How to actually get help

The system isn't hidden. It's just never explained.

Most people who eventually get help say the same thing afterwards: they didn't know where to start. Not that help was refused — that they couldn't work out the first move, so they waited, and things got worse while they waited.

So here is the ordinary route, in order, with what actually happens at each stage. This is for England; Scotland, Wales and Northern Ireland differ in the detail, though the shape is similar.

Step one: your GP

The GP is the front door for almost everything non-urgent. You do not need to have worked out what's wrong, you don't need to use clinical words, and you will not be wasting anyone's time.

What to say. Plain description beats diagnosis every time. "I haven't slept properly in two months, I've stopped seeing anyone, and I can't concentrate at work" tells a GP far more than "I think I have anxiety". Say how long. Say what's changed. Say what you've stopped doing.

Ask for a double appointment when you book, and say it's about your mental health. Ten minutes is not enough and receptionists can usually arrange more.

Write it down beforehand. People minimise in the room — they get in there, feel embarrassed, and say they're fine. A note in your pocket, or a friend in the chair beside you, is worth a great deal.

Step two: talking therapies

For common problems — depression, anxiety, panic, phobias, PTSD, obsessive compulsive disorder — the NHS talking therapies service is the usual next step, and in England you can refer yourself without going through a GP at all. Search "NHS talking therapies" plus your area, or ask at the surgery.

Expect an assessment call first, then a wait. Waits vary enormously by area and by the type of therapy. Ask, at the assessment, how long yours is likely to be — and ask what to do if things get worse while you're waiting, because there is always an answer to that question and it's rarely offered unprompted.

Step three: specialist mental health services

For more serious or more complex problems, a GP can refer to the community mental health team. That's where psychiatrists, community psychiatric nurses and psychologists sit. Referrals are triaged, and not every referral is accepted — if yours isn't, ask the GP what the alternative is rather than assuming the door has closed.

If you're not registered with a GP

You can register with a GP without a fixed address, without ID, and regardless of immigration status. Practices sometimes get this wrong. If you're refused, ask for the reason in writing and contact NHS England — it is worth pushing, because being outside the system is what turns a manageable problem into a crisis.

What to do while you're waiting

Waiting lists are real and pretending otherwise helps nobody. In the meantime: the helplines below are free and immediate, many charities run peer support groups, and some areas have safe havens or crisis cafés that you can walk into in the evening without an appointment. Hub of Hope lists local services by postcode and is the single most useful directory I know of.

Free support, available now

None of these require a referral, a diagnosis or an appointment.

Culturally specific support

If part of what's stopping you is the expectation of not being understood — and for a great many Black and African families in Britain, that is a substantial part of it — these exist for exactly that reason:

• Black Minds Matter UK — connects Black individuals and families with free therapy from Black therapists.
• The Black, African and Asian Therapy Network — a directory of therapists of Black, African, South Asian and Caribbean heritage.
• Nafsiyat Intercultural Therapy Centre — therapy in a range of languages, at low or no cost.

Wanting a therapist who doesn't need the context explained to them is not a fussy request. It is often the difference between going twice and going properly.