My Issues with IAPT (Part 2.)

I want people to quickly reiterate some points from my previous post about IAPT, as well as some new points, before I begin the real meat of this blog post:
  • These are my personal experiences, they could be isolated or they could be true for the whole of the scheme. Unfortunately, I don't know what the general consensus is but I would still urge you to bear the things I say in mind if you are considering ever using IAPT's services
  • My poor experiences have nothing to do with my advisor: they were wonderful, and I believe that IAPT's one on one service is generally sensitive and supportive. My problems have everything to do with the way the service is being run on a higher level, and the resources IAPT have available to them. If anything, this is advocating on their behalf, expressing that they need help in running a service that is more helpful to everyone in need.
  • IAPT's availability and the work it does varies from borough to borough - I have it on good authority that the Bromley service is very supportive, I personally know that Enfield are great one on one, but take a look at what other people in your area have said, and whether the service is indeed available in your area.
  • There are definitely horror stories, take those into account, as well as the praise.
  • IAPT and other NHS run mental health services will be receiving an increase in funding in the new financial year, this may help to alleviate some of my concerns. The details of that can be accessed via this link.
  • If you need immediate help and are in the UK, do not rely on IAPT alone. Please call an emergency line like
    • Lifeline: 0808 808 8000
    • The Samaritans: 08457 90 90 90
    • Or Childline if you are under 18: 0800 1111

Issues with IAPT: Six to Eight Weeks

Once I started my sessions, it was a once a week session I had for one hour in the mornings. The sessions themselves were varied, and were focused mainly on debunking really unhelpful personal beliefs about myself, chipping away at these detrimental standards I seem to hold myself to. It wasn't Cognitive Behavioural Therapy in the way I had imagined it would be, but it was an extremely helpful approach, that prompted me to become self-aware about my anxiety and to understand that not everything I believe to be true about myself, people, and the world around me, is true. I made some emotional breakthroughs, hit some mental walls that I had no idea were there, and all in all it was a positive experience.

At my first session my advisor explained the process: I would get six weeks of sessions, and on the sixth week the decision would be made as to whether I require more help. Six weeks seemed like such a long time that I thought this was fair enough. The sixth weeks came and went, and it wasn't until week 10 that my advisor and I had another conversation about endings because the time had gone so quickly for both of us. The sessions were very effective, but if someone is taking your worldview, flipping it on its head, and trying to make that your new worldview that is not something that can be done in a couple of months.

My advisor admitted he would have wanted more time to work with me, but that the 13th week would have to be the end of our sessions. He assured me that I could refer myself again if I felt that I needed to, but explained to me that sessions could not really go on much longer than mine had. The target, apparently, is around six to eight weeks.

six to eight weeks is absolutely no time at all.

 I'm giving myself time to see how I adjust to working on my anxiety on my own, as my advisor suggested I do, but I find myself relapsing into older, safer, damaging behaviour patterns. I get less sleep, I leave the house less, isolate myself more, and allow worries to pile up in my head rather than ask for help. I'm self-aware at the least, and that's something I can say has definitely stuck, but one of the most major sources of my anxiety is an inability to ask for help when I am struggling. With that in mind: I need help with this because I am struggling, and 13 weeks was not enough time to help me, let alone eight.

I can't help but think of the people who respond to therapy really well, who make progress and really seem to be on the mend, that have their sessions stopped after eight weeks because they seemed to be "all cured", but fall straight back to square one because they don't have the support they once had, and now have to start at the back of the queue again if they want more help.

I can't help but think about the people like myself who found themselves getting stuck often, and right at the moment when they manage to make a real discovery about who they are and how they can help themselves their sessions end and they are left without guidance on what to do next.

I can't help but think of the many, many people who feel as though having to refer themselves is a failure, who are afraid of being burned again, who used all of their courage to reach out the first time and are too afraid to do it all over again.

I don't claim to have a financial solution, because more often than not issues like this are based on money. A lack of money to train more staff, to fund long-term therapy, etc. I will say, however, that this should be a priority for IAPT in the new financial year with its increase in funding. In terms of treating mental illness, time is one of the most important factors because these issues are rarely "quick fixes", they often require long-term and tailored care to be treated properly. 'Parity of esteem' between mental and physical health was promised to us by the coalition government, but on the ground level that does not seem to be the case. Mental health services like IAPT are treated as completely separate from other medical services; I find it frustrating, for example that my GP was more ready to give me pills than refer me to a service like Mind, and never once mentioned IAPT or Cognitive Behavioural Therapy without prompting from my boyfriend. Parity of esteem would mean that being referred to IAPT or other NHS mental health services would be on a level with being referred to a dermatologist, an allergist, or any other specialist that can help with a medical problem your GP cannot help with.