The new president of the Royal College of Psychiatrists has said that too often the NHS is only able to treat patients once they are in a state of acute mental distress
"Access to NHS mental health services is limited because of the increased demand and chronic under-resourcing, so more and more people are going to private therapists who perhaps aren’t as knowledgeable and well trained as they need to be, and certainly not regulated. They might have a really glitzy website, but no training.” Dr Lade Smith, president, Royal College of Psychiatrists
Long waiting lists for mental health treatment on the NHS are leaving vulnerable people at the mercy of unregulated private counsellors, according to the president of the Royal College of Psychiatrists.
Dr Lade Smith, who has recently been appointed to the role, said that very often the NHS was only able to provide a crisis service, treating acute episodes of mental illness. This was leaving thousands of other people at risk.
Currently, according to the College’s analysis of official figures, 1.4 million people are on waiting lists for treatment by community mental health teams. This represents a rise of more than 25% in 16 months. In an interview with the Daily Telegraph, Smith said that too many people, especially children and young people were being denied help from the NHS or left to wait too long. Their problems then became more entrenched and difficult to treat. “Seventy-five per cent of mental health problems arise before the age of 23,” she said. She has called for an expansion in help for children and young people to prevent psychiatric problems lasting throughout their life.
Smith, who is a forensic psychiatrist at the Maudsley hospital, said she the pandemic had fuelled record levels of mental health problems.
“We don’t have the community services to look after people at an early stage, so we end up having to admit people where it might have been avoided, and then there is no room for the people who need to come in,” she added. “It is a really quite horrendous vicious circle.”
Office for National Statistics figures show a 16% rise in people out of work because of mental illness since 2019, with the steepest rise among those aged between 18 and 34.
Smith also spoke of her disquiet at the preponderance of unqualified private counsellors. “What we need is access to speedy, timely mental health assessment and input,” she said. “One of the things that I worry about is particularly because people can’t get access to statutory services … they might go to private therapists who are unregulated. Anybody can do a six-week online course and call themselves a counsellor or therapist and go and set up in Harley Street.”
Counselling is not a government-regulated profession, meaning that anyone can call themselves a counsellor – though to register with the British Association for Counsellors and Psychotherapists, therapists do need to undergo training.
Smith said that when therapists were relying on payment per session, some people could remain in therapy unnecessarily for years.
“Access to NHS mental health services is limited because of the increased demand and chronic under-resourcing, so more and more people are going to private therapists who perhaps aren’t as knowledgeable and well trained as they need to be, and certainly not regulated,” she told the paper. “They might have a really glitzy website, but no training.”
Smith told the Telegraph she was worried about the recent decision by the Metropolitan Police to stop officers from attending most mental health callouts in order to concentrate resources on policing. She said the short timescale for implementation risked leaving people with severe mental health problems in the lurch. Misunderstandings about how the rules should operate could mean police could end up washing their hands of dangerous criminals on the grounds they have a mental health problem, she said.
Dr Lade Smith is right to draw attention to the long waiting lists for mental health support on the NHS. The problem is down, at least in part, to the impact of the pandemic on young people’s mental health, and the difficulty the NHS has in coping with soaring demand for its mental health services. It is not easy to address, but better resourcing of community mental health services, along with greater use of digital tools for self-help, would go some way to tackling the problem. She is also right to raise the issue of unregulated counsellors, who may do more harm than good.
Our campaign in February drew attention to ‘hidden’ waiting lists, with 1 in 4 people waiting over three months between appointments at a time when they are either in crisis or at their most vulnerable.