Regarding your article (Scottish NHS boards pay up to £837 an hour for locums amid psychiatry crisis, 7 October), the solution to this increasingly untenable situation is a change of approach to mental health. Psychiatrists (medically qualified doctors who go on to treat emotional and mental health issues with medications) are necessarily focused on diagnosis of a “disorder” as an illness in the person. However, there is little evidence that this is effective with mental health issues in the vast majority of cases.
Studies have shown that a person-centred, non-diagnosis-led and least-medicalised approach is more effective, quicker and with fewer clinical returns over the longer term. Such an approach does not require consultant psychiatrists, but can be delivered in the main by other therapists, with minimum referral to psychiatrists in a minority of cases.
What is needed is a shift from a medical model of mental health (mental health is a disease or imbalance in the sufferer who is treated in isolation of events in their life) to a “within context” approach (ecological paradigm), which would enable a wider number of therapists to assist those in need. This would also reduce expenditure on expensive private services designed to make a profit for companies that drain vast amounts of much-needed revenue from our NHS.
Dr Jennifer Poole
Chartered psychologist, Romsey, Hampshire
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