8 JULY - AUGUST 2025EUR PEEUR PEBy Dr. Nikki Scheiner, Consultant Psychologist & Founder, The Functional Symptoms ClinicThe Industrialization of Mental Health Care and Its Impact on Patient TreatmentMost of us are familiar with the question as to whether medicine is a science or an art. As a Consultant psychologist who has worked both in the National Health Service (NHS) and in Private Practice in the U.K., I often ask myself if the more appropriate question is whether medicine is an industry or a profession. This question is particularly apposite when considering the provision of mental health treatment.Mental health has long been the poor relation in healthcare in the UK, despite the Royal College of Psychiatrists' ongoing campaign for `parity of esteem'. Go to your local hospital Accident & Emergency with a broken leg and (admittedly, after a wait of some hours), you are guaranteed to receive treatment; if you go with a `broken' mind, you could be facing a delay of well over a year before receiving appropriate care. Who fares better: the individual on crutches or the person whose condition leaves them emotionally and psychologically disabled and immobile, unable to face the world? What criteria are we applying to assess `worthiness for treatment'?Paradoxically, even within mental health there is a lack of parity. Treatment provision for Functional Neurological Disorder (FND) - my own specialty - is unequal across the NHS, with some mental health Trusts lacking capacity to offer anything beyond a single session assessment. The disorder, which sits at the intersection of Neurology and Psychiatry, is characterized by physical and neurological symptoms which inhibit an individual's ability to carry out their daily activities. By the time that patients get to see a specialist, many have endured the indignity of being told that because there is no or insufficient explanatory structural pathophysiology, their symptoms are 'all in their head.' Diagnostic uncertainty and a lack of respect compound their distress - which has been described as comparable to that endured by patients with a severe and enduring mental illness.Inspired by the pioneering work of Mark Hallett in the U.S., and Alan Carlson and Jon Stone in Edinburgh, I wrote a group Recognizing Dr. Nikki Scheiner's expertise in psychology and her commitment to advancing mental health care, this piece explores her work in Functional Neurological Disorder (FND) treatment, the challenges within public and private healthcare systems, and the need for a patient-centered approach. Her insights shed light on the complexities of mental health care accessibility and the importance of reforming treatment models for sustainable, high-quality patient outcomes.MENTAL HEALTH CARE IN THE UK: A PROFESSION OR AN INDUSTRY? A CONSULTANT PSYCHOLOGIST'S PERSPECTIVEDr. Nikki ScheinerIN MY OPINION
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