Blog: Is IAPT ‘too big to fail?’

Andy · Mar 6, 2019

More than ten years on from its launch the Improving Access to Psychological Therapy (IAPT) programme is far from delivering on its targets. Why then, given the astonishing rates of attrition in both IAPT clients and staff, are two of our European neighbours seeking to implement similar models? We re-examine some of the evidence and explore what you see when you only look at a small part of a bigger picture.

The recent translation into Dutch of a book published in 2015 by two of the original proponents of England’s IAPT programme has prompted calls in both the Netherlands and Belgium for the adoption of similar initiatives there.

Closer to home, however, it’s clear that however positive the latest headlines about IAPT may be, all is far from well. Levels of attrition among clients remain high, levels of staff burnout and low morale are at epidemic levels, and services seem to be haemorrhaging staff.

Add to that the fact that Sweden has abandoned its pursuit of a single modality national model, and the interest in replicating IAPT elsewhere starts to look particularly curious. Is there part of the bigger picture that is currently missing?
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http://therapymeetsnumbers.com/is-iapt-too-big-to-fail/

Jonathan Edwards · Mar 6, 2019

Closer to home, however, it’s clear that however positive the latest headlines about IAPT may be, all is far from well. Levels of attrition among clients remain high, levels of staff burnout and low morale are at epidemic levels, and services seem to be haemorrhaging staff.

I am tempted to say I told you so but I admit to have been guessing at the number of chickens.

NelliePledge · Mar 6, 2019

Big Psych expands £££££ €€€€€€€

Sly Saint · Jun 23, 2019

https://twitter.com/user/status/1140891900078985216

have looked at the site; no mention of MUS as far as I can see.

twitterers; maybe someone could query it?

Sly Saint · Oct 26, 2019

Improving Access to Psychological Therapies: An idea that’s failed to deliver
October 21, 2019

One in three GP consultations are now estimated to involve mental health in some way. In the face of this demand, the past few years have seen the introduction of a new model called Improving Access to Psychological Therapies (IAPT). This model has been and continues to be expanded under the Five Year Forward View for Mental Health and the ten year plan. IAPT has been sold as a game changer and a panacea to revolutionise mental healthcare in the community. Sadly, the ground realities appear very different.

We need mental health services that are personalised and have flexibility around access, with the services genuinely designed around the patient. However, the way IAPT has been adopted is exactly the opposite. Overwhelmed and understaffed services with a high attrition rate of staff are hardly the breeding ground for revolutionary care. A model that screens the “service user” with personal questions about their intimate feelings on the phone, and which has been found to keep people waiting for months in some areas, unsurprisingly, results in huge dropout rates. The concept of patient choice under this model remains a distant dream.
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full blog
https://blogs.bmj.com/bmj/2019/10/2...tm_term=&utm_content=SME&utm_campaign=editors

Jonathan Edwards · Oct 26, 2019

Another one arguing for 'more traditional' approaches with just as little evidence base.

Common sense counselling may well be a good thing. I suspect you need something of that sort, but these people need to face up to the reality of needing to have some sort of yardstick for what is justified.

And it is always justified by statements like 'one in three is mental in some way'. I suspect that you could equally say five out of six are physical in some way.

rvallee · Oct 26, 2019

One in three GP consultations are now estimated to involve mental health in some way.
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That's a gigantic red flag that what is considered "involving mental health" has been stripped of all useful meaning.

Bloated belly? Mental health.
Loss of hair? Mental health.
Soft erections? Oh, you bet that's mental health, mein Sigmund.
Belief in magical psychology? Yeah that one but unironically.

I saw a few Twitter threads not long ago that seem to indicate that IAPT actually managed to make both mental health and medical services worse. Which would be kind of impressive if it weren't so harmful.

And now seemingly there is even a crisis of mental health in NHS physicians, at least according to Clare Gerada, possibly because they are placed in impossible situations. Who knew inventing fake problems and propping up a weird ideology could be a problem? Weird. Seems like everything our friend Simon and his ideological brigade touch turns out bad. Consistently. Might wanna apply a bit more scrutiny here, chaps. Just an idea.

Sean · Oct 27, 2019

rvallee said: ↑

Seems like everything our friend Simon and his ideological brigade touch turns out bad. Consistently.
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Wessely's Law: If Sir Simon says it is true, it almost certainly isn't. And vice-versa.

rvallee · Dec 9, 2019

Sly Saint said: ↑

Improving Access to Psychological Therapies: An idea that’s failed to deliver
October 21, 2019

full blog
https://blogs.bmj.com/bmj/2019/10/2...tm_term=&utm_content=SME&utm_campaign=editors
Click to expand...

BMJ just retweeted this article. Wonder why. Cracks in the dam?

https://twitter.com/user/status/1204046012731531265

Sly Saint · Dec 10, 2019

https://twitter.com/user/status/1204129895175118850

Sly Saint · Dec 16, 2019

Simon Wessely is doing his bit
Qatar 8th International Psychiatry and mental health conference 7 Dec 2019

1pm to 1.30pm

Plenary lecture 3

Title: Everything You Need to Know About Unexplained Symptoms, But Were Afraid To Ask

Speaker: Prof. Simon Wessely
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https://www.hamad.qa/EN/All-Events/8qimhc/Program/Pages/Saturday-7-Dec-2019.aspx

Professor Sir Simon Wessely
Professor of Psychological Medicine and Regius Professor of Psychiatry at King’s College London
Consultant Liaison Psychiatrist at King’s College and the Maudsley Hospitals.

Professor Sir Simon Wessely is Professor of Psychological Medicine and Regius Professor of Psychiatry at King’s College London and a Consultant Liaison Psychiatrist at King’s College and the Maudsley Hospitals.

Simon Wessely studied medicine and history of art at Trinity Hall, Cambridge, and finished his medical training at University College Oxford, graduating in 1981. He obtained his medical membership in Newcastle, before moving to London to train in psychiatry at the Maudsley. He has a Master’s and Doctorate in epidemiology. He is a Foundation Senior Investigator of the National Institute for Health Research, past President of the Royal College of Psychiatrists, current President of the Royal Society of Medicine and is also chairing the Independent Review into the Mental Health Act.

He has over 750 original publications, with an emphasis on the boundaries of medicine and psychiatry, unexplained symptoms and syndromes, population reactions to adversity, military health, epidemiology and others. He founded the King’s Centre for Military Health Research, which is now the main source of information on the health and well-being of the UK Armed Forces past and present and has been Civilian Consultant Advisor in Psychiatry to the British Army since 2001, He has co-authored books on chronic fatigue syndrome, randomised controlled trials and a history of military psychiatry, although sadly none of them are best sellers.

He is active in public engagement activities, speaking regularly on radio, TV and at literary and science festivals. He is a trustee of Combat Stress and his contributions to veterans’ charities include cycling (slowly) eight times to Paris to raise funds for the Royal British Legion.
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(wonder if he wrote this profile himself?)
how much to fly over to Qatar to give a 1/2 hour speech?

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Blog: Is IAPT ‘too big to fail?’

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Andy Committee Member

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Sly Saint Senior Member (Voting Rights)

Jonathan Edwards Senior Member (Voting Rights)

rvallee Senior Member (Voting Rights)

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