Mental health and wellbeing

Improving access to psychological therapy – wellbeing

The wellbeing service is an improving access to psychological therapy (IAPT) service. It is a government initiative to provide easily accessible, evidence based treatments, to the general population experiencing common mental health problems such as anxiety and depression.

Hertfordshire wellbeing team was set up in 2008. It has four teams located in GP surgeries and community settings covering the whole county.

Focusing on people with Long Term Conditions (LTC)

In 2016 the Government made a major commitment of £1 billion and set out of a plan to improve mental health care by 2021. This plan is called the Five Year Forward View for Mental Health. Part of this plan concerns people with long term physical conditions and the emotional impact of living with a chronic health condition can have.

Website
www.england.nhs.uk (PDF)

Hertfordshire was fortunate to be selected as one of the 22 pilot sites in the country to upskill wellbeing therapists to work with people with LTC’s. At present the focus has been on Diabetes Type 1 and Type 2, COPD and breathing difficulties, chronic pain, and medically unexplained physical symptoms.

Why psychology

The impact of co-morbid mental health problems like anxiety and depression for people with diabetes can be devastating. However these common psychological problems are highly treatable, resulting in improved wellbeing and management of the physical health condition and reduced healthcare utilisation (The Five Year Forward View for Mental Health, NHS England). Since starting this initiative in 2017 we have observed a 45% reduction in GP appointments following IAPT treatment, consistent with better self-management of diabetes.

The Wellbeing team offer a highly effective, innovative approach to engaging and treating patients with comorbid mental health problems and diabetes. Addressing mental health difficulties may not be the priority for someone who considers their difficulty to be primarily a physical health one – our therapists are sympathetic to this and trained to engage people in a way that makes treatment acceptable and effective for them.

Treatments

Treatment can be delivered in a variety of ways to ensure we can support those needing help as flexibly as possible. Cognitive Behavioural Therapy (CBT) forms the basis of many of our treatments. But we also offer other therapeutic modalities according to individual need including couples therapy for depression, interpersonal therapy and dynamic interpersonal therapy.

Individual CBT Sessions. CBT to meet both the mental health and physical needs of an individual. This is achieved by working with both our medical colleagues and allied health professionals.
Computerised CBT for Diabetes (online therapy).
LTC group therapy. Eight sessions.
Self- help material and books on prescription for LTC and Diabetes.
Signposting to relevant services to ensure continuity of care.

Referral criteria

Clients need to be over the age of 16 years old
Client must be registered with a GP in Hertfordshire
Unable to offer treatment to clients presenting with an Axis II disorder
We are unable to see clients who are actively suicidal or who have made a suicide attempt within the last 3 months. We are not a crisis service. Clients requiring psychiatric or more intensive support should be referred to secondary care services