Charity calls for NHS to implement NICE recommendations on depression
Over 10 million people in the UK (one in six) will suffer depression in their lifetime. Yet people with anxiety and depression are not being given a choice of treatment and services, according to a report published by the Depression Alliance. That's despite recommendations made by the National Institute of Health and Clinical Excellence (NICE) in ‘Depression: management of depression in primary and secondary care (update 2007)'.
The Depression Alliance report, ‘Daring to choose: 10 ways to improve choice for people with depression and anxiety' was based on a survey of 500 people with these conditions. Forty per cent said that their doctor did not involve them in the choice of their treatment. Half said they were not told they could have a choice of antidepressants, while nearly 50% felt they were not given enough information about the common side effects of antidepressants.
The report was backed by a consumer poll of 2253 people in England which showed that:
- 75% had experienced depression or anxiety
- 13% of them didn't go to a health professional for support
- 89% felt that they would be more willing to if they were offered a wider choice of treatments, including a choice of medication and non-medical options such as talking therapies, advice or counselling
- three in five people (60%) were rarely or never offered a choice of treatment options when visiting their GP
- one in four (25%) didn't expect choice when visiting their GP.
Lack of local service capacity, limited training for health professionals on depression and anxiety and inadequate public information all prevent people from being given a choice, says the report.
The charity recommends implementing the NICE guideline on making available the range of treatment options (psychological, medication, social and others). The latter two can include befriending schemes and simple measures such as exercise programmes.
Recommended psychological treatments include problem-solving therapy and cognitive behavioural therapy (this focuses on thoughts and feelings and how to cope with problems). It also includes interpersonal therapy (to address problems in relationships with others) and couples therapy (to help develop a more supportive relationship).
Alternatively, it says counselling or a computer-based system may help. The former involves a trained counsellor who supports and guides people to help themselves, the latter can be used to help develop the skills needed to deal with problems.
In terms of medication, it says people should be given enough information about the different antidepressants on offer so they are able to make an informed choice as to which one they would prefer.
The NICE guideline says that some of these treatments may be combined and will vary according to whether the conditions are mild, moderate or severe.
Says Emer O'Neill, Chief Executive, Depression Alliance: “We believe choice can empower people suffering from the debilitating condition of depression and anxiety so that they become partners in their treatment plan, leading ultimately to self-care.”
His organisation makes a number of other recommendations in its report, which was published during Depression Awareness Week (20-25 April). These include:
- making depression and anxiety a specific national public health priority
- extending and strengthening initiatives to combat stigma and discrimination
- improving the training and education of health professionals in relation to mental health.
‘Depression: management of depression in primary and secondary care (update 2007)' NICE clinical guideline 23 is available from www.nice.org.uk/CG23
‘Daring to choose: 10 ways to improve choice for people with depression and anxiety' is available from the Depression Alliance website at www.depressionalliance.org/documents/daring_to_choose_april_09.pdf
Issued: 11 May 2009
This page was last updated: 10 May 2010