Clinical Practice PSY2003

Why are Mental Health Services Needed?

Alleviation of distress

Improved QoL

Risk Reduction

Social and Economic Benefits

Cost-Effectiveness

Social and economic benefits of MHS

Promote a fairer, more inclusive society while also reducing economic costs.

Chisolm et al. (2016) showed that treatment could lower NHS costs and boost employment.

Cost Effectiveness of MHS

Initiatives like Improving Access to Psychological Therapies (IAPT) demonstrate that providing care can lead to overall savings (Layard & Clark, 2014).

Early intervention in psychosis (EIP) also shows strong financial and social outcomes.

General Structure of MHS

Services exist across the lifespan (children, adults, older adults).

Care ranges from acute to long-term and includes community-based, inpatient, and specialist support.

Primary Care

90% of NHS interactions occur in primary care (e.g., GPs), and about 30% involve psychological distress.

GPs refer to services like:

CAMHS (Child & Adolescent Mental Health Services)

IAPT (for anxiety/depression, CBT-based)

EIP (for first-episode psychosis)

CMHT (Community Mental Health Teams)

Older Adult Mental Health Teams

Secondary/Specialist Services

CRTs: Support adults with long-term needs.

Rehabilitation Services: For acquired brain injuries or functional changes.

Specialist Clinics: For eating disorders, personality disorders, etc.

Crisis and Acute Services

Inpatient Units

Home Treatment Teams

Mental Health Liaison

Inpatient Units

For those at risk of harm or in need of assessment.

Home Treatment Teams

Alternative to hospitalisation for severe crises.

Meantl Health Liaison

In acute hospitals (e.g., A&E) to assess psychiatric risk

Child & Adolescent Services - Tier 1

Generalists (e.g., school nurses) offering low-level support.

Child & Adolescent Services - Tier 2

Specific interventions by trained counsellors.

Child & Adolescent Services - Tier 3

High-level psychological therapies (e.g., CBT).

Child & Adolescent Services - Tier 4

Inpatient or specialist treatments.

Psychiatrists

Medical doctors prescribing medication and making legal assessments (e.g., under the Mental Health Act).

Mental Health Nurses (RMNs)

Support with daily living, medication, and counselling.

Social Workers

Help with access to services and practical challenges.

Occupational Therapists

Assist with daily skill-building and functional rehabilitation.

Clinical Psychologists

Experts in psychological assessment and therapy

Therapists and Counsellors

Offer structured talking therapies—often trained in specific models like CBT or psychoanalysis.

Psychotherapists

Require accredited training and are qualified in one or more therapeutic models.

Registration and Protection

Titles such as "Clinical Psychologist" and "Counselling Psychologist" are protected by law (HCPC regulated), unlike "psychotherapist" or "counsellor," which are not.

Clinical Psychologist - aims

Reduce psychological distress.

Enhance psychological well-being.

Clinical Psychologist - Scope of work

Work across the lifespan and with diverse conditions—e.g., anxiety, psychosis, neurological disorders, adjustment to illness, developmental and behavioural issues.

They work in hospitals, GP clinics, community teams, schools, forensic settings, and private practice.

Clinical Psychologist - functions

Psychological assessment and diagnosis.

Delivery of evidence-based therapies.

Consultation, service development, supervision, and research.

Clinical Psychologist Principles

Grounded in scientific evidence, ethical standards, and lived experience.

Draw from psychological theory and data.

Clinical Psychologist - emerging roles

Increasing involvement in public mental health initiatives (e.g., suicide prevention strategies).

Supporting voluntary sector and policy development.

Educational path - clin psy

An undergraduate degree in psychology (conferring Graduate Basis for Chartered Membership of BPS) - University of Sheffield degrees meet this requirement.

Many programs require at least a 2:1 degree.

Experience Requirements - clin psy

Relevant experience with clients in clinical or support settings (e.g., NHS, charities).

Application Process - clin psy

Via the national Clearing House for Clinical Psychology Training.

Applicants submit evidence of qualifications, clinical experience, and suitability.

Doctorate in Clin Psy

Three-year, NHS-funded program combining placements, academic teaching, and research.

Trainees employed by NHS and registered with HCPC upon completion.

Includes multiple placements (e.g., CAMHS, adult mental health, older adults) and completion of a doctoral research project.