An Unpopular Opinion About the NHS

The NHS Is Letting Women Down. And I'm Done Being Polite About It.

I want to tell you about my friend.

A few years ago she survived a double rape. Horrific doesn't even begin to cover it. The man who did it was eventually caught and sentenced, two nine year terms. Justice, right? Except the sentences were made concurrent instead of consecutive, so in practice he served a fraction of what you'd think "eighteen years" should mean. Then he was let out early. And on top of that, he was given money to help him "get away" back to his own country and start again.

Let that sit for a second. The system found time and resources to help him rebuild his life.

My friend, the woman he attacked twice in one night, had to fight for three and a half to four years just to get trauma informed counselling. Not psychology. Not specialist support. Basic, trauma informed talking therapy with a bit of EMDR mixed in. Years of fighting for that. And it took even longer than that to get any proper psychological support on top.

Four years. To be believed enough, ill enough, "deserving" enough, to get help after being raped twice by the same man in one night.

If you've been anywhere near NHS mental health services, either as a client or as someone trying to refer a client, you already know this isn't a one off. This is the system working exactly as it's designed to work. And that's the disgusting part. It's business as usual.

Here's what I see over and over again with the women I work with.

A woman comes out of a relationship that has hollowed her out. Years of gaslighting, control, maybe violence, maybe sexual coercion, maybe all of it wrapped up in "but he loves me really." She's hypervigilant. She can't sleep. Her nervous system is stuck in fight or flight, or worse, in freeze. She dissociates in meetings. She jumps when the post comes through the letterbox. She's terrified of her own reactions.

She goes to her GP. She gets assessed. And what does she walk away with, nine times out of ten?

Anxiety and depression.

Not complex PTSD. Not trauma. Anxiety and depression, the two labels the system knows how to process, the two labels that fit neatly into a six (and if you are lucky, an extension to twelve sessions) CBT pathway delivered by someone who, through no fault of their own, has often has only minimal training in trauma and often even less in coercive control.

Anxiety and depression aren't wrong exactly. She probably does have those. But they're symptoms. They're the smoke, not the fire. If you treat the smoke and never touch the fire, the fire just keeps burning, and she keeps coming back to the GP, and the GP keeps sending her back into the same self-referal generic pathway, and round and round it goes while she quietly concludes that she must just be broken, that therapy "doesn't work for her," that maybe this is just who she is now.

It isn't who she is. It's what was done to her, and it isn't being treated properly because treating it properly costs more, takes longer, and requires specialist trauma trained professionals that the NHS simply does not have enough of.

Getting a complex PTSD diagnosis, when you've survived domestic abuse or sexual violence, often means fighting for it. You have to be persistent. You have to push back on your GP. You sometimes have to get privately assessed just to have paperwork that says "this is what's actually happening to me" before the NHS will even consider a longer or more appropriate pathway. Women in the middle of surviving trauma, exhausted, scared, running on empty, are the ones being asked to do that fighting. The system puts the burden of proof on the person it has already failed once.

And even once you've got the diagnosis right, even once someone somewhere agrees yes, this is complex trauma, not straightforward anxiety, you then hit the next wall. Waiting lists more often than not combined with a revolving door of different practitioners because of staff turnover, meaning she has to retell her story from scratch every single time, which is retraumatising in itself.

I'm not writing this to have a go at the individual GPs and therapists inside the NHS. Most of them are doing their absolute best inside a system that has been starved of the funding and the training it needs for years. This isn't about blaming the people on the ground. It's about naming what the system does to women who've already survived the worst thing that's ever happened to them, and then makes them survive the help seeking process too.

My friend shouldn't have had to fight for four years. She should have been offered proper, trauma informed, long enough support the moment someone in a position of power heard what had happened to her. Instead the man who attacked her got resettlement funding and an early release, and she got a waiting list.

This is why the work I do exists outside that system. It's why I built things the way I have, because so many women simply cannot wait years for the right label and the right kind of help. But I shouldn't have to exist as the backup plan for a system that's meant to be there in the first place. None of us should.

If this is your story too, if you've been handed "anxiety and depression" when you know in your bones there's more going on, you are not imagining it and you are not being difficult. You are noticing a system that was never built with women like you in mind.

So what do you do while you're waiting, or fighting, or trying to work out if what happened to you even "counts" enough to be taken seriously?

You start somewhere that isn't a waiting list.

I've put together a free course called A Taste Of, and it's exactly what it sounds like. A little snippet from each of the courses I run inside my paid community, so you can actually feel what the work is like before you commit to anything. It won't heal you, I'm not going to pretend a free course can undo what years of trauma have done, but it will give you a real sense of the kind of support that's out there when the NHS route has left you stuck.

No card details needed to start. Once you've worked through it, you're offered 28 days completely free inside the actual community, again with nothing to pay until you decide you want to stay. I built it this way on purpose, because so many of you have already had to fight and prove and justify yourselves just to be believed. I don't want that from you here. I want you to feel safe enough to just try it.

If you want to take a look, you can find A Taste Of here: https://app.heartbeat.chat/lifeafterthecockwombleclub/p/page-7d100c46