Therapy access barriers
66 items
2 sources
Long waiting times and accessibility restrictions for vital psychological therapies for mental health inpatients.
Cross-Source Insight
Therapy access barriers has been flagged across 2 independent accountability sources:
12 inquiry recs
54 PFD reports
This issue has been identified by multiple independent accountability bodies, suggesting it is a recurring systemic concern.
Inquiry Recommendations (12)
BRIS-14 — Provide support for patients experiencing anxiety due to increased medical knowledge
Recommendation: Patients should be supported in dealing with the additional anxiety sometimes created by greater knowledge.
Unknown
33 — Improve HMIP and IMB evidence gathering and reporting processes
Recommendation: HM Inspectorate of Prisons and Independent Monitoring Boards working within immigration removal centres must ensure that they have robust processes for: obtaining and reporting on an enhanced range of evidence and intelligence from detained people and those who represent or …
Gov response: The government stated it is considering its reliance on external scrutiny organisations. This recommendation was directed primarily at HMIP and IMBs.
Accepted in Part
No update 2+ yrs
HIA-8 — Specialist Care and Assistance Facilities
Recommendation: Sufficient funds should be made available by government on a ring-fenced basis for a fixed period of ten years, subject to a review after five years, to establish dedicated specialist facilities in Belfast, Derry and, if necessary, at other suitable …
Gov response: No formal government response published.
Accepted
No update 2+ yrs
78 — Revise Victims Code for CSA victims
Recommendation: The Ministry of Justice should revise the Victims' Code to make clear that victims and survivors of child sexual abuse must be advised by the police that: 1. They are entitled to seek civil compensation through the civil courts and, …
Gov response: On 16 January 2020, the College of Policing made changes to its Authorised Professional Practice to require police officers to provide victims with information on their rights and entitlements under the Victims' Code. On 16 …
Accepted
Delivered
79 — Codes of practice for civil CSA claims
Recommendation: The Local Government Association and the Association of British Insurers should each produce codes of practice for responding to civil claims of child sexual abuse. The codes should include recognition of the long-term emotional and psychiatric or psychological effects of …
Gov response: Association of British Insurers: In August 2021, the Association of British Insurers published a Code of Practice on Responding to Civil Claims of Child Sexual Abuse. It seeks to improve certain aspects of the civil …
Accepted
Delivered
88 — Rehabilitation code for CSA civil claims
Recommendation: The International Underwriting Association of London should take the lead in the production of a code for the benefit of claimants who are bringing civil claims for child sexual abuse. The aim should be to produce a code, comparable to …
Gov response: On 23 February 2021, the International Underwriting Association of London stated that it had established a working party to develop a rehabilitation code. On 14 December 2021, the International Underwriting Association of London stated that …
Accepted
No update 2+ yrs
89 — Church funding policy for victim support
Recommendation: The Church of England and the Church in Wales should each introduce a Church-wide policy on the funding and provision of support to victims and survivors of child sexual abuse concerning clergy, Church officers or those with some connection to …
Gov response: On 7 April 2021, the Church in Wales stated that it had introduced Independent Sexual Violence Adviser (ISVA) support for survivors. The Church in Wales committed to offer funding towards counselling recommended by an ISVA …
Accepted
No update 2+ yrs
FR-16 — Specialist Therapeutic Support
Recommendation: The Inquiry recommends that the UK government and the Welsh Government introduce a national guarantee that child victims of sexual abuse will be offered specialist and accredited therapeutic support. There should be sufficient supply of these services so that children …
Gov response: We accept that victims and survivors must be able to access effective systems for provision of therapeutic support. We will elicit views on the future of therapeutic support, including possible systemic changes to provision, through …
Accepted in Part
In progress
IBI-A-5a — Severe Psychological Harm
Recommendation: The approach of the Infected Blood Psychology Service is adopted so that both a diagnosis made by a psychiatric professional and a formulation-based opinion of all qualified psychological and counselling professionals are accepted as sufficient evidence of severe psychological harm …
Gov response: The Government accepts more needs to be done to test with the community the severity level and evidential requirements for those applying with severe psychological harm under the severe health condition award. The Government has …
Accepted in Part
In progress
IBI-A-8a — Supplementary Route for Affected Persons
Recommendation: The Minister give consideration to there being a supplementary route for people affected. This could include opening the supplemental award for severe psychological harm to people affected. He should involve parents, children, siblings, partners and carers, and their legal representatives …
Gov response: In his oral evidence to the Inquiry, the Minister for the Cabinet Office agreed to look again at how the Scheme compensates affected people through a supplementary route. The Government has accepted the Inquiry's recommendation …
Accepted in Part
In progress
IR2-15 — Support Services for Applicants
Recommendation: I recommend that the scheme should include provision of the following support services to be provided without charge to the applicant: a) an advice and advocacy service, supplemented where necessary by discretionary access to independent legal advice and representation, where …
Gov response: With respect to recommendations 15 and 17 of the Second Interim Report, the Government acknowledges the immense psychological harm that has been caused as a result of this scandal, and is committed to offering psychological …
Accepted
Delivered
IR2-17 — Bespoke Psychological Service
Recommendation: I recommend that without delay steps be taken to provide a bespoke psychological service in England.
