According to a newsletter, yesterday, from NetDoctor.com, which I’ve been unable to verify, the government has announced that it is rolling out, to 32 areas across the country, “talking therapies” for people with depression. The funding is to be £33 million in total, and you can bank on most of it going on training, admin and salaries before the patients even enter the equation – we’ve seen this happen for many years in hospitals.
The key points are these:-
Over the next three years, 3,600 extra therapists will be trained and offer treatment to 900,000 people.
In the first year at least 700 therapists will be trained and see around 100,000 people.
Extrapolating from that last, the training course is a year, or less, and the 700 newly-qualified therapists will get around 150 patients each on average.
Let’s focus on, though, the 3,600 new therapists/900,000 patients equation, which is where it gets scary. This gives an average of 250 patients to each shiny, new, therapist, all of whom they are expected to tackle with the benefit of zero experience. A recipe for disaster right there.
So, on these figures, just how much time will each patient get? Let’s say therapists work a 40-hour week, which is probably over-generous as there are lunch breaks and other breaks to be considered – a 30-hour “actually working” week is more like it, so 30×52 gives you the annual hours, divide that by 12 to get hours per month, and divide again by 250 to get hours per patient per month or, in this case 52 minutes per patient per month. Even if they do actually work 40 hours a week, that figure is improved only a little. Considering the fact that talking therapies are immensely time-consuming, just what benefit is a severely depressed patient going to get from a 52-minute chat (and by the time preliminaries and goodbyes are out of the way, they’ll be lucky to get 45 minutes), once a month?
And which talking therapy is it to be? No-one seems to be saying, but given that CBT seems to be very much in favour with NICE, I’d put my money on that – and my view of CBT is that, for the most part, it’s a crock. Some years ago, briefly, I had a social worker (I can’t, for the life of me, remember how I acquired him), and he’d just qualified as a CBT practitioner. Proudly, he let me read his thesis – and what I read was 5,000 words of the most egregious psychobabble. That put me off CBT for life – I wouldn’t willingly confide in someone who could write such tripe, never mind obtain a qualification for having done so.
Anyway, I don’t need a therapist to tell me why I’m depressed – I already know. Life’s crap, I have an illness that’s gonna kill me, I’m pretty sure I have vascular dementia, and I’m mostly housebound – and I need to get laid! It’d be a sodding miracle if I wasn’t depressed to some degree. I’m not suicidal – I found out what was causing that – see the Drugs for COPD post – and I’m not depressed all the time, but it is a sizable part of my life. What I certainly don’t need is some oik, with the ink still wet on his diploma (This is to certify that the undersigned is now qualified to talk absolute bollocks to unsuspecting victims!), trying to figure out what I already know.
Still, I digress… Something else not made clear is where they are going to recruit 4,300 new therapists. One thing that concerns me is that, for a post as sensitive as this, they need to be highly intelligent people, and are sufficient numbers of such people, with the requisite life experience and empathy, going to be available? Also they need to be native-born English speakers (i.e., from a country where English is the first language).
I don’t care what colour they are just as long as they speak, understand and think in colloquial English, as well as received English. What would be unacceptable is a foreign national with no more than basic English – a depressed person doesn’t need someone who has to translate every word into Polish, Punjabi, or Estonian, in their heads, before they can understand, and maybe get it wrong. I’ve encountered this in general medicine (try explaining to a Greek orthopaedic nurse with about 50 words of English how you were knocked off your Honda by a dog, if you don’t believe me!), where it can be a huge communication problem – someone who’s depressed really doesn’t need a therapist who, quite literally, doesn’t understand them. Nobody does.
Taking all of the above into account, I fear that this is doomed to failure. It would fail on the time factor alone, the rest is just overkill. Sadly, though, the genius(es) who came up with this hopelessly inadequate scheme won’t be the ones to suffer – that’ll be the patients, as always…