The Inequalities in Health Alliance (IHA) is a coalition of more than 250 organisations, convened by the RCP, which campaigns for a cross-government strategy to reduce health inequalities. This guest blog post by Jeremy Bacon, Third Sector Lead in the policy team at the British Association for Counselling and Psychotherapy (BACP) is part of a series by IHA member organisations.
The voluntary sector in the UK has a long tradition of providing community responses to social and health needs and inequalities. The sector provides accessible and inclusive support that sits outside – but is often connected to – NHS services either through delivery of commissioned services, or as trusted partners.
A new report, Bridging the gaps, commissioned by the British Association for Counselling and Psychotherapy (BACP) and written by Public First, details the flexibility and reach of third sector counselling services in England. The report highlights their offer of choice of a wider range of therapeutic approaches and modalities than is available in NHS Talking Therapies, and critically, their ability to reach clients from marginalised community backgrounds, known to be at greater risk of health inequalities.
NHS Talking Therapies (formerly IAPT) has made significant progress in improving access to psychological support, with some of its delivery contracted or sub-contracted to third sector counselling services. However, gaps remain in this provision – notably for people known to be poorly served by mainstream NHS services.
Over the past 18 months, against the backdrop of the cost-of-living crisis, third sector counselling services have seen rapid growth in demand for therapy. They have also been responding to rising rates of referral for their services from NHS and other statutory services, without accompanying funding, and with rising overhead costs. Many services are facing closure, leaving significant gaps in the availability of vital support. This challenging environment has been further exacerbated by services seeing increased running costs alongside reductions in income from donations, with the increase in employers National Insurance contributions in the latest UK government budget adding further financial pressure to already stretched services.
The Bridging the gaps report includes accounts from services that specialise in working with clients from marginalised and racialised community backgrounds, and that offer specialist trauma-informed services and interventions to adult survivors of sexual abuse. Rapid growth in referrals from NHS services which recognise their clients’ preference and need for these specialisms, is extending waiting times for services that lack the resource to meet the demand.
The report calls for better engagement between commissioners and third sector providers, along with simplified commissioning arrangements, and an explicit requirement in commissioning outcomes frameworks to address inequalities through provision of specialist counselling services. When vulnerable people hit crisis point, the third sector steps in. Now though, the third sector is in crisis. We need urgent action to bridge the gap, to ensure that the sector is given sustainable support. The social and economic cost of doing nothing is far too great and it risks exacerbating the mental health crisis facing our most vulnerable communities.
This piece is part of a series of guest blog posts by members of the Inequalities in Health Alliance.
Jeremy Bacon
Third Sector Lead in the policy team at the British Association for Counselling and Psychotherapy
