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Psychological Therapies in the NHS: conference news & presentations

News and presentations from Psychological Therapies in the NHS 2015

PAGES ARE CONTINUALLY UPDATED THROUGHOUT THE CONFERENCE AS SPEAKERS PRESENT

Presentations available below - please scroll down

Quotes from todays conference

"We need to pause to congratulate ourselves on what we have achieved in this sector. In the forthcoming general election all the major parties have pledged to increase the focus on mental health"
Matthew Taylor, Chief Executive, RSA

"Stop talking about service delivery, start talking about engaging"
"There is a lot of measurement in IAPT  - we need data"
Jenny Hyatt, Chief Executive Big White Wall

Question Time: The Mental Health Gap Today: what must the next government do to pick up the talking therapies baton?

Norman Lamb MP (full speech to follow) opened the discussion by stating that "there is discrimination in the NHS against Mental Health" and that we have to hold whoever is in power to implement the vision for mental health that is in place. He stated that we now have comprehensive standards for mental health and it is not just about access but also about choice of evidence based therapy. He stated that "the IAPT programme is an extraordinary programme that is world leading, for the first time in mental health we have this rich data".

Norman Lamb went on to discuss three areas where there is an urgent need for increased joined up working.

1. There is a need to join up IAPT services with job centre plus
2. There is a need to improve the linkage between mental health and schools
3. There is a improve support and joined up working with prisons and the criminal justice system

Norman Lamb also discussed the need to bring together IAPT services with long term medical conditions giving examples of good practice.

Luciana Berger, Shadow Minister for Public Health said that "mental health should be put in the public health agenda".  Luciana discussed the whole person care model - bringing everything together to treat the whole person, she stated that "we have put early intervention and prevention at the forefront of our approach".  Luciana stated that many people are still not getting the help that they need and not enough of these services are available. "I'm pleased thet government has continued to expand the IAPT programme" stated Luciana but emphasised there are marked variation in performance and older adults are not always getting to services. Luciana highlighted that GPs are forced to treat people with medication due to lack of access as evidenced by the increase in antidepression drugs prescribed by GPs.

Luciana stated that "we've looked very closely at the standards and the next labour government would aim for 80% within 28 days - with the same standard for child and adolescent mental health services".  The spend on childrens mental health is currently not good enough and there is an ambition to ensure that all children have access to school based therapy.

Luciana also discussed choice - and the importance of ensuring access to the full range of psychological therapies and choice of therapy and therapist.

In conclusion Luciana stated that psychological therapies should be protected and expanded - they should have the same status as other types of treatment, stating that "we want to update the NHS consitution to ensure patients have the same rights to psychological therapies as they do to other treatments such as medication".

Finally James Morris, MP, and All Party Parliamentary Group Chair for Mental Health opened his presentation by stating that " I'm a believer in Psychological Therapies within the NHS and we need to do everything we can to support it". James went on to discuss the importance of parity of esteem. He expressed concerns about the evolution of IAPT as a programme stating that "if we are genuinely going to get choice of psychological therapy we need to think about how we commission these services, we have a capacity problem". James stated that IAPT has created a monopoly for CBT.  James discussed the importance of delivering genuine choice of therapy and type of therapist as being "critical to cure". Long term psychological therapies also needs to be looked at. James concluded by saying "the future of policy in this area is very bright".

Pulse Article here - implications for GPs

In the closing debate at the end of day 1 the panel discussed the mental health gap in the next 5 years and what can we do to close it.

Simon Stevens Chief Executive NHS England; "Two questions to pose to panel - 1 how do we at atime of ongoing austerity justify a disproportionate investment in mental health services? - 2 I believe there is a strong case for mental health investment that will produce pay offs for other public services.  The relationship between mental health services and employment, also criminial justice services - all provide a return on investment."

Prof Sir Simon Wesseley President The Royal College of Psychiatrists; "the biggest reason people don't present is a perceived belief that treatments don't work and we often have the right services in the wrong place. We need to have more psychiatry in primary care and more primary care in pscyhiatry."

Sarah Brennan Chief Executive YoungMinds; "We are letting children get seriously ill which means we then have expensive inpatient care.  We have children in hospital seeing paediatritians when many of these have an emotional root.  The dots aren't joined up.  We have clear ways we are not using the system very well.  we need to provide services when they are needed.  We need to make sure what happens in other services is joined up.

