The latest news for counselling professionals, updated weekly
This week's news
Payday loan debtline calls up
The Money Advice Trust 27/02/13
Calls to the National Debtline service for help with payday loans shot up by 94 per cent in 2012, debt charity the Money Advice Trust has revealed. Last year the debt helpline took 20,013 calls for help with payday loans, nearly double the 10,301 calls received in 2011. In 2007, when the financial crisis began, the service took just 465 calls for payday loans advice. National Debtline advisers are currently getting calls at a rate of 100 per day from people needing help with payday loan debts. Some callers have taken out as many as 80 payday loans. The Money Advice Trust wants the Office of Fair Trading (OFT) to make use of its new powers to suspend consumer credit licences with immediate effect where it identifies persistent bad practice. Joanna Elson, Chief Executive of the Money Advice Trust, said: ‘Payday loans have come from nowhere to be one of the most common debt problems people face. Borrowing on this scale can have serious ramifications if not dealt with properly.
Relate calls for ‘male-friendly’ counselling
Men’s Health Forum 25/03/13
Relationship counselling services should be more ‘male friendly’, Relate says in a new report published with the Men’s Health Forum. The report, Try to See It My Way, says men have different expectations of counselling; they go to counselling to solve problems, while women see it as a chance to talk about difficulties and review what’s happening in the relationship. Research shows that men are at greater risk of suicide in the aftermath of a relationship breakdown and are less likely to have a network of friends to support them. They also tend to make less use of counselling and psychotherapy services: just 36 per cent of IAPT referrals are male, and only 44 per cent of Relate’s clients. The report says policymakers and service providers across health, education and social care need to deliver services in a more ‘male-friendly’ way and that personal, social, health and economic education (PSHE) should include sex and relationships education and should be offered to all young people as a statutory requirement.
Self-harm campaign launched
Four young people’s charities have launched a national campaign to raise awareness of self-harm. An estimated one in 12 young people in the UK have self-harmed at some point in their lives. Calls to ChildLine from young people who self-harm have risen by 167% in the past two years. It is also affecting younger children: this year it featured for the first time in the top five concerns reported by 13-year-old Childline callers. A survey by YoungMinds also found that GPs, parents and young people themselves didn’t know how and where to get help. The charities, ChildLine, YouthNet, Selfharm.co.uk and YoungMinds, hope that the campaign will help to reduce the stigma attached to self-harming that prevents many young people from seeking help.
Low intensity interventions effective with severe depression
British Medical Journal 28/02/13
Low intensity psychological interventions can help people with more severe depression, a meta-analysis of studies shows. The analysis used data from 16 systematic reviews of trials of stepped care, in which patients are gradually given higher intensity psychological interventions if they fail to respond to treatment. The analysis showed that although many patients were referred for low intensity interventions despite having moderate to severe depression, and there was some evidence that patients with more severe depression showed greater improvement than those with less severe depression – although the difference was small and might not be clinically significant. However patients with more severe depression at baseline did show at least as much clinical benefit from low intensity interventions as less severely depressed patients and could usefully be offered these interventions as part of a stepped care model, the researchers say.
Parenthood a ‘trigger’ for healthy lifestyle
Department of Health 01/03/13
Cohabitation and pregnancy prompt much healthier lifestyles, the first in a new series of twice-yearly ‘Lifecourse Tracker’ surveys published by the Department of Health shows. The survey findings are based on interviews with 1,010 adults aged 18+ in England, 608 young people aged 11–17 and 300 pregnant women and 247 mothers of babies aged under 24 months. Almost all the adults reported at least one negative health behaviour and more than a fifth reported three or more out of the possible six: nutrition, physical activity, smoking, alcohol consumption, drug use and unprotected sex. Risk behaviours increased sharply at ages 15–17 and peaked at age 18–35 before declining rapidly in middle age. But the youngest (18–24) and oldest (75+) adults were least likely to take physical exercise or eat five portions of fruit and vegetables a day. But while parents often gave up smoking, cut back on alcohol and improved their diet during the pregnancy, they tended to revert to their usual behaviour patterns after the child’s birth.
UK people live longer but in worse health
Department of Health 05/03/13
People in the UK are living longer but can expect to live more years in poor health, a special analysis of the Global Burden of Disease Study 2010 shows. Mental health problems are among the leading causes of long-term disability. The report compares health in the UK with 14 other EU countries and Australia, Canada, Norway and the US from 1990–2010. Life expectancy overall increased by 4.2 years in the UK to 79.9 years, but this was less than in other countries. Deaths from Alzheimer’s disease, cirrhosis of the liver, and drug use disorders increased sharply, although the UK achieved the largest drop in deaths from heart disease of any of the 19 countries. However levels of disability in specific age groups did not improve. The major causes of disability include mental and behavioural disorders such as depression, anxiety and schizophrenia, substance abuse including drug and alcohol use, and musculoskeletal disorders such as lower back pain and osteoarthritis. Compared with the other 18 countries, the UK came out worse for years of life lost for most conditions and its relative position has worsened since 1990.
Peers call for post-adoption support
House of Lords Committee on Adoption Legislation 06/03/13
Adoptive parents should receive more support to help them care for vulnerable children, the House of Lords Committee on Adoption Legislation says in a report on the Government’s proposed reforms to speed up the adoption process. The Committee says children adopted from care have often experienced severe neglect and abuse and may have very complex needs. Local authorities and other service providers should be legally obliged to provide post-adoption support to children and adopters; the costs would be more than covered by savings from placement breakdown and improved outcomes for the children, the Committee argues. It also says that families whose child has been taken into care should be offered support ‘to break the cycle of more children being born into families that cannot safely parent them’. The Government should also improve the monitoring of placement breakdown, ‘to inform our understanding of what is going wrong, and how such outcomes can be avoided,’ Chair of the committee Lady Butler-Sloss said.
No link between depression and inequality
British Journal of Psychiatry March/13
Poverty is associated with higher risk of depression but there is no evidence of a link with inequality, a comparison of depression prevalence and contributory socio-economic factors shows. The survey used data from the World Health Organization World Health Surveys and covered 53 countries and 187,496 individuals. Prevalence of depression ranged from 0.4% in Vietnam to 15.7% in Morocco, and from 6% in low-income countries to 7.6% in upper-middle income countries. Most (85%) of the variance was associated with individual-specific factors; some (13.5%) with country-specific factors. Women and divorced or widowed people were at higher risk of depression, as were people with lower levels of education. People with more materials assets were less likely to be depressed but people who spent more were more likely to be depressed. Economically inactive people were also at greater risk, except in low-income countries. The researchers say that depression rates increase in relation to decreasing national income but there was no evidence of a link with income inequality.
CPS to review child sexual abuse prosecution process
Crown Prosecution Service 06/03/13
The Crown Prosecution Service (CPS) and Association of Child Police Officers (ACPO) are to jointly review the current procedures for investigating and prosecuting sexual offences. The decision to tear up and replace all existing guidance is in direct response to the Jimmy Savile sexual abuse scandal and ‘to ensure we have truly learned lessons from the past’, Director of Public Prosecutions Keir Starmer QC has said. In addition to the overhaul of guidance, the review will include training for police and prosecutors and a national scoping panel that will review past complaints that were not pursued by police and prosecutors, if requested. ‘We are clear that the yardsticks for testing the credibility and reliability of victims in sexual abuse cases do not serve the police or prosecutors well and risk leaving an identifiable group of vulnerable victims unprotected by the criminal law,’ Kier Starmer said.
