《经济学人》双语：心理健康治疗计划达到天花板（能继续突破吗）
《经济学人》双语：心理健康治疗计划达到天花板，还能继续突破吗？
文/Irene-自由英语之路
【本篇内容简述】
【Para1】引入：从15年前的经济学家的循证心理疗法讲起，重要性很多，需要一个新的健康服务部门。
【Para2&3】IAPT数据：改善获得心理治疗的服务，去年服务了120万人，预计上升到190万。其他国家效仿英国，康复率从40%上升到54%。数据与资金充足的临床试验中的结果相似。
【Para4】各方观点：有人认为这项服务“可以走得更远”，有人哀叹治疗的“麦当劳化”，有待改善。
【Para5】治疗效果：六周后康复率下降，有些人反对，有些人缺席。有些治疗师质疑。
【Para6&7】措施：医疗服务者发信息提醒，招募需要治疗老年人，发传单，提高治疗次数。与数字服务结合，为治疗提供便利。
【Para8】总结与评论：招聘高级治疗师难，情况有所改善，但人们仍然错过了改善生活的治疗。
（文末的补充材料对理解本文有帮助）
标题：
Therapy
Breaking through
A pioneering mental-health scheme hits a ceiling
治疗
突破
开创性的心理健康计划达到了极限
Can it break through?
它能突破吗？
Paragraph 1：
FIFTEEN YEARS ago Richard Layard, an economist at the London School of Economics, put together a pitch. “We now have evidence-based psychological therapies,” he noted.
15年前，伦敦经济学院经济学家理查德·莱亚德举办了一场推介会。他指出：“我们现在有了循证心理疗法。”
But they were rarely available on the National Health Service. The result was lost lives and, he argued with an eye on the Treasury, lost money, since people with poor mental health were often jobless. A new branch of the health service was needed.
但国家卫生服务系统很少提供这些服务。结果是失去了生命，并且，他以财政部的眼光争辩说，也会失去钱财，因为精神健康不佳的人往往会失业。因此需要一个新的健康服务部门。
Paragraph 2:
That branch is now firmly established. Improving Access to Psychological Therapies (IAPT) has grown fast.
该部门现已牢固建立。改善获得心理治疗（IAPT）服务发展迅速。
Last year the service, which helps those suffering from anxiety, depression and similar illnesses, treated 1.2m people, a number which is planned to rise to 1.9m by 2023-24.
去年，这项服务帮助治疗了那些患有焦虑、抑郁和类似疾病的人，数量有120万人之多，计划到2023-2024年，这个数字将上升到190万。
It has inspired imitators in Australia and Norway. And it has got better at its job, with recovery rates rising from below 40% in 2010 to 54% in early 2019.
它启发了澳大利亚人和挪威人来模仿。效果很好，康复率从2010年的40%以下上升到2019年初的54%。
Paragraph 3:
Since then, however, they have refused to budge, remaining around the 50% target. The trend predates the covid-19 pandemic, when the number of referrals fell by more than half (they have now recovered to normal levels).
然而，从那时起，他们拒绝让退步，保持在50%左右的目标。这一趋势早于新冠大流行，当时转诊人数下降了一半以上（现在已恢复到正常水平）。
It may be that the figures are the best that can be expected of a service sucking up “anybody and everybody who has symptoms of anxiety and depression”, says Helen Gilburt of the King’s Fund, a think-tank.
英国国王基金会智囊团的海伦·吉尔伯特说，这是一个吸纳“任何人和所有有焦虑和抑郁症状的人”的服务，也许这些数字是可预期数据中最好的。
Indeed, they are similar to those in well-funded clinical trials.
事实上，数据与资金充足的临床试验中的结果相似。
Paragraph 4:
David Clark, IAPT’s clinical adviser and chair of experimental psychology at the University of Oxford, nevertheless thinks the service “can go further”.
IAPT的临床顾问和牛津大学实验心理学系主席大卫·克拉克认为这项服务“可以走得更远”。
Critics bemoan the “McDonaldisation” of therapy. Like the hamburger purveyor, IAPT is careful about what is on its menu, using therapies found effective by NICE, an outfit that assesses clinical evidence.
批评家们哀叹治疗的“麦当劳化”。和汉堡包供应商一样，IAPT使用NICE（一家评估临床证据的机构）发现有效的治疗方法，对菜单上的内容非常谨慎。
Improvements are driven by analysis of customer data—in IAPT’s case, data on outcomes, which it is the only part of the mental-health system to collect.
改进的动力来自于对IAPT案例中客户数据的分析，即结果数据，这是心理健康系统唯一需要收集的部分。
Paragraph 5:
Targets push providers to see patients in six weeks, after which recovery rates slump.
目标促使医疗机构在六周内看望患者，之后恢复率大幅下降。
Any longer and they “come to therapy quite negative, quite angry”, says Marc McDonagh, the IAPT lead at Somerset Foundation Trust.
