Who is in bed with whom (Part 2)? A call for your action.

by Julia Evans on December 2, 2010

Nice and cosey does it….  When you are getting in bed with each other!

PS Please read the call to action at the end.  Thank you.

The following is based on the speech by Paul Burstow MP, Minister of State for Care Services, 2 December 2010: New Savoy Partnership (Psychological Therapies) which is available here.  Details of the New Savoy Partnership are available here  and its membership is available in endnote [i].  It will be posted to 2nd December 2010 though circulated in September 2011.

 

There follows statements made by the Minister of State for Care Services.

Remember, regx2 circulations over the last five years have explained how Ministerial Statements are made.  The civil servants, who are no longer servants or mandarins, but model themselves on Tony Blair’s advisors, tell the Minister what to say and the Minister dutifully repeats it.

 

From the text read out by Paul Burstow MP:

Mental health has moved forward significantly in recent years.

I can’t resist saying ‘not before time’ and ‘not far enough’ …

some major steps have been taken.

Acute mental health services lifted out of obscurity. Better community support. Better outreach. More crisis services for those with the most severe mental illness.

And psychological therapies – breaking new ground. Transforming how we think about depression, anxiety and other common mental disorders. And giving GPs more options and patients more hope of recovery.

Real progress.

And progress that’s down to you.

To the members of the New Savoy Partnership and the We Need To Talk coalition – thank you for campaigning so effectively for change.

Because yes, there are issues in acute care. Issues around community treatment. Around variability of standards. Around co-ordination of local services.

And yes, we need to reduce the persistent gap in outcomes between different social groups.

The Mental Health Strategy

Reducing these inequalities will be central to the new strategy for mental health when it’s published early next year.

The other thing this strategy will do is project a much broader vision for mental health.

A vision grounded in wellbeing.

And a vision that sees mental illness as one of the big social challenges of our time.

No longer just a Department of Health issue, or even just a Government issue.

A challenge borne by our society, and to be tackled throughout our society.

Depression, stress and other mental disorders costing the NHS more than £10 billion.

And costing our wider economy at least ten times that amount.

David Cameron saying that general wellbeing should now become a key measure of our success is highly symbolic.

Why? Simply because what a Government measures affects what it does.

But after a painful recession, we also need to heal emotional wounds.

We need a psychological recovery alongside economic recovery.

The value of IAPT

And IAPT is key to this. By reaching into people’s lives, and reaching out across the services that support them, you can be a powerful point of connection. Brokers, if you like, of this new approach to mental health and wellbeing.

I had the pleasure of meeting some of your professional colleagues at a centre in Reading a few months ago.

I spoke to the service users, learnt about how these therapies had changed their lives, transformed their confidence, their outlook, their aspirations for the future.

There was a time when diagnosis of a mental health problem was the end as far as work goes. IAPT is changing that.

Everyone I met there had had their lives turned round by the services they received.

One lady had suffered a serious physical illness and had to leave her job. Going in and out of hospital, and then being stuck at home, she became depressed and withdrawn.

And so when she’d recovered her physical health, she was paralysed with fear and anxiety and couldn’t return to work.

Therapy made all the difference. She regained her confidence, she eased herself back to work, she got back to her normal self.

I know that stories like this inspire the work you do.

And this is where Sue’s [Baker, chair of Time To Talk] organisation comes in.

Reducing stigma. Puncturing myths. Dispelling prejudice. This is absolutely key to the change we need to see.

Expanding the Programme

First, we need to complete the existing training programme.

Two-thirds of the country already covered.

By the end of this financial year, 3,700 newly trained staff will be on board.

The funding we’re releasing from the Spending Review will mean that by 2015, every patient in the country should be able to get timely access to proven psychological therapies.

So we’ll invest the money and work with the local NHS to upskill staff across four other NICE-approved therapies:

In counselling

interpersonal therapy

brief dynamic therapy; and

couples therapy

Children and Young People

You all know the value of intervening early. The cost of reaching out too late.

