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Tory MP Wants Government To “Redouble Efforts” To Fix Mental Health Crisis

Improving Access to Psychological Therapies (IAPT) has now been renamed as Talking Therapies (Alamy)

6 min read

A Conservative MP has said the government needs to “redouble its efforts” to properly research and prioritise NHS mental health treatment, and suggested that the new Major Conditions Strategy presents an opportunity to review the effectiveness and choice available in NHS therapy services.

In January, the Department for Health and Social Care (DHSC) announced a new Major Conditions Strategy which will include mental health alongside cancer and other conditions in an attempt to improve healthcare outcomes, replacing the formerly proposed 10-year cross-party mental health plan.

The decision was met with outrage by some mental health charities, and experts in the sector have said they are worried that reform of mental health services will take a backseat in the new plans, as the backlog of patients waiting for treatment continues to grow in the years following the Covid-19 pandemic. 

James Morris, Conservative MP for Halesowen and Rowley Regis and member of the Health and Social Care Select Committee, has said the Major Conditions Strategy should offer the chance for a "thorough review" into the widely-criticised NHS Talking Therapies programme.

Talking Therapies, previously known as Improving Access to Psychological Therapies (IAPT) before it was rebranded in January, is the programme used by the NHS to treat people for common mental health problems such as anxiety and depression, with cognitive behavioural therapy (CBT) as the favoured method. 

Referrals to IAPT have been increasing year on year, and while the NHS claims success in widening access to mental health services to more patients, the system is under immense pressure with huge waiting lists, including for child and adolescent mental health care.

In 2021/22, there were 1.81 million referrals to NHS talking therapies in England, an increase of 24.5 per cent from the previous year, according to NHS figures. 

“The IAPT programme has been successful for a certain cohort of patients,” Morris told PoliticsHome. 

“But the programme has been running for well over a decade, so as the government puts together its Major Conditions Strategy, now might be a good time to do a thorough review of the IAPT programme and to ensure that a range of different talking therapies are available for those who need them.

“I think a review would need to look at how the programme has worked, the data issues which have been identified and the extent to which we need to broaden access to psychological therapies beyond CBT which is at the core of the IAPT offer."

He said that “significant progress” had been made in pushing mental health up the agenda over the last decade, but that there is a need to “redouble our efforts” to properly research and prioritise the sector in the future. 

Dr Elizabeth Cotton, a senior researcher at Cardiff Metropolitan University and a qualified psychotherapist, told PoliticsHome she was disappointed with the abandonment of the 10-year mental health plan, adding she thought the new Major Conditions Strategy was a “sign of collective exhaustion on all levels”.

“Politicians are exhausted,” she said. “They don't understand the problem. Practitioners and service users are saying ‘stop putting money into something that really hasn't worked’.

“You can't keep defending a system that's broken like this. With such a high number of people being failed by these services, no-one's going to give you a round of applause for extending IAPT services.”

Dr Cotton said she “totally agreed” with Morris’s call for a review. “I think it’s diplomatic but it’s realistic about what could be done at a political level," she said. 

“If [the Major Conditions Strategy] really could include a review it would be greatly welcomed by service users, families and progressive professional networks.”

Ruth Jones, a psychoanalytic psychotherapist and regional representative of the Psychotherapy and Counselling Union (PCU) for the South West and Wales Region, said the current system provides “little choice” and a “lack of care” for patients. 

Since 2019, the contract for IAPT services in Bristol was given to a private company, Jones told PoliticsHome. She said the service has reduced the options for treatment to mainly CBT and psychoeducational groups.

“A service that claims to be providing choice of treatment is actually providing very little choice and thereby a lack of care,” she said.

Jones added that the lack of qualified CBT counsellors also presents a massive problem for the NHS, as many of those with ordinary counselling or psychotherapy training cannot get job opportunities in the IAPT service. 

A representative from the British Association for Counselling and Psychotherapy union (BACP)  said that of their more than 63,000 members, he estimated that the numbers working in the NHS are less than 2,000.

The NHS is working towards a long-term workforce plan, but a DHSC source told PoliticsHome that this will operate "separately" to the Major Conditions Strategy. 

Responding to the workforce issue, health committee member Morris said: “The workforce plan needs to address the long standing issues within mental health.

“IAPT has been the dominant programme within the NHS for many years but we do need to find ways of increasing the supply of appropriately trained therapists in other forms of talking therapy to increase capacity and increase patient choice.”

Labour MP and member of the health select committee Rachael Maskell told PoliticsHome she thinks the Major Conditions Strategy is "completely the wrong approach".

"The NHS is struggling to such an extent that you need to be able to pull out what you can do and then move onto the next area," she said.

"Resourcing and staffing are major concerns. but with no accountability, measurement or follow up, how effective interventions are is impossible to see. The NHS cannot function if it is focused on inputs (aka the IAPT programme) rather than outcomes."

With the Major Conditions Strategy expected to be published this summer, the government has called for evidence this week to “invite views on how best to prevent, early diagnose, treat and manage the 6 major groups of conditions which drive ill health and contribute to the burden of disease in the population in England”.

They are welcoming contributions from those who experience the six listed major conditions of cancer, cardiovascular diseases, chronic respiratory diseases, dementia, mental ill health and musculoskeletal disorders, as well as those working in NHS bodies, local government, and the voluntary and community sector.

A Department for Health and Social Care spokesperson said: “We’re investing £2.3 billion of extra funding a year to expand and transform mental health services in England by March 2024, so an extra two million people can be treated.

“This includes expanding access to NHS Talking Therapies for adults with mental health conditions such as anxiety and depression.”

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