Greater support for GPs to help diagnose common mental health disorders
GPs will be given greater support to help diagnose patients with common mental health disorders like anxiety and depression and ensure that they are offered the right treatment, following latest NICE guidance.
The guidance brings together in one place all of NICE's existing recommendations for common mental health disorders, making it easier for GPs to access all the information they need during a consultation.
Common mental health disorders affect one in six adults, and cost UK employers £25 billion each year through lost work days.
Recognising and treating common mental health disorders is an everyday task for GPs. One in three GP consultations has a mental health element to it, and 90 per cent of mental health disorders are treated in primary care.
Dr Barbara Compitus, a GP in Bristol who was involved in the development of the guidance, said: “This new guideline is a really useful tool for GPs as it will enable us to access all the information we need in a one-stop shop.
“Because patients present in diverse ways GPs need practical and accessible tools to further increase recognition of common mental health disorders. This guideline delivers these tools and will enable GPs to drive up quality and consistency of care provided.”
Dr Clare Gerada, Chair of the Royal College of General Practitioners (RCGP), agreed: “GPs can see patients with two, three or four different conditions and while we have a myriad of guidance, it can be difficult to know where to start.
“The new NICE guidance is really helpful as it lists the various common mental health disorders all on one page for easy reference and brings together existing guidelines.”
The latest guidance has a particular focus on anxiety disorders as recognition is known to be particularly poor in primary care and only a small minority of people experiencing anxiety disorders ever receive treatment.
NICE recommends that GPs be alert to patients who may present with possible anxiety disorders, particularly if they have a past history of an anxiety disorder, possible physical symptoms of an anxiety disorder or have experienced a recent traumatic event.
GPs should consider asking the patient about their feelings of anxiety and their ability to stop or control worry, using the 2-item Generalized Anxiety Disorder scale (GAD-2).
A score of three or more on the GAD-2 scale indicates that they may have an anxiety disorder and should be assessed.
Guidance Chair Tony Kendrick, Professor of Primary Care at the Hull York Medical School, said: “The guidance has an emphasis on the detection of anxiety disorders. We have made good progress on the detection of depression and now need to do the same for anxiety.”
Terence Lewis, a patient with personal experience of mental health problems who took part in the development of the guidelines, said that they would help to bring anxiety “front and centre” for GPs.
“This is an area that is off the pace, but this guideline does a lot to address this,” he said.
Dr Compitus, added: “A few months ago I had a patient who came in with an anxiety disorder. It had taken him two years to seek help but it had got to the point where it felt to him like he was living in a nightmare. He is now much better having received treatment for his anxiety.”
To help put this guideline into practice, NICE has produced a series of support tools including an educational slide set, a baseline assessment tool to help look at variations in practice, a clinical audit tool and a costing support tool.
“We are also working with the RCGP and patient groups to help raise awareness of this guideline and encourage uptake,” added Val Moore, Implementation Programme Director at NICE.
25 May 2011