Post Code lottery for mental health services

People with anxiety and depression should be offered talking therapies within six weeks, according to new guidelines in England. But while 100% of patients in some areas receive this level of treatment, it is only 5% in others - why does this happen?

Martin, 47, has depression and anxiety - he has attempted suicide twice. He has been waiting for 16 weeks for treatment, 10 weeks longer than he should have. "I came out of hospital because of a suicide attempt that nearly worked, but I've got a new liver instead and a new life - but there wasn't much help on the mental health side," he tells Conservative MP Liam Fox on the Victoria Derbyshire programme.

In April, the government in England introduced the Improving Access to Psychological Therapies (IAPT) programme to improve the quality and accessibility of mental health services. More than one in four of the GP-led clinical commissioning groups (CCGs) are not meeting the target of 75% of patients receiving treatment within six weeks of being referred, June figures from the Health and Social Care Information Centre show.

But Martin lives in Macclesfield, part of the Eastern Cheshire CCG, one of the areas where patients wait the longest to access mental health services. The proportion of patients seen within six weeks was:

• 6.3% in April
• 7.4% in May
• 4.4% in June

It is a historical problem - there was already a waiting list of up to a year when the new scheme was introduced, the CCG's mental health lead doctor Dr Ian Hulme says. "We have always struggled with NHS funding because we are an ageing population rather than a population that's deprived - the challenge then is how much can you put into mental health services. What we've always found is historically it tends to get siphoned off into physical health services," he says.

Dr Hulme says the Eastern Cheshire CCG has a clear plan to improve. Since July, patients have been able to self-refer to mental health services in the area, and in August an online service was launched offering access to therapy.

Meanwhile, Martin has turned to a mental health charity. "I'm doing a lot myself, trying to get myself well and back up, but it's always good to have that professional there, someone to hook into, whose guidance and advice will really help you," he says. "Even medication, if it came to that, would help you sail through a bit more on the dark days - and I do have quite a few dark days."

Quick access

In the North and West Reading CCG, the proportion of patients seen within six weeks was:

• 100% in April
• 97.7% in May
• 97.9% in June

Simon, 47, who represented Team GB in the 2012 Paralympics, is visually impaired. He was offered talking therapies within four weeks of self-referring after suffering from depression.

"I felt like I was walking around with a large weight on my shoulders," he says. "It was affecting my relationship with my family, where a lot of my problems had stemmed from, and it also affected my relationships with other people. So it was having a dramatic effect on my life and I had to do something, so I was very lucky to bump into someone who introduced me to talking therapies. If I'd had more time to dwell on it, I may have backed out, and having quick access to something like this is really important."

Dr Barbara Barrie, lead mental health doctor at the CCG says it decided to prioritise mental health. "We were aware our depression prevalence rates were higher than other places in England - running at 14% compared to average of 11%, so we knew it was a key area we needed to focus on," she says. "And in the past year we have invested further on what was a well-established successful service."

For Simon, it certainly worked. "I sit here now, I don't have anything near the depression, the weight on my shoulders, that I had," he says. "I'm looking forward to life, to doing things, going places, being out - I'm not so isolated. I've been really brave with my thought and decided to apply to a blind college, which will help get me back into employment. I don't think I would have had the courage if I hadn't had the therapy."

Community and Social Care Minister Alistair Burt says the variation in waiting times is "not good enough" and the government will monitor CCGs' spending much more closely."Because we have the targets and they're public, there will be a lot more pressure to make sure they are being delivered," he says. "In a way, it's the transparency of the service that will lever up standards."