Written: July 18, 2019
When “Improved Access To Psychological Therapies” means a six-month wait, something has gone very badly wrong.
A young man came to our Suicide Crisis Centre last week. He had been diagnosed with depression by his GP and had been referred to the local NHS Improved Access to Psychological Therapies service (IAPT). They told him that the waiting time for therapy was six months. Two months into that waiting period, his mental health had deteriorated to the extent where his life was now at risk.
We have a crisis in terms of accessing psychological or talking therapies in our part of the country. When “Improved Access to Psychological Therapy” means a six-month wait, something has gone very badly wrong. Previously people could access this service quickly, often within four weeks.
At our Crisis Centre we are used to hearing our clients talk about long waits for therapy in secondary mental health services (for people with more severe and enduring mental health issues). I always felt that there should have been much more of an outcry about such long waits. The focus was instead on the short waiting times for IAPT and that seemed to eclipse what was happening in secondary services.
Delays in accessing psychological therapies undoubtedly put lives at risk. I know this from personal experience. In 2012 I developed symptoms of post-traumatic stress disorder (PTSD) after a traumatic incident. I was informed that I needed psychological therapy to address the symptoms. As the months passed without therapy, I found the post-traumatic symptoms increasingly unbearable, and I attempted suicide twice. It is documented in my medical records that a “loss of hope over accessing therapy” was the trigger to the suicide attempts.
A bereaved father who attended our PTSD group told me that a few days after his son took his own life, a letter came through the door offering him his first psychological therapy appointment. His father had been the person who found his body, causing him to need post-traumatic support himself after such a harrowing experience and such a devastating loss.
For the past five years I have seen little action to address these long waiting lists for those of us under secondary mental health services who need psychological therapy. Perhaps now that we also appear to have a crisis within IAPT, there will be some action taken. Nine out of ten people with mental health problems are supported in primary care, with IAPT having an essential role.
IAPT was introduced to provide fast access to evidence-based treatments for depression and post-traumatic stress disorder, among other conditions.
The Five Year Forward View for Mental Health (created in 2016 by the Independent Mental Health Taskforce to the NHS in England) states that there is a waiting list for IAPT of “just over six days in the best performing areas and 124 days in the worst performing areas”. Our county of Gloucestershire is clearly far in excess of that now, at 180 days. Clients are telling us that this six-month wait is “standard”.
We have contacted both our local mental health trust and our clinical commissioning group (which funds National Health Services) to express our strong concerns.
I find it incomprehensible that this situation is happening at a time when we are assured that mental health funding has been increased. There is an urgent need for action to shorten waiting lists, in both primary and secondary mental health services.
By Joy Hibbins: also published in the HuffPost UK (link below)
For information about the Suicide Crisis Centre: www.suicidecrisis.co.uk