Nearly half of IAPT patients 'move to recovery'

Just under half of patients who are treated under the Government’s Improving Access to Psychological Therapies programme move to recovery, but drop-out rates remains high, according to Caroline Price at Pulse.

Official outcomes data suggest the programme is moving steadily towards the Government’s goal of having half of patients with depression or anxiety recover after treatment. But take-up remains low, with just under 60% of patients referred entering treatment and then less than two-thirds of these completing a minimum of two sessions.

The figures for January to March 2013, published today by the Health and Social Care Information Centre, show 46.8% of patients who completed at least two treatment contacts moved to recovery, defined as a score of less than 8 on the GAD7 and/or less than 10 on the PHQ-9.

This means the programme is getting closer to delivering the Government’s target 50% recovery rate, as set out in Talking Therapies: A four-year plan of action, and is delivering a better average recovery rate than at its outset. The action plan states that by 2014/2015, the NHS should deliver ‘at least 50% of those completing treatment moving to recovery and most experiencing a meaningful improvement in their condition’.

The data suggest all participating areas are performing better, although there is still considerable variation in recovery rates – ranging from 23% in Hull to 83% in North Lincolnshire.

The HSCIC also highlights that a total of 6,776 people moved off sick pay and benefits under the IAPT programme over the final quarter of 2012/2013.

However, access rates have slipped behind the target trajectory – at 2.5% of the eligible population compared with the goal of 3% at this stage.

Dr Mark Ashworth, clinical senior lecturer at King’s College London and a GP in south-east London, said the recovery rates were ‘very impressive’, but that the programme still had a way to go to fulfill it’s aims.

He said: ‘On the other hand, for just 6,776 patients (out of 154,700 starting treatment) to move off sick pay and benefits isn’t really an endorsement of Lord Layard’s founding principle that talking therapies would pay for itself by increasing the numbers of people returning to work.’

He added: ‘At least it looks for now as though the service is safe and will continue to be funded which, in the present climate, has got to be encouraging.’

'Mental Health Pathway' for paramedics to provide appropriate care for mentally ill patients

According to News Medical.NET Ruth Elliot, Senior Lecturer in the department of Mental Health and Learning Disability at the University of Huddersfield, has published an article discussing the need for a national 'Mental Health Pathway' to enable paramedics to provide the appropriate care for people who present mental health issues. 

The Department of Health (DH) (2005a) acknowledges the huge modernisation of the ambulance service in England and faster access to people with immediate life threatening conditions, however the service is also responding to an increasing number of patients who have an urgent primary care need, which includes mental distress, as opposed to clinical emergency. 

The DH (2006) policy calls for a "New Vision" where the ambulance service could increase efficiency and effectiveness towards patients who are experiencing non life threatening emergencies. The key aims are to form a programme of advancement to address both improving mental health and accessibility of services for people with poor mental health. The vision of the policy is that by 2020 mental and physical health will have equal priority. The development of a mental health pathway within the ambulance service may help to reduce admissions or re-attendance whilst improving care for patients. An evidence-based approach is used to provide a balanced, logical and supported argument within a reflection of practice (Borton, 1970,). This is evaluated against a hypothetical patient's case study which reflects common issues faced by paramedics and ambulance technicians. The analytical process considers patient, professional, organisational and multi-disciplinary team perspectives.

5 tips for Caring and Keeping a Smile

Being a caregiver encompasses a lot of different responsibilities, which most of us will encounter often or even daily. Whether it is as a Mum, as a carer for an elderly parent or as a paid care professional. It’s wonderful to think that so many of us care for others, but when caring for someone else it can be easy to forget about yourself. Care.com is the world’s largest online platform for families and caregivers to meet and we know how essential it is for carers to be looked after too.

We’ve put together some tips for any sort of carer to keep in mind – to keep you feeling positive and happy, which in turn keeps you feeling more prepared for your responsibilities.

1. Schedule some ‘you’ time:

When you’re busy caring for other people, along with working and juggling your own commitments, it can feel like a battle to find any time just for you. Think about what you would really enjoy; don’t worry if it’s not productive, or not sociable. This time is about what you want to do – so if you want to schedule in an hour a week for a bath or a chance to watch a film, do so! It’s easy to feel like any time off you have should be spent catching up with people or being busy. Instead focus on what will make you feel good. When you feel ready for this bit of respite, consider hiring a nanny, babysitter or carer for a few hours from so you’re not worrying about others whilst you relax.