Drugs in water supply change fish behaviours
American Association for the Advancement of Science 14/02/13
Benzodiazepines in the water supply are causing marked changes in freshwater fish behaviours, Swedish scientists say. A study, reported at the annual meeting of the American Association for the Advancement of Science, has found that high levels of the anti-anxiety drug Oxazepam can cause perch to behave in uncharacteristic ways. Scientists fed perch with doses of the drug equivalent to the high concentrations found in water supplies. The perch fed the drug were more courageous and more voracious than their peers. They were bolder about swimming outside safe areas, appeared less afraid and much bolder, and also ate more quickly. Another unusual behaviour was that they preferred to swim alone, and some became positively anti-social. ‘Perch that were exposed to Oxazepam lost interest in hanging out with the group, and some even stayed as far away from the group as possible,’ the researchers say.
High internet users suffer withdrawal symptoms
PLOS ONE 07/02/13
Young people who use the internet for excessively long periods can suffer withdrawal symptoms similar to those reported by drug users, research shows. A study of 60 students, all in their mid-20s (27 men and 33 women) found a ‘striking negative impact’ of internet use on the positive mood of those whose internet use was rated at addict levels, although no effect on negative mood. The researchers, from the universities of Swansea and Milan, say the mood change may be serious enough to prompt high users to re-engage in net use to get rid of the unpleasant feelings, which would qualify them as addicts. ‘When these people come off-line, they suffer increased negative mood – just like people coming off illegal drugs like ecstasy,’ they say. The study also found that heavy internet users also tend to be more depressed and show higher levels of autism traits.
Divorce ‘hot-spots’ revealed
Ministry of Justice 20/02/13
Birmingham has the highest divorce rate in England, followed by Weston-Super-Mare, statistics published by the Ministry of Justice for the 12 months October 2011 to September 2012 show. Some 2,799 couples filed for divorce at Birmingham Civil Justice Centre and Family Courts last year, and 2,437 in Weston-super-Mare County Court. The next highest was Leicester County Court, where 1,831 couples filed for divorce. The Government wants couples who decide to separate to use mediation, instead of going to court, to agree how they divide their assets and make arrangements for their children. Relate has welcomed the Government’s emphasis on mediation but says couples should be seeking relationship support sooner. It says a fifth of its counsellors have seen an increase in demand for couples counselling due to the economic downturn and 80 per cent say they have clients who haven’t been able to afford sessions.
Government signs child health pledge
Department of Health 19/02/13
The Government has pledged to improve the health of children and young people in England. The pledge is part of the Government’s response to the Children and Young People’s Health Outcomes Forum, which sets out how it plans to address England’s poor child health rates. England has one of the worst all-cause child mortality rates in Europe. More than a quarter (26%) of children’s deaths are due to failures in care. Over 30% of two to 15 year old children are overweight or obese. Nearly half of all lifetime mental illnesses also start before age 14, and nearly half of looked-after children have a mental disorder. The Government says it is ‘determined’ to: prevent ill health in children and young people and help them and their families to prioritise healthy behaviour; improve the mental health of children and young people by promoting resilience and mental wellbeing and providing early and effective evidence-based treatment for those who need it; support and protect the most vulnerable by focusing on the social determinants of health and providing better support to the groups that have the worst health outcomes, and provide better care for children and young people with long term conditions and disability and increase life expectancy of those with life-limiting conditions.
Obesity hospital admissions increase
Health and Social Care Information Centre 20/02/13
Admissions to hospital for treatment for obesity-related conditions has increased, new NHS data show. Hospitals in England reported 11,740 inpatient admissions with a primary diagnosis of obesity in 2011/12, one per cent more than in 2010/11 (11,570) and triple the number recorded five years earlier (3,860 in 2006/07). Female admissions were almost three times higher than male admissions (8,740 compared to 2,990). Regionally, admission rates were highest in the North East Strategic Health Authority (SHA) area and lowest in the East of England SHA. Hospitals carried out 8,790 bariatric surgery procedures (nine per cent up on 2010/11 and four times more than in 2006/07), of which 6,710 were on women and 2,080 on men. The report also says that just 37 per cent of people in England are ‘normal’ weight, according to Body Mass Index (BMI), although this proportion has remained between 36 per and 38 per cent since 2001. But the proportion of women aged 16 and over who are normal weight has dropped from 50% in 1993 to 39 per cent in 2011, and from 41 to 31 per cent for men, while a quarter of women (26%) and 24% of men were classed as obese in 2011 and 58% of women and 65% of men were classed as either overweight or obese.
Study compares eCBT and cCBT
British Journal of Guidance & Counselling 04/13
People who have online CBT say treatments can be complicated and impersonal, a new study shows. The study surveyed clients who received either eight sessions of therapist-delivered email cognitive behaviour therapy (n=37), or eight sessions of computerised CBT self-administered treatment (n=43). Participants completed a post-treatment questionnaire to determine what they found satisfying about their online treatment. A total of 25 participants (eCBT n=10; cCBT n=15) completed the satisfaction questionnaire. Both groups were satisfied with the access to and useability of the online treatments. Perceived anonymity was important for the eCBT group and the cCBT group found the treatment user-friendly, engaging and also a source of learning. But both groups said they didn’t like the way that online treatment could at times be complicated and impersonal.
BACP Register gets PSA approval
Professional Standards Authority 14/02/13
BACP has become one of the first healthcare organisations to have its voluntary register accredited by the Professional Standards Authority for Health and Social Care (formerly the Council for Healthcare Regulation and Excellence). The scheme was set up by the Department of Health to ensure unregulated health professions are subject to statutory oversight and have to confirm to agreed standards of practice and training. Counsellors and psychotherapists on BACP’s register will be able to display the Accredited Voluntary Register quality mark to demonstrate that they meet the Professional Standards Authority’s standards. All eligible BACP members are being invited to transfer to the voluntary accredited register, or to take a certificate of proficiency to demonstrate their eligibility. BACP Chief Executive, Laurie Clarke, said: ‘Given the increasing number of practitioners offering counselling services, this new safeguard provides a vital standard of service to help people select the very best counsellor or psychotherapist for them.’
Older therapists cry more
Older, more experienced therapists cry more often during therapy sessions, new research shows. Therapists crying in therapy is an under-researched phenomenon. A US study asked 684 qualified and trainee therapists to complete an online survey saying how often they cried in their role as therapist and in their daily life, and to supply other demographic and personality trait information. Nearly three quarters (72%) reported crying in therapy. Analysis of the data suggested that this was less to do with personality or demographic and more to do with the therapy process itself and the therapist's theoretical orientation and clinical experience. Older therapists with more experience cried more in therapy than more recently qualified practitioners, but cried less often in their daily life. Psychodynamic therapists reported slightly higher rates of crying in therapy than cognitive behavioural therapists, despite no difference in crying in daily life. Male and female therapists reported similar levels of crying in therapy, even though the women reported more frequent crying in daily life. The researchers say their findings suggest that experienced therapists feel more confident about allowing themselves to experience these emotions in therapy sessions.
Four in five GPs report therapy waiting lists
Three quarters of GPs say they are prescribing antidepressant medication even though they believe counselling or CBT would be more effective and less than a quarter believe that access to psychological therapies will improve. A survey conducted by the health insurers Aviva also found that 85% of people fear that their mental health will deteriorate while they wait for psychotherapy and 73% say the Government isn’t doing enough to tackle mental health problems. Four in five GPs (84%) in the survey reported long waiting lists for talking therapies, half said their local trust provides a poor service for patients with mental health problems, and 37% said treatment for people with depression is poor. The longest waiting times were reported by GPs in Scotland, followed by Wales, the South East and East Anglia. GPs in West Midlands and Yorkshire and the Humber were most likely to prescribe medication even though they believed talking treatments would be more effective. GPs in the North East were the most likely to report increases in the number of patients seeking help for a mental health condition.
