Improving Access to Psychological Therapies:
Learning from Pilot Project in 3 Estates area of Kings Norton
Lord Layard's report (‘Mental Health: Britain's biggest social problem?') to the Cabinet Office urges that psychological therapy (in particular, Cognitive Behaviour Therapy- CBT) should be made available to people with mental health problems. The report suggested that such a service would pay for itself in the reduced expenditure on incapacity benefits from people being able to go back to work. CSIP explored this contention in a deprived area of Birmingham in a pilot project by providing a 12 week CBT programme focussing on employment related issues referred through Job Centre Plus (JCP).
A series of key messages emerged from this pilot project for the JCP and related agencies. First, although the service was happy to accept referrals from most agencies within the local community (e.g. benefits agency, library, community centre) most came through the Job Centre Plus. The referral process worked best with the Disability Employment Advisors who had a sound knowledge of mental health issues and felt confident about making referrals. It was felt that there was a need for greater information on mental health and CBT issues for other agencies and workforce.
Furthermore, training needed to be provided on how to enable staff to discuss the sensitive issues surrounding mental health with clients in order to smooth the referral process. There was also felt a need to raise awareness of mental health issues and psychological therapies, provide information and awareness of common mental health conditions and reduce stigma associated with such conditions in many agencies. If staff had such training, possibly including motivational interviewing to facilitate clients moving towards referral, then an increased awareness, referrals and benefits for clients would result.
Clients were reported as having complex problems which required significant training and experience on behalf of the therapist, along with a thorough understanding of services and opportunities within the community that clients could access following their CBT course. This important local knowledge was developed through relationships with New Deal for Communities staff.
Following treatment, staff required a basic understanding of CBT and be able to work in a way that supports and reinforces clients' learning during the course. It was noted by Mick Gillingham, CBT therapist, that "there were two components to successful therapy- assessment and treatment by a qualified CBT therapist and then vocational rehabilitation by an Aftercare worker". The process did not stop with the CBT.
The key messages from this successful project were, therefore:
- provide information and training about mental health issues and psychological therapies to local agencies, including JCP staff;
- provide clear information on the referral process to staff and potential clients,
- ensure appropriately trained therapists are available with good knowledge of local services;
- provide support and information to staff who may come into contact with clients in order to support and reinforce the positive benefits of the intervention.
In this way appropriate referrals can be made and the benefits to clients increased, which can go some way to realising the aims of Lord Layard.
Report compiled for CSIP West Midlands by:
Professor Dominic Upton, Head of Psychology and Health Sciences, University of Worcester, April, 2007.