2. Schedule some quality time with the person you care for:

This is about trying to find ways that you can connect with your loved one that involves a shared experience or some fun. Simple things, such as an outing to a park, can lift both your moods and give you something different to focus on.

3. Every day is a new day:

We know it is hard to start afresh every day, as it often feels like jobs and problems drag on. If something got you down yesterday try to give yourself a positive mentality the next day. When you’re caring for someone else it can feel like a job without a break: remember that you can’t change what happened yesterday anyway. Cut yourself some slack and remember that no one is perfect, we all make mistakes and feel stressed at times.

4. Consider getting some extra help:

Feeling stressed and overwhelmed by care responsibilities often also leaves carers feeling guilty, because they feel they should always be doing more or feel they aren’t doing things right. It’s normal to feel guilty as a carer, but that doesn’t mean it can’t be resolved. Why not consider employing someone to help support you and your family? Depending on your circumstances you could consider employing someone to take care of the children for a few hours a week, or have a trained nurse to come and check-in on your elderly parents. It’s simple to also find special needs carers that are ideal for your care situation.

5. Know the signs of stress:

It’s important to be able to notice the signs of stress in yourself. That way, when you start feeling down you can act upon as soon as possible. If you’re not doing your usual activities (such as going to the gym, dinner with friends or reading a book), find it difficult to start the day and are irritable or short-tempered, think of ways you can unwind and de-stress. If you’re feeling overwhelmed and not like yourself, consider talking to someone else and getting their advice – this can be a friend, family member or therapist.


Care.com is the world’s largest online platform for caregivers and families to meet. Whether it is for childcare, elder care, pet care, special needs care or housekeeping, there are caregivers suited to every families’ needs.

A recipe for resilience in fast-paced family life

Sarah Bateup
Clinical Lead PsychologyOnline and qualified Psychotherapist

Many of us feel that the speed of life has increased. We want rapid transport, instant communication and even faster internet connections. Businesses offer fast food, quick fixes and instant solutions. Yet as the pace of life continually increases we may feel a huge pressure to keep up, and as a result stress related illnesses have become more prevalent.

Stress is the result of an imbalance between the demands made upon us and the personal resources we have to deal with these demands. Imagine this as a bank account: if there is too much demand on the account it will go into the red, which is comparable to being under stress.

We all have different temperaments but for certain people life can feel like a constant rush, and you may be in a hurry from one activity or achievement to another on a continual basis. Similarly, balancing working life and family life can be a challenge for men and women alike.

As life becomes busier we can set ourselves unrealistic goals. We may aim for the “perfect” family life, to be the perfect parent and also aim to perform well at work. Magazines and the media can place increased pressure on us to create the perfect home, to look perfect and to have perfect children. In addition to these expectations we can have money worries, family disputes, additional workload and lack of time and we can soon run into a “stress overdraft”.

To help combat these stresses and demands, follow this advice to help you find a bit more balance and relief:

1. Slow down and take one thing at a time. Don’t force yourself to juggle lots of things at once.

2. Take a break! Timetable yourself a little bit of me-time, and give yourself some slack.

3. Learn to be mindful. Being attentive of what is happening in your life, and taking the time to take into consideration the different demands and pressures you feel, can be a very helpful way of coping with stress.

4. Express your feelings and talk to someone about how you’re coping. Whether this is someone close to you like a partner or friend, or if it is to a therapist or counsellor, it is still a way to deal with stress.

Lower you expectations, if you need to. Nobody can ‘have it all’ - try to overcome a perfectionist frame-of-mind.

5. Make time to do things YOU enjoy. Stop and think what it is you would really like to do – have a bath? Meet up with friends for dinner? Watch a film or read a book?

6. Rank priorities and try to think about what really is important, and what could actually wait.

7. If necessary, seek help, speak to your GP.

Graduate blues: Why we need to talk about post-university depression

We all know that students can suffer from mental ill-health at university - but what about post-graduation depression? Clare Dyckhoff investigates with The Independent.

'University is the best few years of your life, enjoy it while it lasts and make the most of it - time goes so fast' - all examples of a plethora of clichés that potential and current students are constantly blasted with.

It is true: university can be one of the best experiences of a young person’s life, wherein you study a beloved subject for three or four years and make the most of the opportunities offered. It seems like a simple equation for the majority; university plus new friends plus new experiences equals happiness.

