Wednesday, July 26, 2017

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

England is in the midst of a unique national experiment, the world’s most ambitious effort to treat depression, anxiety and other common mental illnesses.

The rapidly growing initiative, which has gotten little publicity outside the country, offers virtually open-ended talk therapy free of charge at clinics throughout the country: in remote farming villages, industrial suburbs, isolated immigrant communities and high-end enclaves. The goal is to eventually create a system of primary care for mental health not just for England but for all of Britain.

At a time when many nations are debating large-scale reforms to mental health care, researchers and policy makers are looking hard at England’s experience, sizing up both its popularity and its limitations. Mental health care systems vary widely across the Western world, but none have gone nearly so far to provide open-ended access to talk therapies backed by hard evidence. Experts say the English program is the first broad real-world test of treatments that have been studied mostly in carefully controlled lab conditions.

The demand in the first several years has been so strong it has strained the program’s resources. According to the latest figures, the program now screens nearly a million people a year, and the number of adults in England who have recently received some mental health treatment has jumped to one in three from one in four and is expected to continue to grow. Mental health professionals also say the program has gone a long way to shrink the stigma of psychotherapy in a nation culturally steeped in stoicism.

“You now actually hear young people say, ‘I might go and get some therapy for this,’” said Dr. Tim Kendall, the clinical director for mental health for the National Health Service. “You’d never, ever hear people in this country say that out in public before.” (...)

Dr. Clark, in his university office, said: “If someone has a broken leg, he or she immediately gets treatment. If the person has a broken soul, they usually do not.”

The program began three years later, in 2008, with $40 million from Gordon Brown’s Labour government. It set up 35 clinics covering about a fifth of England and trained 1,000 working therapists, social workers, graduates in psychology and others. The program has continued to expand through three governments, both ideologically left and right leaning, with a current budget of about $500 million that is expected to double over the coming few years. (...)

The biggest challenges may be those created by runaway demand. Therapists are booked solid; some are juggling 25 clients at a time, and the line to get in the door is long, creating the same complaints about waiting lists that the National Health Service has for many medical services and procedures. The average wait is 31 days for a course of therapy, typically shorter for the online variety and longer for face-to-face treatment.

by Benedict Carey, NY Times |  Read more:
Image: Andrew Testa