We Need To Talk's manifesto for better talking therapies for all

Who is We Need to Talk?

We Need to Talk is a coalition of mental health charities, professional organisations, Royal Colleges and service providers who campaign for better access to psychological therapies for people with mental health problems. 

We are calling on the next Government to invest in psychological therapies, so that the NHS in England can offer a full range of evidence-based psychological therapies to all who need them within 28 days of requesting a referral.

What’s happening at the moment?

Our 2014 survey of 2,000 people who have tried to access talking therapies within the last two years found:

  • One third of people had to ask for therapy, rather than being offered
  • Half had waited more than three months for an assessment, with 1 in 10 waiting more than a year for assessment
  • Only 15 per cent were offered the full choice of NICE-approved therapies
  • 56 per cent were offered no choice of therapy
  • 45 per cent didn’t get the different types of therapy explained to them.
  • Half said they didn’t get enough sessions to help them to recover
  • If the therapy offered didn’t work, 37 per cent were not offered anything else
  • While waiting for therapy: 
    • 68 per cent of people became more mentally unwell
    • 66 per cent had suicidal thoughts
    • 40 per cent harmed themselves

There has been welcome investment in increasing access to talking therapies, but that progress is  now at risk. The next 5 years are a crucial period to increase the number of people who are able to benefit from a range of evidence based talking therapies.

What’s needed?

We are calling on the next Government to invest in psychological therapies, so that the NHS in England can offer a full range of evidence-based psychological therapies to all who need them within 28 days of requesting a referral.

In particular, we call for:

A commitment to equality between physical and mental health

We want a right to evidence-based talking therapies for everyone who needs them when they need them.

Universal and equal access to evidence-based talking therapies is crucial in helping people to recover from a mental health problem and preventing problems getting worse. The NHS Constitution currently contains a right to some NICE-approved treatments, but the majority of mental health treatments and therapies are not included.  An equal entitlement to evidence-based talking therapies on the NHS will bring about a real step towards parity between physical and mental health services.

Greater investment in talking therapies

The next Government and NHS England must commit to increasing investment to meet rising demand and address the high level of unmet need for a range of mental health problems for adults and children. In the lead up to General Election we want a manifesto commitment from all political parties to continue to invest in talking therapies to meet rising demand.  Local clinical commissioning groups can also take action now to identify the gaps between levels of need and levels of provision for psychological therapies in order to target investment effectively where it is most needed.

The introduction of national access standards and waiting times

Despite Government commitments to address unequal access to psychological therapies, evidence shows that current access rates and availability of psychological therapies among certain groups remain poor. People from black and minority ethnic (BME) communities, older people, children and young people, people with severe mental illness and homeless people with co-occurring substance misuse are still not able to get access to proven psychological therapies. There are also very high levels of need for psychological therapy among people with long-term physical conditions that are currently poorly met.

We are calling on NHS England to urgently introduce national access and waiting time standards so that everyone who needs it can access evidence-based talking therapies within 28 days of getting a referral, with quicker access for people experiencing a mental health emergency. The NHS Constitution should enshrine 28 days as the maximum waiting time from referral to first treatment. Clinical Commissioning groups can also ensure that all groups have equal and timely access to psychological therapies.

Improving the choice of therapies people are able to access, choice about when and where they access them, as well as help to take informed decisions

We urge that NICE review their guideline development process to allow greater flexibility in assessing clinical evidence relating to talking therapies. This is essential for ensuring that a wider range of therapies are available through IAPT and other services, and also for access standards and waiting times to apply to these. We will work with Clinical Commissioning Groups to help them to commission talking therapies in primary and secondary settings, appropriate to local need.  Increasing the range of therapies available is particularly important for people with the most complex needs, for whom currently available services are often not suitable.

Increasing access to psychological therapies for children and young people

All children and young people should have access to psychological therapies, including access to a counsellor in all secondary schools and colleges.  This would include Children and Young People’s IAPT to extend its scope of evidence based therapies and to have 100 per cent coverage across the country.

Expanding research and evidence base for talking therapies

The Government and NHS England must support investment in high quality research into psychological therapies. This would include encouraging funding bodies to invest in future research to address gaps in the evidence base and to identify innovative clinical research methods to support wider take up by NICE.