But what happens once the glory days are over, the mortarboard is on and there’s a row of students smiling ear to ear, clutching their certificates showcasing years' worth of hard work, hangovers and great experiences? What happens next?

Statistics state that one in four students suffers from depression during their studies, but no official figures exist for graduates in the post-university transition. If a student is suffering from depression during their time at university, there are counselling services and student health centres able to help, not just to hear, but also actually to listen. There's a common misconception that university is just a three-year party with an alcohol supply that never ends - in fact, the party does end, and there is not enough being done to help with the clearing up after.

With the vast majority of students living away from home for the entirety of their university experience, trading new-found independence, power and responsibility for living back at home due to lack of funds can seem like an unnatural step back, or a regression to a pre-university self that was not so in control and independent. For some, returning to home comforts is preferred, but for many, feeling dependent with no real structure feels restrictive.

Poor mental health may be more common in gangs

"Gang violence cause of high levels of mental disorders," reports BBC online. This headline comes from a study that surveyed more than 4,500 young men in Britain. More than a quarter of these men reported being violent but were not involved in gangs, while 108 (about 2%) reported being gang members.

Researchers found that regardless of gang involvement, a history of violence was strongly associated with a higher risk of mental illness. But the risk of developing some types of mental health conditions was significantly higher in gang members. These conditions include: generalised anxiety disorder, psychosis and
antisocial personality disorder – a type of personality disorder characterised by lack of empathy, being prone to violence and poor impulse control drug and alcohol dependency

Analyses suggest that in gang members, this increase in risk could be related to dwelling on violent thoughts, having experienced violent victimisation and fear of further victimisation.

But a major drawback of this study is that it did not determine whether the men had a psychiatric diagnosis before they joined a gang, or if their mental health problems developed afterwards.

As the study was a survey, it also could not carry out the in-depth interviews required to give formal diagnoses.

Despite these limitations, these results provide an insight into a complex problem that needs to be tackled.

Read more from NHS Choices, here.

Hikikomori - the social anxiety phenomenon hitting Japan

William Kremer and Claudia Hammond, of BBC News write that as many as a million young people in Japan are thought to remain holed up in their homes - sometimes for decades at a time. Why?

For Hide, the problems started when he gave up school.

"I started to blame myself and my parents also blamed me for not going to school. The pressure started to build up," he says.

"Then, gradually, I became afraid to go out and fearful of meeting people. And then I couldn't get out of my house."

Gradually, Hide relinquished all communication with friends and eventually, his parents. To avoid seeing them he slept through the day and sat up all night, watching TV.

"I had all kinds of negative emotions inside me," he says. "The desire to go outside, anger towards society and my parents, sadness about having this condition, fear about what would happen in the future, and jealousy towards the people who were leading normal lives."

Hide had become "withdrawn" or hikikomori.

In Japan, hikikomori, a term that's also used to describe the young people who withdraw, is a word that everyone knows.

Tamaki Saito was a newly qualified psychiatrist when, in the early 1990s, he was struck by the number of parents who sought his help with children who had quit school and hidden themselves away for months and sometimes years at a time. These young people were often from middle-class families, they were almost always male, and the average age for their withdrawal was 15.

It might sound like straightforward teenage laziness. Why not stay in your room while your parents wait on you? But Saito says sufferers are paralysed by profound social fears.

"They are tormented in the mind," he says. "They want to go out in the world, they want to make friends or lovers, but they can't."

Read more here.

Can baking improve mental health?

They say baking soothes the soul. How can it not? There is something so reassuring about the ritual – quietly weighing out butter, sugar, flour, cracking eggs, whisking, beating and folding. "If you're feeling a little bit down, a bit of kneading helps," Mary Berry once said. It is not just indulging in the end results – the cake, the biscuits, the scones – that helps to brighten up a blue day, but the therapeutic process itself.

This perceived connection between baking and good mental health has sparked an initiative that will see several pop-up bakeries opening across the UK. During the first weekend in August, the Depressed Cake Shop will open at venues in London, Glasgow, Derby, Cardiff and North Yorkshire, with the proceeds going to mental health charities.

There is plenty of anecdotal evidence to suggest that the organiser, Emma Thomas – aka Miss Cakehead – is on to something with this idea. John Whaite, who won the Great British Bake Off in 2012, recently brought out a cookbook, Recipes for Every Day and Mood, with a chapter dedicated to lifting the spirits. Whaite has experience of depression and describes baking as his escape. For him, it is "meditative", an act of "making something destructive into something constructive, and at the end of it you've got something to be proud of, something to eat, something to show off".

