Mental Health - Talking Therapies: Government Initiatives, NICE Guidelines, and Reality

This week has been very difficult. I’m recovering from severe depression, and also have problems with Obsessive Compulsive Disorder (OCD). At the moment the OCD is severe, it is having a massive impact on my life and I desperately need therapy. The NICE guidelines (section 2.6.2.4) state that if someone has had a course of CBT for OCD, and then has a relapse, the individual must not be put on the normal waiting list for more therapy, but be given further treatment as soon as possible.

I have a lot of sympathy for the staff who deliver treatment in the NHS. I have been well looked after, by a Community Mental Health Team over the last 2-3 years. However, they just do not have the staff to provide therapy. The required staff have been reduced, and I think that there is only one left. Just one psychologist! So the waiting list for therapy is now 12-18 months. I seriously wonder how long it will be before this lone individual needs therapy too, due to the stress and pressure!

This obviously bears no resemblance to what is documented in the NICE guidelines for treatment of OCD. If my local NHS trust was able to implement these guidelines, I would have started therapy about 4 months ago or maybe even more.

I am also not sure how this equates to the government’s initiative to make ‘talking therapies’ much more readily available. In the area in which I live, even individuals whose lives are severely impacted by mental health difficulties can not receive ‘talking therapies’ in a timely manner.

The local CMHT have referred me for assessment at a specialist centre some distance away, with a view to having treatment there. If I am accepted for this treatment the cost will be covered centrally, not by my local NHS Trust. I appear to fulfil the criteria to qualify for this treatment. I have no idea on the timeframe. Every day I hope that there will be an appointment letter in the post, but as yet it has not come. I am not dealing at all well with the uncertainty – just not knowing whether I will still be waiting for a letter in say three months time, or whether it will arrive next week.

Today, there is an article in a local paper stating that our NHS trust has the biggest deficit in England. It states ‘A spokeswoman said the trust had reduced the debt through a programme that focused on efficiency savings "without compromising quality of services or patient safety".’ I am surprised at how much this has upset me. To me this statement is blatantly untrue. Staff cuts have had a direct effect on my treatment – it has meant that I have to wait and wait and wait for therapy – surely this counts as “compromising quality of services”. I just wish the people who are responsible for the local NHS Trust’s financial mess knew the impact that the cuts are having on lives. But then just suppose they were not affected by this information, suppose they just shrugged it off. Maybe it is better that I just continue in the belief that they might actually care.