IAPT should treat distress

It does. This is a silly thing to say. But it doesn't/

The Improved Access to Psychological Therapies scheme only offers
treatment to those with diagnoses of depression and anxiety where
treatment hasn't failed before. No one else. The symptoms can be
experienced with other disorders however Lord Layard, the Royal College
of Psychiatry, the London Schoool of Economics and the We Need to Talk
coalition didn't give a shit about the distress of those who had severe
conditions. They didn't care about people with OCD or those who
experienced psychotic disorders.

CBT doesn't really work very well for psychosis according to the
evidence for high quality trials. The problem is those high quality
trials use measures like PANSS. This is a psychopathology scale rather
than a distress scale per se. GAD, PHQ and other scales measure
distress. I wonder if they just used those measures rather than PANSS
whether they'd find CBT or other talking therapies did work to reduce
distress.

Bit who cares right? Most people with schizophrenia won't work or be in
education in the UK for whatever reason. IAPT was justified by health
economics. Human compassion arguments simply wouldn't have got it
commissioned. IAPT saved money and that's how it got through. Helping
the most ill doesn't save money. It saves lives. It salves pain. But
that's not what IAPT is there for. It's to get the meat back to work.
The unhappy and worried meat. Fuck those who are suffgering. They can
keep waiting or die. In fact the latter works very well in health
economics terms, hence the continued use of antipsychotics in the
community for people with demenita. It's a cheap pill that rids society
of those unwanted behaviours and kills the elderly quicker. Bargain.

I just wish I lived in a time and place where people could argue that
distress and the reduction of distress is what is important.