Why I fear a new children’s book about Princess Diana’s fight against bulimia could be harmful, writes Mind Doctor MAX PEMBERTON

A record number of people are not working because of ill health. Figures from the Office for National Statistics show that over 2.5 million people are on sickness benefits, meaning one person for every 13 workers is on long-term sick leave.

That’s an increase of nearly half a million since the start of the pandemic, which has been attributed, at least in part, to a higher number of people with mental health problems.

Most people with mental illness are not seen by specialist services. Instead, they are managed in primary care, which puts tremendous pressure on GPs to diagnose, treat and treat people.

However, the way this is done is often not ideal. Some services offer CBT (cognitive behavioral therapy) to treat patients with less severe mental illness and get them back to work. But while they used to see people within a few weeks, they are now overwhelmed and waiting lists are growing.

Under new government proposals, GPs will be encouraged to refer people to life coaches rather than signing them off in an effort to tackle the rising number of sick people.

Now I fully support the idea of ​​trying to reduce the number of people who are out of work for medical reasons – it cripples the economy and means people are not reaching their full potential. We know that the longer someone has been on benefits, the harder it is to get them off. But prescribing life coaches is just wasted money.

Most sick people with mental health problems have depression or anxiety, and life coaching is not a recognized treatment for this. I don’t think it’s a treatment at all.

This feels like a silly policy devised by someone who knows little about how to treat mental health issues.

People who aren’t feeling well don’t need coaching on how to live – and if they did, there are plenty of life coaches out there giving free advice on Instagram. They need treatment. And it’s hugely insulting to those struggling because it suggests that all they need is a bit of sage advice — some life-affirming Post-It notes to stick on their kitchen cabinets — and they’ll be right. What nonsense!

This is actually part of a larger problem within mental health, which comes down to the fact that it is a relatively unregulated area.

While there are professional standards bodies, it is not mandatory to be a member to call yourself a counselor or therapist. Believe it or not, anyone can claim to be a therapist (or, for that matter, a life coach).

I often worry that in order to speed up the treatment of people with mental health problems, GPs employ ‘counselors’ who may have no or very limited qualifications. While there are accredited degree programs, counseling is not a protected profession, so anyone can claim to be one.

Psychotherapist is also not a protected professional title – so I always urge patients to check the person’s qualifications and that they belong to a reputable professional standards body.

(It’s important to note that this doesn’t apply to psychiatrists and psychologists, who go through years of training and exams before they’re qualified.)

It makes the whole mental health field incredibly confusing for patients. Too often I have seen them receive psychiatric treatment – often through their GP or university – from people who are not suitably qualified or experienced in dealing with the level of complexity of the patient.

“Therapy” can mean pretty much anything related to sitting down and talking to someone. It is estimated that there are at least 500 types of therapy. But types that are good for some problems may be of very limited use for others.

Psychotherapy is a term used interchangeably with therapy, but it actually refers to a type of talk therapy that uses important psychological principles to inform and help the patient.

Counseling usually describes a supportive form of talking. It is not typically considered a treatment for mental illness, but rather a space for an individual to explore their thoughts and feelings with a listener.

For example, patients I see with major depression may have googled “therapy” and ended up getting counseling when they really needed something that is a real treatment for depression, like CBT. They have been battling their symptoms for months, sometimes years.

That’s not to say counseling is out of place, just that it’s not a treatment for serious mental health issues.

Shocking, isn’t it? And the situation isn’t helped by the fact that many doctors don’t really understand this area either. I have heard many GPs say that a patient needs ‘counseling’ when what they actually mean is CBT.

In general, counseling is good for people who don’t have a mental illness but have feelings or thoughts they want to explore in a supportive environment. Problems with relationships, difficulty coming to terms with someone’s death, or general feelings of being lost or unsure about life can all be remedied with counseling.

All too often it’s offered to people who really need evidence-based psychological treatment – and while there are some excellent counselors out there, lack of regulation means there’s horrific variation in their quality. As for life coaching, it’s just insulting to offer this to people who aren’t feeling well. That’s really madness.

DIANA BOOK DILEMMA

A new children’s book about Princess Diana is about her battle with bulimia.

It describes how her eating disorder developed after learning that her husband, Charles, was in love with another woman and explains how she overindulged in food and then made herself sick.

I have mixed feelings about including this in a children’s book. It seems right that Diana’s struggle with mental illness is included in a book about her life. But there’s always a risk that including such details could put the idea in children’s minds.

I’ve seen this in schools, where a child develops an eating disorder and, in an attempt to address the problem, teachers inadvertently push others to try, leading them into an eating disorder—a psychological phenomenon called “contagion.” .

Such topics should be discussed sensitively and, in the case of eating disorders, without giving too much detail. Doing it right is a very difficult path to walk.

TV presenter Nick Owen has spoken about his prostate cancer diagnosis and its impact on him.

I think there’s something specifically about prostate cancer that makes men shy away from getting things checked out and adds to the emotional burden when they’re diagnosed. They feel squeamish about the research, but there is also the fear that once diagnosed, they will end up in a treatment that will make them impotent. They are afraid of the emotional consequences of this.

Will they be incontinent? Will they be able to get an erection? What happens in the bedroom? Will their partner still love them if they struggle with intimacy? It’s one of the reasons I think so many men put off checking out.

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DR MAX WRITES…

INSPIRATIONAL READING

Not All Heroes Wear Capes belongs to a man who was given up for adoption hours after he was born when his parents saw his face. Jono Lancaster, 37, was born with Treacher Collins syndrome, a rare condition that prevents facial bones and tissues from developing properly. His adoptive mother, Jean, taught him to celebrate his difference and love the way he looks. It is one of the most uplifting books of the year.