Dr Clare Gerada MBE Past President The Royal College of GPs;  Clare discussed the compassion gap towards staff as well as service users.  The way to address the funding issue is to invest in you.  Staff are often depressed, and rates of suicide are going up for health practitioners.  Those who work in health service need to be treated with the same level of compassion and dignity which we expect for our patients.  We have staggering rates of absenteeism - a major factor is mental health.

Simon Stevens responded by saying one of the things we have neglected in this country is work based health.

Clare Gerada; "i am aghast and shocked by the medicalisation...the issue around over prescribing...50% of the adult population is on a prescribed medicine which I find shocking...we need to invest in general medicine...unless we address the generalist agenda we will never have a health service that any of us can afford or any of us want."

Sarah Brennan; "you can't plan your workforce until you know what your workforce is there to do and we haven't got that."

Dr Matthew Patrick Chief Executive South London and Maudsley NHS Foundation Trust; "if we dno't support and invest in the eople in the current workforce we're going to struggle."

Simon Wesseley; "The current workforce need to have more mental health training"

Clare Gerada; "parity of esteem between phsycial and mental health...we need more generalists."

DAY 2

Welfare and Work

Dave Simmonds OBE, Director of the Centre for Economic and Social Inclusion gave the following conclusions to his presentation

-There should be a separate programme for ESA claimants
-But preferably support should follow need rather than benefit entitlement
-Programme should be contracted locally to align with specialist provision
-Suspend ESA sanctions & reform WCA
-Design support to fit with: fluctuating conditions; health and employability progress; job outcomes
-Preparation: capacity and capability of services to respond; contracting; partnerships.
 

Jonathan Portes Director National Institute of Economic and Social Research discussed:

- Where are we now? Next government will be looking to spend less on welfare without a doubt. This is extremely dangerous

- advice to any new government would be to get the system stable and in a reasonable state before making change

- need to approach it with a sense of history

Closing Plenary: The making of a psychological therapist who wants to make a difference

Dr Jacqueline Cornish OBE, National Clinical Director, Young People and Transition to Adulthood at NHS England reminded delegates that early intervention is key with regard to children and young peoples mental health with most lifetime mental disorder arises early adulthood. 50% of lifetime mental illness excluding dementia are apparent at the age of 14 and 75% by the mid 20s. Jacque stated that despite the huge public cost of mental illness in children and adolecents only 6% of current spending on mental health goes to services aimed at children and young people.

Children and Young Peoples IAPT began in April 2011 with specific remit (and limited budget) to work with existing CAMH services to:

•  Improve collaborative practice with children, young people and families
 
• Deliver a workforce to offer evidence based practice (EBP) as recommended by NICE in
oCBT for anxiety disorders and depression
oParenting training for conduct disorder (age 3-10)
oSystemic Family Practice for conduct disorder (over 10s), depression and self-harm, and eating disorders
oInterpersonal Psychotherapy for adolescents (IPT-A) for depression
oCompetency based curriculum using Roth and Pilling CAMHS competencies
• Training for supervisors and service leads
 Outreach and enhanced supervision workshops for other staff not attending training courses within the CYP IAPT Programme
CAMHS for the future will use ROMs (routine outcomes monitoring)
•To guide therapist and supervisor
•To help client monitor and understand how treatment is progressing
•Across ALL Professions
Further Information: www.cypiapt.org

Recent publications: Tier 2/3 Specification for CAMHS and Transition and transfer to and discharge from care seehttp://www.england.nhs.uk/resources/resources-for-ccg

Presentations (more to follow):

Stream 1: Alison Brabban, National Advisor for Severe Mental illness, IAPT

Stream 2: Prof David Clark National Advisor for IAPT

Thrive! The new paradigm for organising chidren and young peoples mental health - Dr Miranda Wolpert

Dr Jacqueline Cornish, National Clinical Director, Children, Young People and Transition to Adulthood

DWP/IAPT Empployment Initiative Kevin Jarman Deputy Programme Director, Adult IAPT, NHS England 

Transforming employment and back-to-work support for people with mental health problems - Tom Pollard, Mind

MINDs report on Work, Benefits and Mental Health here

Welfare and Mental Health Dave Simmonds OBE Centre for Economic & Social Inclusion

Jacqueline Cornish OBE, Children and Young Peoples IAPT

Forthcoming conferences of interest.

 


11 February 2015

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