The crisis in mental health has been long foretold, as I heard these problems from 2007-12 when I sat as a patient representative on committees such as Improving Access to Psychological Therapies (IAPT), and Listen to the Voice of Experience (LIVE) The report in 2012 by the London School of Economics said that 750,000 mental sick patients are untreated.
In 2009, I envisioned community mediation centres as a solution, and in 2010 I founded SECTCo (Social Enterprise Complementary Therapy Company) to contract with commissioners to provide meditation courses in Brighton and Hove. This paper sets out a summary of my vision.
To solve any problem, one has to discover the cause, and remove it. The cause of the crisis in the mental health service is antidepressants, which are doing more harm than good. They are supposed to be taken for just a few weeks to ease your symptoms while you reduce stress, but are addictive, so patients end up taking them for life. They do not even claim to be effective in healing or curing your mental sickness, and create side effects which make you keep coming back, gridlocking the primary care system.
In 2006 the government identified a solution – IAPT- which was supposed to ‘end the Prozac nation’, with one to one Cognitive Behaviour Therapy (CBT) but IAPT hasn’t worked hitherto because CBT only works for about 1 in 10 patients, confirming paragraph 7 of the above article. With nothing else to give patients, antidepressant prescribing has since nearly doubled from 30 -54 m monthly prescriptions pa. Primary care is overwhelmed because the number of patients on antidepressants has doubled from 2 to over 4 million.
The solution is to get them all off antidepressants, by making IAPT work through ‘medication to meditation’. The talking treatment of choice should be changed from CBT to the NICE-recommended Mindfulness Based Cognitive Therapy (MBCT) 8 week course, which is 100 times more cost effective. This is because MBCT is effective in 2 out of 3 patients, and one MBCT facilitator and an assistant can ‘hold the space’ for 15 patients, all of whom get a good healing experience, learn self care, and receive peer support from other patients. There are no contra-indications, and MBCT courses can prevent and treat any mental sickness. It is clinically indicated to anyone with depression or anxiety, and should not be limited to only those who have had 3 previous bouts of depression. This was the entry requirement for the original trial in 2002 which got it NICE recommendation, because it showed that it halves the 5 year relapse rate, but it has since been shown effective for any addiction.
The solution is therefore for IAPT to adopt the MBCT course as the core talking therapy in place of CBT. Of course, funding is needed but this should be provided by diverting funds from the prescribing budget, starting with antidepressants. This reaps the double benefit of providing an effective remedy, and saving adverse drug reactions from side effects.
The solution is to create a system whereby GPs can prescribe NICE-recommended MBCT courses as easily as Prozac by voucher, which patients can cash for a course at meditation centres near each surgery within a few weeks, as described below.
SECTCo’s experience running enhanced sandwich MBCT courses for donations in Hove
I created SECTCo to facilitate MBCT 10 week courses, and have run 15 to date for donations for about 200 people who started and 100 who completed the course. Since the beginning of 2013 I have run them at a shop at 3, Boundary Rd Hove, BN3 4EH, assisted by former clients. We are presently open 2 days per week (Tuesdays and Thursdays), from 8am -5pm, totaling 26 hours per week.
We have bid for public funding unsuccessfully, but if we were sufficiently funded, we could be open for 7 days per week from 8am to 930pm, totaling 94 hours per week. We provide a structure of drop in meditations around a core of the NICE-recommended MBCT course, supported by what we call the ‘enhanced sandwich’ MBCT course, under the following regime:
0800-0900 Dynamic meditation every day of the week.
0930-12 00 MBCT course on Tuesdays, with a MBCT facilitator course on Thursdays
1200-1300 Kundalini meditation on Tuesdays and Thursdays.
1400-1700 Family constellation groups on Tuesdays and Thursdays.
In future, we would like to offer in addition in the evenings:
1730-1830 Kundalini meditation
1900-2130 MBCT course.
Everyone seems to have benefited, and many of my clients have been able to break long standing addictions. I have trained about 30 facilitators who are ready and willing to teach this course if funded. If every surgery in country had a meditation centre like this near them, mental health could be transformed
This structure of meditations has been used for thousands of years in monastries and convents to keep people mentally healthy. In 1979, Dr Jon Kabat-Zinn adapted the Buddhist practice of watching the breath (called ‘vipassana’) to create the secularised Mindfulness Based Stress Reduction (MBSR) 8 week courses into public health care. This has been so successful that it has spread world wide. Dr Mark Williams created the MBCT course out of it. SECTCo provides the MBCT course for 2.5 hours per week for 10 weeks, and also offer additional meditations to make it accessible to all comers.
For further details please see www.sectco.org.uk, and section 9 of www.reginaldkapp.org, particularly paper 9.76, ’47 meditation centres for heartsink patients at half the drugs budget saving £7 for every £1 invested’.