three-and-a-half year wait for psychological therapy
July 26, 2007
by Chris George
People with mental health problems are having to wait up to three-and-a-half
years for psychological therapy.
from Derbyshire Mental Health Trust show there are 428 patients
waiting up to 186 weeks for counselling in Derby and south Derbyshire.
comes at a time when the government is promising to increase access
to psychological therapies in England and Wales for people diagnosed
with depression and anxiety
Telegraph newspaper reported that the waiting times have grown because
of an increase in demand.
16, 2007: Hewitt promises 10 more psychological therapy centres
29, 2007: Cognitive behavioural therapy via computer to be available
from next month to depressed - critics, however, say computerised
therapy is dehumanising
wait? Some don't even get to wait at all
Fenella Lemonsky, Expert by Experience, North London Hub, Mental
Health Research Network, Imperial College London,
August 2, 2007
The problem with the whole Layard
review is to offer more quick-fix CBT, especially to people with
mild to moderate depression in primary care. The reality is this
- CBT is not a cheap quick fix but requires staff with a mental
health background, extensive experience and decent training to deliver.
This is not happening across the board.
Graduate psychologists, and other newly qualified staff are offered
short courses, often in house, in CBT and told get on with it. A
skilled therapist would have done a full structured course - either
a short course for non-complex work or an extended course for complex
work and have lots of experience behind them in managing mental
The other issue is many people need more than 6 to 10 sessions of
CBT. Locally, you are lucky to get 6 in primary care. You can get
10 sessions in secondary care/psychological therapy service, but
long waits to see a psychologist/skilled CBT therapist.
need psychological work such as psychodynamic psychotherapy, cognitive
analytic therapy, trauma-focused CBT for complex trauma, dialectical
behavioural therapy for destructive and impulsive behaviour difficulties,
schema therapy or family therapy. Skilled CBT for schizophrenia
is also not widely available as it requires extra training that
many staff cannot get.
Most psychological therapy services in the UK are stretched . You
can have an assessment, then go and sit on a lengthy waiting list
for a short course of treatment.
There is a huge gap between what Layard recommends, and those set
down by the British Psychological Society for various difficulties
such as personality disorder or the Nice guidelines.
Mental health is the cinderella of health priorities, yet they find
the money for the latest costly atypical antipsychotics (£300
a month for treatment plus monitoring).
Additionally in the UK we have a gross national shortage of consultant
psychiatrists who specialise in psychotherapy. These consultant
posts are super specialist and considered a luxury for mental health
trusts that have such a post.
However, if every locality had one it would mean that the assessment
process would be more thorough and speedier for those with complex
difficulties, and junior doctors would then meet the requirements
of their training in psychotherapy when training as psychiatrists
at a better level.
It would also encourage a more holistic approach away from a medical
model and back-up psychological therapy services, with better liaison
between psychiatry and clinical psychology.
Some people may be fortunate in that after three years they get
something - as many people never even get on a waiting list as there
simply is no resource to offer what they need at clinical effective
The disparity and inequity is also complex and postcode lottery
is another factor.
I have known people to move home in order to get a better service.
My advice is write to Gordon Brown - and keep the letters coming
in. It may not make a difference but at least we tried.
No work for
enthusiastic psychology graduates...
Henning-Pugh, psychology graduate
November 4, 2007
It is a disgrace that people with mental health problems are having
to wait up to three-and-a-half years for psychological therapy and
yet psychology graduates with excellent psychology degrees find
it almost impossible to find suitable employment, or opportunities
to join clinical psychology or similar training programmes to allow
them to practice.
With often as many as 200 applicants for each assistant psychologist
position, and many more applicants for each clinical psychologist
placement, it is no wonder the bottleneck exists.
are large numbers of very well educated and enthusiastic psychology
graduates desperately wanting to provide psychological assistance
to the general community, but very few are afforded the opportunity.
Surely there must be a better way to address the situation and for
these skills to be put to effective use in the community? Currently
many psychologist graduates, who would really prefer to work in
the field of psychology, revert to employment in other non-related
fields. This is such a wasteful use of valuable resources so desperately
needed in this country at this time.
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