New draft guidelines for the NHS recommend cognitive behavioural therapy and group exercise over medication.
The National Institute for Health and Care Excellence (NICE), the clinical watchdog, has published draft guidelines recommending that people in England with mild depression should first be offered a range of alternatives – such as CBT, mindfulness, meditation or group exercise – before they are offered anti-depressants.
“Do not routinely offer anti-depressant medication as first-line treatment for less severe depression, unless that is the person’s preference,” say the guidelines, which are subject to consultation.
NICE calls on doctors to speak to patients about what would suit them best in terms of “treatment” as part of a wider discussion about what may be contributing to their depression and the person’s prior experience of depression and treatment.
The draft guidelines also tell doctors to discuss mental health waiting lists with patients, as well as discussing what might happen if people want to stop taking anti-depressants, including the possibility of withdrawl.
Anti-depressant usage has increased in recent years with around one in seven people in England taking them.
Alexa Knight of Rethink Mental Illness told the BBC: “Improved guidelines will not, on their own, improve people’s experience of care or waiting times. As demand is rising, the range of treatments available and how quickly they can be accessed is ultimately dependent on services being adequately funded and staffed.”
Although Mind broadly welcomed the guidelines, particularly the greater focus on withdrawal from anti-depressants, it also expressed concerns about the huge demand for mental health services.
“We are pleased to see NICE draft guidelines on depression emphasise patient choice so people can access the support they need - in the way that works for them - whether that’s therapy, medication, or a combination of both,” said Stephen Buckley, head of information at Mind.
“But implementation of this will be critical, especially as we don’t yet know how much of the NHS funding from the Spending Review will go towards mental health services, as our hardworking mental health staff struggle to meet increased demand. Right now, 1.6 million people are waiting for mental health support or treatment, and a further eight million people can’t even get on the waiting list because they aren’t deemed unwell enough to access care.”
If you are looking for support with your mental health, you can find sources of local support on this website.
