Sophie

Brief Outline:

When she was 13, Sophie started feeling very low, tired, and had little motivation for friends, study or the things she normally enjoyed. She had some counselling through school and then through a GP referral. She found group counselling more helpful than individual counselling, and feels that local services could be improved by having doctors who specialise in mental health.

Background:

Sophie is at school and works part-time in retail. She lives at home with her parents. Ethnic background / nationality: White British.

More about me...

The first time Sophie went to see the GP on her own was around the age of 12 because she had whooping cough. She recalled that it was ‘really easy for them to tell what was up’ and so ‘it was all resolved pretty quickly’. Her later experiences, though, were more difficult – they put her off going to see GPs, but also built up her ‘resilience’ and made her more ‘adamant’ about asking for help.
When she was 13, Sophie started feeling really low. She constantly felt tired, lost motivation to see her friends or study, and didn’t enjoy doing things she normally liked. At first Sophie thought the reason she felt ‘quite down’ was because her sister had anorexia at the time. She realized that ‘it was something a bit more than that’, though, when her sister was getting better but Sophie’s low mood ‘wasn’t going away’. 

Sophie felt reluctant to talk about how she was feeling but confided in one of her friends, who suggested she talk to the school counsellor. Sophie hadn’t heard about the school’s counselling service and didn’t know what to expect. She recalled thinking that it was the only option available for mental health problems and felt disheartened and disappointed when she felt worse instead of better. The counsellor was friendly, welcoming, and ‘even though there was […] a massive waiting list, it felt like she was happy to make time for you’. The counsellor also made Sophie feel that ‘nothing was too small’ to talk about. Sophie felt that the counselling service should be more widely advertised and that all schools should ensure they have enough counsellors. She advised young people who were considering counselling to ‘give it a go’ but ‘don’t panic’ if it doesn’t help because ‘there are other things and you can be helped in other ways’.

Eventually, it was the counsellor who made a doctor’s appointment for Sophie after eight sessions. Sophie went to the consultation with her parents but, with hindsight, felt she would have preferred to go with a friend. She felt ‘bottled up’ and downplayed her feelings as she didn’t want to upset her parents. Sophie also felt that the doctor wanted to ‘get through the appointment’ instead of trying to understand and reassure her. The doctor asked Sophie to fill out a questionnaire, which she felt was generic and irrelevant. When Sophie told the doctor that she thought the questionnaire wasn’t for her, the GP suggested that she should come back in 4-6 weeks if she didn’t feel any better. 

Sophie visited the local surgery another 6 or 7 times. She saw a number of different doctors, all of whom advised her to come back if she didn’t feel any better. This made her feel that she wasn’t ‘ill enough’ to be taken seriously. Although she found it difficult to talk openly about personal things to a doctor she hardly knew, she felt that if the GPs had known more about mental health, they would have noticed that she genuinely needed help. In her final appointment, Sophie told the doctor that she wasn’t leaving until he referred her somewhere else, which is when she started group therapy through CAMHS (Children and Adolescent Mental Health Services). 

Group therapy helped Sophie realise that ‘no matter who you are, you can struggle with the same things’. The group consisted of people of different ages and backgrounds. She now finds it easier to talk about her problems with friends and family, feels that she has closure, and doesn’t need therapy anymore. When she feels down, she talks to other people or occasionally calls the Samaritans. She also used a phone app for practicing mindfulness, which she found helpful.

Sophie would like GPs to understand that young people ‘don’t just go for fun’ but because they want to be listened to. She felt that doctors should give young people time and space to talk but respect their boundaries if they find it hard to open up about their feelings. She believed that phone and email consultations might facilitate communication for people who find it hard to talk. 
For Sophie, local services could be improved by having doctors who specialise in mental health. She also believed that health professionals should provide more information on mental health organisations (including the Samaritans) and different forms of self-help (e.g. mindfulness) for patients who want an alternative to counselling or medication.

Sophie wanted young people to know that having mental health issues is not embarrassing and much more common than they might think. She advised them to talk about how they’re feeling and take time out for themselves. She advised parents to give their children ‘some space first and then they’ll come to you in their own time’.

