What UK Government is thinking

Half of 10,000 new therapists should be clinical psychologists

Half of a possible 10,000 new NHS psychological therapists to treat depressed people should be clinical psychologists, according to an influential government adviser.

The government last month took its first step on realising a plan for the NHS to employ more counsellors and therapists by launching two pilot cognitive behavioural therapy (CBT) centres for people with depression and anxiety in Doncaster, Yorkshire, and Newham, London.

Health economist Lord Richard Layard, credited with providing the idea behind the initiative, is the lead author of a new report on depression which states that 5,000 extra clinical psychologist could be brought into the NHS if the current intake of 550 yearly trainees was expanded temporarily to 800. Other psychologists could be recruited from outside the NHS.

A further 5,000 therapists could be trained from among the 60,000 nurses, social workers, occupational therapists and counsellors already working in the NHS, recommended Lord Layard and co-authors in the London School of Economics (LSE) report.

If the pilot therapy centres are effective, similar centres will be rolled out to the rest of the country, the government has promised.

Ironically, the British Psychological Society, which accredits clinical psychologist training courses, last month complained that funding for clinical psychologist training in England and Wales has been slashed by 20 per cent.

The LSE report – entitled Depression Report – A New Deal for Depression and Anxiety Disorders – was last week backed by four of the UK’s most influential mental health charities – Mind, Rethink, The Mental Health Foundation and the Sainsbury Centre for Mental Health.

They want to see the government invest massively in psychological therapies for people diagnosed with not only depression and anxiety, but also schizophrenia.

In 2004 the National Institute for Clinical Excellence (NICE) advised that people with mild to moderate depression or anxiety can benefit more from counseling of psychotherapy than medication. NICE recommended in 2002 that psychological therapies, particularly CBT, should be available for people diagnosed with schizophrenia. Usually, however, such an option is not available, and waiting lists can be years.

In a joint statement, the chief executives of the four charities said: “We call upon the NHS to implement NICE guidance on mental health and to invest urgently in sufficient capacity to offer people the treatment they need in a timely manner and to high quality standards.”

The government’s eagerness to follow Lord Layard’s advice is largely driven by a desire to slash incapacity benefit payments by finding ways for the 1.3 million people with a mental health problem who claim such benefits to return to work.

The report, compiled by LSE’s mental health policy group headed by Lord Layard, states that there should be 250 new psychological therapy centres in England, each serving a population of 20,000 by 2013.

A course of therapy costing £750 would pay for for itself in the reduced expenditure on incapacity benefits from people being able to go back to work, said the report.

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