Mental illness may be the biggest single cause of misery in the UK, so it's good news that extra funds will train more 'talking' therapists. But, says Anni Townend, therapies form part of a bigger picture, where coaching and mentoring play their part in offering support.
Improving access to talking therapies is part of a bigger picture of supporting people's wellbeing in all areas of life and work. In education there is a great awareness of the importance of children's mental and emotional wellbeing alongside their physical, intellectual and spiritual wellbeing. The Sainsbury Centre for Mental Health published a policy paper in January 2006 stating that: "Mental wellbeing must be put on the agenda of schools if we are to see a new generation of emotionally aware young adults in 2015".
Absence from work due to sickness is also high up on the political agenda. Lord Richard Layard, economist and author of 'Happiness: Lessons From a New Science', suggests that happiness should be at the top of everyone's agenda, especially the political one. In his opening remarks at the NHS conference in November 2007 he spoke of mental illness being the "biggest single cause of misery in the UK".
This misery is not limited to those suffering from anxiety disorders and depression, but extends also to their families. The IAPT aims to address the great unhappiness caused by anxiety and depression that can prevent people from being able to function happily and healthily at home, in their community or at work. Many people 'drown their sorrows' and ease their unhappiness through drinking, sex and drugs - all of which can become addictive, leading to greater distress and misery for everyone.
The therapeutic relationship
One of the biggest challenges for people who need help is in the asking for it, as and when they need it - not least because anxiety and depression can be very isolating. The point at which they most need help is the point at which many people find it most difficult to ask and to talk. 'Keeping a stiff upper lip' for fear of being seen as weak or vulnerable can be one of the many reasons. An added anxiety, particularly amongst elderly people, is that of being seen as mentally ill and by association being judged by others negatively.
An important part of making 'talking therapies' more accessible will be to reassure people that when they are feeling anxious and depressed talking to a trained therapist can help, and that it is different from talking to a friend or family member. The therapeutic relationship is unlike any other and the skilled therapist is able to meet people 'where they are at' in the here and now, and to use the relationship for helping people to make the changes that will help them in their lives. The therapeutic relationship is transitory, and the therapist – for a short while – is privileged to walk alongside people, offering a helping hand and gently guiding them.
Within business there is growing recognition that people enjoy greater effectiveness when they are able to be their 'best selves' at work and build 'bigger relationships' with each other, leading to more creativity and productivity. Good team work and flexible working are all part of helping people to manage their life-work balance more effectively.
There is much greater recognition that a healthy life-work balance is better for business success and that a key factor is people's happiness and mental/emotional wellbeing. It is very much the responsibility of organisations to readily provide information about all the different kinds of support available to employees internally and externally should they need to draw upon them during their working lives.
Many large organisations offer mentoring and coaching programs to employees and workplace counselling - Employee Assistance Programs (EAPs) - in recognition of the fact that people do need, from time to time, extra help dealing with issues which may have a negative impact on their happiness and their ability to perform successfully at work unless they are addressed.
Some organisations offer corporate ombudsman services where people can raise work-related issues and explore and clarify their options.
So is this level of investment by the NHS really going to make a difference? Certainly it is welcome that NICE has made these recommendations, giving people the choice of therapies within the NHS. However, it can only ever be part of the solution. Until we take a lifetime perspective - including early years in education, through our working lives and into our advanced years - we will not be completely answering the need for psychological support in Britain. This implies both employers in all sectors and educationalists play their part alongside the NHS who will remain our primary health provider. Only if we provide this life time support will we avoid therapy being focused on providing support when problems or issues become crises.
Improving Access to Psychological Therapies (IAPT) was launched by the then Health Secretary, Patricia Hewitt in May 2006. It is a joint project by the Department of Health and the Care Services Improvement Partnership. The program's overall aim is to deliver on the government's general election manifesto pledge of 2005, to improve people's wellbeing through 'talking therapies' to help with anxiety and depression.
Of more than six million people suffering from depression and anxiety in this country, only 25% report having access to the therapies that they would like. The Department of Health has pledged increased funding for IAPT rising from £30m in 2008/09 to £102m in 2009/10 and £170m in 2010/11 to increase provision and train more therapists.
The type of therapies recommended will be determined by the National Institute of Clinical Excellence (NICE) – an independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health to the NHS. The therapies recommended will be those that are proven as being of benefit to patients, evidence-based practices supported by rigorous research. Currently, short term cognitive behavioural therapy is often the therapy of choice as it has been shown to be particularly effective for anxiety disorders, most notably obsessive compulsive disorders and post traumatic stress.
Anni Townend is a business psychologist and author of Assertiveness and Diversity published by Palgrave Macmillan, 2007. For more details visit her website: www.annitownend.com