Half a billion for 'talking therapies'?

[Londinium]

I have mixed feelings about this. More money going into mental health is welcome as the underfunding has been scandalous - suicidal children held in police cells for days because there are no beds. Can you imagine the outcry if a cancer patient was told they'd have to sleep down the local nick because the hospital was full?

As for talking therapies, the problem, IMHO, is not them getting more funding. The wait for such therapies for people that can actually be helped by them - people with anxiety, self-esteem, some depressive disorders - is unacceptably high; I've known somebody with anxiety attacks so crippling he couldn't leave the house have to wait nine months for an appointment. The problem is misdiagnosis and patients being shoved off to talking therapy without a proper investigation of whether they have an issue that can be helped by it. If there is a big push to fund talking therapies, the danger is more people with ME, FM, CRPS or temporal lobe epilepsy get sent off for CBT as the default 'difficult patient' option, much like SSRIs are dished out today. The answer here has to be GP education though, rather than a funding issue.

So hence the mixed feelings: concerned that this will lead to a further 'MUPS' landgrab, but pleased at more money going into mental health in general.

 

[Sean]

I have no problem at all with the appropriate amount of resources and power being granted to mental health programs that have been clearly and adequately demonstrated to be effective and safe.

But that is not what is happening here. It is just being used as an excuse to not do proper research and not provide proper treatments for a whole range of medical problems that have nothing to do with mental illness.

 

[trishrhymes]

I don't think this is new money, just a reshuffling of scarce NHS funds. There is a scandalous lack of acute care and high quality care for patients with serious mental illnesses.

I fear too much of this funding will be diverted into low quality CBT for everyone GPs don't know how to handle.

 

[Sean]

In a no doubt unintended outcome, GP's may well end up our ally. There is only so long the people on the front line can deny the lack of efficacy of a treatment. At some point they will have to admit it isn't living up to its extravagant claims.

 

[Jonathan Edwards]

There is absolutely no doubt that there is a desperate need for more resources in psychiatry. However, what we do not need are politicos who see that in terms of a 'ten year plan'. We need people who have enough intelligence to know what they are doing.

I have this sort of feeling that having joined a group of people lifting a log expecting to find some woodlice we have instead discovered a cesspit writhing with every form of distasteful invertebrate known to man.

 

[SamanthaJ]

The IAPT stuff doing the rounds does suggest we're just going to see the money spread thinly (and inappropriately) over a wider range of conditions, with lots of online CBT (presumably with a profit for providers?). Would love to be wrong, but a lot of decision-makers seem to think this is a cost-effective way to spend the money, and there's financial and professional gain for those advising them. The wider cost to society of insufficient and inappropriate treatment seems to be beyond their remit. Wish mental health charities and champions would call them out on this. The relentless 'mission creep' into physical conditions doesn't help someone unable to access treatment for e.g. psychosis or bulimia.

ETA: I realise psychosis and bulimia may have a biological cause, but at the moment people can't even access existing help.

 

[trishrhymes]

In a no doubt unintended outcome, GP's may well end up our ally. There is only so long the people on the front line can deny the lack of efficacy of a treatment. At some point they will have to admit it isn't living up to its extravagant claims.

Some of the more perceptive GPs may well realise the CBT hasn't worked when patients com back with the same problems.

I fear in many cases it will lead to patients giving up raising their symptoms with the GP, or stopping going to the GP altogether. And in other cases, the GP will fall into the patient blaming trap - if it didn't work you didn't try hard enough.

In my case when I had a course of CBT for depression caused by having to give up work, the CBT was worse than useless, and I eventually found my own way of dealing with it through writing poetry (not for publication).

The GP probably has that CBT recorded as a success, since I never sought further help for depression.

 

[daisybell]

I have a relative who works in the police in London and he says that the vast majority of the cases they get called out to are due to mental health issues - where people have simply not been given the support they need for serious issues - schizophrenia for example. The cells are full of people who should be in inpatient mental health units but there aren't the beds.
Spending more money on cheap mental health 'support' like CBT and psychotherapy is like treating all physical health issues with sticking plasters - totally f'ing useless.
The money needs to be spent on expensive stuff... people with years of training, not months; well-staffed beds; more facilities; more GPs.....