Up to half of all mental illness starts before the age of 14.

Untreated disorders can blight a child’s school years and future prospects in ways that are terribly difficult to recover from.

So we now want to develop a psychological therapies model for children.

We’ll do so by setting up pilot sites, where teams will train up staff to provide appropriate therapies for younger people.

And asking the crucial questions.

What’s the level of unmet needs?

Where and how should we offer these therapies?

How do we work with schools and children’s services most effectively?

The ambition here is very clear: to take the same step forward in access for children and young people that we have in adult services.

With psychological services designed for children, and to a significant extent designed by them.

We will use the knowledge and expertise of organisations like Young Minds and others.

To make sure this IAPT programme genuinely speaks to the needs of children, young people and their families.

And how can we link this up with our Dementia strategy?

We need to find the right answers and we need to do it quickly.

IAPT Aad Severe Mental illness

There are two other major groups not benefiting from IAPT.

The first is the one-and-a-half million people who suffer with severe mental illnesses like schizophrenia and bi-polar and personality disorder.

The National Institute of Clinical Excellence recommends psychological therapies, yet research by Rethink suggests that half of those with these conditions have never been offered these therapies.

Again, we need to do better, and again I want the voluntary sector and the professional community to lead us to the right solutions.

We’ll bring together Rethink, the Royal Colleges and other professional bodies to look at existing capacity, and develop appropriate training for their members and for practising therapists.

IAPT and LTCS

The other excluded group are those with medically unexplained symptoms and with long-term physical conditions.

People with diabetes, hypertension and heart disease have twice the rate of mental illness.

If you have two or more health conditions, you’re seven times more likely to have depression.

And this is reciprocal. Where the depression isn’t treated, your physical recovery suffers too.

Studies show diabetics with depression cost the NHS between 50 and 75 per cent more to treat than those in good mental health.

Which is a pretty active demonstration of the adage that there’s “no health without mental health.”

And that’s a principle that must be etched on the hearts of NHS commissioners.

We can no longer have a health service that patches people up physically, but leaves them struggling mentally.

We need a big shift in emphasis. Mental health on a par with physical health in the NHS.

The big question is how do we make this happen in practice?’ How do we ensure mental health doesn’t slip back in tougher times? To be blunt, how do we ensure there’s life after IAPT?

**** end of quotes from the Minister’s speech

A Call to action

 

The Minister of State for Care Services must have his questions answered by other people than his collaborators: the New Savoy Partnership and the Psychiatric Medical Establishment.  I recommend you feed your answers back through your MP – if upwards of 20 of you do this in through Parliament it will be seen as an important issue. Involve your colleagues……..

 

Where to start?

Start with the Government’s position of being in control of safeguarding Mental Ill-Health and Dis-being.  This is the Sadeian delusion that Government action will cure human-BEINGS with symptoms of distress.

 

Go on to question the position that the recipients of Government-safety-kited-therapy are reduced to:  Objects to be treated in the Government’s Wellbeing or Happiness Factories, based on ‘High Risk Health Industry’ as in Lord Donaldson – the Chief Medical Officer – ‘Consultation analysis report: Good doctors, safer patients and The regulation of the non-medical healthcare professions‘ February 2007[ii].  They are reduced from their full unique subjectivity to being objects who can be coralled into batches via NICE clinical guidelines and then restored to Government-standard economic happiness.

 

Then question where the Minister’s certainty comes from that the training required to attain the practitioner position can be condensed into the Government’s One Standard.

 

Then question how the Government is so certain that they are making inroads into what they define as Mental Ill-Health or Dis-being.  What evaluation process are they using?

 

Then question the use of cost-benefit analysis in this area…..

 

Then question the amount of money they are going to save.

 

Then question whether their collaborators really can provide the miracles they are promising.

