The future of mental health services: the organising challenge ahead

Autumn 2018

We are still failing to protect our mental health services and the people who deliver them. One central reason for current problems is the overwhelming focus of the service on Increased Access to Psychological Therapies (IAPT), the NHS’s largest mental health programme. The ‘evidence base’ for this programme’s effectiveness has been established through the widespread use of performance data, drawn from a system that has itself become highly contested. IAPT is also a key component within the government’s austerity programme and its plans for the introduction of the new ‘fitness for work’ welfare assessment process. And it is also an enabler of the opening up of the mental health sector to outside providers, partly because it paves the way towards a downgrading of jobs. It also fits perfectly with a preoccupation with financial targets and performance indicators that reflect efficiency within the service rather than clinical outcomes. To begin to address all this, there is a need for a public inquiry into the current regime of performance management and the IAPT model, and the development of a new network that can create a platform for national engagement on the key issues.