The Environment, Food and Rural Affairs (EFRA) Committee’s report on rural mental health highlights an alarming disparity in mental health care for rural communities. It points towards a need for a profound overhaul in policy, planning, and service provision that acknowledges the unique circumstances and hardships of rural life. In response, the National Counselling and Psychotherapy Society (NCPS) advocates a practical solution - Direct Access to Counselling.
Rural communities, as EFRA's report posits, are often disadvantaged by an urban-centric focus in mental health policies. The reality of rural life with limited public transport, patchy digital connectivity, and a distinct lack of social infrastructure has been somewhat glossed over in existing strategies. The EFRA committee rightly underscores the necessity of a rural-focused mental health policy, a plea that the NCPS echoes and supports.
The NCPS is at the forefront of campaigning for a transformative mental health care approach: Direct Access to Counselling. This campaign emphasises immediate recruitment to address the current deficit, eliminating waiting lists, and ensuring that referrals don't end without a patient being seen. It advocates widening access to mental health support, broadening the range of therapeutic modalities offered through the NHS, and importantly, empowering patients to become more directive in their care. This approach aligns with the EFRA Committee’s vision of a fundamental redesign in policy and planning, shifting from retrospective 'proofing' to proactive and inclusive policymaking.
The Direct Access to Counselling campaign could be instrumental in reducing the burden on the NHS due to related health conditions like cardiovascular disease, gastric issues, and others, thus having a far-reaching impact on healthcare in the UK. A stronger emphasis on counselling and psychotherapy can also facilitate early intervention, possibly mitigating the severity of mental health issues and improving overall wellbeing.
Moreover, this campaign could significantly benefit rural communities. Many counsellors and psychotherapists are prepared to work remotely, eliminating the physical constraints imposed by traditional services like CAMHS or NHS Talking Therapies. Rural dwellers can access professionals that suit their needs, regardless of their location. This consideration is particularly pertinent, considering EFRA’s highlighting of the limitations of rural public transport and digital connectivity.
The EFRA Committee's report also brings attention to the mental health and wellbeing of agricultural and veterinary sector workers, vulnerable groups often overlooked in mental health discourse. The NCPS strongly supports the call for a programme to improve mental health outcomes for these occupational groups, in line with our emphasis on tailored mental health interventions.
The Committee’s report on the need for improved social infrastructure, especially for children and young people, is particularly concerning. This resonates with the NCPS's ongoing campaign, Access to Counselling for Every Child. This campaign seeks to establish child-led mental health care in all schools and primary care settings, recognising the importance of early and personalised interventions. A critical aspect of this campaign is the provision of remote mental health support, essential for children and young people in rural settings, where traditional, face-to-face mental health services are often limited or non-existent.
The Access to Counselling for Every Child campaign underscores the need to address the 'missing middle', those children whose mental health issues are too severe for low-intensity interventions but not yet severe enough for CAMHS. By providing timely, accessible mental health support, the campaign aims to minimise the risk of worsening mental health problems, poor academic performance, substance abuse, and increased suicide risk.
One of the cornerstones of this campaign is fostering a consistent therapeutic relationship, especially crucial for children in care. A consistent therapeutic relationship can offer a sense of stability, understanding, and compassion, often missing in the lives of children in care. It can be a significant factor in their emotional and psychological wellbeing.
In light of these considerations, the NCPS endorses the proposal to prioritise the roll-out of Mental Health Support Teams to cover 100% of schools and colleges in rural areas by 2026/27. However, we also emphasise the need to integrate and embed counselling and psychotherapy within these teams. We believe that doing so will ensure a comprehensive, inclusive, and child-centred approach to mental health support in rural areas, in line with the principles of our Access to Counselling for Every Child campaign.
While the EFRA Committee's report paints a concerning picture of the state of rural mental health in the UK, it also provides an opportunity. It prompts us to fundamentally reassess how we deliver mental health care in rural areas. The NCPS believes that this is the moment to bring counselling and psychotherapy to the forefront of this conversation, specifically through our Direct Access to Counselling campaign, and in doing so, provide tangible, practical solutions to the mental health crisis in rural communities.
