New research from the BMA unveils a ‘blind spot’ in mental healthcare as most commissioners and providers don’t record the number of people waiting for specialist mental health therapies, leaving patients with serious mental health problems waiting up to two years for vital treatment.
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.
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 to be protected for this use
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 IAPT1 services, which offer easy and often quick access to a limited range of treatments.
“While most doctors would welcome more IAPT services2, 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.
“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.”
Notes to Editors
1 - Find out more about the Adult Improving Access to Psychological Therapies programme here.
2 – “The Five Year Forward View for Mental Health sets the objective that IAPT services should see 1.5m people a year by 2020, with 75% of people accessing care within six weeks and 95% within 18 weeks. This will require the training of an additional 4,500 therapists between 2016 and 2020.” – Stepping forward to 2020/1: The mental health workforce plan for England, July 2017, Health Education England
- The BMA sent Freedom of Information requests to all 207 CCGs (Clinical Commissioning Groups) and 54 mental health trusts in England. 183 CCGs and 47 mental health trusts responded . Two trusts, Oxford and Devon, provided separate figures for two services.
- We asked CCGs and mental health trusts for average waiting times for four types of talking therapies; DBT (dialectical behavioural therapy), CBT (cognitive behavioural therapy), family therapy and dynamic psychotherapy. We also asked for the number of patients waiting for any psychological therapy for less than six months; between six months and a year; and longer than six months. For trusts which did not record waiting times data, we looked at recent CQC inspection reports for evidence of long waits.
- Read the BMA News feature here.
- The BMA spoke to Nicola Mattocks, a 20-year-old psychiatric nursing student who waited a year and a half for DBT. Watch a video interview with Nicola here.
The BMA is a trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.