Survey shows increase in use of NHS therapy
British Journal of Psychiatry February/13
Access to publicly funded therapy has increased in the past two decades, new research shows. A UK-wide study of psychotherapy treatments for common mental disorders in the years 1991 to 2009 shows that, while more affluent and better educated people are more likely to be able to access psychotherapy, and more use private therapists, public provision for people on lower incomes has increased, particularly in the last five years of the period surveyed. The survey also showed that less affluent people tend to have more severe mental health problems, so NHS therapy is now more adequately meeting public health needs. The study, of 28,000 adults, found that, on average per year, 26% reported having a mental health problem and two per cent accessed therapy. Of the 4274 therapy treatments reported, 77.5% was provided by public health services, 21.3% by the private sector and 1.2% by both.
MPs to get their own mental health service
MPs are to get their own in-house mental health referral service, the House of Commons Estimate Committee has agreed. The £25,000-a-year service will allow MPs to be referred and receive secondary care while in Westminster. It will be accessed through the existing Parliamentary Safety, Health and Wellbeing Service (SHWS). The Committee agreed that fear of stigma may prevent MPs seek help in their own constituency. The House of Commons already offers pastoral support. The decision to provide the service follows the final passing of the Mental Health Discrimination Bill, which repeals a number of laws that meant MPs automatically had to stand down from their parliamentary seat if they were sectioned under the Mental Health Act for more than six months, even if they made a full recovery, and prevented people with mental health conditions from becoming or remaining a company director.
Report highlights poor homecare standards
Care Quality Commission 13/02/13
A quarter of homecare services are failing to meet national standards, the Care Quality Commission says. Its review of 250 homecare services found that good care is being delivered by the majority of providers, but 26% are failing on at least one of the five national standards. Concerns included missed or late calls and inconsistent weekend services, lack of staff knowledge and skills, particularly about dementia, inadequate assessment of needs, lack of detailed care plans, including choices and preferences and complex care needs, poor coordination of visits requiring two care workers and lack of involvement of family or carers. The review also found evidence of failures to report safeguarding concerns in line with local policy, out-of-date procedures and staff not understanding safeguarding or whistleblowing procedures. Staff also reported feeling unsupported by their managers and not having enough time to do their work properly, as they would like. David Behan, CQC Chief Executive, said: ‘People have a right to expect to be treated as an individual, to be able to exercise choice, and to make sure their carers are aware of their specific care needs. We found plenty of evidence of this however we also found elements of poor care which happen too often.’
Cancer bereavement does not raise risk of spouse’s death
PLOS ONE 25/01/13
Spouses and partners bereaved through cancer are not at any higher risk of dying following their bereavement than non-bereaved people, a study shows. Bereaved spouses or partners are thought to be at increased risk of morbidity and mortality. This study followed up some 92,129 people for an average four years. Cohabitees of patients who died of cancer were in fact less likely to die of any cause after findings were adjusted for a number of variables, including age, gender, non-psychotropic and psychotropic prescriptions, smoking, alcohol and area deprivation score. But they were more likely to receive a prescription for antidepressant or hypnotic medication and to visit their GP both before and after the death of the cohabitee.
Gay people have more difficult childhoods
PLOS ONE 23/01/13
Gay and other sexual minority people are more likely to have experienced physical, sexual or emotional abuse in childhood, and other adverse childhood experiences such as neglect, exposure to domestic violence, parental discord, and family mental illness, imprisonment and substance abuse, a US study shows. The study used the Adverse Childhood Experiences (ACE) scale to assess and compare multiple developmental risk factors in childhood among over 22,000 sexual minority and heterosexual adults. Compared with heterosexual respondents, gay/lesbian and bisexual people were much more likely to report higher numbers of adverse experiences (six and seven out of eight) and higher rates
Custody is failing children, report says
Prison Reform Trust 06/02/13
High numbers of vulnerable children with mental health needs and learning disabilities are getting caught up in the criminal justice system where services may be inadequate to meet their special needs, a joint report from the Prison Reform Trust and YoungMinds says. Turning Young Lives Around, a briefing paper for staff in the NHS and the criminal justice system, says that 25% of children who offend have IQs of less than 70, 43% of children on community orders and even more of those in custody have mental health and care needs, and 60% of children who offend have communication difficulties. It warns that failure to provide adequate health, support and education services will condemn these young people to a lifetime of crime, poor health and unemployment.
Parental death can cause lifelong emotional damage
Journal of the Royal Society of Medicine 08/02/13
The early death of a parent can cause lifelong harm and suffering if the child and family don’t get adequate support, new research shows. The study, conducted by researchers at the University of Liverpool, found that low self-esteem, loneliness, isolation and inability to express feelings can persist through adulthood and into old age if a child loses a parent at a young age. The research found that disruptions, instability and lack of continuity were common in bereaved children’s lives. They say moving home and separation from family and friends make adjustment to parental death more difficult and increase stress in bereaved children and long periods of disruption or inadequate living arrangements means they are more likely to experience emotional difficulties and feelings of insecurity and loneliness in adult life. Bereaved children should remain in their existing social networks, live in the same area, go to the same school and maintain the same friendships. ‘Our research suggests that if the social network addresses the necessary ‘mothering or fathering’ then a child does not appear to be affected in adult life,’ lead researcher Professor Mari Lloyd-Williams said.
Child poverty ‘under-estimated’
Policy Exchange 08/02/13
The Government is under-estimating the numbers of children living in poverty by failing to take into account wider social factors, not just household income, a new report says. The report, published by the thinktank Policy Exchange, says that nearly one in five children in the UK (some 2.3 million) are in fact living ‘materially deprived’ lives but are not recorded as such because social poverty measures, such as quality of housing, family debt, whether a child has been in care, child or parental conviction rates and a child’s educational attainments, are not taken into account. Policy Exchange argues that a wider measure of child poverty would allow the Government to focus on these other areas that would improve children’s lives.
MPs criticise work capability assessment failures
Public Accounts Committee 08/02/13
The Department for Work and Pensions has been roundly condemned by MPs for failing to challenge what they say is poor practice by Atos Healthcare, the private sector organisation running the Work Capability Assessments. In a scathing report, the House of Commons Public Accounts Committee says the DWP has failed to hold Atos to account for the high number of wrong decisions that have later been successfully appealed. Some 38% of appeals are successful and a third of these have involved no new evidence, the MPs say. The DWP has allowed Atos to establish a near-monopoly and has neither monitored its performance nor penalised it for its failures, the MPs say. ‘This poor decision-making is damaging public confidence and generating a lot of criticism of [Atos Healthcare] but most of the problems lie firmly within the DWP.’
Peer relationships link to depression
Psychology & Psychotherapy: theory, research and practice March/13
Peers can be a significant influence on depression in later life, a study shows. Early life experiences are known to be an influence on emotional resilience but the focus is usually on parental factors, not peers. This study sought to identify what influence peer relationships might have in later life, and how that influence might manifest. A sample of 103 female and 97 male young adults were asked to recall experiences of parenting and peer relationships during early adolescence. Analysis of the findings showed that parents and peers independently contributed to the development of self-criticism and self-reassurance. Overt bullying by peers resulted in self-hating self-criticism, relational victimisation predicted inadequacy self-criticism, and prosocial behaviour resulted in higher levels of self-reassurance. Prosocial behaviour also buffered the effect of bullying on self-reassurance. The researchers say that helping young people to cope with peer bullying and fostering positive peer relationships may help prevent vulnerability in adulthood.
Stigma keeps people with schizophrenia unemployed, report says
Work Foundation 11/02/13
Lack of understanding, stigma, fear and discrimination towards people with schizophrenia are needlessly preventing tens of thousands of people from finding or keeping jobs, a report from the Work Foundation says. Some eight per cent of people with a schizophrenia diagnosis are in employment, compared with the national average of 71%, and 70% say they experience discrimination. Working with Schizophrenia: Pathways to employment, recovery and inclusion describes a range of interventions that would help reduce the barriers to work and highlights how work brings clear health benefits to people with schizophrenia. People with schizophrenia in paid employment are over five times more likely to achieve functional remission than those who are unemployed or in unpaid employment. With the necessary political will and the right support, the employment rate could be more than tripled to 25% within a decade, the report says. It calls on healthcare workers, employers, policymakers, carers and individuals living with the condition to recognise and introduce work as a realistic aspiration.
