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BMA unveils ‘blind spot’ in mental healthcare

Scant data on mental health therapies.

Jo Carlowe

Wednesday, 07 February 2018

Commissioners and providers are failing to record the numbers waiting for specialist mental health therapies, with patients waiting years for vital treatment.

The new data from the British Medical Association unveils a ‘blind spot’ in mental healthcare recording which is resulting in patients with serious mental health problems waiting up to two years to be seen.

Freedom of Information (FoI) requests made by the BMA to Clinical Commissioning Groups (CCGs) and NHS mental health trusts revealed nine in 10 (166) of the 183 CCGs who responded have no records of waiting times for talking therapies for treating severe mental illness last year.

Of the 47 mental health trusts that responded, 22 had no records of waiting times for talking therapies.

The four talking therapies the BMA enquired about were: DBT (dialectical behavioural therapy), CBT (cognitive behavioural therapy), family therapy and dynamic psychotherapy.

Using responses from the trusts and CCGs who did keep records, the BMA found 3,700 patients waited more than six months for talking therapies. Around 1,500 patients waited longer than a year before therapy started, according to FoI responses.

Of all trusts that recorded waiting times for one or more of these services, year-long waits were uncovered in two-thirds.

In Leicestershire, patients waited for up to two years; in Essex and Derbyshire, patients waited for a year and a half before treatment began; in Croydon, more than 100 children were waiting for more than six months for specialised talking therapies.

Only three trusts had information on waiting times for DBT; eight hold data on waits for family therapy.

Hospital trusts pointed to rising demand and a national shortage of the right kind of therapists, as reasons for long waits.

The BMA is calling for true parity of esteem between physical and mental health services and that patients should expect the same high standards of care whether seeking help for mental or physical health problems.

Commenting on the findings, Dr Andrew Molodynski, BMA consultants committee mental health lead, said: “There is increasing inequality between people suffering mild to moderate mental ill health and those with severe mental illness. Over the past decade, there have been great strides in improving access to psychological treatment for people suffering mild depression and anxiety through IAPT (Improving Access to Psychological Therapies) services, which offer easy and often quick access to a limited range of treatments.

“While most doctors would welcome more IAPT services, this service isn’t appropriate for people with serious mental illnesses and health planners risk a ‘blind spot’ where many patients’ needs are overlooked.

“While their conditions can be eased with drugs, most patients with complex mental health needs require a combination of talking therapy and medication to make a meaningful recovery, and patients can find it troubling not knowing how long they will wait for therapy.”

He added: “Without the right therapy, some patients deteriorate and become more vulnerable, being passed from GP surgeries to emergency departments unable to find the most appropriate treatment for their illness.

“The extra investment in IAPTs shouldn’t come at the expense of talking therapies, which are well-regarded and deliver good outcomes. Funding for talking therapies should be protected so CCGs can ensure funding reaches services that need it most before it’s too late."

The BMA is also calling for:

  • An NHS-wide audit of talking therapies for patients with more severe mental health conditions
  • A new programme of funding, workforce and performance checks for a national talking therapies service for patients with more severe mental health problems
  • Extra investment in these four specialist therapies — DBT (dialectical behavioural therapy), CBT (cognitive behavioural therapy), family therapy and dynamic psychotherapy — to be protected for this use.

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