A Psychological Wellbeing Practitioner’s Damning Indictment of Her Role

Last week a PWP (Psychological Wellbeing Practitioner) ALIEE November 25th 2020 put a post on this blog, calling for Panorama to take note of the desperate plight of PWPs – the main providers of services in the Improving Access to Psychological Therapies (IAPT) Service. Unfortunately the track record of the media in this regard is not good. It is a year since Radio 4 chose to broadcast predominantly the voices of  lead figures in IAPT and well known fellow travellers, rather than give expression to those at the coalface  and their clients.   One wonders what it takes for the media to wake up and ‘smell the coffee’ – £4billion has been spent on IAPT over the last decade all without any independent audit. Given the current, parlous state of Government finances this should at least come under independent critical review, perhaps by the Office for Budget Responsibility.

When a PWP candidly admits “I am trained to overlook the full picture”, it raises eyebrows. Then when ALIEE goes on to say that she operates purely with the ‘5 area model’,  this is jaw dropping.  This is not a model for any psychological disorder, by itself it is a heuristic for providing generic cbt, which has never been considered an evidence-supported treatment. Then this PWP states if clients still have high PHQ9 and GAD7 scores by the 4th session, it is the client who should be interrogated for their  competence in scoring, with the threat that if such scores persist there is the spectre of criticism from superiors. This is tantamount to fiddling results. It is atrocious that AIEE has been placed in this invidious position. I do not believe she is weak but rather like a prisoner at Auschwitz charged with the removal of dead bodies from a gas chamber.

The burden of proof is with IAPT to demonstrate that it has procedures in place to make it impossible for ALIEE to have been operating in this way. Protestations that ‘there a few bad apples’ in every workforce simply won’t wash.

Getting the media and politicians to listen is like getting the post war German Government to take action against war criminals. Action was only finally taken following many years of work by children of Holocaust victims. Unfortunately in the short term the implicit plea is that ‘we have enough to do with the Pandemic and Brexit, not to say Climate Change’ but the climate of the upcoming generation is affected by the mental health of today’s adults. 

Dr Mike Scott

If You Are Assaulted The Government Bodies Will Assault You Again

the Government and the Criminal Injuries Compensation Authority (CICA) should be put in the dock for the abuse of the poor.

 I recently came across ‘X’ she was seriously assaulted a few years ago by a group of youths and thought that she would never see her daughter again. For the past 18 months she has been effectively housebound with panic attacks and PTSD. She is unemployed and not eligible for Legal Aid. The CICA told her that she would need a report from a Consultant Psychiatrist or clinical psychologist to stand any chance of reversing their decision not to give her an award. But she did not have the financial resources to secure such a report nor to instruct a solicitor.

The CICA looked at her records and concluded that because she had had a previous post traumatic stress reaction her debility was entirely due to that. By definition PTSD is tied to a clearly specified trauma, and I found that her flashbacks nightmares were entirely of the assault and not of earlier negative life events. Further her significant avoidance of going out only began after the assault. This was corroborated by her GP records and notes from her IAPT therapist. The CICA totally failed to distinguish normal distress in response to negative life events from disorder. The CICA were intent on mis-attributing her ‘PTSD’ to pre-existing difficulties.

‘X’ has found the whole business of mounting an appeal overwhelming and has been re-traumatised by it. She had 8 telephone counselling sessions with IAPT which she said helped  ‘slightly’ in that she learnt breathing exercises for her panic attacks. But she has continued suffering from PTSD, depression, panic disorder and social phobia. IAPT failed to flag up any specific disorder/s. She can’t afford private psychological treatment.

Earlier this week a woman was interviewed incognito on BBC television, she had been raped and had 12 months of counselling with Rape Crisis. She then sought NHS treatment and was told she could not have it because she had already had ‘speciality treatment’. This came after she had already been re-traumatised by the defence Barrister in the rape trial!  I am lost for words to describe this secondary abuse.  It wasn’t clear from the interview which NHS service she had sought help from.

The Government should be put in the dock for not holding the CICA, IAPT and barristers to account.  They   should be challenging their public health  officials who sanction the funding of an IAPT service to the tune of £4 billion and which makes no real world difference to those like ‘X’.

Dr Mike Scott

Government Commits to Mental Health Yet Has Presided Over Increase In Mental Health Staff Abscences

Today the Prime Minister, Mrs May committed the NHS and Civil Service  to protecting the mental health of its’ staff. But a BBC freedom of information request (September 22nd 2017)  has revealed the number of NHS mental health staff who have had to take long-term leave of a month or more rose by 22% in the past 5 years. On the same day the Department of Health announced ‘we are transforming mental health care for everyone in this country, including NHS employees’.

If this is transformation maybe I should enter a home for the bemused and befuddled.

 

Dr Mike Scott