GP's and MH therapy

The following is from the Guardian newspaper , it makes interesting reading -

Britain's GPs are increasingly angry and frustrated at not being able to get the right therapy for people with mental illnesses – especially for children, who face unacceptable delays in receiving help or do not get it at all, according to a new survey.

An "overwhelming" response to a survey sent out to family doctors by the Royal College of General Practitioners (RCGP) has painted a picture of patchy availability of adult psychological services across the country and an even poorer availability for children. Family doctors reported shocking cases of critically mentally ill people having to wait months for help, or not getting it at all, in breach of national guidelines.

The situation of children was worse than for adults, with 78% of doctors saying that they could "rarely" get help for a distressed child within the recommended two months' waiting time. One doctor reported the case of a 16-year-old rape victim who had started self-harming after being refused help, while another said a girl who had seen her sibling burn to death in a car was offered an appointment with the mental health service in six months' time. "Our service is appalling unless the kids are actually slitting their wrists – I see this as an area of huge need," said one GP.

Professor Steve Field, president of the royal college, wrote to members asking whether adult patients suffering from depression or anxiety disorders and requiring specialist psychological therapy were able to get treatment within two months. Some 1,150 doctors replied, with 65% answering "rarely". Only 15% of them answered "usually", with 20% responding "sometimes".

When asked about children suffering from emotional or behaviourial problems who needed such therapies, 78% of the GPs replied that "rarely" could they get the child help within two months with just 5.8% saying they could "usually" access treatment within the Nice (National Institute for Clinical Excellence) guideline of two months. "We were overwhelmed by the responses. It is shocking," said Field. "There is a strong sense of frustration coming through in many parts of the country and patients clearly deserve better. People should have access to approved treatments, and this has to be a wake-up call.

"If patients can't get access to talking therapies, then they will be on medication. Investing in mental health services will save the NHS and the economy a lot of money, and save it very quickly."

The survey was carried out as part of a campaign launched this month by the RCGP, the Royal College of Psychiatrists and the mental health charity Mind calling for all political parties to make a manifesto promise to back a new deal for children and adults with mental health problems. The government began its Improved Access to Psychological Therapies (IAPT) programme in 2007 after repeated clinical trials showed that "talking therapies" – where people are helped to challenge their own negative thoughts – are as effective as drugs in the short term and better in the long term at preventing relapses. That evidence led Nice to issue guidelines stating that people with depression and anxiety disorders should be offered the choice of cognitive behavioural therapy – a talking therapy.

The chief executive of Mind, Paul Farmer, says talking therapies save lives. "When someone is assessed as being in need of counselling or CBT, it is crucial that they can start treatment as soon as possible. Waiting months and months for urgent treatment would not be acceptable for patients with other health problems, and it should not be acceptable for patients with depression."

But while extra money has been given to health trusts around the country, it is now no longer ring-fenced and the campaigners want a political commitment to the IAPT programme from whoever wins May's general election.

"There has been some great work from the government and they deserve credit for being the first British government to take mental health seriously," said Richard Layard, of the London School of Economics.

Layard led a research team who in 2007 published a cost benefit analysis of psychological therapy. It found that the costs of providing psychological therapies would be recouped within two years in savings made on paying out incapacity benefit and lost taxes from more than a million people who are unable to work because of their mental health issues.

Layard said strides forward had been made but the service was spread too thinly. "IAPT has made very good progress, but it is still at a fragile stage if the political will is not behind it. We need to get mental health raised up as a national priority and see significant pressure brought to bear on primary care trusts to invest."