CMG41: Commissioning stepped care for people with common mental health disorders
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This guide for commissioners is a resource to assist commissioners, clinicians and managers to commission high-quality and evidence-based services across England.
- Section 1 is an executive summary.
- Section 2 makes the case for commissioning services for people with common mental health disorders.
- Section 3 outlines a stepped-care approach to commissioning high-quality integrated care for people with common mental health disorders.
- Section 4 helps you assess local service levels.
- Section 5 describes service components.
- Section 6 makes suggestions for contract specification.
- Section 7 explains more about the cost impact of service redesign.
- Section 8 signposts to further information.
NICE guidance provides evidence-based recommendations about clinically effective and cost-effective treatments and interventions to improve health outcomes for individuals and local populations. Making commissioning decisions based on the best available evidence such as NICE guidance and accredited information from NHS Evidence can help commissioners ensure that they are using their resources effectively.
This guide provides advice on commissioning services for people with common mental health disorders. Common mental health disorders are a range of depression and anxiety disorders that include:
- depression
- generalised anxiety disorder
- mixed depression and anxiety
- panic disorder
- obsessive-compulsive disorder
- phobias
- social anxiety disorder (social phobia)
- post-traumatic stress disorder.
This guide for commissioners does not provide advice on commissioning services for people with other prevalent mental health disorders such as bipolar disorder, personality disorder or eating disorders, or for medically unexplained symptoms.
This guide updates and replaces the previous NICE commissioning guide on cognitive behavioural therapy services.
This guide for commissioners should be read together with the following NICE guidance and quality standards:
- NICE clinical guideline 123. Common mental health disorders: identification and pathways to care
- NICE clinical guideline 113. Generalised anxiety disorder and panic disorder (with or without agoraphobia) in adults
- NICE clinical guideline 91. The treatment and management of depression in adults with chronic physical health problems (partial update of CG23)
- NICE clinical guideline 90. The treatment and management of depression in adults (update)
- NICE clinical guideline 31. Obsessive-compulsive disorder: core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder
- NICE clinical guideline 26. Post-traumatic stress disorder (PTSD): The management of PTSD in adults and children in primary and secondary care
- NICE clinical guideline (in development). Social anxiety disorder: recognition, assessment and treatment of social anxiety disorder
- NICE quality standard: Depression in adults
- NICE pathway: Depression in adults
This guide for commissioners highlights any recommendations supporting cases for disinvestment or decommissioning by identifying treatments and interventions that do not add value, enabling commissioners to release resources or generate savings where appropriate.
Implementation of the guidance noted above is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement this guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in the guidance should be interpreted in a way which would be inconsistent with compliance with those duties.
We are keen to improve the guides for commissioners in order to better meet the needs of commissioners. Please send us your ideas for future topic-specific guides or other comments.
Read the NICE disclaimer for information on the use and accuracy of content on the NICE website.
A topic advisory group was established to review and advise on the content of the guide for commissioners; details of membership can be found in section 9.
Topic Advisory Group: common mental health disorders
Date of publication: October 2011
This page was last updated: 02 March 2012