Mental health problems affect a lot of people and shouldn’t be seen as embarrassing. It’s important to talk to someone and take time out for yourself.

I just wasn’t really myself; just feeling kind of quite down, that I was very tired all the time and I didn’t have any motivation to go and see my friends or to do any work, or even things like I normally enjoyed I just wasn’t enjoying them anymore. And it was kind of happening for so long. My sister was getting better but it wasn’t going away. 

And so that’s when I kind of realised it wasn’t primarily based on that. I think it just kind of triggered it and actually it was something a bit more than that. And so when I was feeling just really low, and yeah, just not myself, that’s when I thought, 'I'll go and see a counsellor.'

Yeah. Did anyone suggest it or it's something that came to your mind, or did you look on the internet or discuss anything with anyone, or you just didn’t feel like talking about it at that point?

My friends noticed I was really reluctant to talk about it with anyone, but my friends noticed I just like wasn’t really hanging out with anyone and I was…yeah I was just really reluctant to do anything. 

And so like I kind of confided in one of my friends – I was just saying I'm just not feeling good about myself, and she suggested…she said, "Oh I know someone else who's used a counsellor and maybe that will help you out." So, yeah, it was effectively from her who suggested it.

And can you tell me how old you were at that time?

Well I must have been around thirteen/fourteen I think.

Is there any message or advice you would give to someone who's thirteen/fourteen, feeling a bit like that, they don’t know what to do. So, you know, looking back, in hindsight, is there anything that you would suggest to them?

Yeah. I definitely would say like talk to someone about it. It's not embarrassing, you know, and it happens to a lot more people than you think. Yeah go and talk to someone about it, and also like make sure you're making time for yourself because I think it's really easy, in this day and age, to kind of get wrapped up in everything else and to be kind of completely overwhelmed in work and things. 

But make sure, you know, obviously try to do your work but actually make sure you take out time for yourself and you do actually give yourself a break. And try and keep yourself healthy and know that actually it's really important to do that. And kind of recognise that and just take out time for yourself, but talk to someone about it if it's getting bad.

It took courage for Sophie to go back to the GP and to say that she wanted a referral. It’s sad that it took so long to get help.

So after six or seven appointments and, you know, you felt that you weren't really listened to and the appointments weren't really helping in that way, what happened after that?

Well I basically [coughs]… well I went back; I left it quite a while. But I did eventually just go back and I did…it took quite a bit of courage but I just went back and just said, "You know what, I’m…" – to be fair I would have been quite an angry patient in their eyes, but I did just say to them, "You know what, I'm actually really upset by how you're treating me." And I said to them, "This may sound threatening but I'm not going to leave here today with you telling me again the same thing you’ve told me, and time and time again." And I said to them, "Look, refer me on to somewhere else because that’s what I've come for and you're not helping the situation by what you're doing." And so I think they kind of like, 'Oh god, we need to do something about that,' so....

So that’s a real…that took a lot of courage.

Yeah, yeah it did, and I think it's, you know, it's sad that it took so long to get to that place because, for a lot of people, I don’t think they'd be able to do that, so yeah.

So can you remember the GP, who it was, you know was it a male GP?

Yeah, it was a male GP, yeah. Yeah, I think he was quite taken aback by it, but...

Did he listen?

[Coughs] Yeah, he said, "OK, I hear you." And so eventually he did do something about it but I don’t think…yeah it's just sad that it took so long to kind of tap into that.

Sophie only goes to the doctors’ occasionally now for minor physical problems. For a while she went regularly until she was referred for group therapy.

I think I used to go a lot because, like now, I used to have like colds all the time and I think my mum thought it was, you know I had some kind of long term cold or something. But yeah I remember going with them. Yeah it was, it like, seemed pretty normal then, so....

And then going forwards can you remember other appointments as you got older?

Yeah I went …I kind of…yeah I use it normally so not that often. And then for a while I ended up going quite a bit because they kept turning me away and I kept going back. But now I'm just kind of using it less regularly, so....

So, at one point, you were going quite regularly and they were turning you away?

Yeah.

Can you remember what was happening at the time?

