01273 417997

Save the NHS by joining the Campaign for talking therapies (catt)

Save the NHS by joining the Campaign for talking therapies (catt)
by John Kapp, [email protected], 01273 417997. References are to papers on www.reginaldkapp.org. 20.11.18
Market opportunity
The chancellor has recently increased the mental health budget by £2 bnpa, which creates the following opportunity for counsellors, psychotherapists, and complementary therapists to treat depressed and anxious patients from GP surgeries. I created the Social Enterprise Complementary Therapy Company (SECTCo – www.sectco.org.uk) to do this, and we are seeking additional directors and staff to bid for contracts with the Clinical Commissioning Groups (CCGs). If you are interested, please get in touch with me.
The epidemic of depression
1 There is an epidemic of ‘depression’, in which 7.3 million people in England, and 35,000 in the city of Brighton and Hove, (1 in 8 of the population) are ‘depressed’ and are being ‘treated’ with antidepressants.
2 The National Institute for Clinical Excellence (NICE) guidelines (CG 123, 2011) say that talking therapies should be offered first for mild to moderate depression.
3 GPs can’t prescribe talking therapies as there is an average waiting time of 6 months, because the Clinical Commissioning Groups (CCGs) have failed to procure anough contracts with counsellors and psychotherapists.
4 The most cost-effective talking therapy is NICE recommended Mindfulness Based Cognitive Therapy (MBCT) 8 week course (under CG 23, 2004) because it can be facilitated to groups of up to 15 patients at a time, who also benefit from peer support from the group. (9.76)
5 The Improving Access to Psychological Therapies (IAPT) programme was launched in 2006 under the banner ‘the end of the Prozac nation’, but antidepressant prescribing has since trebled from 2.5 to 7.3 million patients in 2017/18. IAPT now treats 550,000 patients annually with a 50% recovery rate, but 13 times as many patients are being ‘treated’ with antidepressants against NICE guidelines. (9.130)
6 Under the NHS constitution (2009) patients have the statutory right to NICE recommended therapies if their doctor says it is clinically appropriate, which most GPs would say about the MBCT course. However, these rights are more honoured in the breach than in the observance, as CCGs have failed to commission and procure contracts with nearly enough counsellors to provide them. (9.125)
7 The NHS is supposed to provide ‘evidence-based medicine’, but there is abundant evidence that ‘treatment’ with antidepressants is worse than the disease, as they do not even claim to cure depression, but have harmful side effects which condemn patients to keep coming back to primary care to change drug and dosage in a revolving door. This is soul-destroying for GPs, contributing to them burning out and retiring early at an average age of 55. (9.125)
8 The NHS does not treat addicts, saying that they must become clean and dry before they can be treated. The Local Authority Council’s used to provide detox and rehab provision for addicts, but they no longer do so, as their funding has been cut. This lack of treatment has contributed to the rise of homelessness, as most have mental health problems and addictions. (9.114, 9.127)
9 The Better Care Fund (BCF) was enacted in 2013 to treat vulnerable people, personified as Rachel (65, depressed and in sheltered accommodation) and Dave (40, alcoholic and homeless) in Community Care Centres (CCCs) in every GP cluster. The BCF is £5.8 bnpa this year (2018/19) in England, and £28 mpa in our city. However, no CCC has yet been founded in our city, and no Rachel or Dave has been treated. (Answer given to my public question to the city’s Health and Wellbeing Board in June 2017) (9,133)
Solution to the crisis in primary care is to empower GPs to prescribe talking therapies that work, by:
10 Requiring CCGs to commission about 10 times more talking therapies, and procure contracts for their provision from counsellors in the private sector. Funding is already in place from the BCF, half of which (£14 mpa) could provide one MBCT course @£400 for every patient in the city on antidepressants numbering 35,000. (9.133)
11 This can be done by lobbying councillors on Health and Wellbeing Boards, who are statutorily responsible for the CCG’s budgets, to hold the CCGs to account, and ensure that they comply with evidence based medicine and the law. (9.130)
12 We publicise the successes of others who have exposed the problems of drugs, and the solution of talking therapies, including the following:
Robert Whitaker’s book ‘Anatomy of an epidemic. Magic bullets, pschiiatric drugs and the astonishing rise in mental illness in America’ 2010. (9.105)
House of Lords select committee report ‘The mindful nation UK’, oct 2015.
Dr Dainius Puras, UN special rapporteur, who on 6.6.17 called for a world revolution in mental health care, abandoning the medical model, and targeting social determinants. (appendix 11 of 9.120),
Dr Ed Bullmore’s book ‘The inflamed mind’ 2018 (9.132)
Dr James de Fanu’s book ‘Too many pills’. (9.134)
Dr Chris van Tullican, TV documentary ‘The doctor who gave up drugs’ shown on BBC1 on 23.5.18 and 30.5.18, in which a boy got off Ritalin with a mindfulness course.