older psychiatryThe NHS is in danger of being unethical for mental health counsellors to work in, according to a new paper.

In Therapy Today, Dr Gillian Proctor, who trains counsellors from The University of Nottingham’s School of Education, opines that mental health care has moved away from the idea of relationships, and has moved professionals further away from the idea that who we are as people matters.

Additionally, Dr Proctor says healthcare professionals are working towards performance-related pay — and are judged by the numbers of people seen and ‘improving’ on arbitrary symptom-based scales of mental health, rather than by their ability to respond to personal distress.

Dr Proctor is also critical of the rise of the Improving Access to Psychological Therapies (IAPT) programme, saying it now dominates mental health services, meaning they are more about structured standardised short-term interventions than personalised or longer-term therapy.

She also noted that costs are being squeezed in the sector, saying that the only way for private companies to deliver better care to patients at a lower cost than the NHS is by reducing the pay of its employees. In addition, the pay and employment conditions of NHS jobs have reduced substantially in the last 5 years, she claimed.

“The privatisation of the NHS has continued by stealth, with the result of increasing bureaucratisation and medicalisation of mental health care,” she said. “All the new money put into mental health care through IAPT has resulted in patients being treated as numbers to be measured in spurious ways and treated as though counselling was a drug, offered a small dose and then discharged.

“Despite the false rhetoric of increasing choice of therapy for patients, models which prioritise the therapy relationship struggle to fit in such a one-size-fits-all system. Counsellors who respond to patients with distress with humanity and care are being driven out of such conveyor-belt services and patients are dropping out and being left with nothing.

“I’m very disillusioned about the possibility of working as an ethical counsellor and providing a humane service to distressed clients in the NHS.”

A full copy of the report can be viewed here