Gov response: With respect to recommendations 15 and 17 of the Second Interim Report, the Government acknowledges the immense psychological harm that has been caused as a result of this scandal, and is committed to offering psychological …
Accepted
Delivered
PFD Reports (54)
Aaron Taylor
Concerns: HMP Garth has a critical lack of psychologist resources for prisoners, with severe staffing gaps and extensive waiting lists for mental health support.
Response: Practice Plus Group has advertised new psychologist roles at HMP Garth, contacted agencies for interim cover, and has interviews scheduled for the Principal Psychologist post. While awaiting permanent appointments, patients …
Overdue
Leia Sampson-Grimbly
Concerns: Long waiting lists for first appointments at Gender Dysphoria clinics pose a significant risk, delaying crucial care for vulnerable individuals.
Responded
Robert Smith
Concerns: Significant waiting lists for mental health therapies, including Interpersonal Therapy, are preventing patients from accessing essential support in a timely manner due to demand exceeding commissioned capacity.
Responded
Imogen Nunn
Concerns: A severe shortage of British Sign Language interpreters is hindering urgent mental health crisis assessments and delaying judicial proceedings for deaf patients and witnesses.
Responded
Benjamin Compton
Concerns: A significant gap in care exists for autistic individuals in crisis without a treatable mental health condition, and the Special Allocation Scheme failed to address an autistic patient's specific needs.
Responded
Paul Chase
Concerns: There is a critical lack of mental health, alcoholism, and addiction support for veterans, both serving and after release. Resources are extremely limited, leading to extensive waiting times for essential treatment and therapy.
Responded
Isobel Stapleton
Concerns: Mental health practitioners lack easy access to complete patient records across Wales and NHS England. Acute and home treatment teams also suffer from a lack of clinical psychologists and lengthy psychotherapy waiting lists.
Responded
Amina Ismail
Concerns: Delays in transferring mental health patients from independent providers resulted from underfunded local beds, an over-reliance on external services, and a national shortage of specialist rehabilitation units.
Responded
Amarnih Lewis-Daniel
Concerns: Extremely long waiting lists for Gender Identity Clinics, coupled with a severe lack of local support and specialist knowledge in mental health services, and unclear responsibilities for patient welfare, are intensifying distress.
Responded
Jessica Eastland-Seares
Concerns: Critically inadequate community provision and insufficient financial investment for autistic individuals force unnecessary inpatient admissions and A&E attendances due to a severe lack of suitable support placements.
Responded
Alice Litman
Concerns: Mental health services lack adequate training and clarity for supporting transgender individuals, coupled with significant delays and insufficient mental healthcare provision for those awaiting gender-affirming treatment.
Responded
Angela Collins
Concerns: Vulnerable adults under secondary mental health services who are at risk of prescription drug overdose and mental health crisis receive insufficient or no support.
Responded
Lucy Jones
Concerns: Significant delays in providing Cognitive Behavioural Therapy and inadequate follow-up by the Community Psychiatric Nurse after discharge, including limited contact attempts, were identified.
