Antidepressant Prescribing Doubles Since Advent of IAPT

this makes it difficult to believe that GP’s see IAPT as a credible alternative to antidepressants. GP’s welcome the opportunity to refer depressed/anxious patients anywhere (including IAPT), as they get a breather from them, as they struggle to cope with the deluge of patients with physical problems.

On today’s Radio 4, The President of the Royal College of General Practitioners was sanguine about the increased prescribing, citing the benefits of antidepressants. But the evidence that they make a real world difference that lasts is questionable, see link below:

No matter, a rep from the Royal College of Psychiatry (RCP), also on Radio 4 today responded to the doubling of antidepressants, in the last decade, by saying that they should not be the ‘go to’ response to psychological debility. He should perhaps have a chat with the RCGP President! He suggests that instead there should be increased funding for ‘talking therapies’. But he seems unaware that the main provider of talking therapies, IAPT, has never been subjected to independently funded evaluation. The RCP would not tolerate this for claims of the efficacy of a drug, why do they tolerate it for the effectiveness of IAPT? It seems that in the current zeitgeist, being in favour of talking therapies is on a par with being in favour of peace, no one can doubt its’ value. But my study of 90 clients going through IAPT evaluated with a standardised diagnostic interview suggests that only the tip of the iceberg recover, see link below:

Dr Mike Scott

‘Just Give Us The Resources To Treat Personality Disorders’ and then what?

There has been a great clamour this week from mental health bodies, including the Royal College of Psychiatrists (RCP) for more monies  to address the grave problems of clients with personality disorders (PDs). But they have neglected to add that there are few randomised controlled trials of psychological treatments for PDs and those that have been conducted have had very different outcome measures. It is important that clients with personality disorder are given realistic expectations of treatment and are protected from commonplace misdiagnosis.

One of my clients lost access to her children in part because a psychiatrist claimed she had an emotional unstable personality disorder (EUPD), fortunately legal action is being taken against the local authority for their part in this debacle. The latter were insistent she attend a mentalisation group, my protest that she did not have a personality disorder and therefore did not have to  attend went unheard! The stresses of taking the legal action have been colossal. Maybe the energies of the RCP might be better spent making sure its’ members make reliable diagnosis.  As part of the legal proceedings in this case a Psychiatric Expert Witness rejected the opinion of the treating psychiatrist but not before a great deal of distress had already been caused to her and her 3 children.

Dr Mike Scott