NHS Talking Therapies On The Brink?

Six years ago the prevalence of burnout in the predecessor of NHS Talking Therapies (the Improving Access to Psychological Therapies  Service) was reckoned to be as high as 67% (Westwood 2017). Writing in this month’s Psychologist, Kat Wheatley, a Psychological Wellbeing Practitioner writes the following, anonymised to protect the service and the individuals involved:

“In early February 2022, we received a mass email from service leaders stating that we were not on track to meet the monthly target for triage assessments. They stated this was due to too many staff taking leave over half term and being on sick leave. The email went on to tell us we would be required to offer 1-2 additional triage assessments per week throughout the month to ensure the services’ targets were met, and to discuss any concerns with our Line Managers.

Later that day, an informal discussion with my PWP colleagues highlighted the email had provoked shared feelings of stress, frustration, and dread. One of my colleagues became tearful, sharing she was already too overwhelmed by the current workplans. Someone else stated they were going to ignore the request entirely and expressed anger towards managers for not acknowledging the pressure we were already under. Another simply said they were too drained to think about it today. Over the next few weeks, the stress and low morale was tangible, with more colleagues taking sickness leave throughout the month. And while we should have felt relieved when the month was up, instead we all shared a sense of defeat that this would happen all over again at Easter.”

It does not sound as if burnout has reduced in the past six years. There is no sign of an improvement anytime soon. The author opines that is possible to mitigate the deleterious effects of burnout  by shifting ‘towards a culture of compassion within leadership’. This is at best an untested hypothesis. Nevertheless it could serve to keep hope alive amongst staff, to make going into work at least tolerable. But what would likely be the level of ‘mitigation’ achieved? Is it to be seriously suggested that it would have a major impact,  or more realistically, at best a minor impact? Would one have seriously suggested  that developing a ‘culture of compassion within the leadership’ of the Metropolitan Police would have prevented the debacle that we have seen since the murder of Stephen Lawrence, 30 years ago? More plausibly, NHS Talking Therapies has ‘Institutional’ problems that need to be addressed by a publicly funded independent review. This is not to say that individual leaders within NHS Talking Therapies cannot behave better, regarding staff as persons rather than individuals instrumental to a goal.  Similar considerations would doubtless apply to the Confederation of British Industry.

Dr Mike Scott

Westwood, S., Morison, L., Allt, J. & Holmes, N. (2017). Predictors of emotional exhaustion, disengagement and burnout among improving access to psychological therapies (IAPT) practitioners. Journal of Mental Health, 26(2), 172-9.