Government announces social care payment framework
Department of Health 11/02/13
The Government has announced how much older and disabled people will have to pay towards their social care costs. The new measures are based on the recommendations made in 2011 by the Dilnot Commission, an independent panel set up to look at the fairest and most sustainable way to fund care and support in England. From April 2017, the Government will pay for any social care costs over £75,000 (2017/18 prices). The cap will be lower for people of working age who develop care needs before retirement age and people who have care needs before they turn 18 will effectively have their cap set at zero. The threshold for entitlement to statutory support will be raised from £23,250 to £123,000 in 2017/18 prices. The most financial support will go to those with the greatest care needs and the least in savings or home value, and the poorest people will continue to have the majority of their care costs paid. The Government has also ruled that, from April 2015, no one will have to sell their home in their lifetime to pay for residential care. If people cannot afford their fees without selling their home, they will have the right to defer paying during their lifetime. The legislation to enact these changes will also give carers a legal right to an assessment for care for the first time.
Romantic delusions feed online dating scams
Economic and Social Research Council 12/02/13
Victims of online dating scams should be referred for medical help when the fraud is exposed, researchers say. Almost 230,000 people in the UK have been conned by online romance fraudsters since 2007, according to the study, which was carried out by Professor Monica Whitty of University of Leicester and Professor Tom Buchanan of the University of Westminster. The study shows that victims are often in denial when they are told that their 'lover' is a fiction invented by criminal gangs to extort money. This makes them vulnerable to a second attack. It also found that victims can feel suicidal when the scam is exposed. The study recommends that the police call in health professionals as soon as the crime is reported and that victims’ doctors should also be made aware of potential suicidal tendencies.
What clients want from therapy
Journal of Clinical Psychology 04/02/13
People put higher value on the non-specific, relational elements of therapy rather than evidence-based techniques and interventions, new research confirms. Previous research has shown that factors like the warmth and approachability of the practitioner that clients find most helpful in therapy. In this US study, 329 adults (60.2% female, aged on average 36 years) were asked to rate their attitudes toward two kinds of psychotherapy: one emphasising nonspecific common factors, and one emphasising specific, evidence-based therapy ingredients. The respondents (clients and non-clients alike) expressed a clear preference for therapy guided by nonspecific, common factors. The researchers say their findings confirm that these are the qualities that draw people to therapy.
Attachment style a main factor in recovery
Psychotherapy Research 06/02/13
People with more robust attachment styles are more likely to respond to interpersonal therapy for depression, a study shows. A study of 95 clients receiving short-term (16 session) IPT for depression found that those most likely to improve post-treatment had lower scores for fearful attachment on the relationship scales questionnaire used. Among clients with higher fearful attachment scores, those more likely to recover tended to be aged under 25 years when they first became depressed. The researchers say short-term treatments, like the 16-session IPT used in the study, may not be suitable for adults with fearful attachment styles and that therapists should tell their clients longer, more challenging therapy, as this knowledge can improve outcomes. They also point out that fearfully attached adults are less likely to have a robust social network on which to practise social skills.
NHS psychotherapy services are being cut
Severe cuts to NHS psychotherapy services are revealed in a new survey conducted by the British Psychoanalytic Council (BPC) and the UK Council for Psychotherapy (UKCP). The survey of 825 members of the BPC and UKCP working in the NHS found evidence of cutbacks in medium and long-term therapies in the past year. Over three quarters (77%) of respondents reported longer waiting lists, premature ending of treatment and reduced choice of therapies. Over two thirds (68%) said they were being asked to deal with increasingly complex cases and were under increasing pressure to use much shorter term, CBT-based interventions that were not suitable for all their clients. Nearly half (48%) said fewer psychotherapy services were being commissioned – only five per cent reported any increase; 63% said psychotherapist posts had been cut. Some 97% reported other cuts, such as frozen posts, downgrading of posts and rebanding of salaries. The BCP and UKCP say the Government is reneging on its pledge to increase access to psychotherapies through IAPT as medium and long-term treatments are being replaced with IAPT CBT therapies.
Self-help books to be prescribed by GPs
Reading Agency 31/01/13
People in England with mild to moderate mental health problems will be prescribed self-help books that they can take out of their local library. The Reading Well Books on Prescription scheme, which has already been successfully introduced in Wales, is a collaboration between the Society of Chief Librarians and The Reading Agency charity. It is backed by the Royal Colleges of GPs, Nursing and Psychiatrists, the British Association for Behavioural and Cognitive Psychotherapies and the Department of Health through its Improving Access to Psychological Therapies Programme and will be available through English libraries from May 2013. GPs and other health professionals will be able to recommend books from a core list of self-help books available from the local library for anyone to borrow. The scheme will also promote other services in local libraries that promote well-being, including mood-boosting novels and poetry, and reading groups.
New standard for counselling courses
The Quality Assurance Agency for Higher Education (QAA) has published the first ever national benchmark standard for university graduate and postgraduate training in counselling and psychotherapy. This is the first time a national benchmark standard has been set for degree-level counselling training and brings the counselling and psychotherapy profession into line with the other major health professions. The QAA worked with the main organisations representing counsellors and psychotherapists, including BACP. The standard describes the teaching, course content and assessment that higher education providers should offer and the skills and attributes graduates and postgraduates should be able to demonstrate on completion of the course. BACP has warmly welcomed the new standard. ‘These long-awaited guidelines provide an invaluable set of benchmarks to assist higher education establishments in providing the best possible grounding to students and encouraging them to become professional and well-informed practitioners,’ BACP Chief Executive Laurie Clarke said.
Report spells out benefits of e-mental health technology
NHS Confederation Mental Health Network 30/01/13
A new report from the NHS Confederation says that ‘smart’ technology is transforming mental health care. The report, E-mental health: what's all the fuss about?, was written jointly with the e-counselling and self-help platform Big White Wall and the Tavistock and Portman NHS Foundation Trust. The report says that developments like smartphone apps to track changes in mood, online platforms for peer support, and computerised monitoring of symptoms could help more people with mental health problems receive the support they need when and how they want it and calls for service users, providers and commissioners to engage in dialogue about how to optimise the potential of digital technology and how to overcome potential risks and challenges.
MPs call for compulsory suicide prevention strategies
Madeleine Moon MP 29/01/13
Local authorities should be required by law to develop and implement a local suicide strategy, an all-party group of MPs and peers has said. In its report on its inquiry into suicide and self-harm prevention, the All-Party Parliamentary Group (APPG) on Suicide and Self-Harm Prevention says more than a quarter (27%) of local authorities in England do not have any specific suicide prevention strategy, and that local authorities are under no obligation to do so. The APPG says every local council should be required by the Government to develop a suicide prevention plan led by its Director of Public Health or a senior member of the public health team. They also say that local authorities should all have a suicide prevention group. Nearly half of the councils surveyed had no such group, and only a third reported that they funded specific suicide prevention programmes.
Minister outlines IAPT commissioning plans
The NHS Commissioning Board is to appoint a central team to co-ordinate the continued roll out of the IAPT programme for children, young people and adults, Department of Health ministers have said. In a written answer to Paul Burstow MP, former Care Minister, Health Minister Dan Poulter said that the NHS CB is ‘fully committed to delivering the Government's ambition to improve access to psychological therapies, as set out in the [NHS] mandate’. He said that, following a meeting between Care Minister Norman Lamb and Lord Layard and the NHS CB, it was confirmed that the NHS CB plans ‘to have a team working on both children and young people's and adult IAPT as part of its NHS Improvement Body’.
