FOCUS: "International shortage" of therapists stretch online and offline waiting lists

Friday 14 July 2023

An "international shortage" of psychological therapists is continuing to stretch Jersey's waiting lists in person and, now, online – with one islander rated as having the highest level of need told she would have to wait five-and-a-half months to talk to someone via computer.

Express took a closer look at how the recruitment challenges are impacting islanders facing mental health challenges...

Almost half waiting more than four months

Almost half of all islanders seeking help with their mental health are waiting more than four months for treatment through Jersey Talking Therapies, according to recently published figures.

Over the 12 months to the end of May, 45% of islanders who had started treatment through JTT had been waiting over 18 weeks - a widely used target period - for that process to begin. The aim is to get that down to less than 5%.

When it comes to initial assessment following referral, which could be from a GP or the individual themselves, the figures are far better – 98% of people get that within the recognised three-month target. 

That assessment does involve a triage process, meaning that the most serious cases should be receive treatment first – however, after assessment, islanders are waiting an average of 134 days, or over four months, for treatment.

140 per month on average waiting

There was an average of 107 referrals a month to JTT over the 12-month to May, a 12% increase year-on-year.

An average of 140 people a month are waiting for treatment.

Andy Weir, who is Director of Mental Health and Adult Social Care, said he fully appreciated that assessment-to-treatment waiting times for JTT needed to come down.

"We are fishing in a small pond"

“The situation is not ideal, but it is the current reality of demand and resources,” he said.

“There is an international shortage of psychological therapists and everywhere is struggling to recruit. We tried to hire in the UK because some of the work can be done virtually but even that proved very difficult. 

“We are fishing in a small pond - there is a limited workforce and significant demand, particularly since covid.”

Pictured: Andy Weir, who is Director of Mental Health and Adult Social Care.

Mr Weir added: “Against that backdrop, we are assessing how we do things and how we might change things for the better. Some of the job can be quite manualised so we are seeing if we can perhaps bring in people with a lower level of qualification to divide up work in a different way in order free up more qualified therapists."

"I was pretty shocked that the waiting list was so long for online therapy"

One way the mental health service has sought to ease pressures is by giving islanders the option to use online services instead. However, these still entail lengthy waits, as Catherine*, who is in her 20s, found out.

After being graded as having the highest level of need, she was given two options: wait around 37 weeks for an in-person session, which is only available on weekdays between 09:00 and 17:00, or 20 weeks for an online therapist. 

"I was pretty shocked that the waiting list was so long for online therapy," she told Express. "I ideally wanted to see someone in person, as it's easier to talk to a real person rather than someone on a screen, but the in-person appointments are only in working hours and the waiting list is so much longer, so I had to choose the online option even though i don't think it will suit me as well."

Once her referral to online therapy was confirmed, she was told the wait would be 22 weeks – or five-and-a-half months. 

"I hope there is light at the end of the tunnel"

Mr Weir gave reassurance that effort is being put into improving mental health services and their associated waiting lists.

“I hope there is light at the end of the tunnel," he said. "Next week, I am going to Highlands College to meet the team running its counselling training. I want to explore if there is anything we can do jointly, to best use the skills of people completing courses there. 

“They might not be able to perform the whole range of psychological therapy but they might be able to do some of it.”

There are several levels of mental health support for adults in Jersey. It begins with the Listening Lounge, which is run by LV Group, and provides a free counselling service. 

Next, there is JTT, which is run by Health and is resourced to take on more serious cases than the Listening Lounge, which can refer people to it. It can help with such conditions as anxiety, low mood, phobias and post-traumatic stress. 

Finally, the Psychological Assessment and Therapy Service, focusses on more complex needs.

Mr Weir stressed that other services were available for islanders in need of help, including the Mental Health Crisis Service, and third-sector organisations. 

He added that once people were receiving treatment, the outcomes were good, with 76% of people showing reliable improvement.

A real example: Catherine's journey

Catherine* shared details of her journey in accessing mental health services...

• Catherine first contacted the Listening Lounge at the beginning of February and was offered an initial assessment at the beginning of March.
• Received email three days later that a referral to JTT would best suit their needs. Was referred the next day.
• Initial assessment with JTT – a one hour session over the phone - takes place towards end of April. Graded as Level 4, the highest level of need, and put on waiting list for individual therapy. Informed the waiting list was around 20 weeks to see online therapist and 37 weeks for in-person session.  
• Catherine opts for online option due to shorter wait and availability outside of working hours.
• Receives confirmation in mid-May that third-party online therapy service has received referral and wait for appointment could be up to 22 weeks.
• Catherine has heard nothing since. 
• Time since initial self-referral: 22 weeks, or five months.

*Name changed to protect anonymity.