NHS patients with severe mental illness waiting up to two years for treatment, report finds

Patients with serious mental health issues leading them to self-harm or attempt suicide are being left to wait as long as two years for specialist support because of an NHS “blind spot” on waiting times, an investigation has found.

The British Medical Association (BMA) has warned that thousands of patients are waiting more than six months for access to psychological “talking therapies” to help them cope with negative thoughts and feelings.

However the true extent of the waiting time problem is likely to be much larger.

The BMA investigation found that just one in 10 local NHS clinical commissioning groups (CCGs) who and just over half of mental health trusts keep track of how long these patients are waiting.

Doctors warned of a growing inequality faced by people with serious mental health problems who often need both medication and face to face therapies but have seen little improvement.

This contrasts to the efforts made in improving access to support for mild anxiety and depression thorugh the targets in the Improving Access to Psychological Therapies (IAPT) programme.

The BMA made requests under the Freedom of Information Act to all 207 CCG, the bodies responsible for commissioning NHS services, and 54 NHS mental health trusts to ask them about waiting times for accessing talking therapies.

The organisations were asked about access to DBT (dialectical behavioural therapy), CBT (cognitive behavioural therapy), family therapy and dynamic psychotherapy.

Of the 183 CCGs who replied, nine out of ten didn’t record any waiting times for talking therapies in severe mental illness.

While 22 out of 47 responding mental health trusts also don’t keep these records.

Of those who did keep records the BMA found 3,700 patients waited more than six months, and 1,500 waited more than a year.

The longest waits were in Leicestershire, where patients waited two years, and Essex and Derbyshire, where they waited for a year and a half.

But in Croydon more than a hundred children with a severe mental health problem were made to wait more than six months.

The BMA spoke to 20-year-old psychiatry student Nicola Mattocks who needed DBT and was self-harming and regularly taking overdoses, but had to wait a year and a half to get support.

“It had to get bad enough that I was hearing voices telling me to kill myself before I was taken on,” Ms Mattocks told the BMA.

It was about 18 months before I got the specific help I needed. When I got it, it was really useful, I learnt so much and made a book of things I can do when I’m feeling a certain way.

This could include routines like watching a film when she’s feeling sad, however two years ago she experienced mental health relapse and found she was back to square one.

“I was trying to get help again and I had to go back to the very back end of the waiting list.

“It feels like a battle I can’t win.

“I can’t put into words how serious it is, and the cost of waiting is immeasurable.

“While people are waiting, they’re still desperately trying to numb the pain they’re feeling, and while they do that inevitably some will die.”

Dr Sue Mizen, chair of the medical psychotherapy faculty at the Royal College of Psychiatrists said for severe mental illness “there is no comparable strategy” to the IAPT scheme.

“Policy makers must wake up to the fact that without strict measuring and recording of the therapies on offer, they are not only failing to provide adequate treatment for patients with severe and enduring mental health problems, but are also wasting vast amounts of money in the process by not providing patients with the appropriate psychological response.

“This results in repeated use of revolving door admissions leaving underlying problems unresolved.”

Dr Andrew Molodynski, BMA consultants committee mental health lead, said: “There is increasing inequality between people suffering mild to moderate mental ill health and those with severe mental illness.

“Without the right therapy, some patients deteriorate and become more vulnerable, being passed from GP surgeries to emergency departments unable to find the most appropriate treatment for their illness.”

“Funding for talking therapies should be protected so CCGs can ensure funding reaches services that need it most before it’s too late.”

Leila Reyburn, policy and campaigns manager at mental health charity, Mind, said: "It’s not uncommon to hear of waiting lists of well over a year for certain non-IAPT services.

“This isn’t acceptable. We know that when people get the help they need early on it can prevent them becoming more unwell.

"Making someone wait months and months to start a therapy risks making their mental health much worse, which isn’t good for the person and isn’t good for the NHS. We need to see significant investment in non-IAPT talking therapies.”

NHS England was approached for comment but had not responded at the time of publication.