Adult suicides rise in UK
Suicide rates in the UK are rising, particularly among middle-aged men, new ONS data show. The latest ONS statistics on cause of death show that there were 6,045 suicides in people aged 15 and over in the UK in 2011, an increase of 437 over 2010. The highest suicide rate was in males aged 30–44 (23.5 deaths per 100,000 population in 2011). The suicide rate in males aged 45–59 also increased significantly between 2007 and 2011 (22.2 deaths per 100,000 population in 2011). The total male suicide rate in 2011 was the highest since 2002, and the highest among 45–59 year-old men since 1986. Female suicide rates were highest in 45–59-year-olds in 2011 (7.3 deaths per 100,000 population). The overall UK suicide rate increased significantly between 2010 and 2011, from 11.1 to 11.8 deaths per 100,000 population. There were 4,552 male suicides in 2011 (a rate of 18.2 suicides per 100,000 population) and 1,493 female suicides (5.6 per 100,000 population).
Voluntary sector independence ‘under serious threat’
Independence Panel 22/01/13
The independent voice of the voluntary sector has been seriously compromised in the past 12 months, a watchdog of senior charity experts has warned. The latest report of the Independence Panel, Independence under Threat, says that Government actions and failures to act have both severely compromised the independence of campaigning charities. It says that the Government has imposed contractual gagging orders on some charities, stopping them speaking out about government policies or publicly releasing data, advised local authorities not to fund some campaigning charities, and has failed to implement its own policies and pledges to support the independence of charities through its nationally agreed Compact.
CBT workshops cut teenage alcohol use
Institute of Psychiatry 24/01/13
Targeted CBT interventions delivered to teenagers at risk of emotional and behavioural problems can significantly reduce their alcohol consumption, and that of their schoolmates, a large randomised controlled trial shows. The ‘Adventure Trial’ involved 21 schools in London and 2,548 year 10 students. The schools were randomly allocated to either receive the CBT intervention or the UK statutory drug and alcohol education curriculum. The intervention comprised two workshops on cognitive-behavioural strategies for coping with emotional and behavioural problems that were targeted at high-risk students only. After two years, the high-risk students in the 11 intervention schools were at 29% reduced risk of drinking, 43% reduced risk of binge drinking and 29% reduced risk of problem drinking compared with the high-risk students in the 10 non-intervention schools. The intervention also significantly delayed their progression to more risky drinking behaviour. Low-risk teenagers in the intervention schools were also at a 29% reduced risk of taking up drinking and 35% reduced risk of binge drinking compared with the low-risk group in the non-intervention schools, even though they didn’t attend the workshops.
Suicide risk highest in first five years of unemployment
PLOS ONE 16/01/13
The recently unemployed are at highest risk of suicide, a meta-analysis of published studies shows. While the link between unemployment and suicide is well known, this was the first attempt to look at duration of unemployment as a risk factor. The review drew on data from 16 studies. It found that longer duration of unemployment was related to higher risk of suicide and suicide attempt. However people appeared to become immured to the negative effects of suicide over time: risk of suicide was highest in the first five years of unemployment and relative risk in comparison with the general population then fell.
Alcohol outlets raise mental health risk
PLOS ONE 16/01/13
Living in an area where there are outlets selling alcohol is linked with higher levels of harmful alcohol consumption and poorer mental health, an Australian population survey shows. The study was carried out in Perth, Western Australia. Data were obtained on total alcohol consumption, harmful alcohol consumption and medical diagnosis and hospital contacts for anxiety, stress, and depression for 6,837 adults. Harmful levels of drinking and number of drinks per day rose in relation to the number of alcohol outlets available within a 1600m service area. The likelihood of receiving hospital treatment for anxiety, stress or depression was also higher for those who lived near an alcohol outlet than for those who did not. The researchers say their study provides strong evidence of a small link.
Spiritual beliefs may protect young people from suicide
Journal of Spirituality in Mental Health 18/01/13
Spiritual beliefs appear to protect young people from risk of suicide, a new study suggests. The study sought to explore the role of spiritual beliefs as a mediating factor in risk of suicide among college-aged young people. A total of 243 young people were asked to complete questionnaires to assess suicide risk, social support, spiritual wellbeing, and reasons for living. But the analysis of the data suggest that spiritual beliefs are protective not in their own right but because those with spiritual beliefs were more able to ask for social support when they needed it to help them cope with adversity.
CBT self-help books effective for depression
PLOS ONE 11/01/13
Guided CBT bibliotherapy for depression results in better outcomes than usual GP care, a randomised controlled trial in Scotland shows. The trial recruited participants with depression from seven GP practices in Glasgow. Half (141) were allocated to receive guided self-help CBT (GSH-CBT), using the book Overcoming Depression: A Five Areas Approach, backed up with three to four short, face-to-face sessions with a counsellor, totaling two hours in all; 140 were assigned to receive GP treatment as usual (TAU). At four months, depression scores were 5.3 points lower in the GSH-CBT group than in the TAU group. At four and 12 months more patients in the GSH-CBT group had achieved a 50% reduction in their depression scores. Most patients attended two support sessions of some 40 minutes each. However, while only 30% of patients had dropped out at four months, this had risen to over half (59% at 12 months) and nearly a quarter (22%) of patients in the GSH-CBT group didn’t take up the treatment at all.
Smoking ban linked to drop in childhood asthma
Emergency hospital admissions among children with asthma have fallen since the ban on smoking in enclosed public places came into effect. Research published in the journal Pediatrics shows that there was a 12.3% fall in admissions in the first year after the law was introduced in July 2007, and rates have continued to fall subsequently, suggesting a link with the ban. There were some 6,802 fewer hospital admissions in the first three years of the law coming into effect. Hospital admissions for treatment of severe asthma attack in children were increasing by 2.2% a year before the ban. The fall in rates was found among children of both sexes, all ages and across rural and urban centres and poor and high income families alike.
Worriers less likely to benefit from social phobia treatment
Psychology & Psychotherapy 18/01/13
People who suffer from ‘anticipatory worry’ are less likely to benefit from cognitive treatment for social phobia, a small-scale study suggests. Researchers wanted to find out which personality factors appeared to predict outcomes from treatment with either individual cognitive therapy (ICT or intensive (three week) group cognitive treatment (IGCT) for social phobia. A total of 54 participants were assessed for fear of negative evaluation, anticipatory worry, self-directedness and cluster C personality disorder. Anticipatory worry was the strongest negative predictor of outcome in ICT and IGCT both at post-treatment and one-year follow-up. Low self-directedness, signs of cluster C personality disorder and fear of negative evaluation predicted poor post-treatment outcome in ICT but not IGCT. The researchers say practitioners should be aware of this and employ specific techniques for dealing with rumination where appropriate.
Many apples a day keep the blues at bay
British Journal of Health Psychology 24/02/13
Eating more fruit and vegetables may make young people calmer, happier and more energetic in their daily life, new research has suggested. The research investigated the relationship between young people’s daily emotions and diet. A total of 281 young adults aged on average 20 years completed an online daily food diary for 21 consecutive days and were asked to rate how they felt. The results showed a strong day-to-day relationship between more positive mood and higher fruit and vegetable consumption, but not other foods. Additional analysis found that it was eating fruit and vegetables that led to positive mood the next day, not the other way round.
NICE child schizophrenia guideline warns against antipsychotics
Clinicians should do more to identify signs of psychosis and schizophrenia early in children and young people, but they should be offered family and individual CBT, not antipsychotics, a new guideline from NICE says. The guidance on best practice says that GPs should refer young people with psychotic symptoms or other signs of possible psychosis ‘without delay’ to specialist mental health services and that cognitive behavioural therapy (CBT) should be offered, not antipsychotic drugs, to those whose symptoms or mental state changes are not serious enough to merit a diagnosis of psychosis or schizophrenia. NICE also says that every attempt should be made to provide care in the community rather than referral to an inpatient unit, especially if the nearest unit is a long way from the patient’s home.
