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It's good to talk but why must we wait so long? Mental health charity Mind Cymru is calling on Welsh Government to significantly improve access to 'talking therapies'for those who need it. Here, senior policy and campaigns officer Rhiannon Hedge outlines why timely support is so crucial.

Byline: Rhiannon Hedge

Demand for "talking therapies" is ever rising, yet access to them is one of the biggest issues facing those with mental health problems in Wales.

Getting timely access to the right kind of therapy can play a huge role in helping people to recover and stay well.

It can complement other treatments, such as medication or exercise programmes, or can be a stand-alone treatment.

Talking therapies covers a range of psychological treatments, including counselling and Cognitive Behavioural Therapy (CBT).

They involve talking to a trained professional about your thoughts, feelings and behaviour, and aim to: | give you a safe time and place to talk to someone who won't judge you | help you make sense of things and understand yourself better | help you resolve complicated feelings or find ways to live with them | help you recognise unhelpful patterns in the way you think or act and find ways to change them (if you want to).

But in Wales some people are experiencing significant delays in accessing these talking therapies.

There's also very little data on people's experiences of this form of treatment, so the problem isn't really being measured.

In February 2016 Mind Cymru surveyed more than 400 people in Wales who had requested or accessed psychological therapies in Wales in the last three years.

Some of the findings were shocking - almost half of people (48%) had to request psychological therapies rather than being offered them, and 70% of people said they weren't offered any choice in the type of therapy they received.

This lack of choice is really concerning. It's vital that people get a choice of therapies and that those therapies are properly explained.

Otherwise people may be opting for treatments that aren't suitable for their needs, which can hinder their recovery or make them reluctant to seek future support.

A system in which people are having to come to an appointment armed with medical knowledge and confidence, and request treatments that they should be offered is also a system that fails the most marginalised groups in our society.

Of the hundreds of people we spoke to, 57% of them faced a wait of more than three months just to get an assessment of their needs.

Staggeringly, 21% had to wait for more than a year to be assessed.

What's more, after assessment, 50% of people had to wait more than three months to actually start their treatment - with 24% waiting over a year. It's not just our survey that has found this. A recent report by Healthcare Inspectorate Wales found that some people were waiting for more than two years to begin therapy. Welsh Government has actually set targets for people to get access to talking therapies both through their GP and in a hospital setting.

However, we believe these targets are too long and there is no public accountability for missing targets in some settings.

Current targets are 28 days for an assessment, with a further 28 days to begin treatment (if you speak to your GP).

If you've got severe or complex care needs and require talking therapies via hospital or other secondary care environment, those targets are six months. Neither of these are acceptable and people's mental health problems are worsening while they are being made to wait.

Since 2016 we've been calling for waiting times to be no longer than 28 days from the point of seeking support and we believe it's not only achievable but the best way to give people the support they need.

The problems don't end once a person receives treatment. Once that treatment is over, the NHS does not effectively record whether or not the treatment has worked and the person is feeling better.

Without this data we have no way of knowing whether or not the system is working, and people can become disillusioned with services when they don't feel like their feelings and opinions matter.

Our Big Mental Health Survey 2017 found that after their last visit to their GP surgery to discuss their mental health, a quarter of people didn't feel the care they received met their needs, and 82% had no opportunity to provide any feedback.

The good news is that there are many things that can be done to make the situation better.

For one thing, there are nowhere near enough therapists employed by the NHS in Wales and this needs addressing as a matter of urgency.

We want to see a recruitment campaign similar to Welsh Government's own Train, Work, Live drive to recruit more GPs, nurses and other health professionals.

We know from published data and our own Freedom of Information requests that referrals for mental health support are increasing for both local primary mental health support services and community mental health reams. This growth in demand must be matched with growth in capacity.

Allowing people with mental health problems to self-refer to local primary mental health support services could make a real difference and would also free up GPs time to deal with other patients.

Our Big Mental Health Survey in 2017 found that only a small proportion of people who went to their GP to speak about their mental health were referred to these services in the first place.

The charity sector can also play a key role in relieving pressure on GP surgeries. For example, our Active Monitoring service, delivered by Local Minds in many surgeries across Wales, means that a GP can refer you directly to a dedicated mental health practitioner within a week of a GP appointment.

If you are experiencing anxiety, depression, low self-esteem or stress, you could then take part in a guided self-help course over eight weeks in your local surgery.

Our recent survey into mental health in Wales suggested that people would find it really useful to be able to book longer GP appointments to give them a chance to really discuss their needs.

The average appointment length of 10 minutes can be a huge barrier to professionals having the time to find out about patients as individuals and what forms of treatment will work best for them.

There is a lot of work to do to improve our mental health care in Wales, but none of the problems we are facing are insurmountable.

We'll also be continuing our own research this year to find out how much experiences are changing.

Mental Health is one of six priorities for Welsh Government, and we know the will to bring about change is shared by mental health professionals across Wales.

The next delivery plan under the government's mental health strategy, Together for Mental Health, is due this year, as is a progress review of the national plan to improve access to therapies.

We are urging Welsh Government to stand up and be counted, for the good of the one in four of us who will experience a mental health problem in any given year.

Mental Health is one of six priorities for Welsh Government, and we know the will to bring about change is shared by mental health professionals across Wales.


One in four of us will experience a mental health problem in any given year
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Publication:Western Mail (Cardiff, Wales)
Geographic Code:4EUUK
Date:Apr 22, 2019
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