Monday, April 19, 2010

National Health Service in Britain threatens to cut psychological counseling services

From The Times in the UK:

Half a million people with serious mental illness could lose access to counselling and other services as the NHS struggles to make unprecedented efficiency savings, campaigners warn.

Despite manifesto pledges from the three main political parties to increase access to “talking therapies” in the health service, Monitor, the independent regulator for NHS Foundation Trusts, has written to all the organisations that it oversees, asking them to plan for deeper cuts than previously forecast from next month.

The suggested cuts of 5 per cent are equivalent to a spending reduction of an extra £50 million across the 40 Mental Health Foundation Trusts in England, according to Rethink, the mental health charity.

It warned that mental health services were considered a “soft target” for cuts, and that up to 500,000 patients with illnesses such as schizophrenia and bipolar disorder could suffer if clinics and day centres closed or staff posts were lost.

Labour has promised to recruit more than 8,000 new psychological therapists if it wins the election, while the Conservatives and Liberal Democrats also say that they will increase access to counselling services.

But experts say that any political promises could ring hollow as the NHS overall is challenged with making £20 billion of efficiency savings over the next four years.

Paul Jenkins, the chief executive of Rethink, said that mental health services had previously suffered when the NHS went into deficit four years ago. A lack of support could put patients at risk to themselves and others, he added.

“We know from the past what happens with people who have severe mental illness when financial pressures begin to bite. Cutbacks are made from teams working in the community, and instead of people getting the regular contact with services and support they need they become more isolated and enter the ‘revolving-door’ cycle of going in and out of hospital.

“It could be harder for people developing new problems to be picked up and for those getting towards crisis to have access interventions to deal with that.”

Up to one in four of the population suffers from a mental health problem at some point in their lives. However, NHS patients with depression or anxiety disorders often wait months to see a trained professional for counselling or cognitive behavioural therapy. Those people with serious problems, including eating disorders or drug addiction, rely on regular contact with specialists to keep their conditions in check.

“If you cut back teams and caseloads go up, the only way to cope with that is by raising the thresholds for who gets treatment, or the waiting list gets longer,” Mr Jenkins said.

Monitor produces forecasts each year to ensure that all foundation trusts, which control their own budgets, are managing their finances effectively. It revised its “downside” estimates after last month’s Budget. It now suggests that mental health services may have to make cuts of 4.5 to 5 per cent in the coming financial year, compared with about 4 per cent for acute hospital services.

Shôn Lewis, Professor of Adult Psychiatry at the University of Manchester, said: “These services are a soft option — you can drag money out and people won’t die straight away, unlike cancer services. What does happen is that some very vulnerable people have a miserable quality of life and may end up killing themselves a couple of years down the line. If that happens, then we have failed them.”