OCD UK: Accessibility To Mental Health Care For Obsessive-Compulsive Disorder

From symmetry and order to hoarding, obsessive-compulsive disorder (OCD) is a condition with many variations and manifestations. One of the key things they have in common, however, is the potential to significantly disrupt one’s daily life at work, school, in relationships, and more. According to the National Institute for Clinical Excellence (NICE), OCD affects roughly 1.3% of adults in England. 

Despite its impacts, obsessive-compulsive disorder is highly treatable with the guidance of a mental health professional trained to deliver OCD therapy methods. This post aims to explore OCD signs, symptoms, and causes, as well as standard treatments and care options in the UK. It also outlines how to choose a therapist, common barriers to treatment, and online therapy solutions. 

What is obsessive-compulsive disorder?

Terms like obsessive and compulsive are often used colloquially. For example, “He’s obsessed with bargain hunting,” or “I’m so OCD about keeping my car tidy.” Although they’re typically used casually, such phrases can minimize the condition’s potentially long-term impact on an individual’s mental health. 

While most people who develop OCD recognize that their obsessions are illogical or unreasonable, they may struggle to manage them, potentially leading to significant distress. Compulsive behaviours may offer temporary relief or a sense of control, but ultimately, they may only add to the individual’s distress.

Common misconceptions about OCD

There are a few common beliefs some people hold about OCD that simply aren’t true. Examples include, but aren’t limited to, the following:

• “Everyone’s a little OCD about something.”

• “OCD is always about cleanliness, organization, or punctuality.”

• “OCD behaviors are just ‘quirks.’”

• “OCD is just anxiety.”

• “OCD thoughts and behaviors are a choice.”

• “OCD is a ‘phase’ that will eventually go away on its own.”

• “OCD only affects adults.”

OCD causes, types, and symptoms

While scientists still don’t fully know what causes OCD, it’s thought to be influenced by a combination of factors like genetics, differences in brain structure and function, and environment. OCD symptoms often exist on a spectrum and tend to vary between individuals. Still, they typically lead to significant distress, anxiety, fear, and depression and take up considerable time and energy in an individual’s daily life. Below are a few examples of obsessions and compulsions:

• Extreme worries about germs or dirt, leading to excessive cleaning and/or handwashing

• An intense fear of causing harm to oneself or others, leading to “checking” behaviors like repeatedly locking doors or turning the oven off and on several times

• A strong desire for order and symmetry, leading to excessive organizing and arranging

• Unwanted aggressive or sexual thoughts, leading to constantly asking for reassurance from others or mental compulsions like repeated prayers 

The importance of early intervention 

Early intervention can be key to improved OCD outcomes. It may prevent the disorder from worsening, minimize long-term challenges, and significantly improve a person’s quality of life. Early intervention may also reduce the development of comorbidities like anxiety and depression, which can be common in individuals with OCD, although updated evidence is needed.

Research shows that early detection can be challenging, as OCD symptoms, presentation, and course typically differ between adults and children. However, delayed or inadequate intervention is often particularly harmful to children, as untreated OCD can impact brain development, alter the course of the disorder, and result in more severe OCD symptoms in adulthood. 

Evidence-based OCD therapies

Mental health professionals may use a combination of OCD treatments tailored to an individual’s needs, but exposure and response prevention (ERP) and/or medication are the most common, clinically proven methods. An antidepressant called a selective serotonin reuptake inhibitor (or SSRI), designed to increase a chemical called serotonin in the brain that is linked to OCD, is the most common medication used to treat OCD. 

ERP is a type of cognitive behavioral therapy (CBT) that entails creating a structured, hierarchical list of the stressors provoking obsessive thinking. Once these are identified, the therapist typically coaches the client through the process of gradual exposure to those situations or objects that lead to emotional distress and obsessive thoughts. For example, the client may work their way up from exposure to an image or picture to encountering the stressor from a distance, eventually confronting it directly. In general, the goal of the therapy is to reduce and ultimately eliminate the behaviors associated with the stressors. 

How long is ERP therapy?

A typical ERP treatment course can include anywhere from 12 to 20 sessions, occurring once a week or more frequently, depending on the severity of the individual’s symptoms. Sessions usually last about an hour each, and formats may vary depending on the severity of the individual’s symptoms. One might attend individual and/or group sessions in an inpatient, outpatient, or teletherapy setting. 

