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IAPT – Suicidal and Given Online CBT

 I recently came across a former IAPT client that the Organisation’s own documentation described as considering two different means of suicide. He had been bullied at school and engaged in a lot of self-harm. This depressed young man was given computer assisted CBT by IAPT and dropped out after 4 sessions. He told me that it did not teach him anything he did not already know. IAPT’s decision making is based on exigencies rather than clinical need.

Oftentimes a client with thoughts that they would be ‘better off dead’ are passed back to their GP. The GP is then obliged to contact the patient to discover that the ‘suicidal thoughts’ are most often passive and without any active intent or planning. In such instances IAPT had not taken the time to discover whether there was any active planning of suicide. The reaction of the Organisation is that ‘we do not want egg on our face’, so bounce it back to the GP. Unfortunately GP’s don’t complain to their Clinical Commissioning Groups about IAPT, content that they get a break from these ‘non-medical’ cases whilst they are being seen by IAPT, albeit that it is a revolving door.

Dr Mike Scott

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IAPT and Health Service Are Failing Suicidal Clients

Please tell me why a telephone assessment is deemed appropriate for a suicidal client? How many people have commited suicide because of IAPT’s ‘Opt In’ policy? Why is it beyond the remit of NHS Psychiatric Hospitals to offer a ‘One Stop Shop’, including CBT, for suicidal patients?

These pressing issues occurred to me recently when I came across a person who had in recent weeks stepped in front of a car to kill himself and narrowly escaped death on a railway line, because of the care of a passer-by. After attending the Emergency Department of the local NHS Hospital, within days he was assessed by a Mental Health Practitioner and he referred him to IAPT.
The latter wrote to him asking that he ring them to book a telephone assessment, which he did not do and so IAPT discharged him. Inspection of his Hospital records should have alerted the Hospital of this likely sequence of events as he had dropped out of the first session of counselling treatment at a psychiatric Unit a few years ago.

Dr Mike Scott