Rarely do I come across a Tory Policy proposal that makes me both Smile (albeit at the irony) and Shudder (with fear); but today’s report in the Telegraph does exactly this; “Hundreds of thousands of benefit claimants face being stripped of their state allowances if they refuse to undergo treatment for anxiety and depression“, this worries me on several levels.
The article quotes their source as saying “We know that depression and anxiety are treatable conditions. Cognitive behavioural therapies work and they get people stable again but you can’t mandate people to take that treatment“; I totally agree with the closing proviso but the apparent claim CBT works for depression and anxiety is False.
Firstly Depression is not a ‘one size fits all’ disorder, there are different types of this debilitating illness, and a notion it can be conveniently summed up to enforce potentially damaging treatment is downright dangerous as well as being futile. This position applies equally to Anxiety, again there are different types of Anxiety disorders which require different specialist treatments; therefore this all embracing decision, being discussed by Politicians based upon saving money is, to me, terrifying.
Cognitive Behaviour Therapy works to enable people understand the relationships between their feelings, thinking, behaviours and environment, and to identify ways in which these can become problems; ergo CBT only works when depression and, or anxiety arises from internal conflict. Personally I have found CBT to be of little or no use when clinical issues, i.e. schizophrenia, is the primary causes of the disorder; further where external factors are reinforcing the disorders, I personally have found CBT only has limited benefits. I am not purporting CBT has no use in supporting depressive or anxiety sufferers, but it is not the only form of treatment necessary for enabling improved mental health. Given the mandate for this scheme is the ” loads of people who claim ESA (for Depression and Anxiety) who undergo no treatment whatsoever“, it is difficult to understand how the Government is to utilise fully trained CBT workers anyway?
Minsters are already piloting different ways of implementing this scheme, four JobCentres are currently “combining “talking therapies” with employment support“; soon we will witness “group work” to help build the “resilience” of individuals who are out of work and suffering with poor mental health” the “hiring specialist private organisations outside the NHS and welfare system to take control of providing a combination of psychological and employment support to claimants” and finally “online tests and therapies at improving individuals’ health and job prospects“. These four trials will then be assessed, presumably with cost effectiveness, being the primary focus’ so no prizes for guessing which ‘approach’ the Government will adopt – more work for the nudge unit coming up?
These trials are a joint effort between the DWP & Dept of Health, and emerge from the report Talking Therapies: a four year plan of action and initially was targeted at people 18-65 as an “economic case on which it was based showed that providing therapy could benefit not only the individual but also the nation, by helping people come off sick pay and benefits and stay in or return to work“. There we have it another quick fix based on Finance First and presumably will form the basis of yet another area of Cuts in Welfare; but once again aimed at sick and disabled people
As I acknowledge at the beginning of this post, the Government Ministers making these decisions about how mental health sufferers should be treated, deny participation in these trials will be mandatory, seeming to recognise willingness to participate is central any talking treatment working. However the Telegraph states “Conservatives could include the proposal for mandatory treatments in the party manifesto next year as part of the next phase of reforms to the welfare state” and I can’t help but think they are probably accurate in this.
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jaynelinney 