• Shawn Wilson, M.A.

England's Free Therapy Experiment

Photo credit: Ryan Tang

There is a lot of great research that shows therapy helps many people who live with debilitating depression, anxiety, and other mental health conditions. However, one of the major barriers for therapy is that it can be incredibly difficult to access quality therapy. There are often long waiting lists and costs for therapy sessions can be quite high. This lack of access to quality therapy is particularly true in areas such as rural communities. These problems are what makes England's radical model of providing free, quality treatment accessible to all, so innovative and exciting.

As reported by the New York Times, England is in the midst of changing how mental health services are offered. The reported goal is to create a primary care system for mental health services for all of Britain. Currently, the program starts with a phone session, where staff determine how safe the caller is and how quickly the caller needs to access treatment. Depending on the severity of the caller's mental health concerns, the caller might be referred to more intensive individual therapy or group therapy, or have less intensive phone sessions or sessions online.

Essentially, clients are matched with their treatment needs, which is an approach that is modeled after how patients are triaged in hospitals. Perhaps most importantly, all clients are provided with standardized evidence-based treatment that is closely monitored. This ensures that all clients are getting the help they need in a consistent way based on research, which makes it more likely that the clients will benefit from treatment.

This triage approach also helps cut costs; if a client can benefit from four brief over-the-phone sessions that provide some coping strategies, this is more cost-effective than spending a couple of months engaging in individual therapy. In addition, because there are shorter wait times for phone and online sessions, clients can access treatment more quickly if they do not require specialized care.

So what have they found in terms of outcomes? Incredibly, the program screens almost one million people each year in England and the number of adults who have accessed some type of mental health treatment is one in three! These numbers indicate the huge need there is out there for access to quality treatment. In addition, the recovery rate for those who engage in at least two sessions of therapy is now at 50%.

Now this new system is not perfect and still needs some work. For example, there are still long waitlists to see mental health providers in person. There are also still challenges to engaging people who have reservations about treatment. However, it appears that England's system is working well, particularly in comparison to models in other countries. It will be interesting to see how England's model changes as they continue to examine the benefits of offering extra 'booster' sessions and increased online treatment.

There are a lot of exciting components of England's system, particularly regarding how the country is collecting data, including weekly depression and anxiety questionnaires, to help monitor treatment success. Hopefully, by collecting this mass of research, researchers can better determine what works and what does not work for psychological treatment conducted in real-life conditions.

In addition, by offering widespread access to mental health services and making it as common as visiting a physician, England's model can reduce the stigma that is often attached to mental health and therapy, which means that more people may be willing to access the mental health services.

If England's model continues to be successful, hopefully it will encourage more countries to adopt broad mental health access to quality treatment. There clearly is a need and given that mental health problems, including depression, are a leading cause of disability around the world, these types of programs can have a profound impact on individuals, their communities, and their countries more broadly.

Article link: https://www.nytimes.com/2017/07/24/health/england-mental-health-treatment-therapy.html

The Clinically Relevant Insights Blog, part of ShawnWilsonPhD.com, shares news and research regarding psychology and wellness.

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© 2020 by Shawn Wilson