The latest data from the Service shows that in 2022-23, of those at the start of the pathway, 1.76 million, a third (31%) decided that this route was not for them and they did not move beyond an initial contact. Of the 1.22 million who had an assessment, half (44.9%) did not go beyond this one session. Thus, the first two potholes are of a comparable size (i.e the proportion defaulting).
Treatment (defined by the Service as people attending two or more sessions), follows a stepped care model, so that after the 1st two potholes you come to a fork, with 3 possible paths, shown in Table 1 below, whichever one is taken the majority do not finish treatment
Table 1 Casualties in Stepped Care
|
|
Referrals finishing treatment |
Percentage referrals finishing |
Mean number of sessions |
|
Low intensity only |
241,200 |
35.9 |
5.5 |
|
Both low and Hi intensity |
262,063 |
39.0 |
10.3 |
|
Hi intensity therapy only |
141.137 |
21.0 |
8.7 |
The potholes following the fork (i.e the proportion of people who default) are thus deeper than those before.
The pathway needs to be closed for repair and a diversion e.g attendance at a Citizens Advice Bureaux or local Charity, needs to be put in place. There is no evidence travellers would be worse off. It would certainly cost a lot less than the £1 billion a year spent on Adult Mental Health Services in Primary Care.
Dr Mike Scott