Some 65% of doctors say they can "rarely" offer psychological therapy to depression sufferers within two months of referral, a study suggests.
The Royal College of GPs survey of 590 UK doctors also found 15% said access to psychological services was only "usually" possible in that timeframe.
The survey is part of a campaign by mental health charity Mind calling for better access to therapies.
The government says it is working hard with the RCGP to achieve this.
Depression affects one in 10 people a year, with more than half of those experiencing more than one episode.
Manifestos
The National Institute for Clinical Excellence (NICE) recommends talking therapies as the best form of treatment for mild and moderate depression.
Mind's campaign is being backed by the Royal College of Psychiatrists.
It challenges all political parties to make a guarantee in their election manifestos, to offer evidence-based therapies to all those who need them within 28 days of requesting referral.
In 2007, the government earmarked £173m to boost the number of cognitive behavioural therapists available on the NHS.
The Improving Access to Psychological Therapies (IAPT) programme aims to treat 900,000 extra people in England by 2010/11, with half of them moving to recovery and 25,000 fewer on sick pay and benefits.
RCGP chairman Professor Steve Field said: "There has been substantial improvement in the last few years but there is a long way to go.
"It is essential that the current programme is completed within the next Parliament with adequate funding for training and employing extra therapists.
"If we can treat people early we can keep people in work, keep them off medication and help them get on with their lives."
Mind chief executive Paul Farmer said talking therapies could save lives, and it was crucial that people who needed help received it as quickly as possible.
"Waiting months and months for urgent treatment would not be acceptable for patients with other health problems, and it should not be acceptable for patients with depression," he said.
A Department of Health spokesperson said more than 230,000 people had already benefited from the IAPT and that almost three quarters of primary care trusts now offered this service, up from a quarter two years ago.
But in a statement it added: "There is still work to do and we will work closely with the Royal College of GPs and others to achieve this."
'Misery'
Opposition parties have also pledged to widen access to talking therapy treatments.
Tory shadow health minister Anne Milton said: "In the same way that physical conditions get worse when not treated, a mental health condition will also deteriorate. This must be improved.
"We will make sure that GPs have better information about the effectiveness of talking therapies."
A Lib Dem spokesman said: "We are totally committed to ensuring that people with mental health problems are given guaranteed access to the treatment that they need and we want to work with Mind and the Royal College of GPs to find out what the spending implications would be of a 28-day guarantee."
The programme director for Wellbeing at the London School of Economics, Professor Lord Layard, who is spearheading the campaign, has stressed the economic as well as the humanitarian case for investing in treatment, suggesting that successful therapy can help many people return to the workplace.
"Mental illness is perhaps the greatest single cause of misery in our country," he said.
"The least we should offer is the same standard of care we would automatically provide if they had a physical illness."
PDF version The Royal College of GPs (RCGP) is calling for appointments for standard patients to be increased from 10 to 15 minutes so doctors can spend more time with the growing number of people with long-term conditions such as diabetes, cancer and obesity.
Professor Steve Field, the RCGP chairman and leader of the country's 38,000 family doctors, said tonight that patients should get used to seeking help more often from someone other than their GP for small problems such as a cold, sore throat or verruca.
He said: "GPs are seeing many more patients with more complex needs because our population is ageing and people are having things like diabetes, heart failure, hypertension and depression all at the same time."
Such people needed more time, partly because they were usually on a combination of medicines that carried potential side-effects, he said.
GPs – who are paid an average of £106,000 a year in England – are not seeking higher pay for implementing such changes, he said. The NHS could save money by moving in this direction because better early care of patients with complicated medical conditions would help keep them out of hospital.
Demands on GPs' time is rising fast because of an ageing population, advances in medical science and the "worried well".
But GPs handled only 62% of the 300.4m consultations in England in 2008. The number dealt with by nurses has risen sharply to more than in one three appointments.
To allow longer consultations, patients with minor illnesses would have to seek help from a practice nurse or pharmacist or by dealing with their GP by phone, email or internet, said Field.
"At my surgery in central Birmingham we introduced telephone consultations every morning of the week and patients like them. For many it's easier to sit at your desk and hear the results of a blood test or get advice about your medication than take time off to come in," he said.
