At a cost of £2 billion a year for adult and child mental health services. NHSE manages NHS Talking Therapies without any acknowledgment of a failure of governance. It is or should be aware that pychometric tests results provide, at best, circumstantial evidence of effectiveness.
But it presses ahead with its conviction of a 50% recovery rate. It is akin to a person being convicted of an offence on the surmise of a policeman. The failure of NHS England and Talking Therapies has been going on as long as the Post-Office scandal, but with a determined blindness on the part of power-holders.
Blood pressure monitors are a useful device, good for charting hypertension, but unlikely to be relevant to your knee pain. In a similar way, the two psychometric tests, beloved of NHS Talking Therapies, the PHQ-9 and GAD-7, are relevant only if the person is known to be suffering from reliably diagnosed depression or generalised anxiety disorder. No reliable standardised diagnostic interview is conducted in NHS Talking Therapies, in this context the questionaires are meaningless. In NHS Talking Therapies clients complete these measures at the beginning when they are likely at their worst. With the passage of time, as crises subside, and with attention, scores improve. But test scores improve just as well when clients attend the Citizen’s Advice Bureaux. There is no independent evidence of recovery from any of the psychological disorders that are supposed to be the focus of NHS Talking Therapies.
The reports of NHS Talking Therapies clinicians invariably quote PHQ9 and GAD7 scores and the improvement in them as evidence of effectiveness. As an Expert Witness to the Court for over 30 years, I have to regularly point out that the clinician’s reports cannot be relied upon. In a backhanded admission of the unreliability of clinicians reports, NHS Talking Therapies states that their reports cannot be relied upon for medico-legal purposes! Between NHS England and NHS Talking therapies there is a con going on here. The clinician is like a footsoldier in a totalitarian state, doing what he/she is told. The public are failed. The questionnaires are fake news. Perhaps the good news is that NHSE will be abolished in he next 2 years, but will the Department of Health and Social Care want to grasp the nettle?
Dr Mike Scott