Access to psychotherapy

Even before COVID-19, the UK was in the grip of a mental health crisis. Rates of depression and anxiety are rising fast, while many people struggle to access quality care through the NHS due to long waiting times, uneven provision, and lack of choice.

Too many people with complex needs are stuck in the revolving door of therapy, needing to return to care again and again because it wasn’t good enough first time round. 

Expanding patient choice 

By far the most widely available form of talking therapy for most people accessing mental healthcare via the NHS is Cognitive Behavioural Therapy (CBT).  

While CBT is a very effective intervention for some people in some situations, it is not a one-size-fits-all solution. For example, while CBT can very effectively target the ‘symptoms’ of mental health issues, other forms of psychotherapy may be better suited to address the root causes and deliver positive outcomes in the longer term. 

We believe that offering a range of different therapies provides people with the best chance to find an intervention that works for them. Studies have demonstrated that the principle of patient choice leads to better outcomes, and that applies to mental health as well as physical health. 

Psychotherapy works. Everyone should be able to access long term, high quality therapy regardless of their economic situation. 

Expanding the NHS workforce 

In the NHS Long Term Plan, published in January 2019, there was already a clear commitment to substantially expand the NHS workforce, but the COVID-19 pandemic highlighted the need to increase both the scale and urgency of this effort.  

Sustainable investment is crucial to prevent an over-reliance on the voluntary sector and unpaid work to address the burden of trauma and grief in healthcare professionals, care-home staff and the wider public. 

NHS workforce expansion must include much greater numbers of psychotherapists and counsellors, so that people have access to the full range of appropriate therapeutic interventions. 

In 2020 our membership survey showed that 60% of UKCP members have worked or currently work within the NHS and, of those who aren’t currently working in the NHS, 45% would like to. Our members form a professional psychotherapeutic workforce which is ready and equipped to be part of the NHS response to the mental health crisis. 

Our goals 

See public policy for an expanded list of goals which we are pursuing across our policy and campaigns work. Some of the specific measures we’re calling for include: 

1. A Government commitment to provide a genuine choice of talking therapies through primary and secondary care NHS services across the four nations. 
2. Action to avoid over-reliance on an underfunded voluntary sector in providing key mental health services in the wake of COVID-19. 
3. People with complex mental health needs to have access to longer-term therapies, instead of being funnelled through Improving Access to Psychological Therapies (IAPT) services designed for mild to moderate difficulties. 
4. Health Education England (HEE) to commit to rectifying the proportionate underrepresentation of Dynamic Interpersonal Therapy, Counselling for Depression, Couples Therapy and Interpersonal Therapy in IAPT services in England as part of the expansion promised in the NHS Long Term Plan. 
5. Funded trainee places in IAPT for non-Cognitive Behavioural Therapy (CBT) practitioners. 
6. Action to diversify the NHS workforce as a priority. 

Our work in this area includes: 

• reaching out to parliamentarians from all major parties to discuss issues related to psychotherapy, raising specific concerns about the government’s response to the mental health crisis 
• attending Health Education England Workforce Group meetings to feed into workforce planning for the implementation of the NHS Long Term Plan 

• taking part in the Talking Therapies Taskforce looking to improve national infrastructure for talking therapies.