England’s Mental Health Experiment: It makes economic sense

Benedict Carey in The New York Times:

England is in the midst of a unique national experiment, the world’s most ambitious effort to treat depression, anxiety and other common mental illnesses.

MentalThe rapidly growing initiative, which has gotten little publicity outside the country, offers virtually open-ended talk therapy free of charge at clinics throughout the country: in remote farming villages, industrial suburbs, isolated immigrant communities and high-end enclaves. The goal is to eventually create a system of primary care for mental health not just for England but for all of Britain. At a time when many nations are debating large-scale reforms to mental health care, researchers and policy makers are looking hard at England’s experience, sizing up both its popularity and its limitations. Mental health care systems vary widely across the Western world, but none have gone nearly so far to provide open-ended access to talk therapies backed by hard evidence. Experts say the English program is the first broad real-world test of treatments that have been studied mostly in carefully controlled lab conditions. The demand in the first several years has been so strong it has strained the program’s resources. According to the latest figures, the program now screens nearly a million people a year, and the number of adults in England who have recently received some mental health treatment has jumped to one in three from one in four and is expected to continue to grow. Mental health professionals also say the program has gone a long way to shrink the stigma of psychotherapy in a nation culturally steeped in stoicism. “You now actually hear young people say, ‘I might go and get some therapy for this,’” said Dr. Tim Kendall, the clinical director for mental health for the National Health Service. “You’d never, ever hear people in this country say that out in public before.”

The enormous amount of data collected through the program has shown the importance of a quick response after a person’s initial call and of a triage-like screening system in deciding a course of treatment. It will potentially help researchers and policy makers around the world to determine which reforms can work — and which most likely will not. “It’s not just that they’re enhancing access to care, but that they’re being accountable for the care that’s delivered,” said Karen Cohen, chief executive of the Canadian Psychological Association, which has been advocating a similar system in Canada. “That is what makes the effort so innovative and extraordinary.”

More here.

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