Yeah basically it was…this must have been about like three years ago – I'd been referred to my GP from the counsellor at school. But they said I didn’t…I wasn’t kind of high up enough on the list to be referred to CAMHS [Children and Mental Health Services]. And so they basically said come back in, I think it must have been about four/six weeks. And so I'd go back and like I still wasn’t feeling well but they kept doing the same thing, like they'd just be like, "No, we don’t think anything's wrong with you" and turn me away. 

It was…I think it was mainly just because I struggled to speak to them about how I was feeling and so they kind of took it as though you don’t really need to come here. So I ended up going about, it must have been about six or seven times before they actually did something.

It didn’t help when Sophie’s parents went to the appointment with her. It was hard talking about her feelings when she wasn’t ready, and hard to talk to a GP she hardly knew.

When you went to see this GP, did you go by yourself?

No, I went with my parents which was, yeah difficult because I hadn’t been talking to them that much about it so it kind of…

So you went with both your parents?

Yeah.

So it's…how did you feel before the appointment, do you remember?

Yeah, I was really like…I was quite distressed really. Yeah, I didn’t think it helped that both my parents were there. So I was pretty stressed and I was also…I think I was just kind of upset because I don’t want…I wanted to tell them but I didn’t want them to have to find out in that way I would have much rather kind of sat down with them at home and explain things. But it kind of felt like, not that it was forced upon me, but that was just the way it was going to happen whether I liked it or not. So.... 

Would you have liked to have gone to see the GP by yourself? Or with a friend?

Yeah, I think, I think had I gone by myself I think I would have probably just got really upset and I think it would have been quite nerve-wracking for me. But yeah, I think probably with a friend would have been better because, yeah as I say, it was just really difficult for my parents to find out in that way.

So…do you want a break, do you want some water?

Yeah, I might just blow my nose actually.

So, you went to the appointment with your GP, and I think you mentioned earlier that you found it difficult to speak about your feelings. Was it partly because your parents were there or were there other things as well?

Yeah, I think it was probably mainly that my parents were there. But also it was really difficult because I was speaking to the… this person that I'd only met like five minutes ago or so, and you know telling her quite personal things really. I just found that quite difficult, and so I think that was why I was…it was just really difficult for me to speak to her. 

Sophie felt that the GP ‘knew nothing about mental health and she was kind of showing that quite clearly’. The questionnaire seemed to be aimed at children.

I found it difficult because I felt like she knew nothing about mental health and she was kind of showing that quite clearly. And also, even though I was really upset, you know because I wasn’t, you know crying, it would have been nice if she'd attempted to comfort me maybe. Or said, you know, "If this isn't right for you, then we don’t have to talk about it." And that kind of thing. 

But it was kind of a way of she wanted to just pile through it and just do it like any other appointment which, I don’t know, it wasn’t…it wasn’t all that kind of her to do I don’t think. So I’d say it would…people would just really, really appreciate it if you were much more kind of slow and understand like and.... You know if someone is upset, just like with any other illness you'd, you know be a bit, kind to them. You wouldn’t want to upset them even further so....

And you mentioned that it was obvious she didn’t really know much about mental health.

Yeah.

What kind of things gave you that impression that…?

Well she…the first kind of thing she did was she did this…it was like a kind of questionnaire thing on her computer, which was obviously some kind of…like she hadn’t even really spoken to me about it. And it was obviously some kind of generic mental health questionnaire. And it just kind of asked the oddest questions about things like, 'Do you sleep with a teddy bear at night; do you…' like really bizarre kind of questions. And it seemed like it was really aimed at a child or, you know, someone much younger. So yeah it was that. And then when I kind of said I don’t think this is right for me, she was just like, "Well I don’t know what else to do with you." You know, I don’t know – you can only take so much from that really so....

Sophie feels that it would be helpful to have more information in GP surgeries and elsewhere about the confidentiality of doctor’s appointments.

Did you feel that you could trust the GP, that what you were saying was confidential?

Yeah and no. I think for a lot of young people it's very unclear about what's confidential and what's not. And whether they use it to tell your parents if you're under sixteen, and that kind of thing. So, to be honest, I wasn’t really worried about it but I think for a lot of young people they do get very confused about whether it's going to be kept confidential or not.

So more information even in surgeries?

