There is an urgent need for an independent investigation of IAPT. In an earlier blog ‘IAPT half baked’, an IAPT worker commented that it would be ‘hair raising’ for people to learn of his/her experiences. This past week I’ve come across 2 cases that exemplify this,
- ‘X’ was given 3 sessions of guided self-help therapy, judged ‘resistant’, treatment was judged unsuccesful on the basis of PHQ 9 and GAD7 results and it was recommended that ‘X’ was stepped up to trauma focussed therapy. But without any specification of what the trauma was or its’ sequelae. Some months later ‘X’ began a series of 10+ sessions at step 3 for Generalised Anxiety Disorder (GAD) , but during treatment the therapist discovered ‘X’ experienced a very distressing incident many years ago and was upset when thinking about it. This event became the treatment focus and by the end of therapy ‘X’ was allegedly less distressed by this incident. Treatment was judged successful on the basis of changes on PHQ9 and GAD7 scores, but the therapist discharge letter said ‘ may now need to be re-referred for treatment of GAD!
- ‘Y’ saw his/her GP immediately following a needlestick injury was given the IAPT telephone number and a telephone consultation took place within days, PHQ9 and GAD7 scales were completed and the scores were elevated and ‘y’ was scheduled for a face to face treatment 6 weeks later. If you were not distressed/anxious after a needlestick injury you really would be weird, does the GP and IAPT have to collude in this medicalisation of normal distress, is this really a proper use of resources? from a GP’s point of view I can see that it ‘off loads’ a case for a time but really!
My fear is that no one in power really wants to know what is going on at the coal face, it is not helped by the National Audit Offices failure to publish the results of its investigation into IAPT. One can only speculate that the champion’s of IAPT, NHS England have had a gentle word with the Office. The effect is that a political correctness rules expressing concern about mental health, stigma and the need for more resources, but without getting close to the people effected and really listening to what is going on.
Dr Mike Scott