Government pushes talk therapies to help people with mental illness return to work

“Now that we have so successfully reduced unemployment, mental
illness becomes the next priority target for action.”

So said the report prepared by economist Richard Layard for the
prime minister’s strategy unit last December, which made
clear the heavy cost mental illness imposes on the economy.

With more people with mental illness drawing incapacity benefit
than there are unemployed people on jobseeker’s allowance,
mental illness is estimated to cost 2 per cent of the gross
domestic product.

Layard noted that National Institute for Clinical Excellence
guidelines state psychological therapies are as effective as drugs
in treating depression and anxiety and should be offered as
treatment options.

But he found there was little psychological therapy available in
the NHS. “For people who have serious depression there is
usually little help other than a few minutes with a GP and some
pills,” he said.

Layard recommended that within five years all patients should be
given the choice of psychological therapy and mental health
services should help people return rapidly to work.

Last week the government announced plans to launch pilots to test
how a talking therapy – known as cognitive behavioural
therapy – for people with mild to moderate mental health
problems might operate, and whether it will help people return to
work.

The Department of Health is particularly keen to deploy the
therapy, which aims to treat mental illness by changing behaviour
and thinking patterns, because it is seen as sufficiently
“evidence-based”.

It could be delivered by occupational therapists, psychiatric
nurses or therapists already working in the voluntary or
independent sectors.

The pilots have been welcomed by mental health charities.
“Having pilots to work out how people can get access to it
[therapy] when they need it is a good thing,” says Mind
policy officer Moira Fraser.

While the most obvious route to therapy is likely to be through a
GP, Fraser says other professionals, such as social workers, should
also be able to make referrals and people should be able to refer
themselves.

And she argues that the mechanism for delivering the therapy might
also need to change. “You’ve got to base it in local
communities,” she says. “People might want to have a
therapist who is someone from their own cultural background, or the
same gender or age group.”

Fraser accepts that it benefits most people but believes other
treatments, such as exercise and counselling, can also be
effective.

Gil Hitchon, chief executive of mental health charity Together,
formerly Maca, also welcomes the pilots but believes there is a
danger of seeing psychological treatments as a cure-all.

“We’ve got to find answers that aren’t single
solutions,” he argues, suggesting that peer support also has
an important role to play.

And Hitchon cautions against linking therapy too closely with the
benefits system. It should be a positive tool to help people get
back to work but not a condition of receiving incapacity benefit,
he argues.

Fact File

• Nearly 40 per cent of all people who claim incapacity benefit
  have mental health problems
• A third of people going to GP surgeries have mental health
  problems
• About £8bn was spent on public mental health services in
  2002-3
• One in three people experiences mental illness in their
  lifetime
• Of all people with mental illness only 3 per cent saw a
  psychiatrist in 2003 and only 2 per cent a psychologist

Source: Richard Layard – Mental Health:
Britain’s Biggest Social Problem?

www.strategy.gov.uk/downloads/files/mh_layard.pdf