Yeah…[talked together] Yeah, literally just some information to tell you whether or not it will be confidential.

Sophie didn’t know what to expect of counselling and felt it wasn’t for her. She wishes she’d known that counselling was only one of several options for depression.

The first time I kind of chatted to her [the counsellor], yeah, she was a very kind of like welcoming and she arranged an appointment with me. But because like my school is quite big and, because there were so many students, she had a waiting list for, I think it was like four weeks. So that was a bit disheartening because obviously you want to be seeing someone quite quickly. 

So, yeah, that was kind of disappointing. So I think, you know, the schools need to be making kind of like a conscious effort to make sure that they’ve got enough counsellors for the amount of students they have. 

So, yeah, that was the first time I'd ever met her, but then… yeah my first appointment. I mean it's difficult because it was… like counselling isn't for everyone and it's just kind of one way of, you know, being helped. And so I think at first I… I didn’t know what to expect. I didn’t really know how to respond because I… in my head I thought that’s the only way, like that’s the only kind of form of treatment really, where obviously I was really wrong. But so when it…when I found it wasn’t all that like effective for me and I just felt it was kind of just bringing up problems that I just didn’t want to be talking about. 

I felt it wasn’t, it wasn’t really working for me but I…I think I should have known that there are other ways and it was alright if it wasn’t working for me. But, so yeah, I mean they were good in the sense of it was good to be able to have a space to talk to someone and know that if I did want to speak to her I could. But at the same time I think it was… it was difficult because it did feel a bit like it was either that or nothing, so yeah.

Talking to ‘really understanding’ people at group therapy helped. Sophie now finds it easier to talk to friends and family too when something’s wrong.

It was held in I think it was…it was like a mental health centre. I think it must have been about like twenty miles away from my house. I got the bus there. And it was…my first appointment I was…I was kind of nervous because I had no clue what to expect. But it was really friendly, really welcoming, and there were about seven or eight of us I think. And we did literally sit in a circle and we introduced ourselves. And there was two…two, no, three specialists there who were kind of, you know, encouraging us to speak and stuff. And I think it was just…it just worked really well in the sense of it was the first time I felt that I wasn’t alone in it and that there were other people out there who were kind of needing the same kind of treatment as I was.

So that was the group therapy; did your parents know?

Yeah, yeah.

And you went there. Was it mainly people of your age group, or different age groups?

Different age groups yeah that you…I think I was…I wasn’t the youngest but I was the second youngest and there were some older people there too.

So older people as in over twenty or something, over thirty? 

Yeah, yeah, which I was surprised about because I thought, because it was through CAMHS [Children and Mental Health Services], well I thought it was through CAMHS, but it turned out I…if I wanted to do a CAMHS group therapy, I would have had to do a different thing. But I didn’t…I wasn’t fussed by the fact that it was…I thought it worked well because it was different age ranges – I thought that worked really well.

So, when you say different age ranges, so people…well you were the second youngest?

Yeah

And then were there people over forty/fifty/sixty?

Yeah, I think no-one was…probably no-one over sixty, but yeah I'd say like there were some middle aged people there.

And you said the age group and the age difference – that helped?

Yeah [coughs]. I think it helped because it did just show that no matter who you are, you can struggle with the same things, you know, whatever your age you still might struggle with the same thing so.

And you said it helped you feel that you weren't alone.

Yeah.

So the very first time you went there, did you notice a difference at all in how you were feeling?

Yeah, it made me much more kind of open in the sense of I didn’t know these people but they were really understanding. And it kind of made me think that I was able to speak to other people in my life because, you know, they’ll probably be just as understanding. So, yeah, I think it really made a difference in that sense and the fact that I was…I then felt that way and the more I talked about it, kind of, the more people understood that it made things a lot easier.

Talks in assemblies and posters around the school would help people know who the school nurse is and what she does.

Well I think she [school nurse] could have been much more kind of welcoming and understanding. So yeah I think that would have been the first thing really because her tone was quite like she…I don’t, I don’t know whether she…if she really meant it like it, but it felt like she was kind of just looking down on me for coming to her for that reason. 

