Issues with IAPT

I've been really into working on my most recent writing project so I didn't really bother to think of a blog post idea! I've been writing in some form though so I'm still proud of myself.

So I'm going to go back to talking about the joyous, light-hearted topic of therapy! Yay...

It's going to be a little bit of a rant, a furious little observation, about one of my two major gripes with IAPT, the NHS based service I used to access therapy for managing my anxiety.

Issues with IAPT: Time between referral and contact

I was aware, upon referring myself to IAPT Enfield, that I would have to wait. I would have to wait because referral from one's GP puts one at a higher priority that if one were to refer themselves. The time between referral and my first phone conversation with someone from Enfield IAPT's main base was quite speedy, however, and I was booked for a telephone interview within the week. I was really pleasantly surprised, actually, and although the whole phone interview process was nerve wracking it was pretty quick, they took everything I said very seriously, and I felt like I was in the hands of people who really cared about my situation. (I was as it happens. The problem is most likely their limited resources, but we will get to that.)


So the phone interview happened, they told me they would be in contact...and then a month passes without any contact. I call up, they let me know I am on the waiting list. I referred myself between November and December of last year, and it wasn't until February of this year that I received a letter to let me know that I had been deemed eligible for therapy and would have an induction session in early March. Induction! Fantastic, I was making progress! It was a little slower than it had been in the beginning, but still I was going to make progress! The induction happened, it was in the same building as my GP surgery so I didn't have to panic about getting lost on the way to the session, and what really amazed me about the session was the variety of people I was in that induction session with.

It was a real variety of ages, races and walks of life. Men in expensive business suits to boys tracksuit bottoms, women in fur coats to girls in leggings and a t-shirt. Black, White, Asian, mixed, and many other things. It was utterly judgement free, everyone was very much keeping to themselves and you weren't pressured to speak or to interact at all, but it was encouraged. We were given an intro to CBT, an outline of what our sessions would be like, and the opportunity to ask questions.

One woman asked about when our actual sessions would start, and one of the therapists hosting the session said that there is no guaranteed time, and that we would not necessarily all be starting at the same time. 


Fair enough, I thought, I was sure I could wait a few weeks.

I had my first session in September of this year. That is a whole six months. Now, my anxiety was mostly exacerbated by the job I was in during the time I referred myself and had the induction. In May, I changed jobs so my situation changed and much of the information they had on me by the time I started my sessions was out of date. Luckily, my situation isn't as serious as some.

 In six months, so much can happen to a person to change their life. Unemployment, homelessness, accidents, deaths in the family. Your life could completely change in six months, and suddenly the therapy prescribed is not what will help you in your current situation. Six months is enough time for bouts of low mood to become a crippling depression that could make you housebound. You could seriously hurt yourself in that time, and I know they most likely make exceptions for emergency cases, but what if you become an emergency case within those six months? For me, that is a terrifying concept.

The problem is, of course, a lack of resources. There aren't enough therapists or advisors for everyone in need and while these people are absolutely wonderful when you are with them, the care they provide is the kind that does not work if just spread thinly over every case. An ideal situation would be regular, monthly phone calls, emails, or physical visits with a temporary advisor up until the point you have your actual therapy sessions. Changes in personal information could be updated quickly, you could be moved up the waiting list if your situation became more serious, and you would begin to adjust more quickly to the idea of regular appointments. Even better, would be the opportunity for more advisors and therapists to be trained up, shortening the waiting lists.

NHS cuts have very negatively affected IAPT's ability to administer care tailored to the specialist needs of people suffering from a variety of mental illnesses. The idea of illnesses such as depression or anxiety being acknowledged as a common medical issue something which is already brushed off and deemed ridiculous by  modern society. We're battling against public opinion, against people telling us to just 'get over it', and yet behind our backs the mental health sector of the NHS is being diminished so greatly that there won't be enough facilities for many of us to get the help we deserve.

It's really up to us at this point, to write to our local MPs, sign petitions, research, and importantly make sure we make the correct decisions when voting to determine who in government holds our best interests at heart. One of my major focuses when I am deciding who to vote for is going to be: who is the most dedicated to improving our NHS? Who cares about mental health as much as I do? If that is a concern for you then I urge you to do your research as well, find out where your local MP stands and all the different parties stand before the 2015 General Election.

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EDIT: I have just been made aware that there is actually going to be extra investment into IAPT and other NHS run mental health services which is FANTASTIC news!! Details are here: http://www.england.nhs.uk/wp-content/uploads/2014/12/allctn-publ-letter-191214.pdf

 My second gripe with my IAPT experience seems to boil down to the same thing: a lack of resources. I'll speak about that on my next blog post.

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