Responded
Aleksandra Markowska
Concerns: Patients receiving services from BPAS lack direct, confidential access to NHS perinatal psychiatry teams for pregnancy-related mental health decline, hindering timely and private support.
Overdue
James Tice
Concerns: There is a critical lack of beds for informal mental health admissions for older adults and insufficient community psychotherapy services for their needs.
Responded
Neil McDougall
Concerns: Military debriefs lack individual trauma support and promote alcohol use over discussion. The resettlement process for leavers fails to provide mandatory comprehensive mental health assessments, leaving ex-personnel reliant on external services.
Responded
Amanda Hesketh
Concerns: The practice failed to systematically review patients on multiple repeat analgesics or create individual plans, relying on repeat prescriptions without specialist input. There were also concerns about limited access to specialist pain clinics and underutilization of practice pharmacists for complex pain management.
Responded
Marjorie Walker
Concerns: A DNA CPR was not completed according to protocols, and significant delays affected access to specialist pain clinics. Furthermore, health professionals showed a lack of understanding regarding kidney function monitoring for pain medication like Gabapentin, increasing overdose risk.
Responded
Daniel France
Concerns: Vulnerable young people face dangerously long waiting lists (over a year) for psychological therapy and specialist services like the Gender Identity Clinic, leaving a critical gap in support between urgent and non-urgent mental health interventions.
Overdue
Michelle Jennings
Concerns: Critically long national waiting lists for mental health therapy, inconsistent application of referral/discharge policies, and a lack of proper consideration for mental health vulnerabilities during prosecutions, with no clear mechanism for sharing lessons.
Overdue
Joy Burgess
Concerns: Mental health patients face 'chaotic' ward environments unsuitable for recovery due to resource limitations, alongside lengthy waiting times (around one year) for psychological therapies.
Responded
Jane Bush
Concerns: Persistent delays in mental health assessments and access to psychological therapy are driven by ongoing staff recruitment and retention issues, hindering the Trust's ability to manage increased demand for complex cases.
Responded
Dyllon Milburn
Concerns: The current repeat prescription system lacks automated alerts to remind patients to request and collect medication, contributing to non-compliance for those with mental illness.
Responded
Todd Salter
Concerns: A probation officer's inadequate knowledge of mental health services and poor inter-agency collaboration forced the deceased to seek treatment by committing criminal acts.
Responded
Joanna Leven
Concerns: Gaps exist in national therapeutic pathways for Personality Disorders and trauma support services. Separate computer systems between hospital and mental health liaison create a risk of critical information loss.
Responded
Sean Kay
Concerns: A critical gap in mental health service provision in Norfolk and Waveney meant high-risk patients did not meet criteria for available support, leaving them without appropriate care.
Responded
Kelly Hewitt
Concerns: There is an inadequate provision of mental health support for prison officers, which needs urgent review.
Responded
Carole Mitchell
Concerns: Significant regional and national backlogs for mental health therapies and limited bed capacity caused care delays and distant placements. Health professionals also misunderstood patient confidentiality, hindering crucial information gathering from families.
Responded
Patricia Ferguson
Concerns: Community Mental Health Teams in Nottinghamshire have inadequate clinical psychologist staffing, leaving some patients without access to essential psychological services, which poses a risk of preventable deaths.
Responded
Kerry Hunter
Concerns: The proposed in-house Borderline Personality Disorder service access pathway may inadvertently exclude patients due to their condition's characteristics, like avoidance and previous negative treatment experiences.
Responded
Jack May
Concerns: Inadequate university mental health services, characterized by long waits and limited appointments, combined with patchy, poorly trained pastoral support from personal tutors, allowed students to "slip through the net."
Responded
Danyon Chesters
Concerns: Significant delays in accessing NHS mental health services led to fragmented private care, lack of information sharing between professionals, and private therapists not reviewing medication, impacting the deceased's treatment.
Responded
Heather Carey
Concerns: Insufficient funding and staffing led to excessively long waiting times for urgent psychotherapy, which was not comparable to physical life-threatening illnesses, causing distress and increasing suicide risk.
