England’s Mental Health Experiment: No-Cost Talk Therapy


From The New York Times: England is in the midst of a unique national experiment, an initiative that provides open-ended talk therapy free of charge at clinics throughout the country. The initiative has been extremely successful and has received funding from three governments in a row.

“Under the old system, Oliver might have gotten a drug and, possibly, some general psychological guidance and support. But he had never sought mental health treatment before, and he most likely would have gone years before getting any talk therapy because he had no idea it was available. The area where he lives had scores of practicing therapists but no centralized system for ensuring that people got scientifically backed approaches tailored to their specific problem.”

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  1. I think this article is a little optimistic. A lot of people are excluded from the programme, for example, people who have been diagnosed as having a personality disorder or being bipolar, or people who are thought to be at risk of self harm or neglect, or people with drug or alcohol problems, people who have been abused, etc. Different areas can make up their own exclusion criteria, for example, one area doesn’t want people “with multiple life problems having an impact on everyday functioning which reduces ability to engage in therapy”, people who are in a “current mental health crisis or distress” or who have a “history of recurrent treatment failure &/or recurrent lack of engagement with treatment services” which doesn’t sound very friendly or welcoming. If you get through the phone screening process you will most likely get about half a dozen sessions of CBT, either phone, face-to-face, group or computerised. The next most likely thing on offer is guided self help. A lot of people don’t go back after the first session, leaving only about 40 per cent of referrals to complete a course of treatment with completion rather generously defined as having more than one session. In deprived areas it is even lower. Recovery is defined as going from above the cut-off line for “caseness” on a depression and an anxiety rating scale. Meanwhile the use of drug treatment for depression and anxiety continues to rise.

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    • A few years later lots of the IAPT therapists are off sick due to stress and anxiety due to impossible case loads and trying to fulfill overly managerial targets. They ache to do real work and help people but the contracts, which are nice little earners for senior managers, prevent that.

      It is a rubbish programme that fits nicely into the political and philosophical believes of the era. It looks like the government is providing help while conditions of life for many deteriorate. A psychological sticking plaster for a horrid age.

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