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The survey (2) of over 1,600 people who have tried to access talking therapies such as counselling and Cognitive Behaviour Therapy on the NHS in England over the last two years also shows how some people are paying for private therapy to get the help they desperately need. One in ten (11%) said that they had faced costs for private treatment because the therapy they needed was not available on the NHS.
The choice of treatment on offer was also found to be limited even though CBT, the most commonly prescribed talking treatment, doesn’t work for everyone. The coalition found that three in five people (58%) weren’t offered a choice in the type of therapy they received.
Since 2007, the Government’s increased investment in the Improving Access to Psychological Therapies (IAPT) programme has helped millions of people to access psychological therapies on the NHS who otherwise wouldn’t have had this support. However, delays in accessing support and a lack of choice is having a devastating effect on people’s lives and recovery.
The We Need To Talk coalition is calling for the NHS in England to offer a full range of evidence-based psychological therapies to all who need them within 28 days of requesting a referral.
The coalition is raising these concerns as the IAPT team has now moved to NHS England, and is operating on reduced capacity and budget.
This also means that the issues of many marginalized groups may not be addressed. People from Black and minority ethnic (BME) communities, those with long-term mental health problems such as bipolar disorder and schizophrenia, older people and children and young people face specific challenges of their own. The coalition held focus groups with people from BME ethnic heritage and over half of those people said that language barriers was a specific issue that they faced.
We need to talk wants the Government and NHS England to invest more in psychological therapies to meet demand and urgently introduce maximum waiting time standards to ensure timely access to treatment. Locally, clinical commissioning groups must ensure they commission a range of psychological therapies to meet the needs of diverse local communities.
Mind’s Chief Executive Paul Farmer said:
“Since our last We need to talk report, we’ve seen money poured into the IAPT programme with some encouraging improvements in waiting times. However, it is far from acceptable that in some parts of the country people are still waiting over a year to access treatment. This must urgently be addressed if the Government’s commitment to parity between physical and mental health care is to be realised.
“The Government is committed to improving access to talking treatments but our report shows there is still a long way to go. That’s why we’re urging the Government and NHS England to take heed of this new report and make sure that people with mental health problems are getting the right treatment when they need it.”
Care and Support Minister Norman Lamb said:
"More people than ever before are getting access to talking therapies thanks to our £450 million investment in the improving access to psychological therapies programme.
“Due to its initial success, demand has increased and this has led to increased waiting times in some parts of the country.
“We want people to get access to treatment quickly. We have asked NHS England - the body which oversees the NHS – to introduce for the first time new waiting time and access standards for mental health services from 2015.”
Dr David Murphy, Chair of the Professional Practice Board at the British Psychological Society said:
"This new report welcomes the positive steps that have been taken by the coalition Government in increasing access to psychological therapies. This has undoubtedly benefitted thousands of people who might otherwise have not received help. However, considerable progress is still required as access to psychological therapies is still very limited, especially for particular groups such as those from ethnic minorities, older people, those with physical disabilities, and also people with severe mental health problems.
“Those people who do access services are also waiting too long before they receive psychological therapies. Moreover, even after waiting many weeks or months, our own research has shown that often therapy is cut well short of the amount recommended in NICE guidelines because of arbitrary local limits. This is of great concern and illustrates how far we still need to go before treatment of mental health problems and physical health problems have equal priority. It would be front page news if a healthcare organization started limiting prescriptions of antibiotics to half the recommended dose in order to manage costs but this is equivalent to what seems to be happening in many psychological therapies services."
The cost of mental health problems is high. Depression alone costs £7.5 billion, of which only £1.7 billion is to NHS services, with the rest going on the cost of lost employment. Previous research has shown that extending NICE-recommended treatments such as talking therapies to all those with depression could deliver £1 billion in economic benefits each year.
Lisa, 51, has been affected by depression since she was a teenager and also has been diagnosed with anxiety, bipolar disorder and obsessive compulsive disorder (OCD). Born in Africa, Lisa has experienced physical and emotional abuse from people who have not accepted her transgender status, both in her home country and the UK, and she has tried to take her own life many times. Lisa has had to wait over four years to access the psychotherapy that has had such a positive impact on her life.
“I have had to wait so long to receive psychotherapy because the service wasn’t available where I live and I can’t help but think what my life might have been like if I’d received therapy earlier. I’ve now am getting the right treatment for me and it’s made such a difference to my life; psychotherapy truly has turned my life around.”