GPs 'are failing depressed patients'
Half of all sufferers say they are given little or no choice over treatment
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Half of those suffering from depression in the UK are unaware what treatments are available to them, despite government pledges to improve patient choice, according to new research published this week.
Two-thirds of depressed patients leave their GP surgery unaware of any treatment apart from antidepressants, according to a report – Daring to Choose – by the charity Depression Alliance. Only a third of the 513 people surveyed had been told there was a choice of antidepressants, while 70 per cent felt they were given inadequate information about the side effects.
Experts claim these findings show GPs are still failing to follow guidelines from the National Institute for Clinical Excellence (Nice) about the best use of antidepressants, psychological therapies and self-help groups for people suffering from depression.
The Depression Alliance is calling on the Government to make depression a public health priority to curb the growing burden on the NHS and wider economy. Official figures show a quarter of women and one in 10 men will suffer from depression at some point in their lives. Fourteen per cent of adults in the UK suffer from depression and/or anxiety at any one time, costing the economy an estimated £12bn every year, according to the London School of Economics.
The report also calls on NHS officials to ensure the full range of high-quality medical and non-medical services recommended by Nice are available across the country.
Emer O'Neill, chief executive of Depression Alliance, said: "Choice is not a reality for most people with depression and anxiety. While there are some excellent GPs and some well-informed patients, there are huge numbers of people who are sinking because they are brushed off, not taken seriously and walk away from the doctor empty-handed apart from a prescription.
"Choice is at the heart of the proposed NHS constitution, but people with depression cannot choose if they are not given the right information. GPs must be better informed about the range of services that can help a person with depression and have easy access to these."
Ninety per cent of people who seek help are treated by their GP. The number of antidepressants prescriptions reached 31 million in England in 2006, despite guidelines recommending that alternative treatments be tried first for those people with less severe depression.
The Government has committed £173m on improving access to psychological therapies (IAPT) over the next three years to increase the number of cognitive behavioural therapists (CBT) working with GPs.
Phil Hope, care services minister, said: "A total of 35 areas of the country have already set up these services and 81 more are due in the autumn. Every primary care trust in the country will have begun to introduce the expansion of talking therapists by next year."
But some experts are concerned that the focus on CBT will be at the expense of existing services. The Depression Alliance points to the benefits of self-help groups, good nutrition, physical exercise and other therapies, such as family therapy.
Steve Field, president of the Royal College of GPs, said: "I'm surprised that it's as high as 50 per cent but I'm not surprised that some patients don't feel part of their treatment plan. GPs should do everything they can to ensure decisions are made in partnership with patients and that they follow Nice guidelines."
Therapy: NHS couldn't help
Alasdair Mackenzie, 41, from Twickenham, works as a manual labourer.
"I had my most serious breakdown after the birth of my first son two years ago. My GP was supportive but told me I wouldn't get the care I needed from the NHS. Luckily I was able to pay to see a private psychiatrist and CBT therapist. The therapist introduced me to mindfulness, a practice recommended by Nice but I'd never heard about it before. The NHS response has always been antidepressants and a bit of psychotherapy if I was lucky."
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Comments
Successive governments have a lot to answer for in terms of the increase in depression. We should seek to reduce working hours, reduce the easy access to alcohol, pornography, violent video games and illegal drugs. Finally, the government should better use their influence over the media to tackle some of the above.
We now live in a society of excess, of pleasure seeking. As someone put it earlier this week, the UK has turned into a 'Porn-society'. Perversion has become the norm and this has only lead to people becoming increasingly dissatisfied with what they have got. I'm not saying that we cannot make choices to make ourselves happy. I'm just saying that the government-facilitated media is encouraging choices of excess.
I hope that whoever wins the next election will have the courage to forego the suppossed financial benefits of media-generated tax revenue and look at the costs of social breakdown which are now occuring in UK society.
Cheers
http://www.thewellnessshop.co.uk/produc
Some computer systems go even further than this making the information readily available to patients booking their appointments on line or reviewing their own medical records on line.
Here is an example of what is available in surgery -> http://www.patient.co.uk/showdoc/230687
So, any problem with some patients not being given the available information because of pressure on consultation time, could be addressed by doctors 'prescribing' a url to the free site with, or in place of, any prescription.
My OH almost died from liver failure to effexor. Now, his GP has told him that the damage may take years to repair or even be permanent. The withdrawal symptoms from having to cease taking this drug were dreadful.
This drug is dangerous.
The thinking SHOULD be to match the therapy, or a combination approach, to each patient but what exists at present is a 'one-size fits all' approach. Useless.
If you're feeling down, do NOT allow anyone to abuse their position of authority by prescribing happy pills. The purpose of happy pills is only to keep you functioning, producing, consuming, and being normal. You need a lot more than that. Above all you need time and space, and nobody is going to give you any of that.
Sometimes anti-depressants can allow the sufferer to get to a place where they're able to think about asking for support (if there is any available) and may provide a kick-start to somebody looking for a way out of their depression. Don't dismiss it completely!
Anything else I am told, there are no resources for in my area. I see the psychiatrist once every 2 months and the usual consultation ends with 'carry on with the medication and I will see you again in a couple of months, I'm sorry, be there are no resources to offer you anything else' - not exactly helpful, but I imagine he must be as frustrated as I am! This situation is certainly not helping sufferers improve, never mind get better.
NHS will have to work harder on a smaller budget however nothing is impossible. I wish them luck
I thank you
Firozali A. Mulla
As someone who has suffered severe recurrent depressive episodes, medication has saved my life. Once the right combination for me was found, my suicidal depression lifted, and I have not experienced another episode in five years. I continue to take medication.
meication does not "mask the underlying causes of depression" - it cannot do that - it doesn't change your past or the circumstances you live in. It only changes abnormalities in your brain chemistry. And can often make sufferers more able to deal with their lives or pasts.
I don't believe that medication is the magic answer for everyone, and I do believe that antidepressants are over-prescribed. However, depression can be a chemical illness that needs medication to alleviate the symptoms, just as a diabetes sufferer needs insulin.
Whilst it is right to say that therapy should be available to those who might benefit, and that therapy too can save lives, it is not helpful to see medication as evil, and ignore the evidence that it helps many people live normal lives.