Gaps in treatment for people with depression are ‘concerning but not surprising’

Experts respond after study warns of people are ‘stagnating’ in the healthcare system

There are ‘substantial and concerning’ gaps in level of care for people with depression (Getty Images/iStockphoto)

Experts have said the findings from a new study into mental health in the UK are “concerning, but sadly not surprising”.

This week, researchers from the European Brain Council and the Institute of Pshyciatry, Psychology and Neurosience (IOPPN) at King’s College London warned that people are “stagnating” in the UK healthcare system, which results in the illness persisting for longer than it should.

Looking at previous studies on the treatment of depression in six European countries, including the UK, experts analysed the various pathways available to people who are affected by major depressive disorder (MDD).

There are “substantial and concerning” gaps in the level of care for people who are suffering with depression, the study found.

“The NHS mental health services have been operating at the point of overwhelm for several years, and the pandemic has only made things worse,” Dr Antonis Kousoulis, director for England and Wales at the Mental Health Foundation told The Independent in response to the study.

“That’s why we actually need to focus on prevention and ensure that there is wellbeing and social support within the places where we spend most of our time in, such as schools and workplaces. The intention is to remove the pressure on services as far as is possible.

“Early community support would help with reducing the number of people reaching a crisis point and make sure that it’s recognised that better mental health is everyone’s business.”

The charity has warned that adequate wellbeing and social support is paramount given the cost-of-living crisis and the impact of the pandemic.

The rising cost of living is having an adverse affect on people’s mental health (Getty Images)

It is estimated that MDD affects more than 300m people globally. According to the World Health Organization, it is the leading cause of disability.

The research found approximately half of those with depression have not been diagnosed, and that it can take one to eight years to be diagnosed.

In the UK specifically, evidence pointed to an eight-year delay between a person showing initial symptoms of MDD and first contacting a health professional.

Authors of the study, which has been published in the European Psychiatry journal, have made a series of recommendations which they believe can significantly improve the level of care.

The key areas for improvement are the rate of detection, the time taken to diagnosis, the rate of treatment, frequency of follow-ups after treatment and access to specialist services.

Allan Young, a professor of academic psychiatry at IOPPN and a senior author of the study, said depression is one of the “biggest health challenges” in the country right now.

“High rates of missed diagnosis mean that vast swathes of the population cannot get the help that they need, while a lack of follow ups and access to more specialist care often means that those experiencing severe depression are stuck stagnating on a pathway that is not treating them as effectively as it should.”

Low rates of detection were attributed to several factors including non-disclosure of symptoms by a patient, barriers to care, and inaccurate diagnoses. Subsequently, missed or late diagnoses have led to delayed treatment.

The study estimated that 52 per cent of MDD episodes are not diagnosed. In patients where a diagnosis is reached, 38 per cent are untreated.

Although most patients are able access care at some point, they face an average delay of around four years.

Additionally, only 66 per cent of people who start treatment receive follow-up care.

“In summary, many people with symptoms of depression are not able to access or benefit from usual treatments, are not followed up adequately after initial contacts, and cannot access secondary care or specialist services when required,” the study said.

Mind, a mental health charity for England and Wales, has urged the government to increase investment in local mental health services to “address historic underfunding and a surge in demand”.

In April, the government opened a 12-week call for evidence for a new 10-year plan that will seek to improve the nation’s mental health.

Mind said the plan must address social inequalities that affect mental health, such as poor housing, dent, and unemployment.

“As inflation continues to soar and push up the price of basic goods and services, many people are struggling to make ends meet and provide for their households,” Stephen Buckley, head of information at the charity told The Independent.

“At Mind, we know that people living in poverty or on low incomes are more likely to experience mental health problems, and have seen a 30 per cent rise in the number of people getting in touch with our helplines about difficulties they’ve been experiencing with finances and personal debt.”