We need to talk: why therapy matters
Note of the meeting held in
Committee Room 16, House of Commons on Monday 22 October 2007 to discuss the next steps
for the development of the availability of psychological therapies:
Speakers
Lynne
Jones MP, co-chair of the All Party Parliamentary Mental Health Group
Paul
Farmer, Chief Executive, Mind
Kathryn
Tyson, Programme Director, Mental Health, Department of Health
Lord
Layard
Shaun
Johnson, service user
Lynne
Jones thanked the members of the We Need to Talk coalition for organising the meeting,
which was timely given the Secretary of State Alan Johnson’s recent announcement of
new funding to improve access to psychological therapies. She hoped that after the
speakers had given their response to that announcement the meeting would provide a useful
opportunity to ask questions about the funding, and discuss the next steps.
Paul
Farmer highlighted the many accounts he comes across in his role at Mind of mental health
service users who want talking therapies and of GPs who want to prescribe them but who are
faced with unacceptably long waiting times. He welcomed Alan Johnson’s
announcement. This meeting had initially been planned by the members of the We Need
to Talk coalition as a means of highlighting, in advance of the Comprehensive Spending
Review (CSR), the need for more funding for talking treatments. That the CSR had
been brought forward and then followed by the Department of Health’s statement had
been a very pleasant surprise. However, that did not mean the campaigning was over.
There were now important decisions to be made regarding making the most of the
resources available in the best interests of service users. The organisations behind
We Need to Talk are very keen to be involved in that process.
Kathryn Tyson described
the background to the Secretary of State’s announcement and to building the case for
it. She emphasised that although the announcement of new funding followed closely on
the CSR it was not part of it. The money is core Department of Health funding. By
2010/11, the NHS will spend £170m per year on psychological therapies. She
also pointed out that it is meant to develop “evidence-based psychological therapies”,
a broad term which includes cognitive behavioural therapy (CBT), but does not necessarily
exclude other forms of talking treatment. Officials’ recent focus had been on
securing the funding. The next step would now be on developing plans to roll out the
demonstration sites to new areas.
Lord Layard said he had
been moved by Alan Johnson’s announcement of a “groundbreaking psychological
therapy service”. He deserved credit for such a bold statement and it was up to
the rest of us to maintain the momentum to ensure the promise is delivered. It is
important to remember that although the announcement concerned funding for the next three
years the strategy to make evidence-based psychological therapies available to all those
who need them was a six year one. The length of timescale is due in part to the
bottleneck of people waiting to be trained in CBT.
Shaun Johnson described
his experience of talking treatments as someone who has been a user of psychiatric
services for 18 years. He particularly drew attention to the importance of having
psychological services that are easily accessible. As Shaun lives in a rural area
attending appointments with his therapist had entailed a round trip that took up most of
the day and any positive benefits were ultimately outweighed by the stress caused by the
journey. Shaun also said that service users must be properly consulted so that the
services provided are actually the services that people want.
The discussion that
followed included the following points.
Lessons should be
learned from the early expansion of cancer services and funding meant specifically for
psychological services should be protected in some way, possibly ring-fenced.
Efforts should be
made to ensure that older people, young people, offenders, “hard to reach”
groups, those with severe, long-term mental health conditions and Black and Minority
Ethnic communities benefit from the increased availability of talking treatments. Ways of
delivering therapy that do not necessarily involve attending a clinical environment, for
example by providing services by telephone, need to be looked at and developed.
Psychological
therapies need to be made easily accessible to those already accessing non-mental health
services, for example stroke services or relationship support services.
The focus needs to be
not just on CBT but on the full range of evidence-based psychological therapies.
Department of Health
should seek to involve the voluntary sector as fully as possible. Many service users
are more likely to seek help from, for example, Mind or Rethink, than from their GP or
from a hospital, since they are perceived as being less threatening.
There need to be safeguards
to ensure that patients are adequately protected from professional abuse.
Training for cognitive
behavioural therapists needs to be made widely available.
Although the economic
arguments for expanding the availability of therapies are sound, the focus should not be
solely on equipping people to return to, or remain in, work.
Therapies should be
delivered with due regard for diversity issues and must be available in a range of
languages.
Service providers
should promote talking therapies in ethnically diverse communities to combat the view of
them as something for white, middle-class people.
Individuals who are
unable to access talking therapies in the community should be offered home visits.
Services should be
provided locally within pre-existing settings such as GP surgeries, rather than at
centralised mental health-specific sites.
Primary care workers
should proactively recommend talking therapies to reduce the stigma of asking for help
with a mental health issue.
Talking therapies
should be used as a preventative measure.
Effectiveness of
talking treatments should be monitored as rigorously as physical health treatments.
Self-referral should
be encouraged, particularly amongst groups that are less likely to self-refer.
In summing up Lynne Jones
said that the All Party Mental Health Group would be following the progress of the
Improving Access to Psychological Therapy project closely and that today’s meeting
could be followed up with a further meeting when the Department of Health publishes its
implementation plan.
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