The British Association for Behavioural and Cognitive Psychotherapies (BABCP) is the lead organisation for Cognitive Behavioural Therapy (CBT) in the UK and Ireland with over 26,000 members.
CBT is one of the most effective and evidence-based types of talking therapies. It is recommended in NICE Guidelines as an intervention for addressing various conditions, including anxiety disorders, depression, Obsessive Compulsive Disorder (OCD), trauma and associated symptoms, eating disorders, personality disorders amongst others as well as to help people cope with symptoms of many other conditions such as chronic pain.
Investing in evidence-based talking therapies, such as CBT not only work to improve mental health and alleviate suffering of those struggling with a range of conditions but they also contribute to saving public money in the long term as mental health problems are the most important cause of disability in the working age population.
Manifesto for Mental Health
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What are we calling for?
1. Increase access to evidence-based psychological therapies for children and adults
Why?
The Welsh Mental Health and Wellbeing Strategy aims to reduce inequalities in terms of access and experience of mental health provision with a focus on early intervention. The pathways to accessing mental health support in Wales remain inconsistent with varied provision across health boards. We believe that Wales deserves consistent, timely access to NICE-recommended psychological treatments, such as CBT.
Access to evidence-based psychological therapies is not only important for those with a psychiatric presentation but also for those experiencing distress as a result of life-changes or long term health conditions, whether physical or psychological.
Access to evidence-based psychological therapies, such as CBT could also save money to the NHS. In 2019, poor mental health in England was estimated to cost £100 billion, approximately 5% of GDP. A recent study by the London School of Economics, found that for with every pound spent, NHS Talking Therapies generates an additional benefit of £5.50 for the economy.
We need:
The Government should work to unify and create clear structures and delivery of mental health services across all health boards in Wales prioritising evidence-based therapies, such as CBT, as recommended by NICE. This will reduce the current inconsistencies across health boards, improving equity in access and allowing early intervention.
We also need the Government to deliver on their commitment to establish routing outcome measures for psychological therapies.
The planning and design of these services should include co-production with people with lived experience, as expressed in the Mental Health and Wellbeing strategy.
2. Workforce strategy that expands CBT offer in Wales
Why?
There is a shortage of CBT therapists in Wales who can deliver evidence-based therapies, especially CBT, in a client’s first language. The lack of clear training pathways and jobs available in the NHS impacts the career choices of those wanting a career in mental health; which in turn reduces the options for clients and patients to access therapy in their language of choice.
Currently, not all practitioners have access to training if they wish to become a CBT therapist, and the standards of courses and supervision vary. This is particularly important for further training such as children and young people, complex presentations or eating disorders where ongoing professional development is compromised.
The increase of high-quality evidence-based therapies such as CBT and the increase in CBT therapists will also assist with the reduction of waiting lists.
We need:
An assessment of the current workforce followed by a workforce strategy with clear pathways to training, supervision, and competency assurance to ensure equitable access to evidence-based CBT interventions across all health boards and trusts. We also need sufficient funding for posts for CBT therapists to be able to access post-training and ongoing professional development relevant to their expertise.
The new Government should also review the requirement for qualified and accredited CBT therapists to also have a core profession and be registered with another professional body as this may not be appropriate for CBT therapists.
The Government should also consider expanding the offer of BABCP-accredited courses in Wales and establishing a requirement for BABCP accreditation to ensure there is high quality and consistent offer across all health boards in Wales, increasing the availability of CBT therapy, including in the Welsh language.
3. Reduction of waiting lists and increase access to diagnosis in Wales
Why?
An Freedom of Information request placed by Mind in 2024 revealed that around 2,000 adults with severe mental health problems were waiting more than six months to access specialist psychological therapies, with a further 750 waiting more than one year.
Early assessment and diagnosis by suitably trained and qualified practitioners and early intervention is crucial to decrease the likelihood of deterioration on a waiting list. This is particularly important for children where waiting lists for a diagnosis could be up to three years.
We need:
The new Welsh Government needs to deliver on the commitment in the Mental Health and Wellbeing Strategy to reduce waiting times for services including by providing access to Early Mental Health Care for Everyone to improve their early intervention approach. They should also increase the recruitment of qualified and accredited CBT therapists – as per point 2 above – which will help with the waiting lists impacting hundreds of patients in Wales.