Novelist Marian Keyes has also used baking to help her deal with depression. In her book, Saved by Cake, she writes: "Baking hasn't cured me. But it gets me through … To be perfectly blunt about it, my choice sometimes is: I can kill myself or I can make a dozen cupcakes. Right, so I'll do the cupcakes and I can kill myself tomorrow." Keyes and Whaite have spurred many bloggers to share stories of how baking helped with depression like this one who writes about how baking gave her a sense of achievement, or this young mother, who, overwhelmed after the birth of her baby, baked her way through Mary Berry's Baking Bible to help rebuild her confidence.

Read more, written by Huma Qureshi, of The Guardian, here. 

£3.8 million of funding for charities that support military families and programmes providing mental health support for veterans

As the country celebrates Armed Forces Day, the Prime Minister has today visited troops serving on the front-line in Helmand and announced almost £3.8 million of funding for charities that support military families and programmes providing mental health support for veterans.

Almost £2.5 million has been awarded to programmes supporting treatment and awareness of mental health issues for veterans.

Commenting on the support for mental health projects, the Prime Minister said:

“These charities are doing important and innovative work to help veterans who are battling mental health problems. We owe these men and women a great debt of gratitude and this is exactly the kind of help we should give to those who have given so much for our country.”

An additional £1.1 million will go to projects that help armed forces families. For example, the University of Wolverhampton has been awarded £205,000 to launch a programme specifically geared towards helping families of serving Armed Forces personnel, reservists and veterans to launch their own businesses, in collaboration with Black Country Chamber of Commerce and the Army’s HIVE information service.

Read more at the Ministry of Defence Oracle.

Imperial Innovations Group plc: Investment in PsychologyOnline

Imperial Innovations Group plc (AIM: IVO, 'Innovations', or 'the Group') a leading technology commercialisation and investment company, has invested £0.5m in new portfolio company, PsychologyOnline, a Cambridge-based provider of clinically-proven online cognitive behavioural therapy (CBT) for the treatment of depression.

Launched in 2010, PsychologyOnline delivers real time therapy to NHS and private patients with a live therapist via the internet, allowing them to attend sessions in their own home, at times that suit them. Waiting times are reduced to a few days, compared with up to several months for NHS face-to-face services. All PsychologyOnline therapists are experienced Chartered Psychologists or accredited Psychotherapists and are UK trained and accredited.

The company was founded by two Chartered Psychologists who recognised the scarcity of easily available psychological support to patients. The service is already available to NHS customers in some areas in the UK and the additional funding will enable PsychologyOnline to offer its service to a broader range of both NHS and private patients.

Despite being considered both preventable and treatable, depression costs the UK up to £9 billion a year in lost earnings and there are thought to be around 350m people suffering from depression worldwide. CBT is used widely within NHS mental health services as a NICE-recommended treatment for anxiety and depression. However, high demand can mean a long wait for patients and it is estimated that only a quarter of those with mental illness are currently receiving treatment.

The effectiveness of PsychologyOnline's service was demonstrated in a 300 patient clinical trial undertaken at three universities and NHS Trusts, including UCL, which was published in The Lancet in 2009. An average of just six sessions of online therapy was needed for recovery from moderate to severe depression compared to between 16 and 20 for NHS face to face services. Follow up client assessments at four and eight months confirmed that the benefits were maintained.

PsychologyOnline has raised a total of £1.6m from investors so far. Innovations has a 19.6% stake and other investors include Cambridge Angels. Dr Rebecca Todd, Director of Healthcare Investments at Innovations, will join the board of PsychologyOnline.

Susan Searle, Chief Executive Officer at Imperial Innovations, said:

"PsychologyOnline is a great example of how digital and online technologies can improve patient access to healthcare services. We are pleased to back this exciting company at a key time in its development and look forward to a time when all patients can easily access the kind of rapid and convenient healthcare service that PsychologyOnline offers."

Barnaby Perks, CEO of PsychologyOnline, said:

"Our service is already making a difference to NHS patients in areas such as Surrey. This investment will help us to increase the roll out of our service and offer it more widely to patients across the UK. We are also developing our private offering to support those who want a more discreet and confidential service without going via their GP."