The NHS in London plans to introduce longer appointment slots for more complex cases. Along with alternatives to hospital treatment and "remote" consultations, NHS London said it could save £570m a year.
Katherine Murphy, director of the Patients Association, said the RCGPs' plans were sensible.
"Very often people think the GP is the only one that can fix their problem and insist on seeing him, sometimes needlessly," she said. "People have seen their GP as the gatekeeper to medical services. That idea needs to change."
http://www.guardian.co.uk/society/2010/mar/23/gps-consultations-ill-pati...
Britain's GPs are increasingly angry and frustrated at not being able to get the right therapy for people with mental illnesses – especially for children, who face unacceptable delays in receiving help or do not get it at all, according to a new survey.
An "overwhelming" response to a survey sent out to family doctors by the Royal College of General Practitioners (RCGP) has painted a picture of patchy availability of adult psychological services across the country and an even poorer availability for children. Family doctors reported shocking cases of critically mentally ill people having to wait months for help, or not getting it at all, in breach of national guidelines.
The situation of children was worse than for adults, with 78% of doctors saying that they could "rarely" get help for a distressed child within the recommended two months' waiting time. One doctor reported the case of a 16-year-old rape victim who had started self-harming after being refused help, while another said a girl who had seen her sibling burn to death in a car was offered an appointment with the mental health service in six months' time. "Our service is appalling unless the kids are actually slitting their wrists – I see this as an area of huge need," said one GP.
Professor Steve Field, president of the royal college, wrote to members asking whether adult patients suffering from depression or anxiety disorders and requiring specialist psychological therapy were able to get treatment within two months. Some 1,150 doctors replied, with 65% answering "rarely". Only 15% of them answered "usually", with 20% responding "sometimes".
When asked about children suffering from emotional or behaviourial problems who needed such therapies, 78% of the GPs replied that "rarely" could they get the child help within two months with just 5.8% saying they could "usually" access treatment within the Nice (National Institute for Clinical Excellence) guideline of two months. "We were overwhelmed by the responses. It is shocking," said Field. "There is a strong sense of frustration coming through in many parts of the country and patients clearly deserve better. People should have access to approved treatments, and this has to be a wake-up call.
"If patients can't get access to talking therapies, then they will be on medication. Investing in mental health services will save the NHS and the economy a lot of money, and save it very quickly."
The survey was carried out as part of a campaign launched this month by the RCGP, the Royal College of Psychiatrists and the mental health charity Mind calling for all political parties to make a manifesto promise to back a new deal for children and adults with mental health problems. The government began its Improved Access to Psychological Therapies (IAPT) programme in 2007 after repeated clinical trials showed that "talking therapies" – where people are helped to challenge their own negative thoughts – are as effective as drugs in the short term and better in the long term at preventing relapses. That evidence led Nice to issue guidelines stating that people with depression and anxiety disorders should be offered the choice of cognitive behavioural therapy – a talking therapy.
The chief executive of Mind, Paul Farmer, says talking therapies save lives. "When someone is assessed as being in need of counselling or CBT, it is crucial that they can start treatment as soon as possible. Waiting months and months for urgent treatment would not be acceptable for patients with other health problems, and it should not be acceptable for patients with depression."
But while extra money has been given to health trusts around the country, it is now no longer ring-fenced and the campaigners want a political commitment to the IAPT programme from whoever wins May's general election.
"There has been some great work from the government and they deserve credit for being the first British government to take mental health seriously," said Richard Layard, of the London School of Economics.
Layard led a research team who in 2007 published a cost benefit analysis of psychological therapy. It found that the costs of providing psychological therapies would be recouped within two years in savings made on paying out incapacity benefit and lost taxes from more than a million people who are unable to work because of their mental health issues.
Layard said strides forward had been made but the service was spread too thinly. "IAPT has made very good progress, but it is still at a fragile stage if the political will is not behind it. We need to get mental health raised up as a national priority and see significant pressure brought to bear on primary care trusts to invest."
http://www.guardian.co.uk/society/2010/mar/21/gps-therapy-delays-mentall...