‘Go To Hell, If You Don’t Jump Through Our Hoops’

that’s the take home message absorbed by a partner of an ex-soldier with PTSD, broadcast on BBC Radio 4’s Woman’s Hour yesterday, available as a podcast . Her partner was referred by his GP several times for psychological treatment, but he didn’t go though the ‘opt in’ procedure (ringing up and agreeing a telephone assessment) so in the words of the agency the referral was not ‘activated’.  He then developed a psychosis when she developed cancer and there was a further episode of psychosis before treatment got underway. But it doesn’t stop there she was never involved in the treatment despite that they could no longer sleep in the same bed because of his nightmares and his response. The treating clinicians it seems are unaware that social support is the biggest predictor of recovery from PTSD and that the disorder has a devastating impact on relationships.   Fortunately she got some help for herself from an online forum for partners of those with PTSD run by combat stress.

Clinical Commissioning Groups need to be made aware of what goes on in the mental health services they fund to the tune of £6-7 billion a year, with over £300 million being spent on IAPT each year, this amounts to billions of £’s being spent on IAPT since its’ inception, it is surely criminal that this has taken place without any independent evaluation of outcome.  

The ‘go to hell approach’ is unfortunately not confined to the process of engagement with the services, it also features in treatment – a client of mine with PTSD was told in an IAPT service the focus of the session was trauma focussed CBT/EMDR but he was concerned to talk about the devastating impact the Manchester bombing had had on his niece and he was given no such opportunity to discuss these concerns, the trauma focussed treatment proceeded relentlessly, all to no avail. 

I think it would be excellent if people sent the Radio 4 broadcast to their Clinical Commissioning Groups, the links can be accessed below, asking that they critically appraise the operation of IAPT.  Both Radio 4 and Radio 5 Live are making more broadcasts on these matters in the coming weeks and it would be great if people could disseminate the material as far as possible

https://www.england.nhs.uk/ccg-details/

Dr Mike Scott