How to find OCD treatment in the UK

There are many local and national support services available for individuals with OCD in the UK. You may begin by consulting your GP, who can assess your symptoms, prescribe medication (if needed), and refer you to a local service specializing in OCD-targeted cognitive behavioral therapies (often called talking therapy) like ERP. 

Specialist mental health teams

Specialist care teams typically offer targeted care for individuals with more severe or long-term OCD that hasn’t responded to standard treatments. These services are normally accessed through GP referral or local talking therapy services. In some cases, you may be able to self-request a referral to a specialist mental health team for OCD. Specialist teams often work with local and primary care providers to ensure a holistic approach to care. 

Charities and peer support groups for obsessive-compulsive disorder in the UK: Accessibility and more

Charities, peer groups, and local support groups can provide support, information, and advocacy for people affected by OCD. Charitable organizations often include helplines with phone, messaging, and email services to individuals with OCD and their family members, providing advice, information, and guidance. Helplines, such as the one operated by OCD Action, also offer “next steps” support services for individuals while they are in therapy. 

There are also charities focused on supporting specific groups. For example, OCD Action offers OCD Youth, a peer support program run by young people with OCD for those under 25. People with OCD may feel ashamed of or guilty about their obsessions and compulsive behaviors. Hearing from people with similar experiences can be vital for helping those with OCD build self-esteem and self-compassion.   

Independent clinics

Independent clinics frequently offer consultant assessments and specialized therapy for people with OCD. For example, Nightingale Hospital has a specialist day therapy program focused on talking therapy and self-directed exposure tasks (like those in ERP treatment). They also offer an intensive inpatient service for more severe cases. 

The OCD Treatment Centre provides both intensive and non-intensive individual and group therapy options, and the OCD Excellence and OCD London clinics also offer specialized OCD treatments.

Independent therapists 

Additionally, individuals may seek out independent therapists specializing in CBT and ERP for OCD. You may ask for suggestions from your GP, or a quick internet search for “OCD UK therapists near me” can help you find a list of mental health professionals in your area. Many people use online therapy platforms like BetterHelp to match with a credentialed mental health professional. These platforms benefit service users living in remote areas or with accessibility and scheduling challenges.

Choosing a qualified mental health professional

Organizations like OCD-UK suggest individuals seeking personal OCD therapists should look for those accredited by the BABCP (British Association for Behavioural and Cognitive Psychotherapies) or who are registered with the HCPC (Health and Care Professions Council) or GMC (General Medical Council). These accreditations indicate that professionals have the necessary training and expertise in CBT and ERP treatments. 

Request an initial consultation—most therapists offer one to get to know you better, allow you to ask them questions, and establish rapport. Be honest about any concerns or reservations and inquire about their training, qualifications, and if they receive regular supervision to ensure continued development and high ethical and professional standards. Ask about their experience working with clients with similar challenges to yours. 

Common barriers to accessibility

Despite the efficacy of OCD treatments, some people face obstacles to receiving care. For example, the NES offers many OCD treatment clinics and centers, but traveling long distances to specialized treatment centers can be a barrier for individuals, especially those in rural areas. There may be a lack of therapists with expertise in ERP talking therapy, and individual therapy treatment costs can be prohibitive for some. Additionally, misunderstanding about OCD, social stigma, and personal feelings of shame can prevent individuals from seeking help. 

Teletherapy for OCD treatment 

Online therapy can be an excellent solution to many of the barriers faced by individuals seeking care in the UK. For example, BetterHelp has a vast pool of qualified mental health professionals trained in OCD treatments and allows users to attend sessions from the comfort of home—eliminating the need for travel to and from a clinic. Some people fearing mental health stigma may feel more comfortable speaking to a therapist from home on a schedule that fits their needs. BetterHelp offers financial assistance on a sliding scale for those who qualify to support individuals' access to care.

Online video therapy is an effective treatment option, with some current studies suggesting it may be as effective as face-to-face treatment. For example, a retrospective longitudinal study evaluating online ERP treatment for OCD revealed that 38.5% of the study’s 2,173 participants achieved symptom reduction by weeks 13 to 17 of treatment. 53.4% of the participants met full response criteria. Upon the study’s completion, researchers reported that the online program achieved similar or better outcomes in roughly 65% fewer sessions than typical in-person treatment.