 

[Sean]

I have no problem at all with the appropriate amount of resources and power being granted to mental health programs that have been clearly and adequately demonstrated to be effective and safe.

Not to mention relevant, and acceptable to patients.

 

[Sidereal]

What people with mental illness need is more funding for inpatient services and more psychiatrists and nurses. MORE BEDS. No politician will ever honestly speak about this issue because we're all supposed to pretend that "community care" has worked and that closing down thousands of beds was a good idea. You see, according to this line of thinking old asylums = evil, bad, abusive etc. but transferring large numbers of young males with psychosis and/or substance abuse to the streets to be homeless or into prisons = progressive.

 

[slysaint]

This is currently being discussed on the Jeremy Vine show BBC Radio2 (V. Phelps standing in).
eta: finished around 12.30
mostly covered getting ex Mental Health Nurses back.
http://www.bbc.co.uk/programmes/b006wr3p go to listen live then move the slider back to start to listen from beginning of programme

 

[Mrs Sowester]

A friend's son, early 20s, developed extreme mania - the kind that gets you killed or sectioned. There was no appropriate help or bed for him in our area, he had to be an inpatient in London where he had no support network.
His mother is a health care professional, her partner is a GP, she could have paid for his care, but there was no appropriate bed for him within 100miles.
We desperately need places of safety, beds for people with mental health conditions - not more money wasted on magical thinking for the masses.

 

[keenly]

It seems that Mr Jeremy Hunt, the UK health minister, has announced a further £1.3B for mental health staff. People are already saying the figures do not add up but it looks as if half of this is going on psychotherapist salaries for 'talking therapies'. See https://www.theguardian.com/society...xed-response-to-13bn-plan-for-better-services

I think this indicates the scale of the vested interest in psychotherapy that lies behind PACE. OK, talking therapy might be useful for psychiatric illnesses like depression, but I am about as sceptical about use of therapists there as I am for ME in fact. The problem is actually lack of medical and nursing staff.

Quackery is big business.

 

[A.B.]

A friend's son, early 20s, developed extreme mania - the kind that gets you killed or sectioned. There was no appropriate help or bed for him in our area, he had to be an inpatient in London where he had no support network.
His mother is a health care professional, her partner is a GP, she could have paid for his care, but there was no appropriate bed for him within 100miles.

Unbelievable. Meanwhile internet CBT of dubious efficacy is rolled out for kids that may not even need it.

 

[hellytheelephant]

Big YEP!

I have paid for a LOT of therapy in my life for other issues...and I've had some very good, helpful and professional therapists...and I can confirm that NONE OF IT has made any difference to my physical health problems or ME!!

I doubt very much whether this means that the average depressed or anxious patient will be able to access individual talking therapies on the NHS ( as I did 25 years ago) as this would be prohibitively expensive.

Personally, I feel the constant arguing about if ME is a mental health issue or not is missing the point- the point being to get ME patients some treatment that actually works!!

 

[Barry53]

This smacks of Yes Minister (which was rooted in basic truths of course). Unable to smother a news story they are scared off, so create another one to try and swamp it.

 

[NelliePledge]

this is why it is just so appalling - instead of pushing ME patients through the CBT sausage machine they should change direction and use their psych resource on supporting people who actually have mental illnesses - improving things for two sets of patients at a stroke

 

[keenly]

Unbelievable. Meanwhile internet CBT of dubious efficacy is rolled out for kids that may not even need it.

Kids need sunlight, not CBT.

 

[Seven7]

ok so this points to a bigger agenda, that can explain the situation with PACE and why he is pushing to stop the publication. What is the long term plan? is important to know so all start to make sense.

 

[Hip]

I think when providing for and caring for those with mental health conditions, you have accept that at present, in many cases there is often not a great deal that can be done medically; drugs can help to varying degrees, but we don't yet have the medical technology that can "retune the brain" back to normal mental health.

So at present, there needs to be support for those with mental health, in the sense of a shoulder to lean on and someone to turn to, and drug treatment where appropriate. Whether psychiatry is the most effective shoulder to lean on, I don't know. Certainly you need generally psychiatrists in order to help diagnose the mental health condition, and then prescribe the right drugs.

But maybe if the government organized other forms of shoulders to lean on and other forms of social support, this might be more effective, and more cost effective too.