SAMESET基金会的IAPT领导Marc McDonagh说，他们不再“接受治疗，而是非常愤怒”。
“They want to have that all out with the therapist. The first couple of sessions have that shadow over them, with the patient ranting against the service.”
“他们希望与治疗师一起完成这一切。最初的几次治疗都有阴影笼罩着他们，患者大声叫嚷反对这项服务。”
The IAPT manual urges providers to text reminders of appointments in order to reduce no-shows, and to provide a diagnosis.
IAPT手册敦促医疗服务提供者发短信提醒预约，以减少缺席，并提供诊断。
The value of the latter is disputed by some therapists, but is associated with better outcomes.
后者的价值和更好结果被一些治疗师提出质疑。
Paragraph 6:
Professor Clark hopes similar prods will raise recovery rates still further.
克拉克教授希望类似的刺激能进一步提高复苏率。
Old people are both unlikely to come forward for treatment and particularly likely to benefit from therapy, so providers are encouraged to hire “older champions” and to leaflet libraries, post offices and pharmacies.
老年人不太可能出来接受治疗，特别是那些可能会从治疗中受益的老年人，因此鼓励提供者招募“老年拥护者”，并向图书馆、邮局和药店散发传单。
The average number of sessions is a little below the ideal number of nine or ten, suggesting more should be offered.
平均治疗次数略低于理想的9或10次，这表明应该提供更多的治疗次数。
Paragraph 7:
Recent years have seen a rise in the amount of therapy done through digital services. These include ones from SilverCloud (which offers cognitive-behavioural therapy) and Ieso (which offers therapy through an online-messaging service).
近年来，通过数字服务进行的治疗数量有所增加。其中包括SilverCloud（提供认知行为治疗）和Ieso（通过在线信息服务提供治疗）。
Ieso applies a deep-learning model to the transcripts generated by sessions, to find out what is associated with success (“therapeutic praise” comes out top; “therapeutic empathy” last), which is fed back to therapists.
Ieso将深度学习模型应用于治疗后生成的报告单，以找出与成功相关的内容（“治疗性表扬”排在首位；“治疗性共情”排在最后），并反馈给治疗师。
These services offer convenience and in some cases work as well as in-person offerings, but have yet to prove they can consistently outperform them.
这些在线数字服务提供了便利，在某些情况下还可以与面对面的服务媲美，但尚未证明它们能够始终如一地超越它们。
Paragraph 8:
They also provide extra competition for staff who are already in demand. In Somerset it is a struggle to recruit advanced therapists, says Mr McDonagh, making it hard to cut waiting lists.
它们还为已经有需求的员工提供额外的竞争。麦克唐纳表示，在萨默塞特，招聘高级治疗师是一项艰巨的任务，这使得削减排队看病人数变得困难。
Parts of the country do not offer the full range of treatments for depression recommended by NICE, including counselling and short-term psychoanalytic therapy.
该国部分地区没有提供NICE推荐的所有抑郁症治疗方法，包括咨询和短期精神分析疗法。
Things have improved since Lord Layard’s report—but people are still missing out on treatment that would improve their lives.
自从莱亚德勋爵的报告以来，情况有所改善，但人们仍然错过了改善生活的治疗。
（恭喜读完，本篇英语词汇量674个左右）
原文出自2021年10月2日《The Economist》Britain版块。
精读笔记来源于：自由英语之路，仅供个人英语学习交流使用。
【补充资料】
文章中的evidence-based psychological therapies是什么？（来源于网络）
evidence-based psychological therapies：循证心理治疗法，本义为“遵循证据进行心理治疗”，可供使用的研究证据与自己的临床技能整合起来所进行的心理治疗。其内容主要包括研究者及其最佳证据，治疗者及其临床技能，病人的特征、文化与偏好等三个大的方面。它是对具体心理治疗理论、流派及方法的一种整合与超越，代表着西方心理治疗发展的新方向，属于当今开展得如火如荼的循证实践运动的一部分。
【重点词汇】（4个）
pitch/pt/talk or arguments used by a person trying to sell things or persuade people to do sth .
n. 推销行话(熟词偏义：常见意思是“球场”)
referral/rfrl/
n. 被推举的人；转诊病人
rant/rnt/
v. 咆哮，叫嚷；大声抱怨
cut waiting lists
减少排队看病者的人数
【重点句子】（2个）
The result was lost money, since people with poor mental health were often jobless.
结果会失去钱财，因为精神健康不佳的人往往会失业。
Critics bemoan the “McDonaldisation” of therapy.
批评家们哀叹治疗的“麦当劳化”。
【词源故事】（1个）（来源于Tong）
rant=咆哮
拟声词，模仿咆哮，怒吼的声音。
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