Counselling Minus
HUGH SULLIVAN reports on how NHS cuts are set to deplete another mental health service
In HIP 263 we reported on the withdrawal of NHS funding from the Eggtooth Project, which provides mental health services to children and youths. It has now emerged that the adult and youth (16+) mental health agency Counselling Plus Community (CPC), which has been offering a wide range of therapeutic interventions to residents of Hastings and Rother over the past 32 years, faces a similar funding cut.
CPC is the largest counselling service in the area, receiving around 800 referrals for individual clients in 2023. It is currently staffed by three administrators, four clinical team members, 12 employed counsellors (all part-time) and 18 volunteers. It receives referrals from GPs, from Health in Mind (the NHS Talking Therapies service), from CAMHS (Child and Adolescent Mental Health Service) and many local support services, as well as taking direct cases (word of mouth).
CEO, Verra Papaspyrou, says that the ethos of CPC since 1992 has been to provide its counselling therapies on the basis of need “regardless of the client’s ability to pay for the service they receive”. Clients have always paid what they feel they could afford which “can be as low as zero where required”.
INCOME SOURCES
In the current year 2024-25 the service received a grant of just under £65,000 from the Sussex ICB (Integrated Care Board), which now administers NHS funding throughout Sussex. Short-term grants from the Police & Crime Commissioner, Children in Need, the Big Lottery, The People’s Postcode Society, the Henry Smith Charity and other sources for particular projects have regularly boosted the service’s budget in recent years by more than 200%. However, many of these are dependent on showing evidence of continued funding from the ICB and are directed to specific problem areas – for instance, survivors of suicide and those who are feeling suicidal, survivors of rape, sexual and/or domestic abuse, and those bereaved by suicide. For those afflicted with more general traumas that don’t fit into these categories, the ICB funds are crucial.
In July this year Ms Papaspyrou says she received an email, “out of the blue” from the Head of Strategic Commissioning (Mental Health) at NHS Sussex. He informed her that the ICB was “exploring what the impact would be” if it discontinued its current level of annual funding.
“No decisions have yet been taken,” he wrote, though he suggested that, as the service has low infrastructure costs (cheaply rented premises in Cambridge Gardens) that “hopefully Counselling Plus would be in a position to continue operating, albeit with lower levels of capacity to deliver activity than before”. He pointed out that there had been no formal funding contract between the ICB and the charity, hence no stipulated notice period for making changes. However, he warned that any anticipated change of budget might have “an effective date of 1 October 2024”.
RESPONSE TO ICB
Ms Papaspyrou arranged an immediate meeting and responded within 11 days with her own impact assessment. She pointed out that, in the short term, many clients were already on their course of therapeutic treatment or on waiting lists expecting to proceed via ICB funding. Furthermore, as soon as ICB core funding was lost, further external support based on this funding may be put at risk.
In the longer term, all clients whose problems did not fall within a specific area covered by project funding would have to pay the full cost. Obviously, many would simply be unable to afford it and would be unable to access professional therapy.
She also pointed out that 18 voluntary counsellors would lose their current placements, thus (at best) delaying their qualification timetable. “Counsellors are able to progress within the profession due to CPC placements which provide exceptional diversity and client presentation which is unachievable elsewhere.”
None of these arguments seem to have held sway with the ICB, save that it was accepted that existing funding should only be withdrawn on six months notice. Then there will be no phased reduction, but a total cut-off. And that seems to be that. Whilst there are ongoing consultations in the county for savings proposals related to Adult Social Care, there has been none of any substance for cuts to mental health funding, despite well-publicised rises in demand across the country.
APPEAL TO MP
Getting no positive response from the ICB, Ms Papaspyrou wrote last month to Hastings & Rye MP Helena Dollimore. She pointed out not only the breadth of services offered by CPC but also its comparative cost effectiveness. Use of ICB funds in 2023 enabled a block of ten sessions for individual clients to be charged at an average of £118 all in. By comparison, she wrote, one session of private counselling locally has an average charge of £50-70.
Ms Dollimore has not as yet made any response, and indeed it’s difficult to see what influence she can bring to bear as an individual MP. The Sussex ICB covers constituencies across Sussex, and all areas are facing apparently unprecedented financial strain. Two weeks ago, Ms Papaspyrou received final confirmation that NHS funding will be terminated at the end of the financial year next March.
Ms Papaspyrou says that CPC is determined to survive the funding cuts, and that changes have already been implemented to ensure its continuation. It will be looking in the future for private donations as well as larger grants from existing sources.
Recently an ex-client came in to hand over a cheque for a substantial amount. He had had four or five counselling sessions in 2019 and wanted to offer thanks. “If I hadn’t had those sessions with you,” he told Ms Papaspyrou, “I wouldn’t be here any more.”
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In such a trying time for many of us, cost of living, growing geopolitical tension and many other stressors, cuts to MH services are going to cause such an awful detriment and cause a ticking time bomb for the fallout. This is a disgusting set of cuts.