Updated: Jan 7
Dr Rima Lamba CPsychol
Clinical Director and Founder of Blue River Psychology
When I left my team and job in the NHS, I needed to spend some time to think about my goals and what I was going to do. The NHS had been a safe haven, which had provided endless opportunities to learn, train and develop; whilst I am no longer part of it, it is an organisation I will always cherish, respect and admire.
I thought about some of the gaps in statutory healthcare provision (the NHS!) in the field of mental health and I thought about how I could bridge those gaps as an independent psychology practice.
I guess on some level, even early in my life, I was fascinated by the psychology of women, women's mental health needs, how women are positioned in society, their social status, the inequalities they often face and their human rights. I think it’s fair to say I was - and still am today - a feminist! As a woman myself, I have always felt it is my purpose in life to advance and improve the lives of women and to reduce the discrimination and inequalities that have historically penetrated women's lives. The end game being to use my voice and my life to do what I can. As a Counselling Psychologist this focus only became stronger and more embedded in my psyche. I suppose it was only natural for me to create a service that tries to meet the needs of girls and women, after all this is what I'm passionate about.
In 2017, the Mental Health Foundation produced a damning report highlighting how Government policies, which drive mental health services, were failing women and girls.
This same Government has unleashed monstrous "cut-backs" nationwide, creating a culture of austerity which has hit women in particular, very hard. It is clear men also suffer from mental health difficulties, which must continue to be the focus of mental health policymakers. However, statistics still show that when it comes to mental health issues, women continue to make up the majority (see https://weareagenda.org/).
Whilst the Government's agenda has been to drive more money into improving maternal mental health, and this is a positive and necessary step, many women still fall between the cracks.
We now have ample evidence showing widespread and chronic under-funding of mental health services in the UK (please read a journal article published by Mary Docherty and Graham Thornicroft in the International Journal of Mental Health Systems, 2015). I lived and worked within this "starved" and under-resourced system and saw first-hand what it cost members of the public. It is with great regret, that I acknowledge in this blog, women made up the majority of those who accessed psychology services. But this tended to be within the context of psychopathology, rather than in an attachment-focussed, gender-sensitive, culturally-centred and systemic context. By this I mean, access to a psychologist in statutory healthcare is based on whether someone is defined as "clinically" depressed, anxious or "has an eating disorder" or "postnatal depression". Things are changing, but as it stands currently, the mental healthcare system is still based on definitions of pathology. Furthermore, services tend to be funded to manage and treat the complex and severe end of the spectrum of difficulties. Those deemed to have mild-moderate difficulties often have limited options for psychology support and if they do get their foot in the door, they’ll be waiting a long time! With such strict criteria, many women fall outside of the parameters of service access and treatment. Where are these women meant to go?
From this, it felt clear as a Counselling Psychologist, I wanted to create and provide an independent psychology service, which considers evidence-based research but, critically, one which is centred on:
1) A gender-sensitive approach (understanding, exploring and holding the unique needs of women in mind)
2) Being culturally informed and focussed (Black, Asian and Minority Ethnic Women
[BAME] are found to have higher rates of mental health issues)
3) Attachment theory (including relational and psychodynamic concepts)
4) Providing a flexible therapeutic style.
As an independent psychology practice, Blue River Psychology is not directed by resources and funding. Government-funded services tend to be time-limited, for example: many of you will have heard of 6 sessions of cognitive behavioural therapy (CBT). But I think one of the biggest issues is that mental health service provision is also delivered in a dissected fashion. For example, if the problem is anxiety, point them towards CBT; if its depression send them for interpersonal therapy (IPT), all delivered by mental health professionals specifically trained in these one-dimensional models (CBT Therapists or IPT Therapists). Now sometimes this works and sometimes it fits, in which case this makes a great success story. But one thing we have learned in the psychology of human life is that we are not parts that can be fixed. We are part of a whole and that whole is embedded in various relational systems. When human difficulties are viewed as a pathology to be treated in this dissected manner, there are consequences. In a world of austerity where women are already bearing the brunt of cut-backs, providing dissected care at best or nothing at worst, brings together the perfect storm of deepening mental health difficulties. Specifically, for women and girls, their unique mental health needs as well as many other factors (gender, culture, ethnicity, systemic issues) can be missed. The longer-term outcome is that these very women may go on to have their own off-spring, and here we land right in the heart of intergenerational trauma. Those traumas and those psychological difficulties are emotionally transferred to the next generation. The individual, their partner, their children, relationships, families, work systems and the wider community continue to be impacted by ongoing psychological pain. Society ends up paying a price for the psychological pain encountered by girls and women. If we are to have a healthy society, we need to look closely at the psychological needs of individuals, particularly women who seem to make up the majority of service users. In 2016, Statista.com (a statistics portal) examined the population of the UK by gender, women outnumbered men by approximately 892,000! It would be folly to continue to ignore the unique needs of girls and women who make up the majority gender in our country.
At Blue River Psychology there is an opportunity to provide a bespoke and specially tailored service dedicated to the psychology of women and mothers, which explores and holds in mind their unique needs. We provide psychology sessions which are not governed by resources and neither do we provide a dissected system of care. It is never easy to come to terms with the difficulties you are going through, but when you think about accessing a psychology service, you want to know there will be a holistic approach and that you have time to pace yourself within the journey of therapy without worrying about the number of sessions you have left.
I would like to leave you with one last thought. When mainstream services provide a pathology based and time-limited therapy service through a revolving door, the entire psychology of women (their identities, needs, relational processes and wider systemic issues) becomes overlooked and given little importance. When women see this they unconsciously internalise the message that their needs, thoughts and voices hold little value and they in turn remain unable to give importance to their own needs. If we continue doing this, we need to ask ourselves what kind of society we are setting ourselves up for.
Dr Lamba is the Clinical Director and Founder of Blue River Psychology, she works using an integrative framework, which means she draws on numerous theoretical psychological models, to help female clients reach a place of empowerment, insight and strength. If this is what you are looking for, then we are the service for you.