., ambulance services for life-threatening injuries, conditions, and/or illnesses
People in the UK often refer to these health services as “free at the point of use or delivery,” which suggests that any UK resident can, for instance, visit his or her doctor without having to pay for the service during, and sometimes, even after the visit. NHS is “publicly funded,” which means the government has set aside money to pay for any health services (i.e., surgeries, doctor’s appointments, etc.). The funds for these services come from the taxes collected from UK residents.
NHS provides free health care at the time of service. However, there are minor variances in what services are “publicly-funded,” and which ones are easily accessible in the various UK countries. For instance, NHS England requires some residents to partially pay the cost of prescription medications, while Wales, Scotland, and Northern Ireland are “fully-funded” by the government.
What is NICE?
The National Institute for Health and Care Excellence (NICE) is responsible for developing and publishing health and social care guidelines for practitioners and mental health providers. These guidelines not only cover a variety of conditions and treatment methods but also offer valuable tips and evidence-based recommendations to UK residents.
Although these guidelines primarily apply to England and Wales, they are often also applied to Scotland and Northern Ireland health services, because these countries do not have “official” OCD treatment guidelines.
NICE guidelines are considered “best practice,” however, critics suggest that approximately 25% of general practitioners do not consider these guidelines relevant or beneficial for mental health conditions like OCD. Keep in mind that these guidelines are not legally binding, however, dismissing or ignoring them is considered “medical negligence” by those in the medical field. Still, the decision to use or not use them falls on the experts.
What does this mean? It means that NICE guidelines are straightforward in what services should be offered, how patients or clients should be treated, and what should happen if there is a disagreement between a doctor and a patient or client. For instance, when a doctor and patient are unable to agree on an OCD treatment plan, there must be medical evidence to support one theory or the other. Personal opinion does not matter in these cases.
Fortunately, the NICE guidelines for OCD are in-depth and clear, so that practitioners and mental health providers can develop a treatment plan that will help you better manage your symptoms. You can take these guidelines with you to your appointments to show your doctor what you would like to happen.
What if my doctor refuses to follow the NICE guidelines? Well, the next step should be to ask for a copy of your medical records. Then, you should seek a second opinion from another practitioner or mental health provider.
Inform your doctor that you would like him or her to notate that you asked for a NICE-recommended treatment, but were refused. Also, ask your doctor to document (step-by-step) why the particular treatment was denied.
If your attempt to get your desired treatment is unsuccessful, make a list of reasons this decision is “appealable” and contact NICE. A NICE specialist can offer you support as you craft your argument(s), and provide you with contact information for the relevant people on your case. NICE specialists can also provide you with beneficial resources and tools to help you navigate the legal and healthcare systems.
What Types of NHS OCD Treatments Are Available?
There are a host of effective OCD treatments on the market that can reduce or eliminate OCD symptoms, such as:
- Psychotherapy – Psychotherapy, sometimes referred to as “talk therapy,” usually involves cognitive-behavioral therapy (CBT). The CBT is to embolden you to confront your obsessions – i.e., intrusive and illogical thoughts, fears, doubts, mental images, urges, etc. The premise of CBT is that when you can change how you “perceive” or think about a situation, your behavior changes (compulsions).
For instance, if you alter the way you see bacteria (changing it from something that is always deadly to something that can sometimes be beneficial – i.e., probiotics, it may help curb your compulsive need to scrub everything in sight, including your body, to avoid “contamination” or becoming ill.
- Medications – OCD medications typically consist of antidepressants, like selective serotonin reuptake inhibitors (SSRIs). SSRIs (i.e., Luvox, Prozac, Zoloft, etc.) impact your brain function by “evening out” your brain chemistry.
Note: While CBT tends to work fairly quickly, it may take longer to see the positive effects of SSRIs (between 4-8 weeks). If SSRIs are unsuccessful in controlling your OCD symptoms, your doctor may prescribe an alternative medication (an SNRI or tricyclic antidepressant) or he or she may combine medication with therapy.
Can NHS Treatments Help My OCD Symptoms?
Yes, they can!
NHS in England recommends CBT for OCD symptoms. As previously mentioned, this recommendation stems from the NICE guidelines. NHS can provide treatment and support for a variety of conditions (including OCD), procedures, tests, labs, and services. However, keep in mind that accessing OCD treatments, like CBT, through NHS can be a complex and time-consuming health care option. For instance, in England, Clinical Commissioning Groups (CCGs) manage NHS’s healthcare services, including mental health ones. Currently, there are over 195 CCGs in England.
How Can I Access NHS Treatments for My OCD Symptoms?
There are two primary ways to routes to access OCD treatment (CBT) through NHS in England – general practitioner (GP) referrals and “self-referrals.”
The first path (GP referral) usually involves receiving a referral from your general practitioner, who in turn, will refer you to an OCD specialist at your local “Improving Access to Psychological Therapies (IAPT). Once this occurs, you are in the hands of IAPT, in regards to your OCD treatment plan and waiting times.
The second path involves referring yourself to IAPT (this is only available in England. “Self-referrals” do not require you to consult with your doctor before seeing an NHS-based IAPT OCD specialist.
Path 1: General Practitioner (GP)
Although researchers and doctors are gaining a more in-depth understanding of OCD and its treatment, many general practitioners (GPs) and mental health providers are still unable to recognize many OCD symptoms. On top of that, many GPs are also not quite sure how to treat the condition. Therefore, it is important that you clearly articulate that you believe that you have OCD and that you would like a treatment plan that includes CBT and/or exposure and response [ prevention (ERP) therapy.
