Psychological therapies

We know that there are gaps in provision for psychological therapies, but understanding the difference between capacity and demand in different health boards, as well as the differences in how those services are being delivered are important for bringing some consistency to services so that people receive the same access and quality of therapy, regardless of where they live.

The Matrics Cymru guidelines provide quality and assurance for the delivery of psychological therapies in Wales, but here is still a lack of infrastructure and capacity for delivering these therapies to the people that need them. This should be considered a priority in light of anticipated increase in referrals post-COVID and the already significant number of referrals for medical psychotherapy.

For GPs to be able to direct people or refer people to social prescribing options they need to know what is available to them. Communities in Wales host hundreds of arts, cultural and heritage-based activities, butt here needs to be greater interface between the community groups providing opportunities for social prescribing options and the GPs practising in the local area. This needs to change to ensure that people who want the arts to be part of their treatment and support have a menu of options to choose from.

Stats Wales data suggests for primary care therapeutic interventions, the picture across Wales is lacks consistency. Some health boards are much more likely to deliver assessments within 28 days of referral than others. What's more, focus groups with our members on transitions revealed to us that different health boards also had different protocols on how close to the age of 18 CAMHS would accept them.

This means that some patients might face delays in receiving treatment in one area, but wouldn't if they lived somewhere else in Wales. We would like to understand more about the differences in service provision that patients experience across Wales as a starting point to creating a more uniform service, that meets expectations regardless of where they are received. 

In 2019, the College published a position statement on the use of anti depressants which made clear that they are not recommended for mild and sub-threshold depressive symptoms. Furthermore, antidepressant use among children should only be part of a second-line treatment for moderate to severe depression when children are unresponsive to psychological therapies.

There is an absence of recent data in Wales but data from RCGP surveys in 2015 suggests medication is the dominant offer from GPs. We would like the Welsh Government to commission research from the SAIL data bank to understand the treatment offers given to patients, and into understand the behaviors that result in this.