NCPS | NCPS Responds: The Times Health Commission

The Times has published the results of their Health Commission: 10 recommendations to save the NHS. You can find the article here.

The Society made a submission to the Times around mental health provision in February 2023, and it's heartening to see that they have understood the issues that young people are facing at the moment, although it would have been better to see the report go further.

So many of the issues that are being discussed in the report would be improved by better integration of counselling and psychotherapy into public services such as the NHS and the Education system through Mental Health Support Teams (e.g. through the Barnardo's MHST+ model, or through a model based around social prescribing or personal health budgets).

In fact, counselling and psychotherapy could support the aims outlined by the Times in a number of ways, for example:

  • Expanding access to counselling services to reduce waiting times for mental health support and ensure more people get timely help.
  • Increase access to counselling in schools to help build emotional resilience in children and teach coping strategies to manage anxiety, stress, etc. Promote better mental health and prevent issues escalating.
  • Workplace counselling services could help support NHS employees managing mental health issues, reducing sickness absence and improving productivity.

Analysis by the children’s commissioner for England found that half the 1.4 million young people with a probable mental health disorder did not receive any treatment at all from children’s mental health services in 2021/22. Many of those who were seen were only given a single appointment. A third of children who were referred for treatment had their case closed before they got any support.

The Times Health Commission Report 2024

The ETHOS study, conducted by Roehampton University, clearly shows that Humanistic Counselling in young people helps to build resilience, self-esteem, and achieve the goals they set for themselves.

Our findings suggest that, on average, school-based humanistic counselling can help young people, with effects that persist for at least three months after the end of counselling. The counselling was most effective in helping young people improve their self-esteem and achieve personal goals.

The Effectiveness and Cost-effectiveness Trial of Humanistic Counselling in Schools (ETHOS)

Waiting lists can span from months to years, depending on your location. This is down to workforce (staffing) issues in CAMHS services, but why are we continuing to accept workforce shortages as an excuse when there is a huge workforce within counselling and psychotherapy that could be integrated to help reduce the waiting lists, and also to work with those young people who don't (yet) meet the threshold for support through CAMHS.

“It’s quite hard to find the words to describe how bad it is. There’s a mental health emergency for young people at the moment in terms of the number of young people that we hear from who are struggling after the really challenging time of the last few years. We’re hearing from young people waiting up to two years to get support; that’s not uncommon. On average we hear it’s about twenty weeks, or five months, until the first appointment from point of referral but that’s really variable across the country. We hear stories from parents about young people’s mental health really getting worse in that waiting time because if you’re told you are going to get support, on the one hand that feels like it might be a moment of relief and hope that something is going to get better and then it can just go quiet. You might feel like you’ve been forgotten about. Young people talk about not feeling heard or listened to or taken seriously. When you’re 13 and 14, a two-year waiting list is enormous. You can’t imagine what it’s going to be like in two years’ time because those adolescent years are so changeable and you’re a different character from year to year.”

Laura Dunt, CEO, YoungMinds

“We found evidence that childhood anxiety problems are associated with worse outcomes in 15 domains of everyday life. This is about risk of persistent mental health problems but also worse outcomes in education, employment and so on. We found that the aggregated national lifetime loss of earnings for children with anxiety problems at the age of 14, who then failed to achieve at least five GCSEs in England, is more than £850 million. That is a conservative estimate and this is only for one year, so you can imagine if you do these similar calculations for every year, then the billions increase. If we intervene sooner rather than later we can save a lot of money later on along the line, not only for the children and their families but also for the whole society.”

Mara Violato, Health Economist, Oxford University

It cannot be right that young people have to make multiple suicide attempts in order to get support. That is not a cry for help, it is a disaster waiting to happen. The benefits of dealing with problems as they start to emerge and before people reach crisis point or develop a long-term disorder are clear for individuals and the country. National four-week maximum waiting times should be guaranteed for all children and young people who need access to mental health services, with appointments within a week for those at risk of self-harm and suicide. This must not just be a tick box exercise, to meet a target: the crucial thing is that young people start to get professional help.

The Times Health Commission Report 2024

What is abundantly clear from reading the report is that young people are receiving inappropriate care that can take a long time to access, and in many cases isn't helping. Reform needs to look at patient-led care, with people having access to the type of intervention that they feel would be of most benefit to them (counselling, in-patient mental health services, community and peer-based support, exercise, opportunities to be creative and so on), when and where they need it.

Better integration of all available services, not just counselling and psychotherapy, through a model like personal health budgets or social prescribing, would do so much to support people across the UK.

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