If thousands are off work with mental health issues, why is it that so many people are ditching therapy?

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Written By Rivera Claudia

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Hundreds of thousands are walking away from NHS mental health ‘talking therapy’ because, in many cases, they believe it is not working, experts have warned. 

More than a million people are referred for the treatment every year, which is meant to help patients deal with common mental issues such as anxiety and depression.

While many patients see a mental health clinician in-person, a growing number of therapy sessions now take place over the phone, and even in the form of messaging conversations.

Last year, more than 600,000 NHS sessions took place via a chat app. This relatively novel form of care has been backed by the Government as a possible solution for getting thousands with mental health issues back into work.

Official figures have revealed that two-thirds of people claiming incapacity benefits are not employed due to mental health problems – and between 2022 and 2023, it was cited around 870,000 times in claims. 

One in ten young people in the UK is unable to work due to illness – predominantly related to mental health issues. Studies suggest a third of those aged 18 to 24 suffer with depression, anxiety or bipolar.

Over a million people are referred for mental health treatment every year, but thousands are walking away from it because they feel it isn’t working (file photo)

In his Autumn Statement, Chancelllor Jeremy Hunt announced plans to expand the use of so-called digital talking therapies to help tens of thousands more people in England get access to the help they need to return to work.

But damning NHS England figures suggest more than 40 per cent of those referred drop out before completing the course.

Out of 1.2 million referrals to NHS talking therapies in April 2022 to March 2023 only 672,193 completed a full course. Among young teens, the drop-out rate was even higher at over 60 per cent.

NHS England insists half of those who finished talking therapy treatment made a full recovery.

But leading mental health experts argue there is no good evidence that this is true – as there is little or no follow-up to see if patients later relapse.

‘The system is failing patients,’ says Dr Elizabeth Cotton, associate professor at the University of Leicester and author of an upcoming book titled UberTherapy: The New Business Of Mental Health. ‘[NHS talking therapy] has now been downgraded to a highly standardised, short-term solution focused model.

‘Often this is online self-guided support without the input of a clinician. There is pressure on services to show 50 per cent recovery rates and to discharge clients as soon as they indicate an improved mood.

‘Given the quality of many therapists working in the NHS, it is possible some patients might benefit but for others feelings of being fobbed off could make their mental health even worse.’

Around eight per cent of people in the UK suffer from either depression or anxiety. As many as one in ten will experience depression at some point.

Patients who want to undergo talking therapy are either referred by a GP or, in some areas, can access the services directly.

Most of these therapists offer a form of treatment known as cognitive behavioural therapy (CBT), which encourages people to change the way they think and behave in order to manage negative thoughts.

Studies suggest that CBT is effective at combating anxiety and depression – though it usually works best when combined with other treatments such as antidepressant drugs.

The same is true for CBT delivered over the telephone or via a messaging app.

However, experts say the problem with the NHS system is that patients are not given a choice of what type of therapy they would like to receive – which means many get care that does not suit them. This lack of choice is in large part due to the significant increase in the number of NHS mental health patients over the past two decades.

Around eight per cent of people in the UK suffer from either depression or anxiety and as many as one in ten will experience depression at some point  (file photo)

Around eight per cent of people in the UK suffer from either depression or anxiety and as many as one in ten will experience depression at some point  (file photo)

Since 2000, the number of cases of common mental health disorders such as anxiety and depression has risen by a third.

Experts say this has put intense pressure on mental health services, severely limiting the treatment options.

‘Many people can benefit from internet chat therapy, and some even prefer not to be seen face-to-face,’ says Dr Dean Eggitt, a Doncaster-based GP.

‘But patients aren’t offered a choice of therapy options. In my area, you pretty much only get telephone therapy or group sessions, and you usually don’t have a say in which one you get. 

This is because NHS resources are limited so there isn’t the option to offer people face-to-face therapy. So it’s no surprise that so many people drop out, because the type of therapy… isn’t right for them.’

Figures suggest that a growing number of Britons are turning to private therapy. Around 400,000 people pay for therapy. These sessions tend to cost between £50 and £100 per session.

The demand has grown so much that data now suggests around half of private therapists are not accepting new patients.

Last year, a group of mental health specialists, called the Campaign for Universal Access to Counselling and Psychotherapy – launched a petition calling on the Government to reconsider the use of digital therapy and allow more NHS patients to see counsellors.

‘NHS talking therapies have an exceptionally high drop-out rate and very low follow-up,’ says the group. ‘It’s not responding to patients’ needs’.

An NHS spokesman said: ‘The world-leading NHS Talking Therapy Service treated 1.2 million people for common mental health problems last year – with almost nine in ten patients receiving support within six weeks – and thousands more people recovering from anxiety and depression compared to the previous year.’

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