Labour proposes ‘whole person care’ policy
Labour Party 24/01/13
The Labour Party has announced a major review of the funding and organisation of the NHS. In a speech to the King’s Fund, Shadow Health Secretary Andy Burnham pledged to repeal with Health and Social Care Act 2010 and said that the review would explore the full integration of health and social care, with a single budget and a single co-ordinating body managing the treatment of all health needs: physical, mental and social. The ‘Whole-Person Care’ review will be led by Liz Kendall and will report in six months. Burnham said that this approach was the only way to make a ‘decisive shift’ towards prevention and shift resources from hospital to home-based care.
Government admits benefits cut will increase child poverty
The Government has admitted that some 200,000 children will be plunged below the poverty line by its decision to uprate benefits by only one per cent a year and not in line with inflation. In a written response to Labour MP Chris Skidmore, Employment Minister Esther McVey admitted that the one per cent benefits increase in 2013-14, 2014-15 and 2015-16 ‘will result in around an extra 200,000 children being deemed by this measure to be in relative income poverty compared to uprating benefits by CPI’. But she said it was ‘misleading’ to look at the effects of the benefits uprating ‘in isolation’ and that the answer to poverty was to ‘make work pay’ through the universal credit system.
Charity seeks recognition of diabulimia
A charity is campaigning for wider recognition of the link between diabetes and eating disorders. According to figures from the NHS National Diabetes Audit, a high proportion of young women aged between 15 and 30 are deliberately not taking their insulin injections in order to lose weight. In the 12 months up to March 2012 more than 8,000 people were admitted to hospital in England and Wales, with symptoms of not taking enough insulin, and admissions were most common among young women living in deprived areas. The charity Diabetics with Eating Disorders (DWED) says this behaviour, known as diabulimia, is increasingly common and should be formally recognised as a mental illness so that people with the condition can get the specialist treatment they need. Failure to maintain insulin levels can result in blindness and other severely disabling health conditions.
Fast food link to child allergies
Fast food may be linked to the rise in asthma and other allergies in children, an international study suggests. The study, of 319,000 children aged 13 and 14 from 51 countries and 181,000 six and seven year olds from 31 countries, found that teenagers who eat burgers and other fast food more than three times a week are almost 40% more likely to have severe asthma, and six and seven year old children are at 27% increased risk. Children eating a diet high in fast foods were also more likely to have severe eczema and rhinitis. However eating three or more portions of fruit a week reduced the severity of symptoms, by 11% among teenagers and 14% among children. The researchers used data from International Study of Asthma and Allergies in Children (ISAAC). They point out that the study does not establish that the link is causal but if it is, the findings would have major public health significance.
Alzheimer’s Society condemns diagnosis lottery
Alzheimer’s Society 15/01/13
More than half the people living with dementia in the UK have not been formally diagnosed, new data released by the Alzheimer’s Society show. Its survey also reveals massive regional variations: diagnosis rates range from 31.6%, the lowest, in the East Riding of Yorkshire to 75.5% in Belfast. The numbers diagnosed have increased by three per cent in the past year, but that still leaves 54% without a diagnosis, which the Alzheimer’s Society described as ‘disgraceful’. The Alzheimer’s Society has produced an interactive map at alzheimers.org.uk/dementiamap showing how many people in each primary care trust catchment area have been diagnosed. The Alzheimer’s Society has also surveyed memory clinics in the UK. Two thirds of all PCTs responded. Just 11 per cent of all clinics in the UK are accredited. Average waiting time for an appointment is 32.5 working days, but some memory clinics report waiting times of up to nine months.
Childhood distress linked to heart attack risk
Journal of Epidemiology & Community Health 15/01/13
Children with emotional and behavioural problems may be putting themselves at risk of heart disease in later life, a new study suggests. Emotional stress is known to be linked to cardiovascular disease (CVD) in adults. This study followed up 377 children of women enrolled on a perinatal research project in 1959–1966. The researchers used measures of child emotional functioning to gauge the children’s levels of emotional distress, attention and self-regulation. They then compared these with their risk of CVD as adults. Higher emotional distress in childhood put women at 31% higher risk of CVD in adulthood, although those with attention problems were at eight per cent lower risk. For men, childhood emotional distress was associated with 17% high CVD risk. Some of the link in women was explained by greater body mass index and depression, but this was not the case for the men. The researchers suggest that the link between emotional distress and CVD may begin in childhood and that preventive intervention should start much earlier in life and address children’s emotional functioning.
More older people move into residential care
Laing & Buisson 15/01/13
The numbers of older people living in long-term care homes continue to rise, from 422,000 in 2011 to 432,000 in 2012, the latest Care of Elderly People UK Market Survey 2012-13 shows. More than half of these older care home residents are paying all or contributing towards their fees, the survey data show. Some 175,000 older residents (43.4%) paid the full costs of their long-term care fees in 2012, and 56,000 (14%) were topping up the amounts contributed by their local authority. The fees of the remaining 43% were paid in full either by their local council (143,000) or by the NHS (29,000). A much higher proportion of residents were paying their fees in full in the south east (55%), south west (53%) and east of England (50%). The lowest proportions (22%) of full fee payers were in the north east, Northern Ireland and Isle of Man. Market intelligence firm Laing & Buisson say that, even if the Government were to pay the care component of residential care homes, as the Dilnot review proposes, residents and their families would still be paying £399–£418 a week on average for ‘hotel’ costs.
NICE may recommend preventive breast cancer drug
The national clinical guidance authority NICE may recommend that some women receive preventive treatment if they are at high risk of breast cancer, even if they do not yet have symptoms. In its new draft guidance on ‘familial’ breast cancer (where there is a history of breast cancer in first degree relatives), NICE says that all women over 30 in England and Wales who are judged to be at moderate or high risk of breast cancer should be offered either the breast cancer drug tamoxifen and/or raloxifene, which treats symptoms of osteoporosis, as a preventive measure. Breast cancer campaigners have welcomed the draft guidelines, which update NICE’s 2006 guideline and are currently out for consultation. Chris Askew, the chief executive of Breakthrough Breast Cancer, called the step a ‘historic step’. It is, he said, the first time cancer drugs have ever been recommended for use in the NHS as a preventive treatment.
Lamb announces inquiry into terminal care pathway
Department of Health 17/01/13
The Department of Health has appointed Baroness Julia Neuberger, crossbench peer, former chief executive of the Kings Fund thinktank and rabbi, to head up an inquiry into the Liverpool Care Pathway. The controversial palliative care programme, which is recommended in the Department of Health’s End of Life strategy, is intended to help hospital and care staff provide hospice-style palliative care to dying patients. However it has been the subject of numerous complaints from relatives saying that they were not informed or consulted, that their loved one was starved to death and deprived of water, and that it is being used by the NHS to hasten people’s death in order to save money and free up hospital beds. Announcing the inquiry, Norman Lamb said: ‘There have been too many cases where patients or their families were ignored or not properly involved in decisions. This is simply unacceptable.’ He said he was also very concerned about reports that food and drink have been denied dying people. ‘It is so important for relatives to have complete confidence in the care that a loved one is receiving. The email address for the inquiry is LiverpoolCarePathwayReview@dh.gsi.gov.uk
MPs say that drug companies should report all trial data
House of Commons Health Committee 16/01/13
Pharmaceutical companies should be required by law to publish the results of all their trials of new drugs, the House of Commons Health Committee has said. In a report on its inquiry into NICE, the National Institute for Health and Clinical Excellence, the MPs say there should be a professional and legal obligation to ensure that all regulators, including NICE, have access to all available research data about the efficacy and safety of pharmaceutical products in use in the UK. They are also calling for the information from drug trials to be made publicly available and accessible, and say the pharmaceutical industry should commit to this in a new code of practice. They point out that the credibility of NICE’s clinical guideline recommendations is undermined if it cannot access the full data on the drugs it is reviewing. The MPs also welcome the extension of NICE’s remit to include guidance and quality standards for social care and say its guidelines should include advice on the care of people with mental health problems that are linked to their physical health.
