Our primary strategic objective as a charity is to increase access to psychotherapy. Our campaigns work focuses on the processes we can influence to achieve this goal. Central to our ambitions for policy change is making a wider range of therapies available to people free at the point of use, especially through the NHS.
Currently, there are too few opportunities for psychotherapists to work in NHS services. This not only limits the choice of working contexts for psychotherapists, but it also denies many NHS service users access to the talking therapies they need.
For those who are not able to pay for therapy privately, the lack of access to appropriate talking therapy through the NHS can be devastating. And, in the wake of the pandemic, with many pressures on people’s health and cost of living, this problem only stands to get worse.
That’s why we are calling on the national government, local government, MPs and NHS decisionmakers across the four nations to take action now.
To improve access to high quality psychotherapy and psychotherapeutic counselling in the private and public sectors, we are calling for:
We’ve met MPs and Peers from all major parties to build political awareness of the need to provide service users with a choice of therapies, and raise the profile of the unique value of relational psychotherapies. It is vital that anyone struggling with their mental health has access to the right treatment for them and this must extend beyond a choice between medication and a single therapeutic approach.
Becoming a psychotherapist or psychotherapeutic counsellor can be a prohibitively expensive process. The NHS fully funds the training pathway for other psychological professionals it uses within its mental health workforce, yet there is currently no funded pathway for psychotherapists or psychotherapeutic counsellors. We are calling on NHS England and Health Education England to provide a funded qualification pathway that will create far more equitable access to training across the professions, diversify the psychotherapeutic workforce, and increase the supply of these professionals to the NHS mental health services. As this work progresses, we will target the same outcome in Scotland, Wales and Northern Ireland.
As part of our work with the Talking Therapies Taskforce, we’ve commissioned the Centre for Mental Health to conduct a health economic analysis of the use of NHS services by people with complex needs. From people inappropriately signposted to IAPT to people who end up as long-term inpatients, we hope to demonstrate the cost benefit of investing in long-term psychotherapy services in secondary and tertiary care.
Cost of training is a major barrier to the profession, with a disproportionate impact on BAME students, which reflects wider societal inequalities. We’ve written to the Universities Minister requesting that the postgraduate student loan scheme be extended to non-university higher education providers.
As a member of the HEE workforce stakeholder group, we have a unique opportunity to influence workforce planning for the implementation of the NHS Long Term Plan, including IAPT provision. These therapies, which our members are qualified to deliver, are already IAPT-approved but remain significantly underrepresented in IAPT provision. This must change. We welcomed the HEE initiative in March 2021 that made positive inroads by recruiting psychotherapists and counsellors from outside of IAPT, but far more is needed.
Currently, it’s very rare for non-CBT therapists to be paid for trainee work in IAPT despite, in many instances, already having qualified. This has created a disparity between trainees from different modality backgrounds and significantly reduced access to NHS work for many psychotherapists and counsellors. We have worked with Health Education England to find ways to eliminate this major barrier to increasing the range of therapies available to service users, but more funding is required to ensure the March 2021 recruitment drive with funded trainee places can be replicated on a larger scale.
It is clear that the raft of cost-of-living pressures that have been exacerbated by the pandemic have worsened the root causes of many people’s mental ill health. We are calling on the government to reverse its decision to scrap the reversal of its Universal Credit uplift that provided a lifeline to so many families and individuals over the past year. We’re also urging the Department of Work and Pensions (DWP), as part of a coalition of mental health organisations, to permanently end benefit sanctions, which have devastating consequences for many people with mental health issues.
Many health services are exempt from VAT, but counselling and psychotherapy are not. Extending VAT exemption to talking therapies is long overdue and would remove a needless barrier to people accessing care. Currently, VAT requirements on therapists contradict legislation on ‘parity of esteem’ between physical and mental health, and represent unfair and unfounded distinctions between mental health practitioners. Earlier this year we submitted a proposal to the Government proposing this exemption and are renewing our efforts in light of separate changes to Government fiscal policy in the wake of Covid-19.
UKCP is looking at how we as an organisation can do more to promote a more diverse psychotherapy workforce that caters to the needs of a diverse range of clients.
We have a number of priorities in this area of work: we need to decolonise curriculum content, we need to embed best practice for working with difference in all parts of psychotherapy training, we need a fully funded route to becoming a psychotherapist, and we need to ensure that psychotherapy services speak to the needs of ALL people and communities, including those disproportionately affected by structural inequalities.
Much of this work is introspective, but much is also required of the government, NHS decisionmakers and training providers. We will continue to push for these changes as part of the coalition for diversity and inclusion in the psychotherapy and counselling professions as well as through our own Equality, Diversity and Inclusion Taskforce.
The NICE Guideline for Depression in adults will have major implications for service provision in the public and private sector. We’ve played a leading role in a coalition of stakeholders raising concerns about the development of this key guideline, including securing the support of more than 60 parliamentarians. In response to pressure from the coalition, NICE have responded to all six of our methodological concerns and committed to making changes in the third revision of the guideline, now due to be published in May 2022. We will continue to apply pressure to ensure our concerns are fully addressed.