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Psychological therapies for common mental illness: how effective and equitable is provision?

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Objectives To evaluate whether effective psychological therapies are being provided in an inner London population and to describe the ethnicity of clients in relation to estimated need in the population.

Methods A questionnaire survey was sent to 78 providers of structured psychological therapy in the borough.

Results Fifty-nine (76%) providers of structured psychological therapy described the types of therapy they use for each of the common mental illnesses. At least one effective or likely to be effective therapy was used by 70% of voluntary sector providers, 61% of the primary care team, 59% of the primary care counselling service and 53% of private therapists. Twenty-five percent of the primary care team, 23% of voluntary sector providers and 5% of private therapists only used a therapy that was unlikely to be effective. A validated outcome measure was used by 100% of the primary care counsellors, 67% of the primary care team, 10% of private therapists and none of the voluntary sector providers. Twenty-three percent of the population of Greenwich are from a black and minority ethnic (BME) group. Only 15% of the client group for the primary care counselling service were from BME groups compared with 47% of clients of the private sector and 40% of voluntary sector clients.

Conclusions Levels of use of treatment that is unlikely to be effective are unacceptably high for all provider groups. BME groups are more likely to access voluntary and private sector providers of psychological therapies, and services within the NHS should be developed appropriately to address this inequity of access.


Document Type: Research Article

Publication date: March 1, 2005

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