Tory MPs publish personal accounts of mental illness
James Morris 15/01/12
A collective of essays by eight Conservative MPs describing their experiences of mental ill health and how services can be improved has been published by James Morris, MP for Halesowen and Rowley Regis. Contributors to Making Up Our Minds include Charles Walker on the impact of prejudice and discrimination and how these can be overcome; Andrea Leadsom on the importance of intervening early in life to promote good mental health from the start; James Morris on the importance of broadening access to talking therapies on the NHS and John Glen and Oliver Coleville on the mental health needs of armed forces personnel and veterans. ‘During the past twelve months there has been extensive debate and discussion about mental health in Parliament. Speeches by Charles Walker and Kevan Jones about their own experience of mental illness changed the terms of political debate. These essays aim to make a positive contribution to this debate,’ Morris said.
US military suicides rise
Suicides among US military service personnel have risen to a new record high. According to new Pentagon figures, 349 military personnel took their own lives in 2012, up from 301 in 2011 and far more than the 295 killed in active service in Afghanistan. Suicides have outnumbered in-service deaths twice before, in 2008 and 2009, since the Pentagon began tracking these deaths in 2001. Other Pentagon research has found that suicide is more common among young, white, junior enlisted personnel who have not had a college education. Most of the suicides were veterans of Iraq and Afghanistan with depression, post-traumatic stress disorder or substance abuse problems, or soldiers who were not involved in active fighting but had personal problems, the Pentagon has said.
Over a third say they can’t afford a holiday
Around a third of people in the UK say they wouldn’t be able to afford an unexpected financial expense or take a week’s holiday, new data from an ONS study of poverty and social exclusion in the UK and Europe reveal. The study looked at rates of severe material deprivation, risk of poverty and levels of employment in households across European countries in the years 2005 to 2011. In the UK, the overall severe material deprivation rate has remained broadly unchanged between 2005 and 2011, at 5.1 per cent of the population, well below the EU average of 8.7%. But 36.6% of people felt that they would be unable to meet an unexpected but necessary financial expense, 10% up on 2007, and the percentage of people who felt they couldn’t afford a week’s holiday rose to 29.7% from 21.4% in 2007. There were also smaller increases in the percentage who said they couldn’t afford a car, or to heat their home adequately or pay their rent/mortgage, utility bills or loan repayments.
Cutbacks reduce Ireland’s school counselling services
Institute of Guidance Counsellors 13/01/13
Cuts in school counselling services in Ireland are putting young people’s emotional wellbeing at risk, the Irish Institute of Guidance Counsellors has warned. A survey of guidance counsellors in 240 second level schools found that cuts implemented by the Department of Education and Skills in 2012 resulted in a 51.4% reduction in the counsellors’ time available for one-to-one work with students and an overall 21% reduction in the time allocated to guidance and counselling services. The amount of time guidance counsellors are spending in classroom based activity has also increased by 19.8% over that period, suggesting that the cuts have meant that guidance counsellors have been diverted to more classroom based duties.
Children may outgrow autism
Journal of Child Psychology and Psychiatry 16/01/13
Some children may grow out of autism, a small-scale study in the US suggests. The study of 112 children appears to challenge the accepted belief that autism is a lifelong condition. Researchers at the University of Connecticut wanted to test out reports that some people acquire the social and communication skills associated with autism as they grow older. They compared 34 children who had been diagnosed with autism in early childhood with 34 matched non-autistic peers and 44 children with high-functioning autism. They found that the ‘optimal outcome’ children functioned as well as their non-autistic peers on key indicators of autism, such as language, face recognition, socialization, communication, and autism symptoms, and both groups functioned better than the high functioning group. The only difference between the optimal outcome group and the high functioning group was that, at an early point in their development, the optimal outcome group had milder symptoms in the social domain, but they had equally severe difficulties with communication and repetitive behaviours. The researchers say their findings bear out the belief that it is possible to grow out of autism, but the UK National Autistic Society has warned parents not to jump to conclusions from such a small sample.
Government launches sickness absence advisory scheme
Department for Work and Pensions 17/01/13
The Department of Work and Pensions is to set up a new independent assessment and advisory service to help employers get people back to work and keep them off long-term sickness benefits. Some 131 million working days are lost each year to sickness absence in the UK, and over 300,000 people leave work and claim Employment Support Allowance because of ill health. But only 48% of employers have access to an occupational health service, rising to 10% of employees of small firms. The new service is part of a series of measures announced by the Government in response to the Health at Work review of sickness absence by Dame Carol Black and David Frost. In its response, Fitness for work: the Government response to 'Health at work - an independent review of sickness absence' the Government has lifted the threat that tax relief on Employment Assistance Programmes will be discontinued, although it does not guarantee its long-term future. BACP has welcomed the decision but says there should be more investment in workplace counselling services and greater emphasis placed on the employer’s responsibility to provide it to their workforce.
MPs attack Atos for ‘making people sicker’
MPs have disclosed a catalogue of death, sickness and distress among their constituents who have been subjected to assessments by Atos, the private sector firm contracted by the Government to deliver the Work Programme fitness for work tests. In a House of Commons debate Labour MP Michael Meacher described the death, from a major seizure, of a young man with epilepsy shortly after he was classified fit for work and saw his benefit cut by £70 a week. Caroline Lucas, the Green party MP, condemned the assessments as ‘humiliating and demeaning’. Another Labour MP, Madeleine Moon, said a constituent was driven to attempt suicide by her experience of the assessment. Conservative MP Jeremy Lefroy said Atos should be placed in the ‘last chance saloon’ by the Government. Labour MP Iain Wright reported that a female constituent with Crohn’s disease had been advised by Atos that she could wear a nappy to work. Mark Hoban, employment minister, said considerable progress had been made in improving a process that was introduced by Labour and that it was unhelpful to demonise the system with ‘adverse media coverage’.
Spirituality link with mental ill health
British Journal of Psychiatry 01/01/12
Mental ill health is more common among people who hold spiritual beliefs than it is among those who belong to a formal religious faith group and those who have no religious or spiritual beliefs. A study published in the latest British Journal of Psychiatry used data collected from 7403 people interviewed for the 2006/07 National Psychiatric Morbidity Study. Of these, 35% described themselves as religious, 19% said they were spiritual but not religious and 46% were neither. Religious people and those with no religious or spiritual belief were less likely than those with a spiritual belief to have ever used drugs. Spiritual people were both more likely to have used or to be dependent on drugs and more likely to have eating disorders, generalised anxiety disorder and phobias or neurotic disorders. They were also more likely to be taking psychotropic medication. The researchers say that the social support provided by more organised religions may be missing in the lives of people with a spiritual life view.
Cosmetic surgery ‘needs tighter controls’
Department of Health 31/12/12
Tighter controls are needed on the marketing and advertising of cosmetic surgery procedures, responses to the Department of Health Review of the Regulation of Cosmetic Interventions say. The review was set up by the Secretary of State for Health following the PiP breast implant scandal to look at regulation information and aftercare, among other issues. Responses to the consultation suggest a range of additional safeguards for prospective patients, including banning free consultations for cosmetic surgery, so that people don’t feel obliged to go through with surgical procedures; ensuring consultations are with a medical professional, not a sales adviser; imposing tighter restrictions on advertising, including a ban on two-for-one, time limited deals and cosmetic surgery as competition prizes, requiring a two-stage written consent system before surgery so people have time to reflect before making a decision, and providing more information to patients about the risks associated with surgery, including photos of expected bruising and scarring. The review, led by NHS Medical Director Professor Sir Bruce Keogh, is due to report in March.
