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3. Where can I seek help?

Let's start with the expert credentials ("who")

  • Psychiatrist is a doctor of medicine, who provides basic diagnostics and prescribes psychopharmaceuticals (drugs affecting mental states)

  • A psychologist obtained a university degree in psychology (bachelor, master, or doctor), is familiar with wide range of psychological tests, and provides basic psychological counseling

  • The psychotherapist is either a psychiatrist or psychologist, who in addition to his university studies completes state-certified, long-term (4-7 years) psychotherapeutic training

  • A clinical psychologist is a psychologist, most often with psychotherapeutical training, who is certified in healthcare framework (his services are reimbursed by the insurance company)



Another perspective is institutional ("where")

  • Probably the most accessible are counselling websites, phone emergency services, or thematic sites / discussion forums.

  • Chances are, you can also find some self-help group near you. These focus on specific life situation (e.g. maternity leave, bereavement, etc.) or some problem (e.g. Anonymous Alcoholics, Emotional Eaters etc). Some of these groups meet with the participation of a psychologist, others without him.

  • Another option is specialized psychological counseling (for example, marriage and family counselling, victims of violence, gifted children and their parents, etc.)

  • There are also communities - long-term residential groups (several months), mostly outside cities, focusing on a specific problem or diagnosis (for example, addiction, borderline and other personality disorders and others)

  • Key institutions in mental health care are of course health care providers:

  • Most commonly used facilities are probably independent practices of individual experts. Psychiatrists and clinical psychologists have their ambulances, non-state psychotherapists have their private practices. The list of most of them, with regard to location, can be found on

The third perspective could be "how" mental health care is actually done. For sure any expert you turn to will suggest the most appropriate procedure and explain everything. However, here's an overview:

  • At the beginning there is individual self-support - that is how you take care for yourself. For example, neglecting sleep, overloading yourself at work, keeping your problems to yourself and so on increases the risk of mental and physical problems. On the other hand, contact with nature has been proven to reduce stress - even flowers in the office, or the windows background already have a measurable effect. Similarly, regular exercise is one of the most effective prevention and treatment factors (3 x 45 minutes of exercise per week has an effect comparable to conventional antidepressants or psychotherapy).

  • Next level is psychological counseling and / or psychotherapy (you can read about both in other parts of this series (e.g. 1. What is psychotherapy?, 4. What types of psychotherapy do we know? and 5. Does psychotherapy work?).

  • Then there is medication. In case of an emergency, the your general practitioner can prescribe it, but psychiatrist knows much more about mental disorders and their treatment. The goal is to alleviate acute suffering and improve the effectiveness of psychotherapy (which one should attend during medical treatment). Psychopharmaceuticals are sometimes seen by patients as a cause for concern. It is important to realize, that all of them had been subjected to rigorous safety and efficiency testing, and with correct indication and dosage, benefits strongly outweigh any possible side effects ("your body is allowed to relax"). There's widespread opinion that people are overusing drugs - but according to a recent study, only about 5% of people have used antidepressants in the Czech Republic over the past 12 months (the EU average is 7%, in my practice about 20%).

  • In the acute phase of mental illness (such as mania), it may happen that, despite medications and several hours of therapy per week, people and their surroundings are still under too much stress. In such a case, it is possible to enroll into day care center. This means that the client visits a medical facility for an intensive psychotherapeutic program for several weeks, always from morning to afternoon, spending evenings and nights at home. There are day care centers for adults, seniors, or even adolescents.

  • Despite aformentioned options for psychological and psychiatric care, approximately 1,400 people in Czech Republic die each year by their own hand. If someone attempts suicide, is experiencing persistent debilitating anxiety, or can no longer differentiate between what is real and what is not, he or she should definitely seek medical help. In most cases, hospitalization is required (approximately 0.6% of the Czech population a year). Most of these hospitalizations are voluntary (in the sense of "I don't want to, but I know it is necessary"). Only in one tenth of cases the patient does not sign the consent. In that case, hospitalization can only take place if he or she is a serious and immediate threat to him/herself or other people, and each case must be approved by the court within a few days.

  • Usually, hospitalization takes 10 to 20 days and patients comment on it in the sense of "it was good". Maybe they have interrupted the cycle of suffering and relaxed for the first time in some time, sometimes they enjoy some of the many activities (art therapy, canistherapy, etc.), and sometimes they experience for the first time that they are not alone with their suffering and learn to manage it better. The decision to seek help is always challenging, but it is liberating and can save life - in any sense of the word.

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