How do they not work? There's huge amounts of people who take SSRIs and are able to manage their illnesses. Treatment works in tandem with one another - intense therapy, medication, community support. It's not just SSRIs, it's anti psychotics, beta blockers etc.
It is not as hard as you think to be diagnosed with a PD if your PD is so obvious and so apparent. Regardless of the apparent or obviousness of your disorder, if different SSRIs aren't effective in treatment, you're referred to psychiatry. Through psychiatry, they triage you to determine your necessity for help. I'll admit, at the moment, psychiatry will refer you on immediately if you abuse any sort of substance (alcohol, drugs etc).
Triaging pertains to all levels of mental health and the risk associated. A suicidal attempt is a category A emergency in terms of UK mental health triaging - this does not go through the GP. The emergency services must be contacted in this instance. That means sectioning no matter what and they determine whether it's appropriate to allow you back out into the community. Category B - very high risk of imminent harm to self or others (ie, suicidal ideation, harm to others, a clear plan, history of attempts/self-harm/aggression) requires immediate contact of the crisis team within 4 hours. By the time you get to category C, you're reduced to a 24 hour waiting time. Category D, 72 hours. Category D is significant distress associated with severe mental illness. Category E, 4 weeks waiting time. That's the requirement of a specialist mental health assessment. That is some of the UK's triage response to mental illness and risk.
You can be diagnosed via therapy/counselling services and they will contact your GP with their suggested diagnosis. Any GP worth their salt will contact you regarding this. If you express suicidal ideation to a GP, with any outline of a plan, they have a statutory duty of care to you as their patient to contact the emergency services. There is NO way a GP will allow someone with suicidal ideation, aggression, such extreme delusions, signs of mental illness, to go out into the community without care.
I think you’re living in a fantasy land where NICE Guidelines like clockwork, or else your family are lucky enough to work in trusts which have the money to throw at this kinda stuff.
SSRIs might work for some people. But they can’t work in tandem if there’s nothing to work in tandem with.
Ineffective SSRIs don’t always lead to psychiatry. That very much depends on the Trust or CCG pathways. Many trusts have walled off consulting psychs behind layers of community services which take an age to get through.
Even then, psychiatrists are hamstrung by the options available to them. They can’t refer to a service where one doesn’t exist. That can be masked as the triaging you describe.
Counsellors, therapists and GPs do not diagnose mental health disorders.
Suggested diagnoses mean shit without funding for a pathway which will result in diagnosis. That’s not always up to a psychiatrist alone either.