Unemployed young people twice as depressed
Princes Trust 01/01/13
Young people not in work, education or training (NEET) are at more than twice the risk of depression than those who have a job, the Prince’s Trust annual Youth Index for 2013 shows. Some 2,136 young people aged 16–25 were questioned for the report. Over a quarter (27%) of those in work said they always or often felt down or depressed, but this rose to half (48%) of Neets. Nearly a third (31%) of Neets also said they didn’t have anyone to talk to about their problems, as did one in five (22%) of all the young people surveyed. The overall happiness score across all the domains, including employment/education, housing, money, emotional and physical health, family relations and local community was 71, down from 73 last year. The index also reveals that, while 23% of the young people surveyed said the internet gave them a sense of community and friendship that they didn’t have anywhere else in life, and 33% of the unemployed, two thirds (65%) would rather talk to someone in person about their problems than discuss them online.
Government reveals scale of sexual offences
Nearly one in five women in England and Wales has been the victim of a sexual offence since the age of 16, a new official analysis from the Ministry of Justice, Home Office and Office of National Statistics shows. According to this first ever statistical overview of sexual offending, some 473,000 adults are the victims of sex crimes every year, of whom the vast majority (some 400,000) are women. The report confirms that only a very small proportion of sexual offences lead to a conviction: over the past three years an average of just 5,620 offenders were convicted per year for all types of sexual offences, of which 1,070 were convicted for rape. Between 60,000 and 95,000 rapes are recorded each year. Of the estimated 97,000 victims of serious sexual offences last year, 69,000 were female victims of rape and 90% knew the perpetrator. The new analysis challenges the common view that allegations of rape rarely result in prosecution: in 2001 62.5% of rape cases ended in a conviction, eight points higher than in 2005, and 95% of convicted rapists were jailed.
NHS challenged to do more to tackle obesity
Royal College of Physicians 01/01/13
Specialist teams that include psychologists and exercise specialists as well as bariatric surgeons, nurses and dieticians should be commissioned in the NHS to tackle the UK’s growing obesity epidemic, the Royal College of Physicians has said. In a report, Action on Obesity: comprehensive care for all, the college says that the UK has the highest prevalence of obesity in adults and children in the developed world, yet specialist care and treatment is poor. The NHS should be offering multidisciplinary care, not just bariatric surgery. Obesity costs total some £5 billion a year and will double by 2050. Better inpatient treatment is needed and also closer collaboration with primary and mental health care, the college says. GPs should have training in motivational interviewing for weight management and obesity, and special provision should be available for people who cannot easily access community weight management groups, such as those with physical and learning disabilities, people with mental health problems, people in rural areas and socially excluded groups.
Parents like their children’s imaginary friends
British Psychological Society 10/01/13
Most parents don’t worry if their child has an imaginary friend and many think it is helpful, new research shows. Psychologists asked 265 parents about their children’s imaginary friends and 88% said they could see no disadvantages. Invisible friends served a useful purpose in fantasy play and as a companion to play and have fun with, they said. Many offered examples of how the imaginary friend helped their child process and cope with new experiences such as moving house or going on holiday. The researchers say young children also use their interactions with invisible friends to test their parents’ reactions to behaviour that might be disapproved of, which helps them learn to regulate their behaviour. The research also shows that children are more likely to have same-sex imaginary friends.
Healthcare giants cash in on AQP
Large independent sector healthcare companies are winning contracts to provide NHS services under the ‘any qualified provider’ (AQP) initiative, figures obtained from the Department of Health show. A total of 105 private sector providers, including InHealth, Specsavers and Virgin Care have successfully bid for contracts to provide services including physiotherapy, dermatology, hearing aids, MRI scanning and psychological therapy. Under AQP, every NHS primary care trust in England must open up at least three health services to ‘any qualified provider’, whether they are from the NHS, private sector, charity, social enterprise or voluntary organisation. Of the 105 contracts approved to date, 24 are with large private sector companies with at least 250 staff, and 81 are with small or medium-sized enterprises. AQP was intended to ensure that smaller enterprises were not shut out of the burgeoning NHS market.
New service opens for war veterans in south England
Berkshire Healthcare NHS Foundation Trust 01/01/13
A new mental health support service for military veterans has been launched by Berkshire Healthcare NHS Foundation Trust. The South Central Veterans Mental Health Service (SCVS) is based in Reading and will serve Berkshire, Buckinghamshire, Oxfordshire, Hampshire and the Isle of Wight. It will provide assessment, treatment and referral to ex-servicemen and women and also offers an advice and liaison service for local mental health teams and other relevant services on how to work with this client group.
Department of Health reveals public health budget
Department of Health 10/01/13
The Department of Health has announced how much funding public health services can expect to receive over the next two years. Under the NHS reforms, responsibility for public health has been transferred back to local authorities. The Department of Health has allocated local authorities a two-year, ring-fenced budget of £5.45 billion to local authorities to improve the health and wellbeing of their local communities and tackle the wider determinants of poor health. In 2013/14 the total budget for local public health services will be just under £2.7 billion, rising to £2.8 billion in 2014/15. The Department of Health says every local authority will receive a real terms increase in funding.
Government pledges future for IAPT services
Adult and children’s IAPT services will continue after 1 April 2013 when responsibility for funding primary care psychological therapies is transferred to the NHS Commissioning Board, Care Services Minister Norman Lamb has said. In a written response to a question from former health minister Paul Burstow, Norman Lamb said: ‘The Department's mandate to the NHS Commissioning Board and the NHS Outcomes Framework will ensure the sustainability of both the Adult, and Children and Young People's IAPT programme. He also revealed that numbers of therapists trained through IAPT have continued to rise for those training in Counselling for Depression, Couples Therapy for Depression, brief dynamic interpersonal therapy, interpersonal psychotherapy and high intensity (step 3) CBT. A total of 132 therapists were trained in CfD last year, 99 in CTfD, 58 in brief dynamic interpersonal therapy, 155 in interpersonal psychotherapy and 322 in step 3 CBT. Training numbers for step 2 CBT fell slightly from 536 to 459 last year.
Smoking relapse link to anxiety
British Journal of Psychiatry 01/01/13
People who give up trying to quit smoking become much more anxious while those who succeed experience a significant drop in anxiety levels, a new study reveals. A common argument against giving up smoking is that people find it calming. This study followed up 491 smokers attending NHS smoking cessation clinics in England six months after enrolment in a nicotine replacement therapy programme. People who relapsed scored a three-point increase in anxiety from when they joined the programme; anxiety levels dropped by nine points in participants who stayed smoke-free. The highest increases in anxiety following relapse were found in people with a mental illness whose main reason for smoking was to cope with stress, but if they managed to quit they also showed the largest decrease in anxiety. The researchers say their evidence shows not only that cigarette smoking does not relieve stress but that failing to give up may actually increase anxiety levels.
Agoraphobic claimant forced to attend Jobcentre interview
Anxiety UK 11/01/13
Anxiety UK has called for a full review of the way the Department for Work and Pensions and other government agencies treat people with agoraphobia. The call comes after it was revealed that a 22-year old unemployed agoraphobic woman is being forced to attend face-to-face meetings at her local Jobcentre or risk losing her unemployment support allowance. Previously she had been allowed to attend by videolink. be allowed to continue to attend meetings via videolink. As a result she now risks losing her unemployment support allowance. Anxiety UK says it is hearing of more and more such cases of poor treatment by government departments and local authorities which, it says, are ‘ quite clearly a case of discrimination as defined by the Equality Act 2010’.