By Stuart Crawford
The Scottish Government has just announced its performance targets for access to mental health services in the NHS. These HEAT targets (the acronym stands for “health improvement, efficiency, access and treatment”) reflect the government’s priorities for the health services in Scotland and are set for all aspects of healthcare delivery.
The aim is to deliver faster access to mental health services by delivering 26 weeks referral to treatment for specialist Child and Adolescent Mental Health Services (CAMHS) services from March 2013; and 18 weeks referral to treatment for psychological therapies from December 2014.
The rationale is that timely access to healthcare is a key measure of quality and that applies equally in respect of access to mental health services. Early action is more likely to result in full recovery and in the case of children and young people will also minimise the impact on other aspects of their development such as their education, so improving their wider social development outcomes.
The intention is to agree a target of 18 weeks referral to treatment for specialist CAMHS services from December 2014 for inclusion in HEAT next year. Psychological therapies have an important role in helping people with mental health problems, who should have access to effective treatment, both physical and psychological. It is generally accepted that these therapies can have demonstrable benefit in reducing distress, symptoms, risk of harm to self or others, health related quality of life and return to work.
The announcement has been given a qualified welcome by the British Association for Counselling and Psychotherapy (BACP), the leading professional body for counselling and psychotherapy in the UK, which has over 1,500 members in Scotland. Members are employed in a range of services and work with people who have wide ranging needs such as relationship problems, addiction, stress and bereavement through to mental health problems such as depression and anxiety.
Its welcome is qualified because BACP has concerns that the new target refers only to a narrow range of psychological therapies for specific diagnosed conditions. Therefore, an unintended consequence of the HEAT target is its potential to draw funding away from services offering a range of therapies. BACP is committed to patient care as the centrepiece of mental health service design, and is therefore strongly encouraging the Government to widen its view of the mental health and wellbeing needs of the population and the therapies that meet these needs.
Shane Buckeridge, BACP Lead Advisor for Scotland, said: “It is admirable to see that the Scottish Government has developed a target for access to mental health services. It is estimated that at any one time there are some 850,000 Scottish people with mental health problems, and until now it has been a postcode lottery in terms of what is available, leading to a huge disparity in service provision across Scotland.
“The new target makes health boards accountable, and will hopefully ensure that all patients have access to the services they need in a timely manner. However, BACP is concerned that existing services which are excluded from the narrow range of acceptable therapies within the target, may find themselves under threat. These services are often used by GPs to help people with multiple issues which do not fit the referral criteria for current secondary care mental health services.”
BACP points out that many users report wanting choice about what is most appropriate to their needs. The research evidence also suggests that no one approach in this field will be effective with all patients. The Association is therefore continuing to urge the Government to incorporate choice into the new targets to make mental health service provision accessible for all.