Deciding to seek help for a mental health difficulty is frequently the hardest part. Being told the wait is several months, after finally making the decision, is demoralising in a specific way.
Waits of that length are common across many health systems. Some things are genuinely useful during them.
Establish where you are on the list
Practical first, because it affects everything else.
Ask for an estimated timeframe and whether there's a cancellation list. Cancellation slots are common and frequently go to whoever can attend at short notice.
Ask whether the wait differs by therapy type or by practitioner. Sometimes a shorter wait exists for a different modality that would be equally appropriate.
Ask what happens if things deteriorate — what the route is for reassessment. Knowing there's a mechanism reduces the sense of being abandoned in a queue.
And ask about any interim support the service offers. Many provide something — a workbook, a digital programme, a group — and it isn't always offered proactively.
Guided self-help
The intervention with the best evidence for this gap.
Structured self-help programmes based on cognitive behavioural principles have trial evidence, particularly for mild to moderate depression and anxiety, with effects larger when there's some human contact involved than when entirely self-directed.
Materials are widely available, including free resources from health services and reputable charities. Books based on these approaches exist and are inexpensive.
The key is that these are structured programmes to be worked through rather than general reading. The evidence supports doing exercises, not consuming content.
Realistically, adherence without support is poor. If you can arrange any accountability — a friend who asks, a scheduled time — completion rates improve substantially.
Digital programmes
Numerous applications and web programmes exist, with widely varying evidence.
Some have been evaluated in randomised trials and are recommended within health systems. Many have not been evaluated at all.
Worth checking whether a programme has published trial evidence and whether it's endorsed by a health service or professional body. Marketing claims are not evidence and the field is crowded.
Where a service offers a specific digital programme as part of the pathway, that one has usually been assessed and is a reasonable starting point.
Things that help independently
Not substitutes for treatment, and they have their own evidence and are available now.
Physical activity. Reasonable evidence for depressive and anxiety symptoms. The barrier during a low period is motivation, which the condition impairs, so the practical version is very small amounts — a ten-minute walk, ideally at a fixed time, ideally with somebody.
Sleep. Disrupted sleep both results from and worsens mental health difficulties. Behavioural approaches to insomnia have strong evidence and are available in self-help form, and improving sleep frequently improves mood independently.
Reducing alcohol. Commonly used to manage symptoms and reliably makes them worse over time, particularly anxiety and sleep. This is one of the more effective available changes and one of the harder ones.
Structure. Depression erodes routine, and the erosion worsens the depression. Behavioural activation — deliberately scheduling activity, particularly things previously found rewarding — is an evidence-based treatment component that can be self-applied.
Contact with people. Withdrawal is a symptom that maintains the condition. Small, low-demand contact is more sustainable than trying to resume normal social activity.
Other routes to support
Options that may have shorter waits.
Charity-provided counselling, which exists in many areas at low or no cost.
Peer support groups, which have limited formal evidence and which many people find valuable, particularly for the reduction in isolation.
Employee assistance programmes, if your employer has one. These typically offer a small number of sessions quickly and are frequently unused because people don't know they exist.
Educational institutions usually have counselling services with shorter waits than general health services.
And some services allow self-referral without going through a doctor, which can be faster.
When not to wait
The important part.
If you are having thoughts of harming yourself, if you feel unable to keep yourself safe, or if symptoms are deteriorating rapidly, that is not a waiting list situation. Contact your doctor urgently, an out-of-hours service, a crisis line, or emergency services.
Crisis services exist specifically for this and using them is appropriate. People frequently hesitate because they feel their situation isn't serious enough, which is a symptom of the condition rather than an accurate assessment.
The thing worth holding onto
Waiting is genuinely difficult and the difficulty isn't a sign that you're doing something wrong.
What tends to help is having something to do rather than only something to wait for. A structured programme, a walk each morning, a fixed time you speak to somebody. Small, specific and repeated.
And keeping the appointment when it comes, even if things have improved by then. Improvement while waiting is common and doesn't mean the underlying difficulty is resolved.
If you are in crisis, please contact emergency services or a crisis helpline in your country. This article is general information and not a substitute for professional care.