Mental Health Challenges in the U.S. vs. the U.K.

Source: Paul Townsend/Flickr

I’ve just returned from a wonderful stay in London and Ireland, having had the opportunity to train mental health professionals who were eager to learn and absorb “trauma informed” theory and treatment strategies.  The welcome I received was more than kind. The British were anything but “reserved.” They were enthusiastic, had a great sense of humor, and couldn’t bring me cups of tea fast enough.  The Irish were equally wonderful, asked sophisticated questions, and laughed heartily.  Traveling abroad and meeting and training clinicians who are so interested in growing professionally is always an honor. I was struck by the number of participants who carried their own biographies of trauma, many of them holding the intergenerational wounds of World Wars or The Troubles in Northern Ireland.  And yet, they were so committed to making a difference in the world, to help heal the unmetabolized trauma that still permeates their cities.

The Challenges for Mental Health Professionals in the U.K. and Ireland

In England, it was jarring to discover the limitations that mental health professionals are up against.  The only truly acceptable modality is CBT.  Although counseling is paid for by the government it’s extremely brief: typically six visits. I encountered so many psychologists who were desperate to be trained in right-brain based expressive modalities.  Some of them were learning body-based therapies on the side, but they all lamented the fact that their care managers would not support the use of those strategies and their notes needed to reflect the CBT model.  Since government supported counseling services are free it’s nearly impossible to do private practice. Those who do must keep their fees extremely low, so making a living is difficult.

In Ireland, there was surprisingly more freedom regarding treatment models and a greater acceptance about incorporating creative techniques into the work.  However they shared that client-therapist confidentiality has been challenged by the legal system and the content of therapy sessions is not protected or considered confidential.   Clinicians here are up against an extraordinary amount of communal trauma and many of them lamented the lack of resources.  And in both countries, the only recognized, licensed clinicians are Psychologists, not Social Workers. Anyone else can put up a shingle and practice, but the quality of care is not monitored and many people have therapy experiences that re-traumatize them.

There’s No Place Like Home

Although clinicians in the U.S have legitimate gripes about paperwork, and the complications that insurance companies and agency red tape can create, I felt so grateful for the vast array of training opportunities that exist here, for the many freedoms associated with private practice, and the ways in which our licenses seek to promote and protect high practice standards. In the UK and Ireland, I clearly felt a strong, deferential respect for America and our clinical models.  Although the grass was definitely a brighter shade of green in Ireland- meeting clinicians and other mental health professionals in other parts of the world reminds you that there really is no place like home. It made me very proud of my colleagues here, and proud of our ongoing mission statement at The Ferentz Institute: to keep bringing you new and creative training opportunities!

6 thoughts on "Mental Health Professionals: The Grass Isn’t Greener on the Other Side"

  1. Jill minsky says:

    This was very enlightening! Thank you for sharing your experience. Sometimes I have wondered if their government based health care system is a better choice. You have posed one of many draw backs I’m sure.
    Thanks Lisa!

    1. lisaferentz says:

      Jill, I think your curiosity about the efficacy of national health care is felt by many. And many people assume it must be better than what we have in the US. After talking to a diverse group of clinicians, I was so struck by the ways in which they experience national health care as limiting, rigid, and not serving the best interests of trauma survivors at all!

    1. lisaferentz says:

      You’re most welcome Donald.

  2. Pamela R. Weissman says:

    I loved this lisa. Appreciating what we have is
    In and of itself therapeutically sound. I am also happy that you and those you trained in Europe had
    the opportunities you describe to share and to study
    together even amidst some clearly very striking
    contrasts amongst our countries.
    Yup no place like home. In this era of divide
    ness your post was most refreshing.
    In appreciation,
    Pam Weissman,LCSW-C

    1. lisaferentz says:

      Thanks, Pam! I really love your insight that it’s therapeutic to appreciate what we have- it speaks to the healing power of gratitude. Although London is one of my favorite cities, Ireland found a place in my heart, and I completely fell in love with the people, I did feel proud of the work clinicians do in the US and came home with a newfound appreciation for the opportunities we have as clinicians to keep growing professionally and creatively!

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