The problem with IAPT

I’ve just been referred to IAPT when i really shouldn’t have been, i will explain..

A bit of background: most of you know that i have struggled with various mental health issues for the majority of my life. I’ve also used mental health services on and off for the past decade to try and move towards that elusive “recovery” we hear so much about. I’m also a very well-informed service user with 5 years of  experience working with organisations like YoungMinds-basically i know what i’m talking about when it comes to mental health and in particular what is best for me.

I recently went back to my GP in a very distressed state. My anxiety recently has been through the roof and it’s had a crippling knock on effect on my mood and several other conditions which in turn has lead to a sharp deterioration in both my mental and physical health. Basically i was not in a good way-another bad downspike in what for me is a severe and enduring problem.

This one GP in particular is one i try to avoid as we have had several clashes over my treatment in the past. After refusing to prescribe me more medication she offered to refer me back for CBT (which i have had previously & has been relatively effective). I agreed but pointed out it would probably be at least a year until i was seen and that i would need to continue medication in the meantime (which she was not happy about). She told me that several of her patients had only waited a month or two.

This struck me as odd-i look back and want to kick myself; i should have known why.

She was not referring me back to the adult CMHT who have seen me before and know me. She was referring me to IAPT.

I have since been back to the surgery to see a different clinician who confirmed exactly what i already knew: i should never have been referred to IAPT and my local IAPT service won’t take me-i am too severe a case with far more than mild-moderate Depression/Anxiety.

It’s very frustrating to continually have to educate clinicians myself about things they should know about-mental health and services in particular. I often have to explain mental health conditions to GPs (who do not need to have any training on mental health to qualify by the way) or tell them about third sector services in the area that they could refer people to.

I am exhausted from having to constantly and almost aggressively self advocate in order to get any treatment at all.

Oh the irony..

For me this is actually almost painfully ironic.

You see while i was a VIK at YoungMinds i was part of several consultations on IAPT before it was up and running and i even facilitated group workshops for other young people on the subject. I liked the idea in principle, after all it would offer therapy to so many people who usually wouldn’t be considered “ill enough” or would have ended up of the bottom of the average 18 month waiting list of adult mental health services. It would also bring in a self referral element often lacking from statutory mental health services and the waiting lists they suggested were much better too.

But i did argue one point very strongly:

My concern was that the implementation of IAPT might lead to cuts in other psychological therapies on offer and that we ran the risk of IAPT becoming the be-all and end-all. This is because IAPT is quicker and also therefore cheaper than more traditional talking therapies making it more attractive to commissioners and cash-strapped trusts.

I said repeatedly that there must be safeguards put in place and that clinicians and patients needed to be fully aware that IAPT is not appropriate for everyone, especially not those with more severe issues. Especially as IAPT often offers just 6-12 CBT sessions which are not appropriate for every condition and often not enough (i’ve had about 30 sessions over the years so far and i’m still painfully ill).

Sadly it seems my fears have been realised.

From January-March 2012/2013 259,016 people were referred to IAPT but only 154,722 entered treatment which suggests to me that i am not alone in being wrongly referred to the service. (Source: Health & Social Care Information Centre IAPT data set).

I have also spoken to a large number of people, especially in the 18-25 age range who have been referred to IAPT when they should not have been.

I would be very interested to hear of anyone else’s experiences of being wrongly referred and will be voicing my concerns on this matter to the NHS and YoungMinds.

What is IAPT?

IAPT stands for “Improving Access to Psychological Therapies” and is an NHS program to extend access to talking therapies for over 18s in England (there is also CYPIAPT for children and young people). It is usually offered to people with mild-moderate Depression, Anxiety or Stress.

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