 

Then question whether, according to EU Law, the base level of activity has been established (it has not) and whether there has been an impact analysis (there has not). Remind your Parliamentary contacts about the Fire Service Case…… (See Lacanian WorksHow Government Action goes wrong…. ‘The report says the department pushed ahead without undertaking basic project approval checks, taking decisions before testing the ideas for feasibility.’ : by Julia Evans on September 20, 2011)

 

And invent your own reasons

 

BUT DO IT NOW



[i]  And the list of member organisations will not transfer so here is which members signed the initial declaration in 2008:

Signed:

Lord Victor Adebowale CBE Chief Executive Turning Point

Susanna Abse Director The Tavistock Centre for Couple Relationships

Jon Allen Director – Mental Health UnitedHealth UK

Malcolm Allen Chief Executive British Psychoanalytic Council

Madeline Andersen-Warren Chairperson British Association of Dramatherapists

James Gray Antrican Chair UK Council for Psychotherapy

Sue Baker Portfolio Director Time to Change

Nicola Barden Chair British Association for Counselling and Psychotherapy

Steven J Burnell Director Focused_on Ltd

Jeremy Clarke Chair New Savoy Partnership

Yvonne Clarke Co Managing Director Pathways Community Interest Company

Mike Crossley Head of NHS Services AXA ICAS

Ronald Doctor Chair Association for Psychoanalytic Psychotherapy in the National Health Service

Professor Chris Evans President UK Society for Psychotherapy Research

Paul Farmer Chief Executive Mind

Professor Steve Field Chairman Royal College of General Practitioners

Professor Peter Fonagy Chief Executive The Anna Freud Centre

Angela Greatley Chief Executive Centre for Mental Health

Dr Dennis Greenwood Chairman- UPCA

Mark Harrison British Association for the Person Centred Approach

Barbara Herts Chief Executive YoungMinds

Jenny Hyatt Founder Big White Wall Limited

Jonathan Isaac General Secretary – British Society for Mental Health and Deafness

Paul Jenkins Chief Executive Rethink

Fiona Kerr Chief Executive Mental Health Helplines Partnership

Serena Laurence Director – Hoffman Institute

Mariana Larios Rovirosa Society for the Exploration of Psychotherapy in the UK

Dr Gillian Leng Implementation Director National Institute for Health and Clinical Excellence

Lykke Leszczynski Director WPF Therapy

Nicky Lidbetter Chief Executive Officer Anxiety UK

Dr Chris Mace Chair Psychotherapy Faculty Royal College of Psychiatrists

Lucy Marks Chair of Leadership Group, Psychological Services, Tower Hamlets CHS

Professor Pam Maras President British Psychological Society

Dr Andrew McCulloch Chief Executive Mental Health Foundation

Professor Peter McGuffin Dean and Head of School Institute of Psychiatry

Sheila Owen-Jones Chief Executive Officer- Metanoia Institute

Michael Pokorny Ethics Chair Intensive Short Term Dynamic Psychotherapy

Benita Refson Chief Executive The Place2Be

Katy Rose Director Counsellors and Psychotherapists in Primary Care

Stephen Sandford Chair Association of Professional Music Therapists

Sue Scott-Horne Director EGAR – Educational Games and Resources

Steve Shrubb Director Mental Health Network The NHS Confederation

Jane Smethurst Head of Staff Support, Counselling and Stress Management Cheshire and Wirral Partnership NHS Foundation Trust

Neil Springham Chair British Association of Art Therapists

Professor Peter Stratton The Association for Family Therapy and Systematic Practice in the UK

Nick Temple Chief Executive Tavistock and Portman NHS Foundation Trust

Tom Tichler Chief Executive Officer Herts and Beds Counselling Foundation

Nick Turner Director Relate Institute

Beverley Tydeman Chair Association of Child Psychotherapists

David Veale President British Association for Behavioural and Cognitive Psychotherapies

Ms Judy Weleminsky Chief Executive Mental Health Providers Forum

Dr Mark Westacott Chair Association for Cognitive Analytic Therapy

 

[ii] These issues are also explored in Lacanian Works

Registration and Regulation – an attempt at an update and the Government’s Happiness/Wellbeing Factories reappear

by Julia Evans on May 19, 2011