Mental Health: Unregulated Treatment

Lord Alderdice Excerpts

Monday 2nd March 2020 Lords Chamber

[Lord Alderdice (LD)]

My Lords, like other noble Lords I am grateful to my noble friend Lady Jolly for securing this debate. As a psychiatrist in psychotherapy for the whole of my professional life, I found that the question of unregulated psychotherapy came to me as a problem quite early on. It is now 20 years since I introduced a Private Member’s Bill. I did not do that simply off my own bat; I spent many months consulting all the major psychotherapy and counselling bodies in this country—and almost all, even at that time, were entirely in agreement about the need for regulation of psychotherapy.

However, it is not an easy business. Indeed, the practice of psychotherapy is difficult to regulate, so we focused on a Bill that would require the registration of psychotherapists—in other words, the protection of title, so that people would at least know the person with who they were engaging and whether that person was professionally accountable and trained. The Government, however, did not accept it. They said that they still had to be persuaded about matters of effectiveness—though, frankly, that has nothing to do with regulation and registration. They have now had a further 20 years to address that question.

During that 20 years, professions such as medicine—my own core profession—social work, clinical psychology, nursing and, indeed, the functions of the NHS itself have all had to undergo increasing amounts of regulation and supervision, and absolutely properly so. Are the Government still convinced that, while doctors, nurses, clinical psychologists and social workers all need to be regulated, psychotherapists, almost alone among all these professions, can be left to simply regulate themselves?

Let us consider that the vast majority of such therapists are operating on their own, outside the NHS, and not as part of a core profession. Those who are part of a core profession are, in that sense, already regulated. Working within the NHS, they are almost all working not on their own but as part of multi- disciplinary teams, and they are operating within a health service structure which is itself highly regulated. So it is not just a question of psychotherapists; the context in which they are working is so much more open and flexible and therefore has the potential for abuse. My three minutes are virtually up, but, 20 years after my Private Member’s Bill, I think that the Government’s time ought to be up in terms of doing something serious about the registration and regulation of psychotherapy and counselling.