Medication, on the other hand, is usually not a first-line OCD treatment, however, it is sometimes used with therapy, lifestyle changes, and self-help tools, and sometimes without it. Take note that there are long waiting lists for NHS OCD therapy services. If you encounter a long waiting list, you can opt for a medication (SSRI) while you wait for counseling. The hope is that the medication will keep your OCD symptoms at bay while you feel wait for counseling.
Note: Before receiving any type of OCD treatment, it is important to consider ways in which you can properly prepare for the therapy process, and review potential OCD treatment barriers. Moreover, if you believe that your child or teen has OCD, your child’s pediatrician will refer you to your local Child and Adolescent Mental Health Services (CAMHS).
Path 2: “Self-Referral”
Path 2 involves a “self-referral.” As mentioned above, your local Improving Access to Psychological Therapies (IAPT) is responsible for providing NHS-based OCD therapies for UK residents. NHS and CCGs instruct providers to offer IAPT to local UK residents. IAPT was formed to give people more access to psychotherapies (i.e., CBT, ERP therapy, etc.) for UK residents struggling with mood disorders like depression, and anxiety conditions, like OCD.
Many UK patients or clients can “refer themselves” to their local IAPT, eliminating the need to go through their general practitioners (GPs) to see an NHS OCD specialist or therapist. Many clients and patients find this option reduces the wait times to see a doctor, receive OCD medications, and schedule and have surgeries or procedures.
It is also beneficial for patients or clients who live in rural areas and have limited access to GPs. “Self-referrals” allow UK residents to bypass their GPs to receive doctor appointments, surgeries, tests, and/or other OCD treatment services. Once you refer yourself for NHS-based IAPT, you should receive a variety of OCD treatments, including CBT.
Paths: 1 & 2
Once you have been referred yourself or been referred by your GP, the treatment path is the same, for instance, you will likely receive OCD therapy (CBT, ERP therapy, etc.), and/or antidepressants.
What Happens Once NHS Treatment is Over?
Well, that is when the process becomes a little trickier, and a tidbit controversial.
Many NHS patients and clients receive between 6 and 18 therapy sessions, and while this may work for some people with OCD, for others, it may be insufficient.
If you believe that you need more IAPT (CBT or ERP therapy) sessions than what you have been offered or received, you should take the following steps:
- Ask for more NHS-based IAPT sessions within the same IAPT with the same OCD therapist or a new OCD therapist
- Ask for an OCD secondary care services referral
However, some OCD sufferers are reporting that they are being told that are either ineligible for additional IAPT services or they must wait at least 12 weeks before re-entering IAPT for OCD. According to OCD-UK representatives have asserted that all NHS treatment providers must follow NICE guidelines (up to 10 hours of therapy).
Does NHS Offer Any Other Services?
Yes, NHS also offers secondary care services and tertiary national specialist services.
Secondary Care Services
Secondary care services require a referral from a GP or IAPT. Unfortunately, however, being referred to secondary care services can disrupt the continuation of your care. This can happen when your GP believes that you will benefit more from this level of care. In this case, your GP will directly refer you for secondary care services.
Secondary care services resemble conventional OCD treatments with one major difference – these services are typically consultant-based services for mental health conditions. You can also receive other services, such as additional OCD therapy services with a psychologist, medications from a psychiatrist, and access to other OCD resources, medical facilities, and tools. Furthermore, secondary care services tend to be less restrictive, than primary care, allowing you to address your OCD symptoms at your own pace.
However, for a small number of patients and clients, secondary care services are not enough to help them effectively manage their OCD symptoms. These OCD sufferers are then referred to tertiary services. Tertiary services typically involve English OCD treatment clinics, designed to provide a wide range of specialized inpatient and outpatient NHS treatment services.
You can access these specialty clinics by contacting your local CCG for a referral or by fulfilling the national clinical criteria and asking NHS England for a referral and help with services. If you go the NHS route you will not have to ask your local CCG to pay for your OCD treatment services.
If you are referred for tertiary services, you will be given or sent information on specialty OCD clinics (i.e., where they are located, what their services entail, and payment options). Keep in mind that these services and clinics are assigned according to individual OCD needs. The two most common tertiary services for OCD treatment are the Centre for Anxiety Disorders and Trauma Clinic and the Anxiety Disorders Residential Unit Clinic.
Can I Choose My NHS OCD Therapist?
In England, patients and clients have the right to choose their OCD treatment provider (not the actual OCD treatment, but the NHS OCD treatment provider).
Many OCD-sufferers find this beneficial for the following reasons:
- OCD treatments are closer to their jobs (than their homes), so they can go directly to treatment after they get off work.
- OCD patients and clients have access to higher-level specialty OCD treatment clinics and typically have to wait a shorter time to see an OCD specialist.
Note: To assert your “right to choose” your OCD specialist or therapist, you must not already be receiving OCD treatments and you must not be a “self-refer.” In other words, you must go through your GP for an NHS-based OCD therapist referral (for both primary and secondary care treatment services).
Are There Any NHS-Affiliated OCD Support Groups That Can Help Me with My OCD Symptoms?
Yes, there are!
The truth living with OCD can be overwhelming and confusing. So, attending an NHS-affiliated OCD support group may be what you need to get a grip on your OCD symptoms.
Listed below are several NHS-Affiliated OCD Support groups for UK residents:
Are There Any Self-Help Tools That Can Support My OCD Treatment Plan?
Yes, a variety of self-help tools can support your treatment plan.
These self-help tools may include dietary changes, natural remedies, herbal and vitamin supplements, proper sleep, regular exercise, stress-management techniques (i.e., deep-breathing, yoga, hypnosis, mindfulness meditation, and online OCD treatment programs, like Impulse Therapy).