But, yeah, I think it would have helped if she knew more, or just yeah, even if she didn’t know personally information, she could have directed me on where to go because I think it's really important that, you know, people know about these things, so....

And a few people that we've talked to have talked about the school nurses at school.

Yeah

Is there any message or advice you could give to school nurses all over the UK, in terms of how they can be good as school nurses for young people?

I'd probably say I guess a lot of them, their main thing that they come across as just kind of general kind of in-school health concerns, I feel ill/ I need to go home. But I think it would be really appreciated if they could do more on kind of long term mental health. And so, even if you have like a student in school, make yourself known to them if you’ve got a student in school that maybe has mental health issues. Make yourself known to them that you're kind of a place to go if you're feeling not right, or if you do want to go home, that kind of thing. 

So yeah, like it would be really, really appreciated if they could kind of clue up on mental health especially like long term mental health.

So much more information.

Yeah.

Knowing who in the school it might be worth talking to so that they can then come and see them if they feel like it?

Yeah exactly, yeah I think that would be good.

How can they best get this information out in schools – do you think it’s worth having talks in assemblies or in classes or certain lessons? How do you think the schools could do better to get this information out?

I think, yeah definitely, I know in my school it was kind of a case of you never saw the school nurse unless you were in the room with the school nurse. So I think it would be good basically if they just made their face known, and made their role known so we all kind of knew that she was available if we did want to go and speak to her and that kind of thing. 

So I think that, but also just, yeah every now and then speaking to students maybe; yeah maybe through assemblies but also maybe some posters up round school saying that she's available for anyone if anyone wants to go to chat to her.

When Sophie had mental health issues, getting an appointment was easier than finding a GP she could open up to. Good care is more important than extended opening.

If you do need to go and see someone Saturday and Sunday, then it would be good to, but actually when you think about it, if you're…if you're going to be waiting three weeks anyway, you can wait those extra two days, that kind of thing. But also I think in my case it wasn’t really a case of timing it. It was a case of the quality of it, and so improve the quality first before you extend the opening hours of a GP's surgery.

That's a really good point. So improve the quality?

Yeah, because otherwise I think the more you have the GP's surgery open, if it's not providing good quality care, then it's just going to stretch it even more and make it even worse, and so there's...that's just a really kind of daft way to go about it, so make sure…you know, speak to the patients and speak to people who have been through the experience, and speak to how they feel. Do they want a seven day a week open GPs surgery. For me that’s definitely not my priority when it comes to improving GP's surgeries.

The Samaritans were very helpful when Sophie wanted someone to talk to about her feelings.

What did you do then because you'd been put off going to the GP?

Yeah. Well I used…like my friends a lot, my family a lot tried to talk about it a lot. But also I found, yeah as things kind of came more popular on the internet, things like the Samaritans, of which I found really useful.

That’s really, you know helpful what you're saying.

Yeah.

So someone else who's in a similar situation, what would you…how would you say that the Samaritans have been helpful?

Well it's really just a case of like, when I was going to my GP it was because I…there was someone I wanted to talk to about my problems and I didn’t know how to go about kind of finding the solution. 

And so with the Samaritans and other things like that, it's just really good to know that there's someone always there like at the end of the phone. And, you know, you can say whatever you want to them and it's…yeah, they’ll talk to you. And if you just need a voice to talk to, it's really good.

So two things that you’ve mentioned a bit earlier is talking over the phone.

Yeah.

Because they don’t necessarily need to see anything.

Yeah, yeah.

And someone who knows a lot more about mental health problems and things like that, which you felt your GP didn’t.

Yeah.

Those things really made a difference then?

Yeah, definitely.

It can be hard to talk to parents about mental health. It helps when they understand and accept that you might talk to your friends first and to them later.

Any advice you want to give to young people?

Yeah, I just always say, always talk to people and yeah, you're never alone in these situations. And, yeah, it's not odd or strange the way you're feeling so, yeah, talk to people about it.

And to parents?

The understanding of your child; if they are struggling to speak to you about it because it's really difficult. So, be understanding if they don’t come to you straight away, if they go to their friends…if they go to their friends first. But yeah, you know, I think as, you know, parents just want to…what's best for their children and so just make sure you give them some space first and then they’ll come to you in their own time.