Responded
Stephen Kennedy
Concerns: A patient couldn't access recommended psychological therapy due to internal service barriers and long waiting lists. Additionally, a severe lack of acute inpatient mental health beds led to further self-harm and suicide attempts.
Responded
Arun Viswambaran
Concerns: Excessive waiting times of up to 18 weeks for IAPT therapy and difficulties in contacting the team risked mental health deterioration and disengagement from services.
Overdue
[REDACTED]
Concerns: Significant delays in IAPT counselling and an unclear, difficult-to-follow electronic record system with poorly defined risk assessment protocols raised concerns for patient safety.
Responded
John Derwent
Concerns: Excessive waiting times for CBT (12 months) due to insufficient capacity and ineffective escalation mechanisms between commissioning and service providers prevented timely access to essential mental health treatment.
Overdue
John Haines
Concerns: Mental health inpatients and those supported by Home Treatment Teams lack timely access to qualified psychological therapy, a repeated concern due to commissioning issues and long waiting lists.
Overdue
David Hamilton
Concerns: Healthy Minds lacked documentation for therapy selection, clarity on referral triggers, and a formal escalation process for concerns. Limited information sharing between health professionals meant an incomplete patient picture.
Responded
Linsay Bushell
Concerns: A significant lack of provision and priority for commissioning therapeutic psychological services for mentally disordered female patients with Emotionally Unstable Personality Disorder was identified.
Overdue
Thomas Green
Concerns: There was a critical failure to action a psychiatric referral during inpatient care and no follow-up for complex PTSD post-discharge. This highlighted a commissioning gap for suitable services for complex mental health conditions.
Overdue
David Read
Concerns: Critical delays occurred in arranging mental health appointments, with re-referrals being treated as new, resulting in dangerously long waiting lists and delayed access to care.
Responded
Emma Timbrell
Concerns: Patients with suicidal ideation were given a non-free out-of-hours crisis number, creating a financial barrier to accessing urgent mental health support for those with limited means.
Overdue
Simon Klineberg
Concerns: Concerns include insufficient psychiatric bed availability, inadequate resourcing for home treatment teams, and significant waiting lists for psychological therapy, especially for high-risk patients.
Overdue
William Higgleton
Concerns: A critical lack of psychotherapy services for patients with anti-social personality disorder means their primary treatment is unavailable, creating a risk of future deaths.
Overdue
Guy Robinson
Concerns: The 'AWOL' protocol was improperly applied due to staff unfamiliarity, lacking Trust-wide implementation. A significant service gap exists with no inpatient clinical psychology access, disadvantaging vulnerable patients.
Responded
Tania Hristova
Concerns: The patient received antidepressant medication for over five years without adequate review and was not offered additional psychological therapies such as counselling or CBT.
Responded
Craig Bell
Concerns: There was an unmet need for psychological therapies for prisoners with personality disorders, poor information sharing about self-harm risk, and a lack of senior clinician attendance at discharge reviews.
Overdue
Janette Insley
Concerns: Inpatients lacked access to psychological treatment due to unavailable psychologists and resources, with an overemphasis on community services, leaving vulnerable patients without support post-discharge.
Responded
Rowena Golton
Concerns: Critical shortages and significant waiting times for psychological services within crisis teams hinder adequate provision and timely access for vulnerable patients.
Responded
Roseanne Cooke
Concerns: Lack of inpatient psychological support, delayed/confused referrals, and critical communication breakdowns between family and care teams resulted in inadequate post-discharge support for a vulnerable patient.
Pending
Frances Andrade
Concerns: Vulnerable witnesses require clear advice on psychiatric counselling and timely explanations of trial proceedings. Additionally, better measures are needed to secure prescription medication from family members with a history of overdoses.
Overdue
Graeme Kidd
Concerns: Locum doctors lacked access to vital electronic records and awareness of mental health services, while GPs faced referral barriers due to mandatory physical checks. Additionally, patients lacked essential medication advice in the prescribing doctor's absence.
Overdue
Michael Worrall
Concerns: The limited availability of psychological therapy at Avesbury House risks adverse outcomes for patients, particularly upon discharge to the community if prior therapy is discontinued.
Overdue