Therapy referrals down, prescriptions up – latest stats

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Alarming numbers show rise in prescriptions and a fall in therapy sought out across the UK.

Lockdown measures have deeply affected the mental health of people across the UK. In tandem, therapy referrals have declined, in spite of the switch made by many therapists to digital services. Prescriptions for anxiety and depression have risen sharply,  despite the concept that sessions with a qualified practitioner may generate greater long term benefit for the suffering person.  

Since the first lockdown, mental health has become a subject of note for the mainstream news and for household conversations as people have spotted a noticeable decline in their mental health as a result of being so disconnected from what they consider to be normal life. 

A traffic analysis from Rethink.org displayed a shocking number of people searching for support for a number of mental health problems since Boris Johnson announced that the country would go into lockdown for the first time.

Mental health snapshot

Medications, Tablets, Medicine, Cure, Pharmaceutical

Over 2.3 million people visited the Rethink website in the six months after the first lockdown. Here are some further statistics provide by the site:

  • 183% increase in people seeking information on anxiety. 
  • 188% increase in people seeking advice about how to support someone experiencing suicidal thoughts. 
  • 229% increase in people seeking advice and information regarding self-harm. 

With these kinds of statistics, it is no surprise that many people across the UK have been seeking help from their GP for mental health problems.  The  issue  is that those seeking help appear to be being referred to medications rather than therapy that may help them in the long-run. 

With limitations to social interaction, medication may have seemed like the most immediately applicable choice  for doctors at the time, but now as the UK eases lockdown restrictions, that hat is their excuse for cutting qualified therapists out of the mental health equation? 

Easy access medication

Amy, 27 from the UK, told The Independent that she has struggled with poor mental health since her teens, but in 2020 she decided to finally reach out to her GP for some advice on how to best deal with her issues. After a phone call with her GP that Amy says was “no longer than three minutes” she was prescribed for Citalopram, an antidepressant.  Amy likened the exchange to a “business transaction” and said that afterward she felt “a little bit scared” at how quick the process was.

In Wales, the BBC reports that more than 3.2 million antidepressant items were prescribed by GPs in Wales in the six months following the start of the pandemic, this number was an increase of 115,660 compared to the year prior. 

Research produced by the Welsh government at Statswales shows that in the same period as this rise in antidepressants being prescribed, the number of people being referred for talking therapies fell by a third, down to 25,520.

According to the latest available data from the NHS, there were 601,530 referrals to the Improving Access to Psychological Therapies programme from the six months leading to the end of August 2020 – comparing this to last year’s data, that is 235,000 fewer referrals than in 2019, a 28% drop.

Steep reduction in counselling referrals 

Dr Esther Cohen-Tovée, chair of the British Psychological Society’s division of clinical psychology told The Guardian that they were 

 “Shocked and extremely concerned about the massive extent of the reduction in referrals for psychological help during a time of huge anxiety, stress and distress for the whole population. This is even more concerning when there has been a huge increase in the prescription of antidepressants.”

In an article for The Pharmaceutical Journal, Ciara Ni Dhubhlaing, president of the College of Mental Health Pharmacy, said that in her practice she has seen   

A large increase in anxiety disorders, including social anxiety and panic attacks, amongst those with no previous history of mental health difficulties as well as those with an anxiety disorder diagnosis.”  

A rise in anxiety disorders could explain such a rise in anti-depressants, as most antidepressants are licensed to treat both depression and anxiety, but it does not explain why fewer people are seeking out therapy and instead opting or being advised to take medication right away.

Greater awareness of options needed

People struggling with mental health should be aware of their options and aware that while medications such as anti-depressants are generally effective, David Taylor, director of pharmacy and pathology at the Maudsley Hospital in South London warns: “They are not innocuous”. Taylor warns that “sudden cessation of treatment may lead to withdrawal symptoms and lead to an increased risk of relapse” and so the rate of people being prescribed should “gradually fall as lockdown eases” to avoid such risks.

For therapists, this is concerning news as fewer referrals means fewer clients, and higher prescription rates can mean fewer people getting the help from therapy that they could benefit from in the long-run. 

Could anxiety be biological? 

In an upcoming talk with Private Practice Hub, Jonathan Cohen, founder of Functional Diagnostix will be hosting a webinar to discuss some of the many ways that people diagnosed with anxiety and depression could identify a deeper problem within their bodies that may explain the symptoms they have been suffering using blood markers, enabling therapists to identify a root cause and treating it, rather than having to prescribe medications such as the ones we have been discussing today.

As lockdown lifts and people are becoming more comfortable with face-to-face meetings, hopefully the number of people coming to therapy rather than medication will rise once again, creating a balance within the world of mental health, for now, all therapists can do is make sure that they are advertising their practices well and making themselves accessible to those who may be struggling to find the help they need within their current circumstances. 

Join Private Practice Hub today for more updates on articles and webinars on the ever-changing landscape of the therapy world, to make sure that your practice stays up to date and informed. 

Article written by Maisie Violet Wicks, BA Hons, columnist for Private Practice Hub. Have something to share? Email us at newsdesk@privatepracticehub.co.uk

References

A looming mental health crisis?. 2021. A looming mental health crisis?. [online] Available at: <https://www.rethink.org/news-and-stories/news/2020/10/charity-warns-rising-demand-for-support-signals-a-looming-mental-health-crisis-urges-people-to-seek-support-if-they-re-struggling/> [Accessed 2 July 2021].

The Pharmaceutical Journal. 2021. Antidepressant prescribing up 6% in last three months of 2020 – The Pharmaceutical Journal. [online] Available at: <https://pharmaceutical-journal.com/article/news/antidepressant-prescribing-up-6-since-2019> [Accessed 2 July 2021].

the Guardian. 2021. Antidepressant use in England soars as pandemic cuts counselling access. [online] Available at: <https://www.theguardian.com/society/2021/jan/01/covid-antidepressant-use-at-all-time-high-as-access-to-counselling-in-england-plunges> [Accessed 2 July 2021].

BBC News. 2021. Covid: More antidepressants prescribed but therapy down. [online] Available at: <https://www.bbc.co.uk/news/uk-wales-56087135> [Accessed 2 July 2021].

NHS Digital. 2021. Psychological Therapies, Reports on the use of IAPT services – NHS Digital. [online] Available at: <https://digital.nhs.uk/data-and-information/publications/statistical/psychological-therapies-report-on-the-use-of-iapt-services> [Accessed 2 July 2021].

Statswales.gov.wales. 2021. Referrals for a LPMHSS assessment, by LHB, age and month. [online] Available at: <https://statswales.gov.wales/Catalogue/Health-and-Social-Care/Mental-Health/Mental-Health-Measure/Part-1/referralsforalpmhssassessment-by-lhb-month> [Accessed 2 July 2021].

The Independent. 2021. The people who started antidepressants during lockdown. [online] Available at: <https://www.independent.co.uk/life-style/antidepressants-lockdown-mental-health-pandemic-b1784515.html> [Accessed 2 July 2021].