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Strange bedfellows: economics, happiness and mental disorder

Published online by Cambridge University Press:  11 April 2011

Brian Cooper
Brian Cooper*
Affiliation:
Division of Psychological Medicine, Institute of Psychiatry, London (United Kingdom)
*
Address for correspondence: Professor B. Cooper, Bachstrasse 34, 69121 Heidelberg (Germany). E-mail: [email protected]
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Summary

Aim – The high economic and social costs associated with the ‘common mental disorders’, and the need to scale up appropriate care services, are now widely recognized, but responses vary from country to country. In Britain, a current government initiative to promote psychological therapy is driven both by economic pressures and by research on the factors of happiness, or life-satisfaction. This article provides a short critical review of the project. Method – A health policy analysis, with regard to problem definition; objectives; sources of information; criteria for evaluation; impact on existing services, and comparison with alternative strategies. Results – The new programme, Improving Access to Psychological Therapies (IAPT), aims to expand treatment services by training 3,600 ‘psychological therapists’ in cognitive behavioural therapy (CBT), which they will then apply in the wider community. This service, with an initial budget of £173 million, will provide treatment for depression and chronic anxiety from local centres across the country. The programme is intended to pay for itself by reducing incapacity costs. Closer examination, however, raises questions concerning the project’s theoretical basis, logistics and research methodology, and casts doubt on its advantages over alternative approaches. Conclusions – The IAPT project is ill-designed to achieve its objectives and unsuitable as a model for treatment and care of the common mental disorders in other countries. An alternative strategy, based on closer integration of community mental health and primary health care, should be tested and on previous experience seems likely to prove more cost-effective.

Declaration of Interest: None.

Keywords

Depressionanxiety disorderscognitive behaviour therapymental health services
Type
Special Articles
Information
Epidemiology and Psychiatric Sciences , Volume 18 , Issue 3 , September 2009 , pp. 208 - 213
Copyright
Copyright © Cambridge University Press 2009

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