In 2008, the government released a statement highlighting their plans to improve mental health services in the UK, in new ‘Improving Access to Psychological Therapies’ (IAPT) reforms. These reforms aimed to employ more licensed practitioners, and treat more people suffering from anxiety and depression, while simultaneously reducing waiting times for these services, however they have not been entirely successful with this. In 2015/16, 1.4 million referrals were received for talking therapies, of which only around 67% ever received treatment. Of those treated, the average wait time for treatments was 29 days, however some waited up to 139 days, and this is only once referrals had actually been made. It is likely that in most cases, individuals waited even longer to be referred – that is if they were even lucky enough to receive a referral.
Recently, the NHS commissioned an IAPT expansion programme for 2017/18, whereby they aim to train and employee more individuals to carry out a number of low-intensity intervention strategies such as panic-management and cognitive restructuring. By introducing these roles the goal is to ensure more mental health employees are available; however while these new roles may be useful in providing short-term assistance, they will not necessarily address concerns regarding the availability and accessibility of clinical treatments. In sum, this new service may be helpful in providing contact prior to treatment, however it is unlikely to come close to solving the long-standing issue of a lack of access to qualified mental health professionals.
Of course, the short term nature of these roles is acknowledged by the NHS, meanwhile the long-term problems remain unaddressed. It is understood that these interventions will not provide the same support as a series of traditional therapies would do, however the NHS struggles with a lack of available staff to administer these sessions. Qualifying as a clinical psychologist, or equivalent professionalism, takes years of study and experience – therefore a shortage in this area is hard to address rapidly. Further, this problem is made increasingly difficult as a result of recent government cuts to the NHS in general, with particular budget cuts to several mental health services across the UK.
As with any government cuts to funding, the consequences can be dire, but especially so for mental health services. Currently in 2017 there are more people than ever before on waiting lists for mental health care, and trends suggest that this will continue to rise. The current system for referring and treating individuals, although showing signs of improvement, is currently just not appropriate for the scale of mental health cases in the UK. Waiting lists can often cause mental health issues to become heightened – meaning that by the time an individual is seen by a professional, that professional/service may no longer be the right one for them. Worse still, individuals on these waiting lists may not live long enough to receive the treatment they need desperately, as it is estimated that between 2003 and 2013, 18,220 people in the UK with mental health problems took their own life (University of Manchester, 2015). And, according to the Samaritans (Suicide Statistics Report, 2017), these figures continue to rise at an alarming rate.
It is clear that desperate action needs to be taken to solve the UK’s current mental health crisis, however as highlighted before, the current procedure for referring and treating individuals is simply not effective or quick enough, even with recent reforms accounted for. Accessibility to services may be improved in the long-term only through drastic change to how these services operate and are received, such that the procedure of seeking mental health advice needn’t be so long-winded. One potential way to do this may be through remote video therapy, which has the potential to speed up referrals while also reducing costs and making the best use of professional time.
Remote, or online, video therapy is something which may be administered from the comfort of one’s own home or office, and has shown promising effects which suggest it may be just as effective as face-to-face therapies. This kind of therapy is administered in a similar way to traditional therapies, but over video call from two separate locations, rather than the traditional method of therapist and client in the same room. A number of therapy techniques have shown to be just as effective using this method, such as CBT and psychotherapy to name a few, and it’s advantages for both therapists and clients respectively are numerous.
Using remote therapies could help reduce running costs for several mental health services, meaning that money could be spent more efficiently in order to help a wider scope of people. Further, these types of remote therapies free up time between sessions, meaning that more clients could be seen in a shorter period of time with less repercussions in the instance of no shows, or unexpected emergency appointments. In the case of online therapy, an appointment could quickly and easily be reassigned, rescheduled or redirected – meaning less wasted time or money, and fewer unused slots. In terms of improving accessibility, clients and professionals alike are less likely to be inconvenienced by waiting times, physical barriers to travel, or prior commitments, as these therapies can be carried out anywhere, anytime, as long as internet access is readily available. This has the potential to speed up the time between sessions, with professionals available even at non-standard times, which could alleviate the pressures currently experienced by the NHS by increasing the number of people seen within a day.
Currently however, the NHS does not offer this kind of service, despite its advantages. And, while the current IAPT reforms seem to be slowly improving accessibility, they have a long way to go if they are to catch up with the growing number of individuals with mental health complaints. At the moment, online therapy sessions are available privately, such as through the Dr Julian app, which may be suitable for those who feel that waiting months for an appointment is just not an option. The app currently allows individuals to book therapy sessions with their chosen professional at a time to suit them, without the need for a referral; which cuts out the NHS referral system altogether. Appointments can be booked and received the same day, without even leaving the house – making this up to 100x faster than the NHS. In the future, it may be that the public mental health system adopts this kind of online therapy booking system, however for the time being this is exclusively something available privately.
-University of Manchester (2015). National Confidential Inquiry into Suicide and Homicide by People with Mental Illness: Annual Report 2015: England, Northern Ireland, Scotland and Wales July 2015. Manchester: University of Manchester
-House of Commons Mental Health Problems Statistics on Prevalance and Services, available at: http://researchbriefings.parliament.uk/ResearchBriefing/Summary/SN06988
-Outline of current NHS IAPT reforms: https://www.england.nhs.uk/mental-health/resources/access-waiting-time/
-Samaritans statistics available here: https://www.samaritans.org/about-us/our-research/facts-and-figures-about-suicide
Source: Dr julian